WorldWideScience

Sample records for improvement systematic review

  1. Improving the uptake of systematic reviews: a systematic review of intervention effectiveness and relevance.

    LENUS (Irish Health Repository)

    Wallace, John

    2014-01-01

    Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved.

  2. The quality of systematic reviews about interventions for refractive error can be improved: a review of systematic reviews.

    Science.gov (United States)

    Mayo-Wilson, Evan; Ng, Sueko Matsumura; Chuck, Roy S; Li, Tianjing

    2017-09-05

    refractive error are low methodological quality. Following widely accepted guidance, such as Cochrane or Institute of Medicine standards for conducting systematic reviews, would contribute to improved patient care and inform future research.

  3. How can we improve the interpretation of systematic reviews?

    Directory of Open Access Journals (Sweden)

    Straus Sharon E

    2011-03-01

    Full Text Available Abstract A study conducted by Lai and colleagues, published this week in BMC Medicine, suggests that more guidance might be required for interpreting systematic review (SR results. In the study by Lai and colleagues, positive (or favorable results were influential in changing participants' prior beliefs about the interventions presented in the systematic review. Other studies have examined the relationship between favorable systematic review results and the publication of systematic reviews. An international registry may decrease the number of unpublished systematic reviews and will hopefully decrease redundancy, increase transparency, and increase collaboration within the SR community. In addition, using guidance from the Preferred Items for Systematic Reviews and Meta-analyses (PRISMA: http://www.prisma-statement.org/ Statement and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE: http://www.gradeworkinggroup.org/ approach can also be used to improve the interpretation of systematic reviews. In this commentary, we highlight important methodological issues related to the conduct and reporting of systematic reviews and also present our own guidance on interpreting systematic reviews. Please see Research article: http://www.biomedcentral.com/1741-7015/9/30/.

  4. Practice-level quality improvement interventions in primary care: a review of systematic reviews.

    Science.gov (United States)

    Irwin, Ryan; Stokes, Tim; Marshall, Tom

    2015-11-01

    To present an overview of effective interventions for quality improvement in primary care at the practice level utilising existing systematic reviews. Quality improvement in primary care involves a range of approaches from the system-level to patient-level improvement. One key setting in which quality improvement needs to occur is at the level of the basic unit of primary care--the individual general practice. Therefore, there is a need for practitioners to have access to an overview of the effectiveness of quality improvement interventions available in this setting. A tertiary evidence synthesis was conducted (a review of systematic reviews). A systematic approach was used to identify and summarise published literature relevant to understanding primary-care quality improvement at the practice level. Quality assessment was via the Critical Appraisal Skills Programme tool for systematic reviews, with data extraction identifying evidence of effect for the examined interventions. Included reviews had to be relevant to quality improvement at the practice level and relevant to the UK primary-care context. Reviews were excluded if describing system-level interventions. A range of measures across care structure, process and outcomes were defined and interpreted across the quality improvement interventions. Audit and feedback, computerised advice, point-of-care reminders, practice facilitation, educational outreach and processes for patient review and follow-up all demonstrated evidence of a quality improvement effect. Evidence of an improvement effect was higher where baseline performance was low and was particularly demonstrated across process measures and measures related to prescribing. Evidence was not sufficient to suggest that multifaceted approaches were more effective than single interventions. Evidence exists for a range of quality improvement interventions at the primary-care practice level. More research is required to determine the use and impact of quality

  5. Continuous quality improvement in nephrology: a systematic review.

    Science.gov (United States)

    Nunes, Julie Wright; Seagull, F Jacob; Rao, Panduranga; Segal, Jonathan H; Mani, Nandita S; Heung, Michael

    2016-11-24

    Continuous quality improvement (CQI) has been successfully applied in business and engineering for over 60 years. While using CQI techniques within nephrology has received increased attention, little is known about where, and with what measure of success, CQI can be attributed to improving outcomes within nephrology care. This is particularly important as payors' focus on value-based healthcare and reimbursement is tied to achieving quality improvement thresholds. We conducted a systematic review of CQI applications in nephrology. Studies were identified from PubMed, MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, ProQuest Dissertation Abstracts and sources of grey literature (i.e., available in print/electronic format but not controlled by commercial publishers) between January 1, 2004 and October 13, 2014. We developed a systematic evaluation protocol and pre-defined criteria for review. All citations were reviewed by two reviewers with disagreements resolved by consensus. We initially identified 468 publications; 40 were excluded as duplicates or not available/not in English. An additional 352 did not meet criteria for full review due to: 1. Not meeting criteria for inclusion = 196 (e.g., reviews, news articles, editorials) 2. Not nephrology-specific = 153, 3. Only available as abstracts = 3. Of 76 publications meeting criteria for full review, the majority [45 (61%)] focused on ESRD care. 74% explicitly stated use of specific CQI tools in their methods. The highest number of publications in a given year occurred in 2011 with 12 (16%) articles. 89% of studies were found in biomedical and allied health journals and most studies were performed in North America (52%). Only one was randomized and controlled although not blinded. Despite calls for healthcare reform and funding to inspire innovative research, we found few high quality studies either rigorously evaluating the use of CQI in nephrology or reporting best practices. More rigorous

  6. Producing Cochrane systematic reviews-a qualitative study of current approaches and opportunities for innovation and improvement.

    Science.gov (United States)

    Turner, Tari; Green, Sally; Tovey, David; McDonald, Steve; Soares-Weiser, Karla; Pestridge, Charlotte; Elliott, Julian

    2017-08-01

    Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review production and emerging opportunities to improve the efficiency and sustainability of these processes. To inform discussions about how to best achieve this, we conducted 26 interviews and an online survey with 106 respondents. Respondents highlighted the importance and challenge of creating reliable, timely systematic reviews. They described the challenges and opportunities presented by current production models, and they shared what they are doing to improve review production. They particularly highlighted significant challenges with increasing complexity of review methods; difficulty keeping authors on board and on track; and the length of time required to complete the process. Strong themes emerged about the roles of authors and Review Groups, the central actors in the review production process. The results suggest that improvements to Cochrane's systematic review production models could come from improving clarity of roles and expectations, ensuring continuity and consistency of input, enabling active management of the review process, centralising some review production steps; breaking reviews into smaller "chunks", and improving approaches to building capacity of and sharing information between authors and Review Groups. Respondents noted the important role new technologies have to play in enabling these improvements. The findings of this study will inform the development of new Cochrane Review production models and may provide valuable data for other systematic review producers as they consider how best to produce rigorous, reliable, up-to-date reviews.

  7. Systematic review protocol of interventions to improve the psychological well-being of general practitioners.

    Science.gov (United States)

    Murray, Marylou; Murray, Lois; Donnelly, Michael

    2015-09-22

    The challenges and complexities faced by general practitioners are increasing, and there are concerns about their well-being. Consequently, attention has been directed towards developing and evaluating interventions and strategies to improve general practitioner well-being and their capacity to cope with workplace challenges. This systematic review aims to evaluate research evidence regarding the effectiveness of interventions designed to improve general practitioner well-being. Eligible studies will include programmes developed to improve psychological well-being that have assessed outcomes using validated tools pertaining to well-being and related outcomes. Only programmes that have been evaluated using controlled study designs will be reviewed. An appropriately developed search strategy will be applied to six electronic databases: the Cochrane Database of Systematic Reviews, MEDLINE, Embase, CINAHL, PsycINFO and Web of Science. Studies will be screened in two stages by two independent reviewers. A third reviewer will arbitrate when required. Pre-specified inclusion and exclusion criteria will be assessed during a pilot phase early on in the review process. The Cochrane data extraction form will be adapted and applied to each eligible study by two independent reviewers, and each study will be appraised critically using standardised checklists from the Cochrane Handbook. Methodological quality will be taken into account in the analysis of the data and the synthesis of results. A narrative synthesis will be undertaken if data is unsuited to a meta-analysis. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance. This will be the first systematic review on this topic, and the evidence synthesis will aid decision-making by general practitioners, policy makers and planners regarding ways in which to improve GP well-being. Findings will be disseminated at general practitioner meetings

  8. Physical Activity to Improve Erectile Function: A Systematic Review of Intervention Studies

    DEFF Research Database (Denmark)

    Gerbild, Helle Nygaard; Larsen, Camilla Marie; Graugaard, Christian

    2018-01-01

    , and metabolic syndrome. Physical activity (PA) has proved to be a protective factor against erectile problems, and it has been shown to improve erectile function for men affected by vascular ED. This systematic review estimated the levels of PA needed to decrease ED for men with physical inactivity, obesity...... for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was performed of research articles specifically investigating PA as a possible treatment of ED. The review included research on ED from physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases......Introduction: The leading cause of erectile dysfunction (ED) is arterial dysfunction, with cardiovascular disease as the most common comorbidity. Therefore, ED is typically linked to a web of closely interrelated cardiovascular risk factors such as physical inactivity, obesity, hypertension...

  9. Systematic Review of International Colposcopy Quality Improvement Guidelines.

    Science.gov (United States)

    Mayeaux, Edward J; Novetsky, Akiva P; Chelmow, David; Choma, Kim; Garcia, Francisco; Liu, Angela H; Papasozomenos, Theognosia; Einstein, Mark H

    2017-10-01

    The American Society for Colposcopy and Cervical Pathology Colposcopy Standards Committee organized multiple working groups to draft colposcopy standards for the United States. As part of this project, international quality assurance and improvement measures were examined. The quality improvement working group performed a systematic review of the literature to collate international guidelines related to quality improvement. Source guidelines were collected using searches in Medline, Google Scholar, the International Federation of Cervical Pathology and Colposcopy Web site, other regional colposcopy group's Web sites, and communications with International Federation of Cervical Pathology and Colposcopy board of directors' members and other expert members of various national groups. Once identified, the sources were reviewed by multiple workgroup members for potential guideline materials. Fifty-six unique documents were identified, of which 18 met inclusion criteria and contributed data to the analysis. Information was abstracted and grouped by related subject. Wide variation exists in colposcopy guidance and quality indicators from regional and national colposcopy societies. Abstracted international guidelines are presented.

  10. Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Loh SY

    2015-03-01

    Full Text Available Siew Yim Loh, Aisya Nadia Musa Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, 'therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction: Included review year, study aim, total number of participants included, and results. Data synthesis: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods for addressing the domains of psychosocial, cognitive, and

  11. Systematic review

    DEFF Research Database (Denmark)

    Bager, Palle; Chauhan, Usha; Greveson, Kay

    2017-01-01

    of evidence is needed and the aim of this article was to systematically review the evidence of IBD advice lines. MATERIALS AND METHODS: A broad systematic literature search was performed to identify relevant studies addressing the effect of advice lines. The process of selection of the retrieved studies...... was undertaken in two phases. In phase one, all abstracts were review by two independent reviewers. In phase two, the full text of all included studies were independently reviewed by two reviewers. The included studies underwent quality assessment and data synthesis. RESULTS: Ten published studies and 10...... congress abstracts were included in the review. The studies were heterogeneous both in scientific quality and in the focus of the study. No rigorous evidence was found to support that advice lines improve disease activity in IBD and correspondingly no studies reported worsening in disease activity. Advice...

  12. Self-efficacy strategies to improve exercise in patients with heart failure: A systematic review

    OpenAIRE

    Rajati, Fatemeh; Sadeghi, Masoumeh; Feizi, Awat; Sharifirad, Gholamreza; Hasandokht, Tolu; Mostafavi, Firoozeh

    2014-01-01

    BACKGROUND Despite exercise is recommended as an adjunct to medication therapy in patients with heart failure (HF), non-adherence to exercise is a major problem. While improving self-efficacy is an effective way to increase physical activity, the evidence concerning the relationship between strategies to enhance self-efficacy and exercise among HF has not been systematically reviewed. The objective of this systematic review is to assess the effect of interventions to change the self-efficacy ...

  13. Health literacy in type 2 diabetes patients: a systematic review of systematic reviews.

    Science.gov (United States)

    Caruso, Rosario; Magon, Arianna; Baroni, Irene; Dellafiore, Federica; Arrigoni, Cristina; Pittella, Francesco; Ausili, Davide

    2018-01-01

    Aim To summarize, critically review, and interpret the evidence related to the systematic reviews on health literacy (HL) amongst type 2 diabetes mellitus (T2DM). Methods The methodology for this study consisted of a systematic review of systematic reviews, using the PRISMA statement and flowchart to select studies, and searching on PubMed, CINAHL, Scopus, and Cochrane. The search covered the period between January 2006 and June 2016. Results From the 115 identified record by the queries, only six systematic reviews were included, following a quality evaluation using AMSTAR. The included systematic reviews content was analyzed by the independent work of two authors, using a narrative synthesis approach. The findings of this study (i.e., main themes) are areas of consensus and gaps in knowledge. Areas of consensus are HL definition, HL measurement tools, and the relationship between T2DM patient knowledge (or literacy) and his/her HL. The gaps in knowledge were the assessment of the relations between HL and health outcomes and self-efficacy, the gender differences, the effectiveness of interventions to improve HL, the cost-effectiveness study of interventions to improve HL, and the understanding of the influence of organizational environment on HL. Conclusion This review provides a current state of knowledge to address clinical practice and research proposals. HL could be useful to personalize patients' follow-up and it should be routinely assessed in its three dimensions (i.e. functional, interactive and critical) to enhance patients' ability to cope with clinical recommendations. Future research should be mainly aimed to test the effectiveness of evidence-based interventions to improve HL amongst T2DM patients.

  14. Practices for Improving Secondary School Climate: A Systematic Review of the Research Literature.

    Science.gov (United States)

    Voight, Adam; Nation, Maury

    2016-09-01

    School climate has received increased attention in education policy and, in response, educators are seeking strategies to improve the climates of their middle and high schools. However, there has been no comprehensive synthesis of the empirical evidence for what works in school climate improvement. This article constitutes a systematic review of programs and practices with empirical support for improving school climate. It defines school climate and provides a methodology for identifying and evaluating relevant studies. The review identified 66 studies with varying strength of evidence and nine common elements that cut across reviewed programs and practices. The review concludes with a critical appraisal of what we know about school climate improvement and what we still need to know. © Society for Community Research and Action 2016.

  15. Quality of systematic reviews in pediatric oncology--a systematic review.

    Science.gov (United States)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W; van Dalen, Elvira C; Kremer, Leontien C M

    2009-12-01

    To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. We identified eligible systematic reviews through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological quality of systematic reviews was low for all ten items, but the quality of Cochrane systematic reviews was significantly higher than systematic reviews published in regular journals. On a 1-7 scale, the median overall quality score for all systematic reviews was 2 (range 1-7), with a score of 1 (range 1-7) for systematic reviews in regular journals compared to 6 (range 3-7) in Cochrane systematic reviews (pmethodological flaws leading to a high risk of bias. While Cochrane systematic reviews were of higher methodological quality than systematic reviews in regular journals, some of them also had methodological problems. Therefore, the methodology of each individual systematic review should be scrutinized before accepting its results.

  16. Improving the evidence base for energy policy: The role of systematic reviews

    International Nuclear Information System (INIS)

    Sorrell, Steve

    2007-01-01

    The concept of evidence-based policy and practice (EBPP) has gained increasing prominence in the UK over the last 10 years and now plays a dominant role in a number of policy areas, including healthcare, education, social work, criminal justice and urban regeneration. But despite this substantial, influential and growing activity, the concept remains largely unknown to policymakers and researchers within the energy field. This paper defines EBPP, identifies its key features and examines the potential role of systematic reviews of evidence in a particular area of policy. It summarises the methods through which systematic reviews are achieved; discusses their advantages and limitations; identifies the particular challenges they face in the energy policy area; and assesses whether and to what extent they can usefully be applied to contemporary energy policy questions. The concept is illustrated with reference to a proposed review of evidence for a 'rebound effect' from improved energy efficiency. The paper concludes that systematic reviews may only be appropriate for a subset of energy policy questions and that research-funding priorities may need to change if their use is to become more widespread

  17. Dissemination of performance information and continuous improvement: A narrative systematic review.

    Science.gov (United States)

    Lemire, Marc; Demers-Payette, Olivier; Jefferson-Falardeau, Justin

    2013-01-01

    Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems.

  18. Quality of systematic reviews in pediatric oncology--a systematic review

    DEFF Research Database (Denmark)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W

    2009-01-01

    BACKGROUND: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. METHODS: We identified eligible systematic reviews...... through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality...... assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. RESULTS: We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological...

  19. A systematic review of systematic reviews on interventions for caregivers of people with chronic conditions.

    Science.gov (United States)

    Corry, Margarita; While, Alison; Neenan, Kathleen; Smith, Valerie

    2015-04-01

    To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear. A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions. The electronic databases of PubMed, CINAHL, British Nursing Index, PsycINFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions. Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R-AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results. Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers. Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings. © 2014 John Wiley & Sons Ltd.

  20. Treatment of periodontitis improves the atherosclerotic profile : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Teeuw, Wijnand J.; Slot, Dagmar E.; Susanto, Hendri; Gerdes, Victor E. A.; Abbas, Frank; D'Aiuto, Francesco; Kastelein, John J. P.; Loos, Bruno G.

    AimSystematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. Material and MethodsLiterature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials,

  1. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Teeuw, W.J.; Slot, D.E.; Susanto, H.; Gerdes, V.E.A.; Abbas, F.; D'Aiuto, F.; Kastelein, J.J.P.; Loos, B.G.

    2014-01-01

    Aim Systematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. Material and Methods Literature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials,

  2. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Teeuw, Wijnand J.; Slot, Dagmar E.; Susanto, Hendri; Gerdes, Victor E. A.; Abbas, Frank; D'Aiuto, Francesco; Kastelein, John J. P.; Loos, Bruno G.

    2014-01-01

    AimSystematic review and meta-analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile. Material and MethodsLiterature was searched in Medline-PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials,

  3. Systematic review

    DEFF Research Database (Denmark)

    Christensen, Troels Dreier; Spindler, Karen-Lise Garm; Palshof, Jesper Andreas

    2016-01-01

    to earlier diagnosis and improved survival. Method: In this paper, we describe the incidence as well as characteristics associated with BM based on a systematic review of the current literature, following the PRISMA guidelines. Results: We show that the incidence of BM in CRC patients ranges from 0.6 to 3...

  4. Dissemination bias in systematic reviews of animal research: a systematic review.

    Directory of Open Access Journals (Sweden)

    Katharina F Mueller

    Full Text Available Systematic reviews of preclinical studies, in vivo animal experiments in particular, can influence clinical research and thus even clinical care. Dissemination bias, selective dissemination of positive or significant results, is one of the major threats to validity in systematic reviews also in the realm of animal studies. We conducted a systematic review to determine the number of published systematic reviews of animal studies until present, to investigate their methodological features especially with respect to assessment of dissemination bias, and to investigate the citation of preclinical systematic reviews on clinical research.Eligible studies for this systematic review constitute systematic reviews that summarize in vivo animal experiments whose results could be interpreted as applicable to clinical care. We systematically searched Ovid Medline, Embase, ToxNet, and ScienceDirect from 1st January 2009 to 9th January 2013 for eligible systematic reviews without language restrictions. Furthermore we included articles from two previous systematic reviews by Peters et al. and Korevaar et al.The literature search and screening process resulted in 512 included full text articles. We found an increasing number of published preclinical systematic reviews over time. The methodological quality of preclinical systematic reviews was low. The majority of preclinical systematic reviews did not assess methodological quality of the included studies (71%, nor did they assess heterogeneity (81% or dissemination bias (87%. Statistics quantifying the importance of clinical research citing systematic reviews of animal studies showed that clinical studies referred to the preclinical research mainly to justify their study or a future study (76%.Preclinical systematic reviews may have an influence on clinical research but their methodological quality frequently remains low. Therefore, systematic reviews of animal research should be critically appraised before

  5. Strategies to improve adherence to treatment in adolescents and young adults with cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Robertson EG

    2015-07-01

    Full Text Available Eden G Robertson,1,2 Claire E Wakefield,1,2 Kate H Marshall,2 Ursula M Sansom-Daly1–3 1Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, University of New South Wales, Kensington, NSW, Australia; 2Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, 3Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, NSW, Australia Purpose: Adolescents and young adults (AYAs with cancer have higher rates of nonadherence to treatment relative to younger and older cancer patients. Efforts to improve adherence in this population are therefore increasing. This review aimed: 1 to synthesize recommendations and strategies used to improve treatment adherence in AYAs with cancer, and 2 to summarize the available evidence supporting the efficacy of adherence-promoting strategies for AYAs with cancer.Methods: We conducted a systematic review with two stages: 1 a narrative stage, to analyze expert recommendations, and 2 an evaluative stage, to summarize quantitative evidence for interventions. Four electronic databases were searched for studies involving AYAs, aged 10–39 years, with cancer, published from 2005 to 2015. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines were used to ensure quality of the review. The Delphi list was used to assess study quality.Results: Nine articles were identified in the narrative stage of the review. For the evaluative stage, out of 113 screened abstracts, only one eligible intervention was identified. Common themes of adherence-promoting strategies were grouped into five domains: developmental, communication, educational, psychological well-being, and logistical/management strategies. Strategies to address developmental stage and to improve communication were the most highly recommended to improve adherence. Few strategies focused on the role of the patient in adherence. One

  6. Virtual reality for improving balance in patients after stroke: A systematic review and meta-analysis.

    Science.gov (United States)

    Li, Zhen; Han, Xiu-Guo; Sheng, Jing; Ma, Shao-Jun

    2016-05-01

    To evaluate the effectiveness of virtual reality interventions for improving balance in people after stroke. Systematic review and meta-analysis of randomized controlled trials. Studies were obtained by searching the following databases: MEDLINE, CINAHL, EMBASE, Web of Science and CENTRAL. Two reviewers assessed studies for inclusion, extracted data and assessed trial quality. Sixteen studies involving 428 participants were included. People who received virtual reality interventions showed marked improvements in Berg Balance Scale (mean difference: 1.46, 95% confidence interval: 0.09-2.83, Pvirtual reality to improve balance after stroke. © The Author(s) 2015.

  7. Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

    Science.gov (United States)

    Gettelfinger, John D; Paulk, P Barrett; Schmalbach, Cecelia E

    2017-06-01

    Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

  8. Review of systematic reviews of non-pharmacological interventions to improve quality of life in cancer survivors.

    Science.gov (United States)

    Duncan, Morvwen; Moschopoulou, Elisavet; Herrington, Eldrid; Deane, Jennifer; Roylance, Rebecca; Jones, Louise; Bourke, Liam; Morgan, Adrienne; Chalder, Trudie; Thaha, Mohamed A; Taylor, Stephanie C; Korszun, Ania; White, Peter D; Bhui, Kamaldeep

    2017-11-28

    Over two million people in the UK are living with and beyond cancer. A third report diminished quality of life. A review of published systematic reviews to identify effective non-pharmacological interventions to improve the quality of life of cancer survivors. Databases searched until May 2017 included PubMed, Cochrane Central, EMBASE, MEDLINE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Published systematic reviews of randomised trials of non-pharmacological interventions for people living with and beyond cancer were included; included reviews targeted patients aged over 18. All participants had already received a cancer diagnosis. Interventions located in any healthcare setting, home or online were included. Reviews of alternative therapies or those non-English reports were excluded. Two researchers independently assessed titles, abstracts and the full text of papers, and independently extracted the data. The primary outcome of interest was any measure of global (overall) quality of life. Quality assessment assessing methdological quality of systematic reviews (AMSTAR) and narrative synthesis, evaluating effectiveness of non-pharmacological interventions and their components. Of 14 430 unique titles, 21 were included in the review of reviews. There was little overlap in the primary papers across these reviews. Thirteen reviews covered mixed tumour groups, seven focused on breast cancer and one focused on prostate cancer. Face-to-face interventions were often combined with online, telephone and paper-based reading materials. Interventions included physical, psychological or behavioural, multidimensional rehabilitation and online approaches. Yoga specifically, physical exercise more generally, cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR) programmes showed benefit in terms of quality of life. Exercise-based interventions were effective in the short (less than 3-8 months) and long

  9. Do safety checklists improve teamwork and communication in the operating room? A systematic review.

    Science.gov (United States)

    Russ, Stephanie; Rout, Shantanu; Sevdalis, Nick; Moorthy, Krishna; Darzi, Ara; Vincent, Charles

    2013-12-01

    The aim of this systematic review was to assess the impact of surgical safety checklists on the quality of teamwork and communication in the operating room (OR). Safety checklists have been shown to impact positively on patient morbidity and mortality following surgery, but it is unclear whether this clinical improvement is related to an improvement in OR teamwork and communication. A systematic search strategy of MEDLINE, EMBASE, PsycINFO, Google Scholar, and the Cochrane Database for Systematic Reviews was undertaken to obtain relevant articles. After de-duplication and the addition of limits, 315 articles were screened for inclusion by 2 researchers and all articles meeting a set of prespecified inclusion criteria were retained. Information regarding the type of checklist, study design, assessment tools used, outcomes, and study limitations was extracted. Twenty articles formed the basis of this systematic review. All articles described an empirical study relating to a case-specific safety checklist for surgery as the primary intervention, with some measure of change/improvement in teamwork and/or communication relating to its use. The methods for assessing teamwork and communication varied greatly, including surveys, observations, interviews, and 360° assessments. The evidence suggests that safety checklists improve the perceived quality of OR teamwork and communication and reduce observable errors relating to poor team skills. This is likely to function through establishing an open platform for communication at the start of a procedure: encouraging the sharing of critical case-related information, promoting team coordination and decision making, flagging knowledge gaps, and enhancing team cohesion. However, the evidence would also suggest that when used suboptimally or when individuals have not bought in to the process, checklists may conversely have a negative impact on the function of the team. Safety checklists are beneficial for OR teamwork and

  10. Stakeholder involvement in systematic reviews: a protocol for a systematic review of methods, outcomes and effects.

    Science.gov (United States)

    Pollock, Alex; Campbell, Pauline; Struthers, Caroline; Synnot, Anneliese; Nunn, Jack; Hill, Sophie; Goodare, Heather; Watts, Chris; Morley, Richard

    2017-01-01

    Researchers are expected to actively involve stakeholders (including patients, the public, health professionals, and others) in their research. Although researchers increasingly recognise that this is good practice, there is limited practical guidance about how to involve stakeholders. Systematic reviews are a research method in which international literature is brought together, using carefully designed and rigorous methods to answer a specified question about healthcare. We want to investigate how researchers have involved stakeholders in systematic reviews, and how involvement has potentially affected the quality and impact of reviews. We plan to bring this information together by searching and reviewing the literature for reports of stakeholder involvement in systematic reviews. This paper describes in detail the methods that we plan to use to do this. After carrying out comprehensive searches for literature, we will: 1. Provide an overview of identified reports, describing key information such as types of stakeholders involved, and how. 2. Pick out reports of involvement which include detailed descriptions of how researchers involved people in a systematic review and summarise the methods they used. We will consider who was involved, how people were recruited, and how the involvement was organised and managed. 3. Bring together any reports which have explored the effect, or impact, of involving stakeholders in a systematic review. We will assess the quality of these reports, and summarise their findings. Once completed, our review will be used to produce training resources aimed at helping researchers to improve ways of involving stakeholders in systematic reviews. Background There is an expectation for stakeholders (including patients, the public, health professionals, and others) to be involved in research. Researchers are increasingly recognising that it is good practice to involve stakeholders in systematic reviews. There is currently a lack of evidence

  11. Quality of systematic reviews in pediatric oncology - A systematic review

    NARCIS (Netherlands)

    Lundh, Andreas; Knijnenburg, Sebastiaan L.; Jørgensen, Anders W.; van Dalen, Elvira C.; Kremer, Leontien C. M.

    2009-01-01

    Background: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. Methods: We identified eligible systematic reviews

  12. Interventions to improve hemodialysis adherence: a systematic review of randomized-controlled trials.

    Science.gov (United States)

    Matteson, Michelle L; Russell, Cynthia

    2010-10-01

    Over 485,000 people in the United States have chronic kidney disease, a progressive kidney disease that may lead to hemodialysis. Hemodialysis involves a complex regimen of treatment, medication, fluid, and diet management. In 2005, over 312,000 patients were undergoing hemodialysis in the United States. Dialysis nonadherence rates range from 8.5% to 86%. Dialysis therapy treatment nonadherence, including treatment, medication, fluid, and diet nonadherence, significantly increases the risk of morbidity and mortality. The purpose of this paper is to systematically review randomized-controlled trial intervention studies designed to increase treatment, medication, fluid, and diet adherence in adult hemodialysis patients. A search of Cumulative Index of Nursing and Allied Health Literature (CINAHL) (1982 to May 2008), MEDLINE (1950 to May 2008), PsycINFO (1806 to May 2008), and all Evidence-Based Medicine (EBM) Reviews (Cochran DSR, ACP Journal Club, DARE, and CCTR) was conducted to identify randomized-controlled studies that tested the efficacy of interventions to improve adherence in adult hemodialysis patients. Eight randomized-controlled trials met criteria for inclusion. Six of the 8 studies found statistically significant improvement in adherence with the intervention. Of these 6 intervention studies, all studies had a cognitive component, with 3 studies utilizing cognitive/behavioral intervention strategies. Based on this systematic review, interventions utilizing a cognitive or cognitive/behavioral component appear to show the most promise for future study. © 2010 The Authors. Hemodialysis International © 2010 International Society for Hemodialysis.

  13. Does physical exercise improve obstacle negotiation in the elderly? A systematic review.

    Science.gov (United States)

    Guadagnin, Eliane C; da Rocha, Emmanuel S; Duysens, Jacques; Carpes, Felipe P

    2016-01-01

    Physical exercise improves walking in the elderly but much less is known about its effect on more challenged gait, such as obstacle negotiation. We conducted a systematic review to discuss the effects of regular physical exercise on kinematics and kinetics of obstacle negotiation in the elderly. A comprehensive literature search revealed 859 citations for review, whereof 206 studies entered the full-text analysis. After application of inclusion and exclusion criteria, 13 studies were included in this systematic review. Most of them presented a reasonable quality (average 0.68) but none of them reached the level of a randomized control trial. Interventions were heterogeneous, with training periods lasting from 5 days to 10 months. Studies assessed obstacle negotiation basically considering 3 types of testing paradigm, namely a walkway with either a single obstacle crossing, or with multiple obstacles, or else a treadmill with an obstacle avoidance task under time pressure. In general, longer training programs had better results and very short ones were not effective. A weekly frequency of 2-3 times was the most common among the studies showing positive effects. Regardless of exercises types performed, most of them were effective and so far, there is no consensus about the best exercise for improving obstacle negotiation. A lack of studies on this topic still is evident. Including a record of fall score can further help in deciding which programs are to be preferred. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews.

    Science.gov (United States)

    Ryan, Rebecca; Santesso, Nancy; Lowe, Dianne; Hill, Sophie; Grimshaw, Jeremy; Prictor, Megan; Kaufman, Caroline; Cowie, Genevieve; Taylor, Michael

    2014-04-29

    Many systematic reviews exist on interventions to improve safe and effective medicines use by consumers, but research is distributed across diseases, populations and settings. The scope and focus of such reviews also vary widely, creating challenges for decision-makers seeking to inform decisions by using the evidence on consumers' medicines use.This is an update of a 2011 overview of systematic reviews, which synthesises the evidence, irrespective of disease, medicine type, population or setting, on the effectiveness of interventions to improve consumers' medicines use. To assess the effects of interventions which target healthcare consumers to promote safe and effective medicines use, by synthesising review-level evidence. We included systematic reviews published on the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. We identified relevant reviews by handsearching databases from their start dates to March 2012. We screened and ranked reviews based on relevance to consumers' medicines use, using criteria developed for this overview. We used standardised forms to extract data, and assessed reviews for methodological quality using the AMSTAR tool. We used standardised language to summarise results within and across reviews; and gave bottom-line statements about intervention effectiveness. Two review authors screened and selected reviews, and extracted and analysed data. We used a taxonomy of interventions to categorise reviews and guide syntheses. We included 75 systematic reviews of varied methodological quality. Reviews assessed interventions with diverse aims including support for behaviour change, risk minimisation and skills acquisition. No reviews aimed to promote systems-level consumer participation in medicines-related activities. Medicines adherence was the most frequently-reported outcome, but others such as knowledge, clinical and service-use outcomes were also reported. Adverse events were less commonly

  15. Training improves agreement among doctors using the Neer system for proximal humeral fractures in a systematic review

    DEFF Research Database (Denmark)

    Brorson, Stig; Hróbjartsson, Asbjørn

    2008-01-01

    OBJECTIVE: To systematically review studies of observer agreement among doctors classifying proximal humeral fractures according to the Neer system. STUDY DESIGN AND SETTING: A systematic review. We searched for observational studies in which doctors classified proximal humeral fractures according......, and the methodological quality was assessed. RESULTS: We included 11 observational studies (88 observers and 468 cases). Mean kappa-values for interobserver agreement ranged from 0.17 to 0.52. Agreement did not improve through selection of experienced observers, advanced imaging modalities, or simplification...

  16. Reporting and methodologic quality of Cochrane Neonatal review group systematic reviews

    Directory of Open Access Journals (Sweden)

    Al Faleh Khalid

    2009-06-01

    Full Text Available Abstract Background The Cochrane Neonatal Review Group (CNRG has achieved a lot with limited resources in producing high quality systematic reviews to assist clinicians in evidence-based decision-making. A formal assessment of published CNRG systematic reviews has not been undertaken; we sought to provide a comprehensive assessment of the quality of systematic reviews (both methodologic and reporting quality published in CNRG. Methods We selected a random sample of published CNRG systematic reviews. Items of the QUOROM statement were utilized to assess quality of reporting, while items and total scores of the Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ were used to assess methodologic quality. Two reviewers independently extracted data and assessed quality. A Student t-test was used to compare quality scores pre- and post-publication of the QUOROM statement. Results Sixty-one systematic reviews were assessed. Overall, the included reviews had good quality with minor flaws based on OQAQ total scores (mean, 4.5 [0.9]; 95% CI, 4.27–4.77. However, room for improvement was noted in some areas, such as the title, abstract reporting, a priori plan for heterogeneity assessment and how to handle heterogeneity in case it exists, and assessment of publication bias. In addition, reporting of agreement among reviewers, documentation of trials flow, and discussion of possible biases were addressed in the review process. Reviews published post the QUOROM statement had a significantly higher quality scores. Conclusion The systematic reviews published in the CNRG are generally of good quality with minor flaws. However, efforts should be made to improve the quality of reports. Readers must continue to assess the quality of published reports on an individual basis prior to implementing the recommendations.

  17. Technology-based self-care methods of improving antiretroviral adherence: a systematic review.

    Directory of Open Access Journals (Sweden)

    Parya Saberi

    Full Text Available As HIV infection has shifted to a chronic condition, self-care practices have emerged as an important topic for HIV-positive individuals in maintaining an optimal level of health. Self-care refers to activities that patients undertake to maintain and improve health, such as strategies to achieve and maintain high levels of antiretroviral adherence.Technology-based methods are increasingly used to enhance antiretroviral adherence; therefore, we systematically reviewed the literature to examine technology-based self-care methods that HIV-positive individuals utilize to improve adherence. Seven electronic databases were searched from 1/1/1980 through 12/31/2010. We included quantitative and qualitative studies. Among quantitative studies, the primary outcomes included ARV adherence, viral load, and CD4+ cell count and secondary outcomes consisted of quality of life, adverse effects, and feasibility/acceptability data. For qualitative/descriptive studies, interview themes, reports of use, and perceptions of use were summarized. Thirty-six publications were included (24 quantitative and 12 qualitative/descriptive. Studies with exclusive utilization of medication reminder devices demonstrated less evidence of enhancing adherence in comparison to multi-component methods.This systematic review offers support for self-care technology-based approaches that may result in improved antiretroviral adherence. There was a clear pattern of results that favored individually-tailored, multi-function technologies, which allowed for periodic communication with health care providers rather than sole reliance on electronic reminder devices.

  18. Making progress with the automation of systematic reviews: principles of the International Collaboration for the Automation of Systematic Reviews (ICASR).

    Science.gov (United States)

    Beller, Elaine; Clark, Justin; Tsafnat, Guy; Adams, Clive; Diehl, Heinz; Lund, Hans; Ouzzani, Mourad; Thayer, Kristina; Thomas, James; Turner, Tari; Xia, Jun; Robinson, Karen; Glasziou, Paul

    2018-05-19

    Systematic reviews (SR) are vital to health care, but have become complicated and time-consuming, due to the rapid expansion of evidence to be synthesised. Fortunately, many tasks of systematic reviews have the potential to be automated or may be assisted by automation. Recent advances in natural language processing, text mining and machine learning have produced new algorithms that can accurately mimic human endeavour in systematic review activity, faster and more cheaply. Automation tools need to be able to work together, to exchange data and results. Therefore, we initiated the International Collaboration for the Automation of Systematic Reviews (ICASR), to successfully put all the parts of automation of systematic review production together. The first meeting was held in Vienna in October 2015. We established a set of principles to enable tools to be developed and integrated into toolkits.This paper sets out the principles devised at that meeting, which cover the need for improvement in efficiency of SR tasks, automation across the spectrum of SR tasks, continuous improvement, adherence to high quality standards, flexibility of use and combining components, the need for a collaboration and varied skills, the desire for open source, shared code and evaluation, and a requirement for replicability through rigorous and open evaluation.Automation has a great potential to improve the speed of systematic reviews. Considerable work is already being done on many of the steps involved in a review. The 'Vienna Principles' set out in this paper aim to guide a more coordinated effort which will allow the integration of work by separate teams and build on the experience, code and evaluations done by the many teams working across the globe.

  19. Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review.

    Directory of Open Access Journals (Sweden)

    Sarah L Brand

    Full Text Available Healthcare professionals throughout the developed world report higher levels of sickness absence, dissatisfaction, distress, and "burnout" at work than staff in other sectors. There is a growing call for the 'triple aim' of healthcare delivery (improving patient experience and outcomes and reducing costs; to include a fourth aim: improving healthcare staff experience of healthcare delivery. A systematic review commissioned by the United Kingdom's (UK Department of Health reviewed a large number of international healthy workplace interventions and recommended five whole-system changes to improve healthcare staff health and wellbeing: identification and response to local need, engagement of staff at all levels, and the involvement, visible leadership from, and up-skilling of, management and board-level staff.This systematic review aims to identify whole-system healthy workplace interventions in healthcare settings that incorporate (combinations of these recommendations and determine whether they improve staff health and wellbeing.A comprehensive and systematic search of medical, education, exercise science, and social science databases was undertaken. Studies were included if they reported the results of interventions that included all healthcare staff within a healthcare setting (e.g. whole hospital; whole unit, e.g. ward in collective activities to improve physical or mental health or promote healthy behaviours.Eleven studies were identified which incorporated at least one of the whole-system recommendations. Interventions that incorporated recommendations to address local need and engage the whole workforce fell in to four broad types: 1 pre-determined (one-size-fits-all and no choice of activities (two studies; or 2 pre-determined and some choice of activities (one study; 3 A wide choice of a range of activities and some adaptation to local needs (five studies; or, 3 a participatory approach to creating programmes responsive and adaptive to

  20. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.

    Science.gov (United States)

    Harrison, Anne L; Shields, Nora; Taylor, Nicholas F; Frawley, Helena C

    2016-10-01

    Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? A systematic review of randomised trials. Pregnant women diagnosed with gestational diabetes mellitus. Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196]. Copyright © 2016 Australian Physiotherapy Association. Published by Elsevier B.V. All rights

  1. Do systematic reviews on pediatric topics need special methodological considerations?

    OpenAIRE

    Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A.; Soll, Roger; Moher, David; Offringa, Martin

    2017-01-01

    Background Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child ...

  2. Use of computer-based interventions to improve literacy skills in students with autism spectrum disorders: A systematic review

    NARCIS (Netherlands)

    Ramdoss, S.; Mulloy, A.; Lang, R.B.; O'Reilly, M.F.; Sigafoos, J.; Lancioni, G.E.; Didden, H.C.M.; El Zein, F.

    2011-01-01

    The purpose of this review is to provide a systematic analysis of studies investigating computer-based interventions (CBI) to improve literacy skills (e.g., reading, writing, and vocabulary) in students with autism spectrum disorders (ASD). This review synthesizes intervention outcomes, appraises

  3. Self-efficacy strategies to improve exercise in patients with heart failure: A systematic review

    Science.gov (United States)

    Rajati, Fatemeh; Sadeghi, Masoumeh; Feizi, Awat; Sharifirad, Gholamreza; Hasandokht, Tolu; Mostafavi, Firoozeh

    2014-01-01

    BACKGROUND Despite exercise is recommended as an adjunct to medication therapy in patients with heart failure (HF), non-adherence to exercise is a major problem. While improving self-efficacy is an effective way to increase physical activity, the evidence concerning the relationship between strategies to enhance self-efficacy and exercise among HF has not been systematically reviewed. The objective of this systematic review is to assess the effect of interventions to change the self-efficacy on exercise in patients with HF. METHODS A systematic database search was conducted for articles reporting exercise self-efficacy interventions. Databases such as PubMed, ProQuest, CINAHL, Scopus, and PsycINFO, and the Cochrane Library were searched with restrictions to the years 2000-June 2014. A search of relevant databases identified 10 studies. Published randomized controlled intervention studies focusing strategies to change self-efficacy to exercise adherence in HF were eligible for inclusion. In addition, studies that have applied self-efficacy-based interventions to improve exercise are discussed. RESULTS Limited published data exist evaluating the self-efficacy strategies to improve exercise in HF. Dominant strategies to improve patients’ self-efficacy were performance accomplishments, vicarious experience, verbal persuasion, emotional arousal. CONCLUSION Evidence from some trials supports the view that incorporating the theory of self-efficacy into the design of an exercise intervention is beneficial. Moreover, exercise interventions aimed at integrating the four strategies of exercise self-efficacy can have positive effects on confidence and the ability to initiate exercise and recover HF symptoms. Findings of this study suggest that a positive relationship exists between self-efficacy and initiating and maintaining exercise in HF, especially in the short-term period. PMID:25815022

  4. Self-efficacy strategies to improve exercise in patients with heart failure: A systematic review

    Directory of Open Access Journals (Sweden)

    Fatemeh Rajati

    2014-11-01

    Full Text Available BACKGROUND: Despite exercise is recommended as an adjunct to medication therapy in patients with heart failure (HF, non-adherence to exercise is a major problem. While improving self-efficacy is an effective way to increase physical activity, the evidence concerning the relationship between strategies to enhance self-efficacy and exercise among HF has not been systematically reviewed. The objective of this systematic review is to assess the effect of interventions to change the self-efficacy on exercise in patients with HF. METHODS: A systematic database search was conducted for articles reporting exercise self-efficacy interventions. Databases such as PubMed, ProQuest, CINAHL, Scopus, and PsycINFO, and the Cochrane Library were searched with restrictions to the years 2000-June 2014. A search of relevant databases identified 10 studies. Published randomized controlled intervention studies focusing strategies to change self-efficacy to exercise adherence in HF were eligible for inclusion. In addition, studies that have applied self-efficacy-based interventions to improve exercise are discussed. RESULTS: Limited published data exist evaluating the self-efficacy strategies to improve exercise in HF. Dominant strategies to improve patients’ self-efficacy were performance accomplishments, vicarious experience, verbal persuasion, emotional arousal. CONCLUSION: Evidence from some trials supports the view that incorporating the theory of self-efficacy into the design of an exercise intervention is beneficial. Moreover, exercise interventions aimed at integrating the four strategies of exercise self-efficacy can have positive effects on confidence and the ability to initiate exercise and recover HF symptoms. Findings of this study suggest that a positive relationship exists between self-efficacy and initiating and maintaining exercise in HF, especially in the short-term period. 

  5. Systematic review

    DEFF Research Database (Denmark)

    Enggaard, Helle

    Title: Systematic review a method to promote nursing students skills in Evidence Based Practice Background: Department of nursing educate students to practice Evidence Based Practice (EBP), where clinical decisions is based on the best available evidence, patient preference, clinical experience...... and resources available. In order to incorporate evidence in clinical decisions, nursing students need to learn how to transfer knowledge in order to utilize evidence in clinical decisions. The method of systematic review can be one approach to achieve this in nursing education. Method: As an associate lecturer...... I have taken a Comprehensive Systematic Review Training course provide by Center of Clinical Guidelines in Denmark and Jonna Briggs Institute (JBI) and practice in developing a systematic review on how patients with ischemic heart disease experiences peer support. This insight and experience...

  6. The difficulties of systematic reviews.

    Science.gov (United States)

    Westgate, Martin J; Lindenmayer, David B

    2017-10-01

    The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. We drew on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora-including nonrandom selection of review topics, small-world properties of semantic networks, and spatiotemporal variation in word meaning-greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for narrative reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review and highlights 2 useful directions for future research. First, in cases where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods-such as natural language processing or the construction of research thesauri and ontologies-that provide tools for mapping and resolving that complexity. These tools could help individual researchers classify research material in a more robust manner and provide valuable guidance for future researchers on that topic. Second, a linguistic perspective highlights that scientific writing is a rich resource worthy of detailed study, an observation that can sometimes be lost during the search for data during systematic review or meta-analysis. For example, mapping semantic networks can reveal redundancy and complementarity among scientific concepts, leading to new insights and research questions. Consequently

  7. Assessing harmful effects in systematic Reviews

    Directory of Open Access Journals (Sweden)

    Woolacott Nerys F

    2004-07-01

    Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

  8. Home- and Community-Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review.

    Science.gov (United States)

    De Coninck, Leen; Bekkering, Geertruida E; Bouckaert, Leen; Declercq, Anja; Graff, Maud J L; Aertgeerts, Bert

    2017-08-01

    The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  9. Making literature reviews more reliable through application of lessons from systematic reviews.

    Science.gov (United States)

    Haddaway, N R; Woodcock, P; Macura, B; Collins, A

    2015-12-01

    Review articles can provide valuable summaries of the ever-increasing volume of primary research in conservation biology. Where findings may influence important resource-allocation decisions in policy or practice, there is a need for a high degree of reliability when reviewing evidence. However, traditional literature reviews are susceptible to a number of biases during the identification, selection, and synthesis of included studies (e.g., publication bias, selection bias, and vote counting). Systematic reviews, pioneered in medicine and translated into conservation in 2006, address these issues through a strict methodology that aims to maximize transparency, objectivity, and repeatability. Systematic reviews will always be the gold standard for reliable synthesis of evidence. However, traditional literature reviews remain popular and will continue to be valuable where systematic reviews are not feasible. Where traditional reviews are used, lessons can be taken from systematic reviews and applied to traditional reviews in order to increase their reliability. Certain key aspects of systematic review methods that can be used in a context-specific manner in traditional reviews include focusing on mitigating bias; increasing transparency, consistency, and objectivity, and critically appraising the evidence and avoiding vote counting. In situations where conducting a full systematic review is not feasible, the proposed approach to reviewing evidence in a more systematic way can substantially improve the reliability of review findings, providing a time- and resource-efficient means of maximizing the value of traditional reviews. These methods are aimed particularly at those conducting literature reviews where systematic review is not feasible, for example, for graduate students, single reviewers, or small organizations. © 2015 Society for Conservation Biology.

  10. Systematic review automation technologies

    Science.gov (United States)

    2014-01-01

    Systematic reviews, a cornerstone of evidence-based medicine, are not produced quickly enough to support clinical practice. The cost of production, availability of the requisite expertise and timeliness are often quoted as major contributors for the delay. This detailed survey of the state of the art of information systems designed to support or automate individual tasks in the systematic review, and in particular systematic reviews of randomized controlled clinical trials, reveals trends that see the convergence of several parallel research projects. We surveyed literature describing informatics systems that support or automate the processes of systematic review or each of the tasks of the systematic review. Several projects focus on automating, simplifying and/or streamlining specific tasks of the systematic review. Some tasks are already fully automated while others are still largely manual. In this review, we describe each task and the effect that its automation would have on the entire systematic review process, summarize the existing information system support for each task, and highlight where further research is needed for realizing automation for the task. Integration of the systems that automate systematic review tasks may lead to a revised systematic review workflow. We envisage the optimized workflow will lead to system in which each systematic review is described as a computer program that automatically retrieves relevant trials, appraises them, extracts and synthesizes data, evaluates the risk of bias, performs meta-analysis calculations, and produces a report in real time. PMID:25005128

  11. Interventions to improve recall of medical information in cancer patients: a systematic review of the literature.

    NARCIS (Netherlands)

    Meulen, N. van der; Jansen, J.; Dulmen, S. van; Bensing, J.; Weert, J. van

    2008-01-01

    This systematic review investigates which interventions are effective to improve recall of medical information in cancer patients. A literature research was done in PubMed, PsychINFO, CINAHL and Cochrane Library, following the guidelines of the Cochrane Collaboration. The methodological quality of

  12. A systematic review of interventions to improve outcomes for young adults with Type 1 diabetes.

    LENUS (Irish Health Repository)

    O'Hara, M C

    2016-10-20

    Many young adults with Type 1 diabetes experience poor outcomes. The aim of this systematic review was to synthesize the evidence regarding the effectiveness of interventions aimed at improving clinical, behavioural or psychosocial outcomes for young adults with Type 1 diabetes.

  13. Systematic reviews: guidance relevant for studies of older people.

    Science.gov (United States)

    Shenkin, Susan D; Harrison, Jennifer K; Wilkinson, Tim; Dodds, Richard M; Ioannidis, John P A

    2017-09-01

    Systematic reviews and meta-analyses are increasingly common. This article aims to provide guidance for people conducting systematic reviews relevant to the healthcare of older people. An awareness of these issues will also help people reading systematic reviews to determine whether the results will influence their clinical practice. It is essential that systematic reviews are performed by a team which includes the required technical and clinical expertise. Those performing reviews for the first time should ensure they have appropriate training and support. They must be planned and performed in a transparent and methodologically robust way: guidelines are available. The protocol should be written-and if possible published-before starting the review. Geriatricians will be interested in a table of baseline characteristics, which will help to determine if the studied samples or populations are similar to their patients. Reviews of studies of older people should consider how they will manage issues such as different age cut-offs; non-specific presentations; multiple predictors and outcomes; potential biases and confounders. Systematic reviews and meta-analyses may provide evidence to improve older people's care, or determine where new evidence is required. Newer methodologies, such as meta-analyses of individual level data, network meta-analyses and umbrella reviews, and realist synthesis, may improve the reliability and clinical utility of systematic reviews. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.

  14. Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews.

    Science.gov (United States)

    Golder, Su; Loke, Yoon K; Zorzela, Liliane

    2014-06-01

    Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. To compare search methods in systematic reviews of adverse effects with other reviews. The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials (RCTs). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE. However, reviews of adverse effects are more likely to include a range of study designs (not just RCTs) and search beyond MEDLINE. © 2014 Crown Copyright.

  15. Healthcare team training programs aimed at improving depression management in primary care: A systematic review.

    Science.gov (United States)

    Vöhringer, Paul A; Castro, Ariel; Martínez, Pablo; Tala, Álvaro; Medina, Simón; Rojas, Graciela

    2016-08-01

    Although evidence from Latin America and the Caribbean suggests that depression can be effectively treated in primary care settings, depression management remains unevenly performed. This systematic review evaluates all the international evidence on healthcare team training programs aimed at improving the outcomes of patients with depression. Three databases were searched for articles in English or Spanish indexed up to November 20, 2014. Studies were included if they fulfilled the following conditions: clinical trials, meta-analyses, or systematic reviews; and if they evaluated a training or educational program intended to improve the management of depression by primary healthcare teams, and assessed change in depressive symptoms, diagnosis or response rates, referral rates, patients' satisfaction and/or quality of life, and the effectiveness of treatments. Nine studies were included in this systematic review. Five trials tested the effectiveness of multi-component interventions (training included), and the remaining studies evaluated the effectiveness of specific training programs for depression management. All the studies that implemented multi-component interventions were efficacious, and half of the training trials were shown to be effective. Contribution of training programs alone to the effectiveness of multi-component interventions is yet to be established. The lack of specificity regarding health providers' characteristics might be a confounding factor. The review conducted suggests that stand-alone training programs are less effective than multi-component interventions. In applying the evidence gathered from developed countries to Latin America and the Caribbean, these training programs must consider and address local conditions of mental health systems, and therefore multi-component interventions may be warranted. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Systematic reviews identify important methodological flaws in stroke rehabilitation therapy primary studies: review of reviews.

    Science.gov (United States)

    Santaguida, Pasqualina; Oremus, Mark; Walker, Kathryn; Wishart, Laurie R; Siegel, Karen Lohmann; Raina, Parminder

    2012-04-01

    A "review of reviews" was undertaken to assess methodological issues in studies evaluating nondrug rehabilitation interventions in stroke patients. MEDLINE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews were searched from January 2000 to January 2008 within the stroke rehabilitation setting. Electronic searches were supplemented by reviews of reference lists and citations identified by experts. Eligible studies were systematic reviews; excluded citations were narrative reviews or reviews of reviews. Review characteristics and criteria for assessing methodological quality of primary studies within them were extracted. The search yielded 949 English-language citations. We included a final set of 38 systematic reviews. Cochrane reviews, which have a standardized methodology, were generally of higher methodological quality than non-Cochrane reviews. Most systematic reviews used standardized quality assessment criteria for primary studies, but not all were comprehensive. Reviews showed that primary studies had problems with randomization, allocation concealment, and blinding. Baseline comparability, adverse events, and co-intervention or contamination were not consistently assessed. Blinding of patients and providers was often not feasible and was not evaluated as a source of bias. The eligible systematic reviews identified important methodological flaws in the evaluated primary studies, suggesting the need for improvement of research methods and reporting. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Do large-scale hospital- and system-wide interventions improve patient outcomes: a systematic review.

    Science.gov (United States)

    Clay-Williams, Robyn; Nosrati, Hadis; Cunningham, Frances C; Hillman, Kenneth; Braithwaite, Jeffrey

    2014-09-03

    While health care services are beginning to implement system-wide patient safety interventions, evidence on the efficacy of these interventions is sparse. We know that uptake can be variable, but we do not know the factors that affect uptake or how the interventions establish change and, in particular, whether they influence patient outcomes. We conducted a systematic review to identify how organisational and cultural factors mediate or are mediated by hospital-wide interventions, and to assess the effects of those factors on patient outcomes. A systematic review was conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Database searches were conducted using MEDLINE from 1946, CINAHL from 1991, EMBASE from 1947, Web of Science from 1934, PsycINFO from 1967, and Global Health from 1910 to September 2012. The Lancet, JAMA, BMJ, BMJ Quality and Safety, The New England Journal of Medicine and Implementation Science were also hand searched for relevant studies published over the last 5 years. Eligible studies were required to focus on organisational determinants of hospital- and system-wide interventions, and to provide patient outcome data before and after implementation of the intervention. Empirical, peer-reviewed studies reporting randomised and non-randomised controlled trials, observational, and controlled before and after studies were included in the review. Six studies met the inclusion criteria. Improved outcomes were observed for studies where outcomes were measured at least two years after the intervention. Associations between organisational factors, intervention success and patient outcomes were undetermined: organisational culture and patient outcomes were rarely measured together, and measures for culture and outcome were not standardised. Common findings show the difficulty of introducing large-scale interventions, and that effective leadership and clinical champions, adequate

  18. A Systematic Review on the Effectiveness of Interventions to Improve Hand Hygiene Compliance of Nurses in the Hospital Setting.

    Science.gov (United States)

    Rn, Olena Doronina; Jones, Denise; Martello, Marianna; Biron, Alain; Lavoie-Tremblay, Mélanie

    2017-03-01

    The purpose of the present systematic review is to identify the interventions that improve hand hygiene compliance (HHC) specifically among nurses. A systematic review was performed guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to evaluate the short and long-term effects of interventions to promote hand hygiene practices among nurses in the hospital setting. A search of the Cumulative Index to Nursing and Allied Health Literature, Medline Global Health, and Embase was conducted in addition to studies identified by the most recent systematic review. Six studies met inclusion criteria: three randomized controlled trials (RCTs), one controlled before and after studies (CBAs), and two interrupted times series (ITS). One RCT reported effectiveness and 6-month sustainability of the effect related to multimodal-directed and multimodal with team leadership-directed strategies. The other two RCTs found positive effect of education and feedback on compliance; however, compliance rates declined after 1 month. Education was also found to improve HHC up to 3 months postintervention. An electronic reminder and feedback system evaluated by an ITS improved HHC and detected variation in HHC through the day. This review showed that single and combined interventions do improve hand hygiene practices among nurses; however, there is a need for more methodologically robust studies to define the most effective and sustainable interventions. Although hand hygiene is the most effective measure to prevent healthcare-associated infections, compliance with hand hygiene remains low. Nurses are among the healthcare providers who spend the most time in direct patient contact. Therefore, there is a need for research to identify the interventions that improve HHC in this group. © 2017 Sigma Theta Tau International.

  19. Methodology of a systematic review.

    Science.gov (United States)

    Linares-Espinós, E; Hernández, V; Domínguez-Escrig, J L; Fernández-Pello, S; Hevia, V; Mayor, J; Padilla-Fernández, B; Ribal, M J

    2018-05-03

    The objective of evidence-based medicine is to employ the best scientific information available to apply to clinical practice. Understanding and interpreting the scientific evidence involves understanding the available levels of evidence, where systematic reviews and meta-analyses of clinical trials are at the top of the levels-of-evidence pyramid. The review process should be well developed and planned to reduce biases and eliminate irrelevant and low-quality studies. The steps for implementing a systematic review include (i) correctly formulating the clinical question to answer (PICO), (ii) developing a protocol (inclusion and exclusion criteria), (iii) performing a detailed and broad literature search and (iv) screening the abstracts of the studies identified in the search and subsequently of the selected complete texts (PRISMA). Once the studies have been selected, we need to (v) extract the necessary data into a form designed in the protocol to summarise the included studies, (vi) assess the biases of each study, identifying the quality of the available evidence, and (vii) develop tables and text that synthesise the evidence. A systematic review involves a critical and reproducible summary of the results of the available publications on a particular topic or clinical question. To improve scientific writing, the methodology is shown in a structured manner to implement a systematic review. Copyright © 2018 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Efficacy of interventions to improve physical activity levels in individuals with stroke: a systematic review protocol

    Science.gov (United States)

    Aguiar, Larissa Tavares; Martins, Júlia Caetano; Nadeau, Sylvie; Britto, Raquel Rodrigues; Teixeira-Salmela, Luci F; Faria, Christina D C M

    2017-01-01

    Introduction Stroke is a leading health problem worldwide and an important cause of disability. Stroke survivors show low levels of physical activity, and increases in physical activity levels may improve function and health status. Therefore, the aims are to identify which interventions that have been employed to increase physical activity levels with stroke survivors, to verify their efficacy and to identify the gaps in the literature. Methods and analysis A systematic review of randomised controlled trials that investigated the efficacy of interventions aiming at increasing physical activity levels of stroke survivors will be conducted. Electronic searches will be performed in the MEDLINE, Physiotherapy Evidence Database (PEDro), Excerpta Medica (EMBASE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SCIELO) databases. Hand searches of the reference lists of the included studies or relevant reviews will also be employed. Two independent reviewers will screen all the retrieved titles, abstracts and full texts. A third reviewer will be referred to solve any disagreements. The quality of the included studies will be assessed by the PEDro Rating Scale. This systematic review will also include a qualitative synthesis. Meta-analyses will be performed, if the studies are sufficiently homogeneous. This review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The quality of the evidence regarding physical activity will be assessed, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Discussion This systematic review will provide information on which interventions are effective for increasing physical activity levels of stroke survivors. This evidence may be important for clinical decision-making and will allow the identification of gaps in the literature that may be useful for the definition of future research

  1. A systematic review of the quality of conduct and reporting of systematic reviews and meta-analyses in paediatric surgery.

    Directory of Open Access Journals (Sweden)

    Paul Stephen Cullis

    , review includes comparison of interventions and review registration. The latter three variables were significant in multivariate regression.There are gaps in the conduct and reporting of systematic reviews in paediatric surgery. More endorsement by journals of the PRISMA guideline may improve review quality, and the dissemination of reliable evidence to paediatric clinicians.

  2. The evidence base for psychological interventions for rheumatoid arthritis: A systematic review of reviews.

    Science.gov (United States)

    Prothero, Louise; Barley, Elizabeth; Galloway, James; Georgopoulou, Sofia; Sturt, Jackie

    2018-06-01

    Psychological interventions are an important but often overlooked adjunctive treatment option for patients with rheumatoid arthritis. Findings from systematic reviews of psychological interventions for this patient group are conflicting. A systematic review of reviews can explain inconsistencies between studies and provide a clearer understanding of the effects of interventions. To: 1) determine the effectiveness of psychological interventions in improving biopsychosocial outcomes for adults with rheumatoid arthritis, 2) determine the relationship between the intensity of the psychological interventions (number of sessions, duration of sessions, duration of intervention) on outcomes, and 3) assess the impact of comparator group (usual care, education only) on outcomes. We conducted a systematic review of reviews using the following inclusion criteria: 1) randomised controlled trials of psychological interventions (including cognitive behavioural therapy, supportive counselling, psychotherapy, self-regulatory techniques, mindfulness-based cognitive therapy and disclosure therapy) provided as an adjunct to medication, 2) included rheumatoid arthritis patients aged ≥ 18 years, 3) reported findings for at least 1 of the primary outcomes: pain, fatigue, psychological status, functional disability and disease activity and 4) were published in English between January 2000 and March 2015 (updated January 2018). We searched in MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. Reference lists were searched for additional reviews. Study selection and 50% of the quality assessments were performed by two independent reviewers. Methodological quality was measured using the Assessment of Multiple Systematic Reviews checklist. Data extraction was conducted by one reviewer using a predesigned data extraction form. Eight systematic reviews met inclusion criteria (one review was excluded due to

  3. Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review.

    Science.gov (United States)

    Munce, Sarah E P; Perrier, Laure; Shin, Saeha; Adhihetty, Chamila; Pitzul, Kristen; Nelson, Michelle L A; Bayley, Mark T

    2017-09-07

    While many outcomes post-stroke (e.g., depression) have been previously investigated, there is no complete data on the impact of a variety of quality improvement strategies on the quality of life and physical and psychological well-being of individuals post-stroke. The current paper outlines a systematic review protocol on the impact of quality improvement strategies on quality of life as well as physical and psychological well-being of individuals with stroke. MEDLINE, CINAHL, EMBASE, and PsycINFO databases will be searched. Two independent reviewers will conduct all levels of screening, data abstraction, and quality appraisal. Only randomized controlled trials that report on the impact of quality improvement strategies on quality of life outcomes in people with stroke will be included. The secondary outcomes will be physical and psychological well-being. Quality improvement strategies include audit and feedback, case management, team changes, electronic patient registries, clinician education, clinical reminders, facilitated relay of clinical information to clinicians, patient education, (promotion of) self-management, patient reminder systems, and continuous quality improvement. Studies published since 2000 will be included to increase the relevancy of findings. Results will be grouped according to the target group of the varying quality improvement strategies (i.e., health system, health care professionals, or patients) and/or by any other noteworthy grouping variables, such as etiology of stroke or by sex. This systematic review will identify those quality improvement strategies aimed at the health system, health care professionals, and patients that impact the quality of life of individuals with stroke. Improving awareness and utilization of such strategies may enhance uptake of stroke best practices and reduce inappropriate health care utilization costs. PROSPERO, CRD42017064141.

  4. Time to consider sharing data extracted from trials included in systematic reviews

    Directory of Open Access Journals (Sweden)

    Luke Wolfenden

    2016-11-01

    Full Text Available Abstract Background While the debate regarding shared clinical trial data has shifted from whether such data should be shared to how this is best achieved, the sharing of data collected as part of systematic reviews has received little attention. In this commentary, we discuss the potential benefits of coordinated efforts to share data collected as part of systematic reviews. Main body There are a number of potential benefits of systematic review data sharing. Shared information and data obtained as part of the systematic review process may reduce unnecessary duplication, reduce demand on trialist to service repeated requests from reviewers for data, and improve the quality and efficiency of future reviews. Sharing also facilitates research to improve clinical trial and systematic review methods and supports additional analyses to address secondary research questions. While concerns regarding appropriate use of data, costs, or the academic return for original review authors may impede more open access to information extracted as part of systematic reviews, many of these issues are being addressed, and infrastructure to enable greater access to such information is being developed. Conclusion Embracing systems to enable more open access to systematic review data has considerable potential to maximise the benefits of research investment in undertaking systematic reviews.

  5. A quantitative systematic review of the efficacy of mobile phone interventions to improve medication adherence.

    Science.gov (United States)

    Park, Linda G; Howie-Esquivel, Jill; Dracup, Kathleen

    2014-09-01

    To evaluate the characteristics and efficacy of mobile phone interventions to improve medication adherence. Secondary aims are to explore participants' acceptability and satisfaction with mobile phone interventions and to evaluate the selected studies in terms of study rigour, impact, cost and resource feasibility, generalizability and implications for nursing practice and research. Medication non-adherence is a major global challenge. Mobile phones are the most commonly used form of technology worldwide and have the potential to promote medication adherence. Guidelines from the Centre for Reviews and Dissemination were followed for this systematic review. A comprehensive search of databases (PubMed, Web of Science, CINAHL, PsycInfo, Google Chrome and Cochrane) and bibliographies from related articles was performed from January 2002-January 2013 to identify the included studies. A quantitative systematic review without meta-analysis was conducted and the selected studies were critically evaluated to extract and summarize pertinent characteristics and outcomes. The literature search produced 29 quantitative research studies related to mobile phones and medication adherence. The studies were conducted for prevention purposes as well as management of acute and chronic illnesses. All of the studies used text messaging. Eighteen studies found significant improvement in medication adherence. While the majority of investigators found improvement in medication adherence, long-term studies characterized by rigorous research methodologies, appropriate statistical and economic analyses and the test of theory-based interventions are needed to determine the efficacy of mobile phones to influence medication adherence. © 2014 John Wiley & Sons Ltd.

  6. Identifying Lesbian, Gay, Bisexual, and Transgender Search Terminology: A Systematic Review of Health Systematic Reviews.

    Directory of Open Access Journals (Sweden)

    Joseph G L Lee

    Full Text Available Research on the health of lesbian, gay, bisexual, and transgender (LGBT populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28-29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching.

  7. Making evidence more wanted: a systematic review of facilitators to enhance the uptake of evidence from systematic reviews and meta-analyses.

    Science.gov (United States)

    Wallace, John; Byrne, Charles; Clarke, Mike

    2012-12-01

    The increased uptake of evidence from systematic reviews is advocated because of their potential to improve the quality of decision making for patient care. Systematic reviews can do this by decreasing inappropriate clinical variation and quickly expediting the application of current, effective advances to everyday practice. However, research suggests that evidence from systematic reviews has not been widely adopted by health professionals. Little is known about the facilitators to uptake of research evidence from systematic reviews and meta-analyses. To review the facilitators to the uptake by decision makers, of evidence from systematic, meta-analyses and the databases containing them. We searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Grey literature and knowledge translation research was particularly sought. Reference lists of primary studies and related reviews were also searched. Studies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. One investigator screened titles to identify candidate articles, and then two reviewers independently assessed the relevance of retrieved articles to exclude studies that did not meet the inclusion criteria. Quality of the included studies was also assessed. Using a pre-established taxonomy, two reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Differences were resolved by consensus. Of articles initially identified, we selected unique published studies describing at least one facilitator to the uptake of evidence from systematic reviews. The 15 unique studies reported 10 surveys, three qualitative investigations and two mixed studies that addressed potential facilitators. Five studies were from Canada, four from the UK, three from

  8. Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis.

    Science.gov (United States)

    Thota, Anilkrishna B; Sipe, Theresa Ann; Byard, Guthrie J; Zometa, Carlos S; Hahn, Robert A; McKnight-Eily, Lela R; Chapman, Daniel P; Abraido-Lanza, Ana F; Pearson, Jane L; Anderson, Clinton W; Gelenberg, Alan J; Hennessy, Kevin D; Duffy, Farifteh F; Vernon-Smiley, Mary E; Nease, Donald E; Williams, Samantha P

    2012-05-01

    To improve the quality of depression management, collaborative care models have been developed from the Chronic Care Model over the past 20 years. Collaborative care is a multicomponent, healthcare system-level intervention that uses case managers to link primary care providers, patients, and mental health specialists. In addition to case management support, primary care providers receive consultation and decision support from mental health specialists (i.e., psychiatrists and psychologists). This collaboration is designed to (1) improve routine screening and diagnosis of depressive disorders; (2) increase provider use of evidence-based protocols for the proactive management of diagnosed depressive disorders; and (3) improve clinical and community support for active client/patient engagement in treatment goal-setting and self-management. A team of subject matter experts in mental health, representing various agencies and institutions, conceptualized and conducted a systematic review and meta-analysis on collaborative care for improving the management of depressive disorders. This team worked under the guidance of the Community Preventive Services Task Force, a nonfederal, independent, volunteer body of public health and prevention experts. Community Guide systematic review methods were used to identify, evaluate, and analyze available evidence. An earlier systematic review with 37 RCTs of collaborative care studies published through 2004 found evidence of effectiveness of these models in improving depression outcomes. An additional 32 studies of collaborative care models conducted between 2004 and 2009 were found for this current review and analyzed. The results from the meta-analyses suggest robust evidence of effectiveness of collaborative care in improving depression symptoms (standardized mean difference [SMD]=0.34); adherence to treatment (OR=2.22); response to treatment (OR=1.78); remission of symptoms (OR=1.74); recovery from symptoms (OR=1.75); quality of

  9. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    Science.gov (United States)

    Elliott, Julian H; Turner, Tari; Clavisi, Ornella; Thomas, James; Higgins, Julian P T; Mavergames, Chris; Gruen, Russell L

    2014-02-01

    The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

  10. Consideration of health inequalities in systematic reviews: a mapping review of guidance.

    Science.gov (United States)

    Maden, Michelle

    2016-11-28

    Given that we know that interventions shown to be effective in improving the health of a population may actually widen the health inequalities gap while others reduce it, it is imperative that all systematic reviewers consider how the findings of their reviews may impact (reduce or increase) on the health inequality gap. This study reviewed existing guidance on incorporating considerations of health inequalities in systematic reviews in order to examine the extent to which they can help reviewers to incorporate such issues. A mapping review was undertaken to identify guidance documents that purported to inform reviewers on whether and how to incorporate considerations of health inequalities. Searches were undertaken in Medline, CINAHL and The Cochrane Library Methodology Register. Review guidance manuals prepared by international organisations engaged in undertaking systematic reviews, and their associated websites were scanned. Studies were included if they provided an overview or discussed the development and testing of guidance for dealing with the incorporation of considerations of health inequalities in evidence synthesis. Results are summarised in narrative and tabular forms. Twenty guidance documents published between 2009 and 2016 were included. Guidance has been produced to inform considerations of health inequalities at different stages of the systematic review process. The Campbell and Cochrane Equity Group have been instrumental in developing and promoting such guidance. Definitions of health inequalities and guidance differed across the included studies. All but one guidance document were transparent in their method of production. Formal methods of evaluation were reported for six guidance documents. Most of the guidance was operationalised in the form of examples taken from published systematic reviews. The number of guidance items to operationalise ranges from 3 up to 26 with a considerable overlap noted. Adhering to the guidance will require more

  11. "Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review".

    Science.gov (United States)

    Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen

    2017-10-01

    The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. [Audit and feedback, and continuous quality improvement strategies to improve the quality of care for type 2 diabetes: a systematic review of literature].

    Science.gov (United States)

    Vecchi, Simona; Agabiti, Nera; Mitrova, Susanna; Cacciani, Laura; Amato, Laura; Davoli, Marina; Bargagli, Anna Maria

    2016-01-01

    we analysed evidence on effective interventions to improve the quality of care and management in patients with diabetes type 2. This review focuses particularly on audit and feedback intervention, targeted to healthcare providers, and continuous quality improvement (CQI) involving health professionals and health care systems, respectively. we searched The Cochrane Library, PubMed, and EMBASE (search period: January 2005-December 2015) to identify systematic reviews (SR) and randomized controlled trials (RCTs) considering patients' outcomes and process measures as quality indicators in diabetes care. Selection of studies and data extraction were carried out independently by two reviewers. Methodological quality of individual studies was assessed using the checklist «Assessment of methodological quality of systematic review» (AMSTAR) and the Cochrane's tool, respectively. We produced summaries of results for each study design. the search process resulted in 810 citations. One SR and 7 RCTs that compared any intervention in which audit and feedback and CQI was a component vs. other interventions were selected. The SR found that audit and feedback activity was associated with improvements of glycaemic (mean difference: 0.26; 95%CI 0.08;0.44) and cholesterol control (mean difference: 0.03; 95%CI -0.04;0.10). CQI interventions were not associated with an improvement of quality of diabetes care. The RCTs considered in this review compared a broad range of interventions including feedback as unique activity or as part of more complex strategies. The methodological quality was generally poor in all the included trials. the available evidence suggests that audit and feedback and CQI improve quality of care in diabetic patients, although the effect is small and heterogeneous among process and outcomes indicators.

  13. Methodology in conducting a systematic review of systematic reviews of healthcare interventions

    LENUS (Irish Health Repository)

    Smith, Valerie

    2011-02-03

    Abstract Background Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need. Methods The methods used to identify and appraise published and unpublished reviews systematically, drawing on our experiences and good practice in the conduct and reporting of systematic reviews are described. The process of identifying and appraising all published reviews allows researchers to describe the quality of this evidence base, summarise and compare the review\\'s conclusions and discuss the strength of these conclusions. Results Methodological challenges and possible solutions are described within the context of (i) sources, (ii) study selection, (iii) quality assessment (i.e. the extent of searching undertaken for the reviews, description of study selection and inclusion criteria, comparability of included studies, assessment of publication bias and assessment of heterogeneity), (iv) presentation of results, and (v) implications for practice and research. Conclusion Conducting a systematic review of reviews highlights the usefulness of bringing together a summary of reviews in one place, where there is more than one review on an important topic. The methods described here should help clinicians to review and appraise published reviews systematically, and aid evidence-based clinical decision-making.

  14. Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Emma J Schneider

    2016-10-01

    Full Text Available Questions: In people receiving rehabilitation aimed at reducing activity limitations of the lower and/or upper limb after stroke, does adding extra rehabilitation (of the same content as the usual rehabilitation improve activity? What is the amount of extra rehabilitation that needs to be provided to achieve a beneficial effect? Design: Systematic review with meta-analysis of randomised trials. Participants: Adults aged 18 years or older that had a diagnosis of stroke. Intervention: Extra rehabilitation with the same content as usual rehabilitation aimed at reducing activity limitations of the lower and/or upper limb. Outcome measures: Activity measured as lower or upper limb ability. Results: A total of 14 studies, comprising 15 comparisons, met the inclusion criteria. Pooling data from all the included studies showed that extra rehabilitation improved activity immediately after the intervention period (SMD = 0.39, 95% CI 0.07 to 0.71, I2 = 66%. When only studies with a large increase in rehabilitation (> 100% were included, the effect was greater (SMD 0.59, 95% CI 0.23 to 0.94, I2 = 44%. There was a trend towards a positive relationship (r = 0.53, p = 0.09 between extra rehabilitation and improved activity. The turning point on the ROC curve of false versus true benefit (AUC = 0.88, p = 0.04 indicated that at least an extra 240% of rehabilitation was needed for significant likelihood that extra rehabilitation would improve activity. Conclusion: Increasing the amount of usual rehabilitation aimed at reducing activity limitations improves activity in people after stroke. The amount of extra rehabilitation that needs to be provided to achieve a beneficial effect is large. Trial registration: PROSPERO CRD42012003221. [Schneider EJ, Lannin NA, Ada L, Schmidt J (2016 Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review. Journal of Physiotherapy 62: 182–187

  15. Systematic Reviews in Sports Medicine.

    Science.gov (United States)

    DiSilvestro, Kevin J; Tjoumakaris, Fotios P; Maltenfort, Mitchell G; Spindler, Kurt P; Freedman, Kevin B

    2016-02-01

    The number of systematic reviews published in the orthopaedic literature has increased, and these reviews can help guide clinical decision making. However, the quality of these reviews can affect the reader's ability to use the data to arrive at accurate conclusions and make clinical decisions. To evaluate the methodological and reporting quality of systematic reviews and meta-analyses in the sports medicine literature to determine whether such reviews should be used to guide treatment decisions. The hypothesis was that many systematic reviews in the orthopaedic sports medicine literature may not follow the appropriate reporting guidelines or methodological criteria recommended for systematic reviews. Systematic review. All clinical sports medicine systematic reviews and meta-analyses from 2009 to 2013 published in The American Journal of Sports Medicine (AJSM), The Journal of Bone and Joint Surgery (JBJS), Arthroscopy, Sports Health, and Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) were reviewed and evaluated for level of evidence according to the guidelines from the Oxford Centre for Evidence-Based Medicine, for reporting quality according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and for methodological quality according to the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Analysis was performed by year and journal of publication, and the levels of evidence included in the systematic reviews were also analyzed. A total of 200 systematic reviews and meta-analyses were identified over the study period. Of these, 53% included evidence levels 4 and 5 in their analyses, with just 32% including evidence levels 1 and 2 only. There were significant differences in the proportion of articles with high levels of evidence (P Systematic reviews and meta-analyses in orthopaedics sports medicine literature relied on evidence levels 4 and 5 in 53% of studies over the 5-year study period. Overall, PRISMA and

  16. Interventions to Improve Hand Hygiene Compliance in the ICU: A Systematic Review.

    Science.gov (United States)

    Lydon, Sinéad; Power, Michael; McSharry, Jennifer; Byrne, Molly; Madden, Caoimhe; Squires, Janet Elaine; O'Connor, Paul

    2017-11-01

    To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. Systematic searches were conducted in November 2016 using five electronic databases: Medline, CINAHL, PsycInfo, Embase, and Web of Science. Additionally, the reference lists of included studies and existing review papers were screened. English language, peer-reviewed studies that evaluated an intervention to improve hand hygiene in an adult ICU setting, and reported hand hygiene compliance rates collected via observation, were included. Data were extracted on the setting, participant characteristics, experimental design, hand hygiene measurement, intervention characteristics, and outcomes. Interventional components were categorized using the Behavior Change Wheel. Methodological quality was examined using the Downs and Black Checklist. Thirty-eight studies were included. The methodological quality of studies was poor, with studies scoring a mean of 8.6 of 24 (SD= 2.7). Over 90% of studies implemented a bundled intervention. The most frequently employed interventional strategies were education (78.9%), enablement (71.1%), training (68.4%), environmental restructuring (65.8%), and persuasion (65.8%). Intervention outcomes were variable, with a mean relative percentage change of 94.7% (SD= 195.7; range, 4.3-1155.4%) from pre to post intervention. This review demonstrates that best practice for improving hand hygiene in ICUs remains unestablished. Future research employing rigorous experimental designs, careful statistical analysis, and clearly described interventions is important.

  17. Is mindfulness research methodology improving over time? A systematic review.

    Directory of Open Access Journals (Sweden)

    Simon B Goldberg

    Full Text Available Despite an exponential growth in research on mindfulness-based interventions, the body of scientific evidence supporting these treatments has been criticized for being of poor methodological quality.The current systematic review examined the extent to which mindfulness research demonstrated increased rigor over the past 16 years regarding six methodological features that have been highlighted as areas for improvement. These feature included using active control conditions, larger sample sizes, longer follow-up assessment, treatment fidelity assessment, and reporting of instructor training and intent-to-treat (ITT analyses.We searched PubMed, PsychInfo, Scopus, and Web of Science in addition to a publically available repository of mindfulness studies.Randomized clinical trials of mindfulness-based interventions for samples with a clinical disorder or elevated symptoms of a clinical disorder listed on the American Psychological Association's list of disorders with recognized evidence-based treatment.Independent raters screened 9,067 titles and abstracts, with 303 full text reviews. Of these, 171 were included, representing 142 non-overlapping samples.Across the 142 studies published between 2000 and 2016, there was no evidence for increases in any study quality indicator, although changes were generally in the direction of improved quality. When restricting the sample to those conducted in Europe and North America (continents with the longest history of scientific research in this area, an increase in reporting of ITT analyses was found. When excluding an early, high-quality study, improvements were seen in sample size, treatment fidelity assessment, and reporting of ITT analyses.Taken together, the findings suggest modest adoption of the recommendations for methodological improvement voiced repeatedly in the literature. Possible explanations for this and implications for interpreting this body of research and conducting future studies are

  18. The methodological quality of systematic reviews of animal studies in dentistry.

    Science.gov (United States)

    Faggion, C M; Listl, S; Giannakopoulos, N N

    2012-05-01

    Systematic reviews and meta-analyses of animal studies are important for improving estimates of the effects of treatment and for guiding future clinical studies on humans. The purpose of this systematic review was to assess the methodological quality of systematic reviews and meta-analyses of animal studies in dentistry through using a validated checklist. A literature search was conducted independently and in duplicate in the PubMed and LILACS databases. References in selected systematic reviews were assessed to identify other studies not captured by the electronic searches. The methodological quality of studies was assessed independently and in duplicate by using the AMSTAR checklist; the quality was scored as low, moderate, or high. The reviewers were calibrated before the assessment and agreement between them was assessed using Cohen's Kappa statistic. Of 444 studies retrieved, 54 systematic reviews were selected after full-text assessment. Agreement between the reviewers was regarded as excellent. Only two studies were scored as high quality; 17 and 35 studies were scored as medium and low quality, respectively. There is room for improvement of the methodological quality of systematic reviews of animal studies in dentistry. Checklists, such as AMSTAR, can guide researchers in planning and executing systematic reviews and meta-analyses. For determining the need for additional investigations in animals and in order to provide good data for potential application in human, such reviews should be based on animal experiments performed according to sound methodological principles. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    Directory of Open Access Journals (Sweden)

    Julian H Elliott

    2014-02-01

    Full Text Available The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are high quality, up-to-date online summaries of health research, updated as new research becomes available, and enabled by improved production efficiency and adherence to the norms of scholarly communication. Together with innovations in primary research reporting and the creation and use of evidence in health systems, living systematic review contributes to an emerging evidence ecosystem.

  20. DOES QUALITY IMPROVEMENT IMPROVE PATIENTS’ HEALTH? A SYSTEMATIC REVIEW OF MEASURES OF EFFECT USED IN PDSA PROJECTS

    DEFF Research Database (Denmark)

    Hermansen, Nanna Kastrup; Vestergaard, Anne Sig; Ehlers, Lars Holger

    , and if the authors provide scientific evidence that their choice of effect measure, i.e. the quality indicator, is associated with patients’ health. Methods The basis of the present study was a systematic review of studies on PDSA quality improvement projects published in 2015-2017. For all identified papers...... as such. Conclusion Process indicators, rather than health-related outcome measures, appear to be used most often in quality improvement projects applying the PDSA method. Evidence-based indicators were only applied in four studies. Overall, this challenges the ability to show if, and how, interventions......Abstract Introduction Quality improvement is an inherent part of modern healthcare systems worldwide, used for the continuous advancement in effectiveness and safety. Amongst other approaches, the plan-do-study-act (PDSA) method, a four-step iterative method, is widely used for testing...

  1. The Reporting Quality of Systematic Reviews and Meta-Analyses in Industrial and Organizational Psychology: A Systematic Review.

    Science.gov (United States)

    Schalken, Naomi; Rietbergen, Charlotte

    2017-01-01

    Objective: The goal of this systematic review was to examine the reporting quality of the method section of quantitative systematic reviews and meta-analyses from 2009 to 2016 in the field of industrial and organizational psychology with the help of the Meta-Analysis Reporting Standards (MARS), and to update previous research, such as the study of Aytug et al. (2012) and Dieckmann et al. (2009). Methods: A systematic search for quantitative systematic reviews and meta-analyses was conducted in the top 10 journals in the field of industrial and organizational psychology between January 2009 and April 2016. Data were extracted on study characteristics and items of the method section of MARS. A cross-classified multilevel model was analyzed, to test whether publication year and journal impact factor (JIF) were associated with the reporting quality scores of articles. Results: Compliance with MARS in the method section was generally inadequate in the random sample of 120 articles. Variation existed in the reporting of items. There were no significant effects of publication year and journal impact factor (JIF) on the reporting quality scores of articles. Conclusions: The reporting quality in the method section of systematic reviews and meta-analyses was still insufficient, therefore we recommend researchers to improve the reporting in their articles by using reporting standards like MARS.

  2. An overview of systematic review.

    Science.gov (United States)

    Baker, Kathy A; Weeks, Susan Mace

    2014-12-01

    Systematic review is an invaluable tool for the practicing clinician. A well-designed systematic review represents the latest and most complete information available on a particular topic or intervention. This article highlights the key elements of systematic review, what it is and is not, and provides an overview of several reputable organizations supporting the methodological development and conduct of systematic review. Important aspects for evaluating the quality of a systematic review are also included. Copyright © 2014 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  3. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap.

    OpenAIRE

    Julian H Elliott; Tari Turner; Ornella Clavisi; James Thomas; Julian P T Higgins; Chris Mavergames; Russell L Gruen

    2014-01-01

    The current difficulties in keeping systematic reviews up to date leads to considerable inaccuracy, hampering the translation of knowledge into action. Incremental advances in conventional review updating are unlikely to lead to substantial improvements in review currency. A new approach is needed. We propose living systematic review as a contribution to evidence synthesis that combines currency with rigour to enhance the accuracy and utility of health evidence. Living systematic reviews are ...

  4. Does hippotherapy improve balance in persons with multiple sclerosis: a systematic review.

    Science.gov (United States)

    Bronson, C; Brewerton, K; Ong, J; Palanca, C; Sullivan, S John

    2010-09-01

    Multiple sclerosis (MS) leads to changes in balance due to the breakdown of a number of neurological processes. Hippotherapy utilizes the movement of the horse to provide sensory feedback and has been used as a therapeutic intervention for different neurological conditions. Little is known about the effects of hippotherapy in MS. The purpose of this study is to systematically review and examine the evidence for hippotherapy as an intervention to improve balance in persons with MS. Major electronic databases were searched for articles relating to hippotherapy, MS and balance. Only full length articles published in peer reviewed journals that were written in English or translated into English were included. Articles were assessed using a modified quality index that was used for descriptive purposes only and did not exclude any study from the review. All studies examined in this review were either case-control or case-series. Collectively all three studies reported improvements in balance. Pre-test and post-test Berg Balance Scale scores in two studies revealed that primary progressive MS demonstrated the greatest amount of change after hippotherapy compared to other subtypes of MS. Hippotherapy has a positive effect on balance in persons with MS and has an added benefit of enhancing quality of life. The data is limited and further research will lead to a greater knowledge base and has the potential to increase accessibility for hippotherapy to be used as a rehabilitation modality.

  5. Mobile phone text messaging for improving the uptake of vaccinations: a systematic review protocol.

    Science.gov (United States)

    Kalan, Robyn; Wiysonge, Charles S; Ramafuthole, Tshepiso; Allie, Kurt; Ebrahim, Fatima; Engel, Mark Emmanuel

    2014-08-04

    Low vaccine coverage is a major public health concern, the consequences of which contribute to around 1.5 million child deaths from vaccine-preventable diseases. Thus, innovative strategies to rapidly increase coverage and recall rates for vaccinations are urgently required. Mobile text messaging (or short messaging service, SMS) has the potential to help increase vaccination coverage and therefore we propose to conduct a review of the current best evidence for the use of SMS as an intervention to promote vaccination coverage. This article describes the protocol for a systematic review of the effectiveness of SMS in improving the uptake of vaccination. Primary and secondary outcomes of interest are prespecified. We will preferably include randomised controlled trials (RCTs). However, non-randomised studies (NRS) will be considered if there is an inadequate number of RCTs. We will search several bibliographic databases (eg,PubMed, EMBASE, CINAHL, CENTRAL, Science Citation Index, Africa-Wide Information and WHOLIS electronic databases and search sources for grey literature. Following data extraction and assessment of risk of bias, we will meta-analyse studies and conduct subgroup analyses, according to intervention subtypes. We will assess clinical heterogeneity and statistical heterogeneity. For outcomes without quantitative data, a descriptive analysis will be used. This review protocol is registered in the PROSPERO International Prospective Register of systematic reviews, registration number 2014:CRD42014007531 ETHICS AND DISSEMINATION: Ethics is not required for this study, given that this is a protocol for a systematic review, which uses published data. The findings of this study will be disseminated through peer-reviewed publications and conference presentations. We anticipate that the results could be used by researchers and policymakers to help inform them of the efficacy of mobile phone text messaging interventions to promote increased vaccination coverage

  6. A systematic review of systematic reviews of homeopathy

    Science.gov (United States)

    Ernst, E

    2002-01-01

    Homeopathy remains one of the most controversial subjects in therapeutics. This article is an attempt to clarify its effectiveness based on recent systematic reviews. Electronic databases were searched for systematic reviews/meta-analysis on the subject. Seventeen articles fulfilled the inclusion/exclusion criteria. Six of them related to re-analyses of one landmark meta-analysis. Collectively they implied that the overall positive result of this meta-analysis is not supported by a critical analysis of the data. Eleven independent systematic reviews were located. Collectively they failed to provide strong evidence in favour of homeopathy. In particular, there was no condition which responds convincingly better to homeopathic treatment than to placebo or other control interventions. Similarly, there was no homeopathic remedy that was demonstrated to yield clinical effects that are convincingly different from placebo. It is concluded that the best clinical evidence for homeopathy available to date does not warrant positive recommendations for its use in clinical practice. PMID:12492603

  7. Do systematic reviews on pediatric topics need special methodological considerations?

    Science.gov (United States)

    Farid-Kapadia, Mufiza; Askie, Lisa; Hartling, Lisa; Contopoulos-Ioannidis, Despina; Bhutta, Zulfiqar A; Soll, Roger; Moher, David; Offringa, Martin

    2017-03-06

    Systematic reviews are key tools to enable decision making by healthcare providers and policymakers. Despite the availability of the evidence based Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA-2009 and PRISMA-P 2015) statements that were developed to improve the transparency and quality of reporting of systematic reviews, uncertainty on how to deal with pediatric-specific methodological challenges of systematic reviews impairs decision-making in child health. In this paper, we identify methodological challenges specific to the design, conduct and reporting of pediatric systematic reviews, and propose a process to address these challenges. One fundamental decision at the outset of a systematic review is whether to focus on a pediatric population only, or to include both adult and pediatric populations. Both from the policy and patient care point of view, the appropriateness of interventions and comparators administered to pre-defined pediatric age subgroup is critical. Decisions need to be based on the biological plausibility of differences in treatment effects across the developmental trajectory in children. Synthesis of evidence from different trials is often impaired by the use of outcomes and measurement instruments that differ between trials and are neither relevant nor validated in the pediatric population. Other issues specific to pediatric systematic reviews include lack of pediatric-sensitive search strategies and inconsistent choices of pediatric age subgroups in meta-analyses. In addition to these methodological issues generic to all pediatric systematic reviews, special considerations are required for reviews of health care interventions' safety and efficacy in neonatology, global health, comparative effectiveness interventions and individual participant data meta-analyses. To date, there is no standard approach available to overcome this problem. We propose to develop a consensus-based checklist of essential items which

  8. The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies.

    Science.gov (United States)

    Morrison, Andra; Polisena, Julie; Husereau, Don; Moulton, Kristen; Clark, Michelle; Fiander, Michelle; Mierzwinski-Urban, Monika; Clifford, Tammy; Hutton, Brian; Rabb, Danielle

    2012-04-01

    The English language is generally perceived to be the universal language of science. However, the exclusive reliance on English-language studies may not represent all of the evidence. Excluding languages other than English (LOE) may introduce a language bias and lead to erroneous conclusions. We conducted a comprehensive literature search using bibliographic databases and grey literature sources. Studies were eligible for inclusion if they measured the effect of excluding randomized controlled trials (RCTs) reported in LOE from systematic review-based meta-analyses (SR/MA) for one or more outcomes. None of the included studies found major differences between summary treatment effects in English-language restricted meta-analyses and LOE-inclusive meta-analyses. Findings differed about the methodological and reporting quality of trials reported in LOE. The precision of pooled estimates improved with the inclusion of LOE trials. Overall, we found no evidence of a systematic bias from the use of language restrictions in systematic review-based meta-analyses in conventional medicine. Further research is needed to determine the impact of language restriction on systematic reviews in particular fields of medicine.

  9. Guiding inpatient quality improvement: a systematic review of Lean and Six Sigma.

    Science.gov (United States)

    Glasgow, Justin M; Scott-Caziewell, Jill R; Kaboli, Peter J

    2010-12-01

    Two popular quality improvement (QI) approaches in health care are Lean and Six Sigma. Hospitals continue to adopt these QI approaches-or the hybrid Lean Sigma approach-with little knowledge on how well they produce sustainable improvements. A systematic literature review was conducted to determine whether Lean, Six Sigma, or Lean Sigma have been effectively used to create and sustain improvements in the acute care setting. Databases were searched for articles published in the health care, business, and engineering literatures. Study inclusion criteria required identification of a Six Sigma, Lean, or Lean Sigma project; QI efforts focused on hospitalized patients; descriptions of project improvements; and reported results. Depending on the quality of data reported, articles were classified as summary reports, pre-post observational studies, or time-series reports. Database searches identified 539 potential articles. After review of titles, abstracts, and full text, 47 articles met inclusion criteria--10 articles summarized multiple projects, 12 reported Lean projects, 20 reported Six Sigma projects, and 5 reported Lean Sigma projects. Generally, the studies provided limited data, with only 15 articles providing any sort of follow-up data; of the 15, only 3 report a follow-up period greater than two years. Lean, Six Sigma, and Lean Sigma as QI approaches can aid institutions in tackling a wide variety of problems encountered in acute care. However, the true impact of these approaches is difficult to judge, given that the lack of rigorous evaluation or clearly sustained improvements provides little evidence supporting broad adoption. There is still a need for future work that will improve the evidence base for understanding more about QI approaches and how to achieve sustainable improvement.

  10. Updated method guidelines for cochrane musculoskeletal group systematic reviews and metaanalyses

    DEFF Research Database (Denmark)

    Ghogomu, Elizabeth A T; Maxwell, Lara J; Buchbinder, Rachelle

    2014-01-01

    The Cochrane Musculoskeletal Group (CMSG), one of 53 groups of the not-for-profit, international Cochrane Collaboration, prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. It is important that authors conducting CMSG reviews and the readers of our...... reviews be aware of and use updated, state-of-the-art systematic review methodology. One hundred sixty reviews have been published. Previous method guidelines for systematic reviews of interventions in the musculoskeletal field published in 2006 have been substantially updated to incorporate...... using network metaanalysis. Method guidelines specific to musculoskeletal disorders are provided by CMSG editors for various aspects of undertaking a systematic review. These method guidelines will help improve the quality of reporting and ensure high standards of conduct as well as consistency across...

  11. Improving medication adherence among community-dwelling seniors with cognitive impairment: a systematic review of interventions.

    Science.gov (United States)

    Kröger, Edeltraut; Tatar, Ovidiu; Vedel, Isabelle; Giguère, Anik M C; Voyer, Philippe; Guillaumie, Laurence; Grégoire, Jean-Pierre; Guénette, Line

    2017-08-01

    Background Medication non-adherence may lead to poor therapeutic outcomes. Cognitive functions deteriorate with age, contributing to decreased adherence. Interventions have been tested to improve adherence in seniors with cognitive impairment or Alzheimer disease (AD), but high-quality systematic reviews are lacking. It remains unclear which interventions are promising. Objectives We conducted a systematic review to identify, describe, and evaluate interventions aimed at improving medication adherence among seniors with any type of cognitive impairment. Methods Following NICE guidance, databases and websites were searched using combinations of controlled and free vocabulary. All adherence-enhancing interventions and study designs were considered. Studies had to include community dwelling seniors, aged 65 years or older, with cognitive impairment, receiving at least one medication for a chronic condition, and an adherence measure. Study characteristics and methodological quality were assessed. Results We identified 13 interventions, including six RCTs. Two studies were of poor, nine of low/medium and two of high quality. Seven studies had sample sizes below 50 and six interventions focused on adherence to AD medication. Six interventions tested a behavioral, four a medication oriented, two an educational and one a multi-faceted approach. Studies rarely assessed therapeutic outcomes. All but one intervention showed improved adherence. Conclusion Three medium quality studies showed better adherence with patches than with pills for AD treatment. Promising interventions used educational or reminding strategies, including one high quality RCT. Nine studies were of low/moderate quality. High quality RCTs using a theoretical framework for intervention selection are needed to identify strategies for improved adherence in these seniors.

  12. Conducting systematic reviews of economic evaluations.

    Science.gov (United States)

    Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

    2015-09-01

    types of evidence. The updated JBI guidance will be useful for researchers wanting to synthesize evidence about economic questions, either as stand-alone reviews or part of comprehensive or mixed method evidence reviews. Although the updated methodology produced by the work of the working group has improved the JBI guidance for systematic reviews of economic evaluations, there are areas where further work is required. These include adjusting the critical appraisal tool to separate out questions addressing intervention cost and effectiveness measurement; providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.

  13. Do evidence summaries increase policy-makers' use of evidence from systematic reviews: A systematic review protocol.

    Science.gov (United States)

    Petkovic, Jennifer; Welch, Vivian; Tugwell, Peter

    2015-09-28

    Systematic reviews are important for decision-makers. They offer many potential benefits but are often written in technical language, are too long, and do not contain contextual details which makes them hard to use for decision-making. There are many organizations that develop and disseminate derivative products, such as evidence summaries, from systematic reviews for different populations or subsets of decision-makers. This systematic review will assess the effectiveness of systematic review summaries on increasing policymakers' use of systematic review evidence and to identify the components or features of these summaries that are most effective. We will include studies of policy-makers at all levels as well as health-system managers. We will include studies examining any type of "evidence summary," "policy brief," or other products derived from systematic reviews that present evidence in a summarized form. The primary outcomes are the following: (1) use of systematic review summaries decision-making (e.g., self-reported use of the evidence in policy-making, decision-making) and (2) policy-maker understanding, knowledge, and/or beliefs (e.g., changes in knowledge scores about the topic included in the summary). We will conduct a systematic review of randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), controlled before-after studies (CBA), and interrupted time series (ITS) studies. The results of this review will inform the development of future systematic review summaries to ensure that systematic review evidence is accessible to and used by policy-makers making health-related decisions.

  14. Maca (L. meyenii for improving sexual function: a systematic review

    Directory of Open Access Journals (Sweden)

    Shin Byung-Cheul

    2010-08-01

    Full Text Available Abstract Background Maca (Lepidium meyenii is an Andean plant of the brassica (mustard family. Preparations from maca root have been reported to improve sexual function. The aim of this review was to assess the clinical evidence for or against the effectiveness of the maca plant as a treatment for sexual dysfunction. Methods We searched 17 databases from their inception to April 2010 and included all randomised clinical trials (RCTs of any type of maca compared to a placebo for the treatment of healthy people or human patients with sexual dysfunction. The risk of bias for each study was assessed using Cochrane criteria, and statistical pooling of data was performed where possible. The selection of studies, data extraction, and validations were performed independently by two authors. Discrepancies were resolved through discussion by the two authors. Results Four RCTs met all the inclusion criteria. Two RCTs suggested a significant positive effect of maca on sexual dysfunction or sexual desire in healthy menopausal women or healthy adult men, respectively, while the other RCT failed to show any effects in healthy cyclists. The further RCT assessed the effects of maca in patients with erectile dysfunction using the International Index of Erectile Dysfunction-5 and showed significant effects. Conclusion The results of our systematic review provide limited evidence for the effectiveness of maca in improving sexual function. However, the total number of trials, the total sample size, and the average methodological quality of the primary studies were too limited to draw firm conclusions. More rigorous studies are warranted.

  15. Maca (L. meyenii) for improving sexual function: a systematic review.

    Science.gov (United States)

    Shin, Byung-Cheul; Lee, Myeong Soo; Yang, Eun Jin; Lim, Hyun-Suk; Ernst, Edzard

    2010-08-06

    Maca (Lepidium meyenii) is an Andean plant of the brassica (mustard) family. Preparations from maca root have been reported to improve sexual function. The aim of this review was to assess the clinical evidence for or against the effectiveness of the maca plant as a treatment for sexual dysfunction. We searched 17 databases from their inception to April 2010 and included all randomised clinical trials (RCTs) of any type of maca compared to a placebo for the treatment of healthy people or human patients with sexual dysfunction. The risk of bias for each study was assessed using Cochrane criteria, and statistical pooling of data was performed where possible. The selection of studies, data extraction, and validations were performed independently by two authors. Discrepancies were resolved through discussion by the two authors. Four RCTs met all the inclusion criteria. Two RCTs suggested a significant positive effect of maca on sexual dysfunction or sexual desire in healthy menopausal women or healthy adult men, respectively, while the other RCT failed to show any effects in healthy cyclists. The further RCT assessed the effects of maca in patients with erectile dysfunction using the International Index of Erectile Dysfunction-5 and showed significant effects. The results of our systematic review provide limited evidence for the effectiveness of maca in improving sexual function. However, the total number of trials, the total sample size, and the average methodological quality of the primary studies were too limited to draw firm conclusions. More rigorous studies are warranted.

  16. Interventions to improve patient hand hygiene: a systematic review.

    Science.gov (United States)

    Srigley, J A; Furness, C D; Gardam, M

    2016-09-01

    Nosocomial pathogens may be acquired by patients via their own unclean hands, but there has been relatively little emphasis on patient hand hygiene as a tool for preventing healthcare-associated infections (HCAIs). The aim of this systematic review was to determine the efficacy of patient hand hygiene interventions in reducing HCAIs and improving patient hand hygiene rates compared to usual care. Electronic databases and grey literature were searched to August 2014. Experimental and quasi-experimental studies were included if they evaluated a patient hand hygiene intervention conducted in an acute or chronic healthcare facility and included HCAI incidence and/or patient hand hygiene rates as an outcome. All steps were performed independently by two investigators. Ten studies were included, most of which were uncontrolled before-after studies (N=8). The majority of interventions (N=7) were multi-modal, with components similar to healthcare worker hand hygiene programmes, including education, reminders, audit and feedback, and provision of hand hygiene products. Six studies reported HCAI outcomes and four studies assessed patient hand hygiene rates; all demonstrated improvements but were at moderate to high risk of bias. In conclusion, interventions to improve patient hand hygiene may reduce the incidence of HCAIs and improve hand hygiene rates, but the quality of evidence is low. Future studies should use stronger designs and be more selective in their choice of outcomes. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol

    Directory of Open Access Journals (Sweden)

    Patel Vikram

    2010-10-01

    Full Text Available Abstract Background The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health around the world. Findings To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1 interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2 interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3 interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders. A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms for the following mobile electronic devices (MEDs and a range of compatible media: mobile phone; personal digital assistant (PDA; handheld computer (e.g. tablet PC; PDA phone (e.g. BlackBerry, Palm Pilot; Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player; handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will

  18. The effectiveness of M-health technologies for improving health and health services: a systematic review protocol.

    Science.gov (United States)

    Free, Caroline; Phillips, Gemma; Felix, Lambert; Galli, Leandro; Patel, Vikram; Edwards, Philip

    2010-10-06

    The application of mobile computing and communication technology is rapidly expanding in the fields of health care and public health. This systematic review will summarise the evidence for the effectiveness of mobile technology interventions for improving health and health service outcomes (M-health) around the world. To be included in the review interventions must aim to improve or promote health or health service use and quality, employing any mobile computing and communication technology. This includes: (1) interventions designed to improve diagnosis, investigation, treatment, monitoring and management of disease; (2) interventions to deliver treatment or disease management programmes to patients, health promotion interventions, and interventions designed to improve treatment compliance; and (3) interventions to improve health care processes e.g. appointment attendance, result notification, vaccination reminders.A comprehensive, electronic search strategy will be used to identify controlled studies, published since 1990, and indexed in MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, the Cochrane Library, or the UK NHS Health Technology Assessment database. The search strategy will include terms (and synonyms) for the following mobile electronic devices (MEDs) and a range of compatible media: mobile phone; personal digital assistant (PDA); handheld computer (e.g. tablet PC); PDA phone (e.g. BlackBerry, Palm Pilot); Smartphone; enterprise digital assistant; portable media player (i.e. MP3 or MP4 player); handheld video game console. No terms for health or health service outcomes will be included, to ensure that all applications of mobile technology in public health and health services are identified. Bibliographies of primary studies and review articles meeting the inclusion criteria will be searched manually to identify further eligible studies. Data on objective and self-reported outcomes and study quality will be independently extracted by two review

  19. A low proportion of systematic reviews in physical therapy are registered: a survey of 150 published systematic reviews.

    Science.gov (United States)

    Oliveira, Crystian B; Elkins, Mark R; Lemes, Ítalo Ribeiro; de Oliveira Silva, Danilo; Briani, Ronaldo V; Monteiro, Henrique Luiz; Azevedo, Fábio Mícolis de; Pinto, Rafael Zambelli

    Systematic reviews provide the best evidence about the effectiveness of healthcare interventions. Although systematic reviews are conducted with explicit and transparent methods, discrepancies might occur between the protocol and the publication. To estimate the proportion of systematic reviews of physical therapy interventions that are registered, the methodological quality of (un)registered systematic reviews and the prevalence of outcome reporting bias in registered systematic reviews. A random sample of 150 systematic reviews published in 2015 indexed on the PEDro database. We included systematic reviews written in English, Italian, Portuguese and Spanish. A checklist for assessing the methodological quality of systematic reviews tool was used. Relative risk was calculated to explore the association between meta-analysis results and the changes in the outcomes. Twenty-nine (19%) systematic reviews were registered. Funding and publication in a journal with an impact factor higher than 5.0 were associated with registration. Registered systematic reviews demonstrated significantly higher methodological quality (median=8) than unregistered systematic reviews (median=5). Nine (31%) registered systematic reviews demonstrated discrepancies between protocol and publication with no evidence that such discrepancies were applied to favor the statistical significance of the intervention (RR=1.16; 95% CI: 0.63-2.12). A low proportion of systematic reviews in the physical therapy field are registered. The registered systematic reviews showed high methodological quality without evidence of outcome reporting bias. Further strategies should be implemented to encourage registration. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. The quality of systematic reviews of health-related outcome measurement instruments.

    Science.gov (United States)

    Terwee, C B; Prinsen, C A C; Ricci Garotti, M G; Suman, A; de Vet, H C W; Mokkink, L B

    2016-04-01

    Systematic reviews of outcome measurement instruments are important tools for the selection of instruments for research and clinical practice. Our aim was to assess the quality of systematic reviews of health-related outcome measurement instruments and to determine whether the quality has improved since our previous study in 2007. A systematic literature search was performed in MEDLINE and EMBASE between July 1, 2013, and June 19, 2014. The quality of the reviews was rated using a study-specific checklist. A total of 102 reviews were included. In many reviews the search strategy was considered not comprehensive; in only 59 % of the reviews a search was performed in EMBASE and in about half of the reviews there was doubt about the comprehensiveness of the search terms used for type of measurement instruments and measurement properties. In 41 % of the reviews, compared to 30 % in our previous study, the methodological quality of the included studies was assessed. In 58 %, compared to 55 %, the quality of the included instruments was assessed. In 42 %, compared to 7 %, a data synthesis was performed in which the results from multiple studies on the same instrument were somehow combined. Despite a clear improvement in the quality of systematic reviews of outcome measurement instruments in comparison with our previous study in 2007, there is still room for improvement with regard to the search strategy, and especially the quality assessment of the included studies and the included instruments, and the data synthesis.

  1. Surgical interventions for gastric cancer: a review of systematic reviews.

    Science.gov (United States)

    He, Weiling; Tu, Jian; Huo, Zijun; Li, Yuhuang; Peng, Jintao; Qiu, Zhenwen; Luo, Dandong; Ke, Zunfu; Chen, Xinlin

    2015-01-01

    To evaluate methodological quality and the extent of concordance among meta-analysis and/or systematic reviews on surgical interventions for gastric cancer (GC). A comprehensive search of PubMed, Medline, EMBASE, the Cochrane library and the DARE database was conducted to identify the reviews comparing different surgical interventions for GC prior to April 2014. After applying included criteria, available data were summarized and appraised by the Oxman and Guyatt scale. Fifty six reviews were included. Forty five reviews (80.4%) were well conducted, with scores of adapted Oxman and Guyatt scale ≥ 14. The reviews differed in criteria for avoiding bias and assessing the validity of the primary studies. Many primary studies displayed major methodological flaws, such as randomization, allocation concealment, and dropouts and withdrawals. According to the concordance assessment, laparoscopy-assisted gastrectomy (LAG) was superior to open gastrectomy, and laparoscopy-assisted distal gastrectomy was superior to open distal gastrectomy in short-term outcomes. However, the concordance regarding other surgical interventions, such as D1 vs. D2 lymphadenectomy, and robotic gastrectomy vs. LAG were absent. Systematic reviews on surgical interventions for GC displayed relatively high methodological quality. The improvement of methodological quality and reporting was necessary for primary studies. The superiority of laparoscopic over open surgery was demonstrated. But concordance on other surgical interventions was rare, which needed more well-designed RCTs and systematic reviews.

  2. Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.

    Science.gov (United States)

    Janamian, Tina; Upham, Susan J; Crossland, Lisa; Jackson, Claire L

    2016-04-18

    To conduct a systematic review of the literature to identify existing online primary care quality improvement tools and resources to support organisational improvement related to the seven elements in the Primary Care Practice Improvement Tool (PC-PIT), with the identified tools and resources to progress to a Delphi study for further assessment of relevance and utility. Systematic review of the international published and grey literature. CINAHL, Embase and PubMed databases were searched in March 2014 for articles published between January 2004 and December 2013. GreyNet International and other relevant websites and repositories were also searched in March-April 2014 for documents dated between 1992 and 2012. All citations were imported into a bibliographic database. Published and unpublished tools and resources were included in the review if they were in English, related to primary care quality improvement and addressed any of the seven PC-PIT elements of a high-performing practice. Tools and resources that met the eligibility criteria were then evaluated for their accessibility, relevance, utility and comprehensiveness using a four-criteria appraisal framework. We used a data extraction template to systematically extract information from eligible tools and resources. A content analysis approach was used to explore the tools and resources and collate relevant information: name of the tool or resource, year and country of development, author, name of the organisation that provided access and its URL, accessibility information or problems, overview of each tool or resource and the quality improvement element(s) it addresses. If available, a copy of the tool or resource was downloaded into the bibliographic database, along with supporting evidence (published or unpublished) on its use in primary care. This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in

  3. How effective are interventions to improve social outcomes among offenders with personality disorder: a systematic review.

    Science.gov (United States)

    Connell, Catriona; Furtado, Vivek; McKay, Elizabeth A; Singh, Swaran P

    2017-11-17

    Offenders with personality disorder are supported by health, criminal justice, social care and third sector services. These services are tasked with reducing risk, improving health and improving social outcomes. Research has been conducted into interventions that reduce risk or improve health. However, interventions to improve social outcomes are less clearly defined. To review the effectiveness of interventions to improve social outcomes we conducted a systematic review using Cochrane methodology, expanded to include non-randomised trials. Anticipated high heterogeneity of the studies informed narrative synthesis. Eleven studies met inclusion criteria. Five contained extractable data. No high-quality studies were identified. Outcomes measured clustered around employment and social functioning. Interventions vary and their mechanisms for influencing social outcomes are poorly operationalised. Although change was observed in employment rates, there was no evidence for the effectiveness of these interventions. There is a lack of evidence for effective interventions that improve social outcomes. Further research is recommended to reach consensus on the outcomes of importance, identify the factors that influence these and design theoretically-informed and evidence-based interventions.

  4. Compliance of systematic reviews in veterinary journals with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) literature search reporting guidelines.

    Science.gov (United States)

    Toews, Lorraine C

    2017-07-01

    Complete, accurate reporting of systematic reviews facilitates assessment of how well reviews have been conducted. The primary objective of this study was to examine compliance of systematic reviews in veterinary journals with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for literature search reporting and to examine the completeness, bias, and reproducibility of the searches in these reviews from what was reported. The second objective was to examine reporting of the credentials and contributions of those involved in the search process. A sample of systematic reviews or meta-analyses published in veterinary journals between 2011 and 2015 was obtained by searching PubMed. Reporting in the full text of each review was checked against certain PRISMA checklist items. Over one-third of reviews (37%) did not search the CAB Abstracts database, and 9% of reviews searched only 1 database. Over two-thirds of reviews (65%) did not report any search for grey literature or stated that they excluded grey literature. The majority of reviews (95%) did not report a reproducible search strategy. Most reviews had significant deficiencies in reporting the search process that raise questions about how these searches were conducted and ultimately cast serious doubts on the validity and reliability of reviews based on a potentially biased and incomplete body of literature. These deficiencies also highlight the need for veterinary journal editors and publishers to be more rigorous in requiring adherence to PRISMA guidelines and to encourage veterinary researchers to include librarians or information specialists on systematic review teams to improve the quality and reporting of searches.

  5. The use of maca (Lepidium meyenii) to improve semen quality: A systematic review.

    Science.gov (United States)

    Lee, Myeong Soo; Lee, Hye Won; You, Sooseong; Ha, Ki-Tae

    2016-10-01

    The aim of this review was to assess the evidence for the effectiveness of maca (Lepidium meyenii) in improving semen quality. We searched 11 databases from their inception to March 2016 and included all clinical trials on the improvement of semen quality parameters in infertile and healthy men, regardless of the study design or the type of maca. The risk of bias for each study was assessed using the Cochrane criteria. The selection of studies, data extraction, and validation were performed independently by the first two authors. Discrepancies were resolved through discussion by the same two authors. Five studies - 3 randomized clinical trials (RCTs) and 2 uncontrolled observational studies (UOSs) - met all of the inclusion criteria. One RCT found favorable effects of maca on sperm mobility in infertile men. The two other RCTs showed positive effects of maca on several semen quality parameters in healthy men. The two UOSs also suggested favorable effects of maca on semen quality. The results of our systematic review provide suggestive evidence for the effectiveness of maca in improving semen quality. However, the total number of trials, the total sample size, and the risk of bias of the included studies prevent the drawing firm conclusions. More rigorous studies are warranted. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. A systematic review of peri-operative melatonin

    DEFF Research Database (Denmark)

    Andersen, L P H; Werner, M U; Rosenberg, J

    2014-01-01

    We systematically reviewed randomised controlled trials of peri-operative melatonin. We included 24 studies of 1794 participants that reported eight peri-operative outcomes: anxiety; analgesia; sleep quality; oxidative stress; emergence behaviour; anaesthetic requirements; steal induction......%, respectively. Qualitative reviews suggested the melatonin improved sleep quality and emergence behaviour, and might be capable of reducing oxidative stress and anaesthetic requirements....

  7. Metabolomics as a tool to identify biomarkers to predict and improve outcomes in reproductive medicine: a systematic review.

    Science.gov (United States)

    Bracewell-Milnes, Timothy; Saso, Srdjan; Abdalla, Hossam; Nikolau, Dimitrios; Norman-Taylor, Julian; Johnson, Mark; Holmes, Elaine; Thum, Meen-Yau

    2017-11-01

    Infertility is a complex disorder with significant medical, psychological and financial consequences for patients. With live-birth rates per cycle below 30% and a drive from the Human Fertilisation and Embryology Authority (HFEA) to encourage single embryo transfer, there is significant research in different areas aiming to improve success rates of fertility treatments. One such area is investigating the causes of infertility at a molecular level, and metabolomics techniques provide a platform for studying relevant biofluids in the reproductive tract. The aim of this systematic review is to examine the recent findings for the potential application of metabolomics to female reproduction, specifically to the metabolomics of follicular fluid (FF), embryo culture medium (ECM) and endometrial fluid. To our knowledge no other systematic review has investigated this topic. English peer-reviewed journals on PubMed, Science Direct, SciFinder, were systematically searched for studies investigating metabolomics and the female reproductive tract with no time restriction set for publications. Studies were assessed for quality using the risk of bias assessment and ROBIN-I. There were 21 studies that met the inclusion criteria and were included in the systematic review. Metabolomic studies have been employed for the compositional analysis of various biofluids in the female reproductive tract, including FF, ECM, blastocoele fluid and endometrial fluid. There is some weak evidence that metabolomics technologies studying ECM might be able to predict the viability of individual embryos and implantation rate better than standard embryo morphology, However these data were not supported by randomized the controlled trials (RCTs) which showed no evidence that using metabolomics is able to improve the most important reproductive outcomes, such as clinical pregnancy and live-birth rates. This systematic review provides guidance for future metabolomic studies on biofluids of the female

  8. A systematic review of surgeon-patient communication: strengths and opportunities for improvement.

    Science.gov (United States)

    Levinson, Wendy; Hudak, Pamela; Tricco, Andrea C

    2013-10-01

    Effective communication is critical to patient satisfaction, outcomes of care and malpractice prevention. Surgeons need particularly effective communication skills to discuss complicated procedures and help patients make informed choices. We conducted a systematic review of the literature on surgeon-patient communication. Searches were conducted in MEDLINE, PsycINFO, and Sociological Abstract. Two reviewers screened citations and full-text articles. Quality was appraised using the Critical Appraisal Skills Program tool. Studies were categorized into content of communication, patient satisfaction, relationship of communication to malpractice, and duration of visits. 2794 citations and 74 full-text articles, 21 studies and 13 companion reports were included. Surgeons spent the majority of their time educating patients and helping them to make choices. Surgeons were generally thorough in providing details about surgical conditions and treatments. Surgeons often did not explore the emotions or concerns of patients. Potential areas of improvement included discussing some elements of informed decision making, and expressing empathy. Surgeons can enhance their communication skills, particularly in areas of relative deficiency. Studies in primary care demonstrate communication programs are effective in teaching these skills. These can be adapted to surgical training and ultimately lead to improved outcomes and satisfaction with care. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews.

    Science.gov (United States)

    Halter, Mary; Pelone, Ferruccio; Boiko, Olga; Beighton, Carole; Harris, Ruth; Gale, Julia; Gourlay, Stephen; Drennan, Vari

    2017-01-01

    Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

  10. Economic analysis of the health impacts of housing improvement studies: a systematic review

    Science.gov (United States)

    Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

    2013-01-01

    Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

  11. The impact of improving teamwork on patient outcomes in surgery: A systematic review.

    Science.gov (United States)

    Sun, Rosa; Marshall, Dominic C; Sykes, Mark C; Maruthappu, Mahiben; Shalhoub, Joseph

    2018-05-01

    The aviation industry pioneered formalised crew training in order to improve safety and reduce consequences of non-technical error. This formalised training has been successfully adapted and used to in the field of surgery to improve post-operative patient outcomes. The need to implement teamwork training as an integral part of a surgical programme is increasingly being recognised. We aim to systematically review the impact of surgical teamwork training on post-operative outcomes. Two independent researchers systematically searched MEDLINE and Embase in accordance with PRISMA guidelines. Studies were screened and subjected to inclusion/exclusion criteria. Study characteristics and outcomes were reported and analysed. Our initial search identified 2720 articles. Following duplicate removal, title and abstract screening, 107 full text articles were analysed. Eight articles met our inclusion criteria. Overall, three articles supported a positive effect of good teamwork on post-operative patient outcomes. We identified key areas in study methodology that can be improved upon, including small cohort size, lack of unified training programme, and short training duration, should future studies be designed and implemented in this field. At present, there is insufficient evidence to support the hypothesis that teamwork training interventions improve patient outcomes. We believe that non-significant and conflicting results can be attributed to flaws in methodology and non-uniform training methods. With increasing amounts of evidence in this field, we predict a positive association between teamwork training and patient outcomes will come to light. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  12. Enablers and Barriers to Large-Scale Uptake of Improved Solid Fuel Stoves: A Systematic Review

    Science.gov (United States)

    Puzzolo, Elisa; Stanistreet, Debbi; Pope, Daniel; Bruce, Nigel G.

    2013-01-01

    Background: Globally, 2.8 billion people rely on household solid fuels. Reducing the resulting adverse health, environmental, and development consequences will involve transitioning through a mix of clean fuels and improved solid fuel stoves (IS) of demonstrable effectiveness. To date, achieving uptake of IS has presented significant challenges. Objectives: We performed a systematic review of factors that enable or limit large-scale uptake of IS in low- and middle-income countries. Methods: We conducted systematic searches through multidisciplinary databases, specialist websites, and consulting experts. The review drew on qualitative, quantitative, and case studies and used standardized methods for screening, data extraction, critical appraisal, and synthesis. We summarized our findings as “factors” relating to one of seven domains—fuel and technology characteristics; household and setting characteristics; knowledge and perceptions; finance, tax, and subsidy aspects; market development; regulation, legislation, and standards; programmatic and policy mechanisms—and also recorded issues that impacted equity. Results: We identified 31 factors influencing uptake from 57 studies conducted in Asia, Africa, and Latin America. All domains matter. Although factors such as offering technologies that meet household needs and save fuel, user training and support, effective financing, and facilitative government action appear to be critical, none guarantee success: All factors can be influential, depending on context. The nature of available evidence did not permit further prioritization. Conclusions: Achieving adoption and sustained use of IS at a large scale requires that all factors, spanning household/community and program/societal levels, be assessed and supported by policy. We propose a planning tool that would aid this process and suggest further research to incorporate an evaluation of effectiveness. Citation: Rehfuess EA, Puzzolo E, Stanistreet D, Pope D, Bruce

  13. A Review of Systematic Reviews on Pain Interventions in Hospitalized Infants

    Directory of Open Access Journals (Sweden)

    Janet Yamada

    2008-01-01

    Full Text Available BACKGROUND: Hospitalized infants undergo multiple, repeated painful procedures. Despite continued efforts to prevent procedural pain and improve pain management, clinical guidelines and standards frequently do not reflect the highest quality evidence from systematic reviews.

  14. How to write a systematic review.

    Science.gov (United States)

    Harris, Joshua D; Quatman, Carmen E; Manring, M M; Siston, Robert A; Flanigan, David C

    2014-11-01

    The role of evidence-based medicine in sports medicine and orthopaedic surgery is rapidly growing. Systematic reviews and meta-analyses are also proliferating in the medical literature. To provide the outline necessary for a practitioner to properly understand and/or conduct a systematic review for publication in a sports medicine journal. Review. The steps of a successful systematic review include the following: identification of an unanswered answerable question; explicit definitions of the investigation's participant(s), intervention(s), comparison(s), and outcome(s); utilization of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and PROSPERO registration; thorough systematic data extraction; and appropriate grading of the evidence and strength of the recommendations. An outline to understand and conduct a systematic review is provided, and the difference between meta-analyses and systematic reviews is described. The steps necessary to perform a systematic review are fully explained, including the study purpose, search methodology, data extraction, reporting of results, identification of bias, and reporting of the study's main findings. Systematic reviews or meta-analyses critically appraise and formally synthesize the best existing evidence to provide a statement of conclusion that answers specific clinical questions. Readers and reviewers, however, must recognize that the quality and strength of recommendations in a review are only as strong as the quality of studies that it analyzes. Thus, great care must be used in the interpretation of bias and extrapolation of the review's findings to translation to clinical practice. Without advanced education on the topic, the reader may follow the steps discussed herein to perform a systematic review. © 2013 The Author(s).

  15. A systematic review of interventions aiming to improve involvement in physical activity among adults with intellectual disability.

    Science.gov (United States)

    Brooker, Katie; van Dooren, Kate; McPherson, Lyn; Lennox, Nick; Ware, Robert

    2015-03-01

    Evidence suggests that most adults with intellectual disability do not participate in sufficient amounts of physical activity (PA). A systematic review of peer-reviewed studies that reported an intervention aiming to improve PA levels of adults with intellectual disability was conducted. Keywords related to intellectual disability and physical activity were used to search relevant databases. Studies were excluded if they did not measure PA as an outcome for adults with intellectual disability, were non-English, and were not peer-reviewed. All relevant studies were included in the review regardless of methodological quality and design. Six articles met the inclusion criteria. These included health education or health promotion programs with PA, nutrition, and weight loss components. The quality of studies included in this review was generally poor. Most studies used a prepost design, sample sizes were small, and measurement tools were used that are not valid and reliable for the population assessed. PA interventions have the potential to improve the health and wellbeing of people with intellectual disability, a vulnerable group who require attention from public health practitioners and researchers. Given the health inequities that exist, public health researchers should target efforts to improve PA levels among this group.

  16. Can Team-Based Care Improve Patient Satisfaction? A Systematic Review of Randomized Controlled Trials

    Science.gov (United States)

    Wen, Jin; Schulman, Kevin A.

    2014-01-01

    Background Team-based approaches to patient care are a relatively recent innovation in health care delivery. The effectiveness of these approaches on patient outcomes has not been well documented. This paper reports a systematic review of the relationship between team-based care and patient satisfaction. Methods We searched MEDLINE, EMBASE, Cochrane Library, CINAHL, and PSYCHOINFO for eligible studies dating from inception to October 8, 2012. Eligible studies reported (1) a randomized controlled trial, (2) interventions including both team-based care and non-team-based care (or usual care), and (3) outcomes including an assessment of patient satisfaction. Articles with different settings between intervention and control were excluded, as were trial protocols. The reference lists of retrieved papers were also evaluated for inclusion. Results The literature search yielded 319 citations, of which 77 were screened for further full-text evaluation. Of these, 27 articles were included in the systematic review. The 26 trials with a total of 15,526 participants were included in this systematic review. The pooling result of dichotomous data (number of studies: 10) showed that team-based care had a positive effect on patient satisfaction compared with usual care (odds ratio, 2.09; 95% confidence interval, 1.54 to 2.84); however, combined continuous data (number of studies: 7) demonstrated that there was no significant difference in patient satisfaction between team-based care and usual care (standardized mean difference, −0.02; 95% confidence interval, −0.40 to 0.36). Conclusions Some evidence showed that team-based care is better than usual care in improving patient satisfaction. However, considering the pooling result of continuous data, along with the suboptimal quality of included trials, further large-scale and high-quality randomized controlled trials comparing team-based care and usual care are needed. PMID:25014674

  17. A Web-based archive of systematic review data

    Directory of Open Access Journals (Sweden)

    Ip Stanley

    2012-02-01

    Full Text Available Abstract Systematic reviews have become increasingly critical to informing healthcare policy; however, they remain a time-consuming and labor-intensive activity. The extraction of data from constituent studies comprises a significant portion of this effort, an activity which is often needlessly duplicated, such as when attempting to update a previously conducted review or in reviews of overlapping topics. In order to address these inefficiencies, and to improve the speed and quality of healthcare policy- and decision-making, we have initiated the development of the Systematic Review Data Repository, an open collaborative Web-based repository of systematic review data. As envisioned, this resource would serve as both a central archive and data extraction tool, shared among and freely accessible to organizations producing systematic reviews worldwide. A suite of easy-to-use software tools with a Web frontend would enable researchers to seamlessly search for and incorporate previously deposited data into their own reviews, as well as contribute their own. In developing this resource, we identified a number of technical and non-technical challenges, as well as devised a number of potential solutions, including proposals for systems and software tools to assure data quality, stratify and control user access effectively and flexibly accommodate all manner of study data, as well as means by which to govern and foster adoption of this new resource. Herein we provide an account of the rationale and development of the Systematic Review Data Repository thus far, as well as outline its future trajectory.

  18. Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review.

    Science.gov (United States)

    Chen, Xin-Lin; Mo, Chuan-Wei; Lu, Li-Ya; Gao, Ri-Yang; Xu, Qian; Wu, Min-Feng; Zhou, Qian-Yi; Hu, Yue; Zhou, Xuan; Li, Xian-Tao

    2017-11-01

    To assess the methodological quality of systematic reviews and meta-analyses regarding acupuncture intervention for stroke and the primary studies within them. Two researchers searched PubMed, Cumulative index to Nursing and Allied Health Literature, Embase, ISI Web of Knowledge, Cochrane, Allied and Complementary Medicine, Ovid Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Traditional Chinese Medical Database to identify systematic reviews and meta-analyses about acupuncture for stroke published from the inception to December 2016. Review characteristics and the criteria for assessing the primary studies within reviews were extracted. The methodological quality of the reviews was assessed using adapted Oxman and Guyatt Scale. The methodological quality of primary studies was also assessed. Thirty-two eligible reviews were identified, 15 in English and 17 in Chinese. The English reviews were scored higher than the Chinese reviews (P=0.025), especially in criteria for avoiding bias and the scope of search. All reviews used the quality criteria to evaluate the methodological quality of primary studies, but some criteria were not comprehensive. The primary studies, in particular the Chinese reviews, had problems with randomization, allocation concealment, blinding, dropouts and withdrawals, intent-to-treat analysis and adverse events. Important methodological flaws were found in Chinese systematic reviews and primary studies. It was necessary to improve the methodological quality and reporting quality of both the systematic reviews published in China and primary studies on acupuncture for stroke.

  19. Chicken Essence for Cognitive Function Improvement: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Siew Li Teoh

    2016-01-01

    Full Text Available Chicken essence (CE is a popular traditional remedy in Asia, which is believed to improve cognitive functions. CE company claimed that the health benefits were proven with research studies. A systematic review was conducted to determine the cognitive-enhancing effects of CE. We systematically searched a number of databases for randomized controlled trials with human subjects consuming CE and cognitive tests involved. Cochrane’s Risk of Bias (ROB tool was used to assess the quality of trials and meta-analysis was performed. Seven trials were included, where six healthy subjects and one subject with poorer cognitive functions were recruited. One trial had unclear ROB while the rest had high ROB. For executive function tests, there was a significant difference favoring CE (pooled standardized mean difference (SMD of −0.55 (−1.04, −0.06 and another with no significant difference (pooled SMD of 0.70 (−0.001, 1.40. For short-term memory tests, no significant difference was found (pooled SMD of 0.63 (−0.16, 1.42. Currently, there is a lack of convincing evidence to show a cognitive enhancing effect of CE.

  20. A systematic review and meta-analysis of acupuncture for improving learning and memory ability in animals.

    Science.gov (United States)

    Huang, Kai-Yu; Liang, Shuang; Yu, Mei-Ling; Fu, Shu-Ping; Chen, Xia; Lu, Sheng-Feng

    2016-08-19

    Memory loss is the most prominent symptoms of brain aging, but there is currently no evidence-based treatment strategy. Acupuncture has been widely used in China and the effectiveness for improving learning and memory has been mentioned in previous studies. We conducted this systematic review and meta-analysis to evaluate the effectiveness of acupuncture for improving learning and memory in animal experiments. We searched Pubmed, Embase, Ovid Medline(R), the China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP) and Wanfang data Information Site to collect studies published up to December 2015. Study quality for each included article was evaluated according to the CAMARADES 10-item checklist. Outcome measure is Morris water maze. A meta-analysis was conducted according to the Cochrane systematic review method by using RevMan 5.3 software. Forty-two studies involving 944 animals were included. The quality score of the studies ranged from 2 to 8, with a mean of 5.3. Meta-analysis results showed that 24 studies reported significant effect of acupuncture for decreasing escape latency (-3.00, 95 % CI: -3.78 ~ -2.23, P learning and memory ability in animal models, suggesting it as a candidate therapy for memory loss of aged brain.

  1. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review.

    Science.gov (United States)

    Schoeppe, Stephanie; Alley, Stephanie; Van Lippevelde, Wendy; Bray, Nicola A; Williams, Susan L; Duncan, Mitch J; Vandelanotte, Corneel

    2016-12-07

    Health and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults. Systematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers. Twenty-seven studies were included, most were randomised controlled trials (n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies (n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies (n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics

  2. Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews.

    Science.gov (United States)

    Azar, Farbod Ebadifard; Azami-Aghdash, Saber; Pournaghi-Azar, Fatemeh; Mazdaki, Alireza; Rezapour, Aziz; Ebrahimi, Parvin; Yousefzadeh, Negar

    2017-06-19

    Due to extensive literature in the field of lung cancer and their heterogeneous results, the aim of this study was to systematically review of systematic reviews studies which reviewed the cost-effectiveness of various lung cancer screening and treatment methods. In this systematic review of systematic reviews study, required data were collected searching the following key words which selected from Mesh: "lung cancer", "lung oncology", "lung Carcinoma", "lung neoplasm", "lung tumors", "cost- effectiveness", "systematic review" and "Meta-analysis". The following databases were searched: PubMed, Cochrane Library electronic databases, Google Scholar, and Scopus. Two reviewers (RA and A-AS) evaluated the articles according to the checklist of "assessment of multiple systematic reviews" (AMSTAR) tool. Overall, information of 110 papers was discussed in eight systematic reviews. Authors focused on cost-effectiveness of lung cancer treatments in five systematic reviews. Targeted therapy options (bevacizumab, Erlotinib and Crizotinib) show an acceptable cost-effectiveness. Results of three studies failed to show cost-effectiveness of screening methods. None of the studies had used the meta-analysis method. The Quality of Health Economic Studies (QHES) tool and Drummond checklist were mostly used in assessing the quality of articles. Most perspective was related to the Payer (64 times) and the lowest was related to Social (11times). Most cases referred to Incremental analysis (82%) and also the lowest point of referral was related to Discounting (in 49% of the cases). The average quality score of included studies was calculated 9.2% from 11. Targeted therapy can be an option for the treatment of lung cancer. Evaluation of the cost-effectiveness of computerized tomographic colonography (CTC) in lung cancer screening is recommended. The perspective of the community should be more taken into consideration in studies of cost-effectiveness. Paying more attention to the topic of

  3. Effective implementation of research into practice: an overview of systematic reviews of the health literature.

    Science.gov (United States)

    Boaz, Annette; Baeza, Juan; Fraser, Alec

    2011-06-22

    The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials).

  4. Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review.

    Science.gov (United States)

    Lee, Edward S; Vedanthan, Rajesh; Jeemon, Panniyammakal; Kamano, Jemima H; Kudesia, Preeti; Rajan, Vikram; Engelgau, Michael; Moran, Andrew E

    2016-01-01

    The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). In order to reduce preventable CVD mortality and morbidity, LMIC health systems and health care providers need to improve the delivery and quality of CVD care. As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, we reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. We conducted a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement interventions in LMICs. Conditions selected a priori included hypertension, diabetes, hyperlipidemia, coronary artery disease, stroke, rheumatic heart disease, and congestive heart failure. MEDLINE and EMBASE electronic databases were systematically searched. Studies were categorized as occurring at the system or patient/provider level and as treating the acute or chronic phase of CVD. From 847 articles identified in the electronic search, 49 met full inclusion criteria and were selected for review. Selected studies were performed in 19 different LMICs. There were 10 studies of system level quality improvement interventions, 38 studies of patient/provider interventions, and one study that fit both criteria. At the patient/provider level, regardless of the specific intervention, intensified, team-based care generally led to improved medication adherence and hypertension control. At the system level, studies provided evidence that introduction of universal health insurance coverage improved hypertension and diabetes control. Studies of system and patient/provider level acute coronary syndrome quality improvement interventions yielded inconclusive results. The duration of most studies was less than 12 months. The results of this review suggest that CVD care quality

  5. What do we know about preventing school violence? A systematic review of systematic reviews.

    Science.gov (United States)

    Lester, Soraya; Lawrence, Cayleigh; Ward, Catherine L

    2017-03-01

    Many children across the world are exposed to school violence, which undermines their right to education and adversely affects their development. Studies of interventions for school violence suggest that it can be prevented. However, this evidence base is challenging to navigate. We completed a systematic review of interventions to reduce four types of school violence: (a) peer violence; (b) corporal punishment; (c) student-on-teacher violence and (d) teacher-on-student violence. Reviewers independently searched databases and journals. Included studies were published between 2005 and 2015; in English; considered school-based interventions for children and measured violence as an outcome. Many systematic reviews were found, thus we completed a systematic review of systematic reviews. Only systematic reviews on interventions for intimate partner violence (IPV) and peer aggression were found. These reviews were generally of moderate quality. Research on both types of violence was largely completed in North America. Only a handful of programmes demonstrate promise in preventing IPV. Cognitive behavioral, social-emotional and peer mentoring/mediation programmes showed promise in reducing the levels of perpetration of peer aggression. Further research needs to determine the long-term effects of interventions, potential moderators and mediators of program effects, program effects across different contexts and key intervention components.

  6. A review of the reporting of web searching to identify studies for Cochrane systematic reviews.

    Science.gov (United States)

    Briscoe, Simon

    2018-03-01

    The literature searches that are used to identify studies for inclusion in a systematic review should be comprehensively reported. This ensures that the literature searches are transparent and reproducible, which is important for assessing the strengths and weaknesses of a systematic review and re-running the literature searches when conducting an update review. Web searching using search engines and the websites of topically relevant organisations is sometimes used as a supplementary literature search method. Previous research has shown that the reporting of web searching in systematic reviews often lacks important details and is thus not transparent or reproducible. Useful details to report about web searching include the name of the search engine or website, the URL, the date searched, the search strategy, and the number of results. This study reviews the reporting of web searching to identify studies for Cochrane systematic reviews published in the 6-month period August 2016 to January 2017 (n = 423). Of these reviews, 61 reviews reported using web searching using a search engine or website as a literature search method. In the majority of reviews, the reporting of web searching was found to lack essential detail for ensuring transparency and reproducibility, such as the search terms. Recommendations are made on how to improve the reporting of web searching in Cochrane systematic reviews. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Exercise improves depressive symptoms in older adults: An umbrella review of systematic reviews and meta-analyses.

    Science.gov (United States)

    Catalan-Matamoros, Daniel; Gomez-Conesa, Antonia; Stubbs, Brendon; Vancampfort, Davy

    2016-10-30

    Late-life depression is a growing public health concern. Exercise may be of added value but the literature remains equivocal. We conducted a systematic overview of meta-analyses and an exploratory pooled analysis of previous meta-analyses to determine the effect of exercise on depression in older adults. Two independent researchers searched Pubmed, CINAHL, Cochrane Plus, PsycArticles, and PsycInfo for meta-analyses on exercise in late-life depression. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. We pooled effect sizes from previous meta-analyses of randomized controlled trials to determine the effect of exercise on depression in older adults. The systematic review yielded 3 meta-analyses. In total, 16 unique cohorts of 1487 participants were included. The quality of the three included meta-analyses was considered as "moderate" according to AMSTAR scores. No serious adverse events were reported. Compared to controls (n=583), those exercising (n=541) significantly reduced depressive symptoms. Our umbrella review indicates that exercise is safe and efficacious in reducing depressive symptoms in older people. Since exercise has many other known health benefits, it should be considered as a core intervention in the multidisciplinary treatment of older adults experiencing depression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Systematic Review of the Application of Lean and Six Sigma Quality Improvement Methodologies in Radiology.

    Science.gov (United States)

    Amaratunga, Thelina; Dobranowski, Julian

    2016-09-01

    Preventable yet clinically significant rates of medical error remain systemic, while health care spending is at a historic high. Industry-based quality improvement (QI) methodologies show potential for utility in health care and radiology because they use an empirical approach to reduce variability and improve workflow. The aim of this review was to systematically assess the literature with regard to the use and efficacy of Lean and Six Sigma (the most popular of the industrial QI methodologies) within radiology. MEDLINE, the Allied & Complementary Medicine Database, Embase Classic + Embase, Health and Psychosocial Instruments, and the Ovid HealthStar database, alongside the Cochrane Library databases, were searched on June 2015. Empirical studies in peer-reviewed journals were included if they assessed the use of Lean, Six Sigma, or Lean Six Sigma with regard to their ability to improve a variety of quality metrics in a radiology-centered clinical setting. Of the 278 articles returned, 23 studies were suitable for inclusion. Of these, 10 assessed Six Sigma, 7 assessed Lean, and 6 assessed Lean Six Sigma. The diverse range of measured outcomes can be organized into 7 common aims: cost savings, reducing appointment wait time, reducing in-department wait time, increasing patient volume, reducing cycle time, reducing defects, and increasing staff and patient safety and satisfaction. All of the included studies demonstrated improvements across a variety of outcomes. However, there were high rates of systematic bias and imprecision as per the Grading of Recommendations Assessment, Development and Evaluation guidelines. Lean and Six Sigma QI methodologies have the potential to reduce error and costs and improve quality within radiology. However, there is a pressing need to conduct high-quality studies in order to realize the true potential of these QI methodologies in health care and radiology. Recommendations on how to improve the quality of the literature are proposed

  9. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Wells Cherie

    2013-01-01

    Full Text Available Abstract Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back

  10. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews

    Science.gov (United States)

    2013-01-01

    Background Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. Methods This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. Results A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. Conclusion There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small

  11. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews.

    Science.gov (United States)

    Wells, Cherie; Kolt, Gregory S; Marshall, Paul; Hill, Bridget; Bialocerkowski, Andrea

    2013-01-19

    Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological

  12. Systematic review on the financial return of worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity

    NARCIS (Netherlands)

    Dongen, J.M. van; Proper, K.I.; Wier, M.F. van; Beek, A.J. van der; Bongers, P.M.; Mechelen, W. van; Tulder, M.W. van

    2011-01-01

    Summary: This systematic review summarizes the current evidence on the financial return of worksite health promotion programmes aimed at improving nutrition and/or increasing physical activity. Data on study characteristics and results were extracted from 18 studies published up to 14 January 2011.

  13. Effectiveness of Interventions to Address Visual and Visual-Perceptual Impairments to Improve Occupational Performance in Adults With Traumatic Brain Injury: A Systematic Review.

    Science.gov (United States)

    Berger, Sue; Kaldenberg, Jennifer; Selmane, Romeissa; Carlo, Stephanie

    2016-01-01

    Visual and visual-perceptual impairments occur frequently with traumatic brain injury (TBI) and influence occupational performance. This systematic review examined the effectiveness of interventions within the scope of occupational therapy to improve occupational performance for adults with visual and visual-perceptual impairments as a result of TBI. Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews were searched, and 66 full text articles were reviewed. Sixteen articles were included in the review. Strong evidence supports the use of scanning, limited evidence supports the use of adaptive strategies, and mixed evidence supports the use of cognitive interventions to improve occupational performance for adults with TBI. Evidence related to vision therapy varies on the basis of the specific intervention implemented. Although the strength of the research varied, implications are discussed for practice, education, and research. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  14. Evaluating clinical librarian services: a systematic review.

    Science.gov (United States)

    Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

    2011-03-01

      Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  15. Effective intervention strategies to improve health outcomes for cardiovascular disease patients with low health literacy skills: a systematic review.

    Science.gov (United States)

    Lee, Tae Wha; Lee, Seon Heui; Kim, Hye Hyun; Kang, Soo Jin

    2012-12-01

    Systematic studies on the relationship between health literacy and health outcomes demonstrate that as health literacy declines, patients engage in fewer preventive health and self-care behaviors and have worse disease-related knowledge. The purpose of this study was to identify effective intervention strategies to improve health outcomes in patients with cardiovascular disease and low literacy skills. This study employs the following criteria recommended by Khan Kunz, Keijnen, and Antes (2003) for systematic review: framing question, identifying relevant literature, assessing quality of the literature, summarizing the evidence, and interpreting the finding. A total of 235 articles were reviewed by the research team, and 9 articles met inclusion criteria. Although nine studies were reviewed for their health outcomes, only six studies, which had a positive quality grade evaluation were used to recommend effective intervention strategies. Interventions were categorized into three groups: tailored counseling, self-monitoring, and periodic reminder. The main strategies used to improve health outcomes of low literacy patients included tailored counseling, improved provider-patient interactions, organizing information by patient preference, self-care algorithms, and self-directed learning. Specific strategies included written materials tailored to appropriate reading levels, materials using plain language, emphasizing key points with large font size, and using visual items such as icons or color codes. With evidence-driven strategies, health care professionals can use tailored interventions to provide better health education and counseling that meets patient needs and improves health outcomes. Copyright © 2012. Published by Elsevier B.V.

  16. Methodology in conducting a systematic review of systematic reviews of healthcare interventions.

    LENUS (Irish Health Repository)

    Smith, Valerie

    2011-02-01

    Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need.

  17. Effective implementation of research into practice: an overview of systematic reviews of the health literature

    Directory of Open Access Journals (Sweden)

    Fraser Alec

    2011-06-01

    Full Text Available Abstract Background The gap between research findings and clinical practice is well documented and a range of interventions has been developed to increase the implementation of research into clinical practice. Findings A review of systematic reviews of the effectiveness of interventions designed to increase the use of research in clinical practice. A search for relevant systematic reviews was conducted of Medline and the Cochrane Database of Reviews 1998-2009. 13 systematic reviews containing 313 primary studies were included. Four strategy types are identified: audit and feedback; computerised decision support; opinion leaders; and multifaceted interventions. Nine of the reviews reported on multifaceted interventions. This review highlights the small effects of single interventions such as audit and feedback, computerised decision support and opinion leaders. Systematic reviews of multifaceted interventions claim an improvement in effectiveness over single interventions, with effect sizes ranging from small to moderate. This review found that a number of published systematic reviews fail to state whether the recommended practice change is based on the best available research evidence. Conclusions This overview of systematic reviews updates the body of knowledge relating to the effectiveness of key mechanisms for improving clinical practice and service development. Multifaceted interventions are more likely to improve practice than single interventions such as audit and feedback. This review identified a small literature focusing explicitly on getting research evidence into clinical practice. It emphasizes the importance of ensuring that primary studies and systematic reviews are precise about the extent to which the reported interventions focus on changing practice based on research evidence (as opposed to other information codified in guidelines and education materials.

  18. Nitrate supplementation improves physical performance specifically in non-athletes during prolonged open-ended tests: a systematic review and meta-analysis.

    Science.gov (United States)

    Campos, Helton O; Drummond, Lucas R; Rodrigues, Quezia T; Machado, Frederico S M; Pires, Washington; Wanner, Samuel P; Coimbra, Cândido C

    2018-03-01

    Nitrate (NO3 -) is an ergogenic nutritional supplement that is widely used to improve physical performance. However, the effectiveness of NO3 - supplementation has not been systematically investigated in individuals with different physical fitness levels. The present study analysed whether different fitness levels (non-athletes v. athletes or classification of performance levels), duration of the test used to measure performance (short v. long duration) and the test protocol (time trials v. open-ended tests v. graded-exercise tests) influence the effects of NO3 - supplementation on performance. This systematic review and meta-analysis was conducted and reported according to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. A systematic search of electronic databases, including PubMed, Web of Science, SPORTDiscus and ProQuest, was performed in August 2017. On the basis of the search and inclusion criteria, fifty-four and fifty-three placebo-controlled studies evaluating the effects of NO3 - supplementation on performance in humans were included in the systematic review and meta-analysis, respectively. NO3 - supplementation was ergogenic in non-athletes (mean effect size (ES) 0·25; 95 % CI 0·11, 0·38), particularly in evaluations of performance using long-duration open-ended tests (ES 0·47; 95 % CI 0·23, 0·71). In contrast, NO3 - supplementation did not enhance the performance of athletes (ES 0·04; 95 % CI -0·05, 0·15). After objectively classifying the participants into different performance levels, the frequency of trials showing ergogenic effects in individuals classified at lower levels was higher than that in individuals classified at higher levels. Thus, the present study indicates that dietary NO3 - supplementation improves physical performance in non-athletes, particularly during long-duration open-ended tests.

  19. The effect of mobile application interventions on influencing healthy maternal behaviour and improving perinatal health outcomes: a systematic review protocol.

    Science.gov (United States)

    Daly, Lisa M; Horey, Dell; Middleton, Philippa F; Boyle, Frances M; Flenady, Vicki

    2017-02-08

    Perinatal morbidity and mortality remain significant public health issues globally, with enduring impact on the health and well-being of women and their families. Pregnant women who adopt, practice and maintain healthy behaviours can potentially improve the health of themselves and their babies. Mobile applications are an increasingly popular mode of accessing, storing and sharing health information among pregnant women. The main objective of this review is to evaluate the effects of mobile application interventions during pregnancy on maternal behaviour and associated maternal and infant outcomes. This review will include randomised and non-randomised studies which tested use of mobile applications designed to improve either maternal knowledge or behaviours to address known risk factors associated with adverse perinatal health outcomes. This review will include studies which included pregnant women and/or women during birth. The search strategy will utilise a combination of keywords and MeSH terms. Literature databases such as PubMed, Embase, The Cochrane Library, CINAHL and WHO Global Health Library will be searched. Two reviewers will independently screen retrieved citations to determine if they meet inclusion criteria. Studies will be selected that provide information about interventions commenced in early pregnancy, late pregnancy or labour. Comparisons to be made include mobile applications versus interventions relying on paper-based or text-messaging-based communication; interpersonal communication such as face-to-face or telephone conversation; and no intervention or standard care. Quality assessment of included randomised studies will utilise established guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. Quality assessment of non-randomised studies will be based on the Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-I) assessment tool. Quality of the evidence will be evaluated using the Grades of

  20. The Effectiveness of Mobile Phone Text Messaging in Improving Medication Adherence for Patients with Chronic Diseases: A Systematic Review.

    Science.gov (United States)

    Ershad Sarabi, Roghayeh; Sadoughi, Farahnaz; Jamshidi Orak, Roohangiz; Bahaadinbeigy, Kambiz

    2016-05-01

    Medication non-adherence is a commonly observed problem in the self-administration of treatment, regardless of the disease type. Text messaging reminders, as electronic reminders, provide an opportunity to improve medication adherence. In this study, we aimed to provide evidence addressing the question of whether text message reminders were effective in improving patients' adherence to medication. We carried out a systematic literature search, using the five electronic bibliographic databases: PubMed, Embase, PsycINFO, CINAHL, and the Cochrane central register of controlled trials. Studies were included on the basis of whether they examined the benefits and effects of short-message service (SMS) interventions on medication adherence. The results of this systematic review indicated that text messaging interventions have improved patients' medication adherence rate (85%, 29.34). Included in the review, those who had problems with adherence, or those whom text messaging was most helpful had HIV, asthma, diabetes, schizophrenia and heart disease (73.5%). The period of intervention varied from 1 week to 14 months. The most common study design was randomized controlled trials (RCTs) (66%) carried out in the developed countries. This study demonstrated the potential of mobile phone text messaging for medication non-adherence problem solving.

  1. Effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries: A Systematic Review.

    Science.gov (United States)

    Tilahun, Dejene; Birhanu, Zewdie

    2011-01-01

    Background A great burden of infant and under-five childhood mortality occurs during the neonatal period, usually within a few days of birth. Community based behavioural change communication (such as interpersonal, group and mass media channels, including participatory methods at community level) intervention trials have been shown to be effective in reducing this mortality. However, to guide policy makers and programme planners, there is a need to systematically appraise and synthesise this evidence.Objective To systematically search, appraise and synthesise the best available evidence on the effect of community based behavioural change communication intervention to improve neonatal mortality in developing countries.Inclusion Criteria This review considered randomised controlled community trials on the effectiveness of community based behavioural change communication interventions aimed at decreasing neonatal mortality that were conducted in developing countries.Search Strategy This review considered English language articles on studies published between December, 2006 to January, 2011 and indexed in PubMed, CINAHL, EMBASE, Mednar, popline, Proquest, or Hinari.Methodological quality Studies that met the inclusion criteria were assessed for methodological quality using the Joanna Briggs Institute Meta Analysis of Statistical Assessment and Review Instrument by two independent reviewers. Data were analysed using a fixed effects model with RevMan5 software. Community based behavioural change communication interventions were found to be associated with a significant reduction in neonatal mortality of 19% (average OR 0.81; 95%CI 0. to 0.88), early neonatal mortality by 20% (average 0.80; 95%CI 0. to 0.91), late neonatal mortality by 21% (average 0.79; 95%CI 0. to 0.99). In addition, the intervention also resulted in significant improvement of newborn care practice; breast feeding initiation, clean cord cutting and delay in bathing were improved by 185%, 110% and 196

  2. Can exercise improve self esteem in children and young people? A systematic review of randomised controlled trials.

    Science.gov (United States)

    Ekeland, E; Heian, F; Hagen, K B

    2005-11-01

    A systematic review to determine if exercise alone or as part of a comprehensive intervention can improve self esteem in children and young people is described. Twenty three randomised controlled trials were analysed. A synthesis of several small, low quality trials indicates that exercise may have short term beneficial effects on self esteem in children and adolescents. However, high quality research on defined populations with adequate follow up is needed.

  3. The use of mobile apps to improve nutrition outcomes: A systematic literature review.

    Science.gov (United States)

    DiFilippo, Kristen N; Huang, Wen-Hao; Andrade, Juan E; Chapman-Novakofski, Karen M

    2015-07-01

    We conducted a systematic review to determine if the use of nutrition apps resulted in improved outcomes, including knowledge and behavior, among healthy adults. Using app(s), cellular phone, iPads, mobile phone, mobile telephone, smart phone, mobile and mHealth as search terms with diet, food and nutrition as qualifiers we searched PubMed, CINAHL (January 2008-October 2013) and Web of Science (January 2008-January 2014). Inclusion criteria were peer-reviewed randomized controlled trials, non-controlled trials, and cohort studies published in English that used apps to increase nutrition knowledge or improve behavior related to nutrition. Studies that were descriptive, did not include apps, focused on app development, app satisfaction app feasibility, text messaging, or digital photography were excluded. We evaluated article quality using the Academy of Nutrition and Dietetics Evidence Analysis Manual. Data was extracted for knowledge, behavior and weight change. Our initial search identified 12,010 titles from PubMed, 260 from CINAHL and 4762 from Web of Science; of these, only four articles met all search criteria. Positive quality ratings were given to three articles; only one reported knowledge outcomes (non-significant). All four articles evaluated weight loss and suggested an advantage to using nutrition apps. Behavioral changes in reviewed studies included increased adherence to diet monitoring (p app (p = 0.024). Few studies, however, have explored the use of nutrition apps as supportive educational interventions. Most apps focus on weight loss with inconsistent outcomes. We conclude that using apps for education needs additional research which includes behavior theory within the app and improved study design. © The Author(s) 2015.

  4. Patients' involvement in improvement initiatives: a qualitative systematic review.

    Science.gov (United States)

    van, Claire; McInerney, Patricia; Cooke, Richard

    2015-10-01

    Over the last 20 years, quality improvement in health has become an important strategy in health services in many countries. With the emphasis on quality health care, there has been a shift in social paradigms towards including service users in their own health on different levels. There is growing evidence in literature on the positive impact on health outcomes where patients are active participants in their personal care. There is however less information available on the broader influence of users on improvement in systems. The objective of this review was to identify the barriers and enablers to patients being involved in quality improvement efforts directed towards their own health care. This review considered studies that included adults and children of any age experiencing any health problem.The review considered studies that explored patient or user participation in quality improvement and the factors enabling and hindering this processThe qualitative component of this review considered studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research. Other texts such as opinion papers and reports were also considered. The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilized in this review. The searches using all identified keywords and index terms included the databases PubMed, PsycINFO, Medline, Scopus, EBSCOhost and CINAHL.Qualitative, text and opinion papers were considered for inclusion in this review.Closely related concepts like community involvement, family involvement, patients' involvement in their own care (for example, in the case of shared decision making), and patient centeredness in the context of a consultation were excluded. Qualitative and textual papers selected for retrieval were assessed by two independent reviewers for authenticity prior to inclusion in the review using

  5. Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review.

    Science.gov (United States)

    Saracoglu, Ismail; Emuk, Yusuf; Taspinar, Ferruh

    2018-04-01

    Taping is used with or without other interventions for many purposes, especially to manage pain and improve functional activity in patients with shoulder pain. The aim of this review was to determine whether any taping technique in addition to physiotherapy care is more effective than physiotherapy care alone in patients with shoulder impingement syndrome. A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID), The Kinesio Kinesio® Taping Method, Kinesio® Tex Tape UK and International websites ( www.kinesiotaping.co.uk ; www.kinesiotaping.com ) was conducted to June 2015. The outcome measures were pain, disability, range of motion and muscle strength. As data were not suitable for meta-analysis, narrative synthesis were applied. Three randomized controlled trials and one controlled trial (135 patients) were included. The results were conflicting and weak on the effectiveness of taping as an adjunct therapy for improvement of pain, disability, range of motion and muscle strength. Clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with shoulder impingement syndrome, especially for the initial stage of the treatment; however, we need further robust, placebo controlled and consistent studies to prove whether it is more effective than physiotherapy interventions without taping.

  6. Interventions to improve work outcomes in work-related PTSD: a systematic review

    Directory of Open Access Journals (Sweden)

    Bonato Sarah

    2011-10-01

    Full Text Available Abstract Background Posttraumatic stress disorder acquired at work can be debilitating both for workers and their employers. The disorder can result in increased sick leave, reduced productivity, and even unemployment. Furthermore, workers are especially unlikely to return to their previous place of employment after a traumatic incident at work because of the traumatic memories and symptoms of avoidance that typically accompany the disorder. Therefore, intervening in work-related PTSD becomes especially important in order to get workers back to the workplace. Methods A systematic literature search was conducted using Medline, PsycINFO, Embase, and Web of Science. The articles were independently screened based on inclusion and exclusion criteria, followed by a quality assessment of all included articles. Results The systematic search identified seven articles for inclusion in the review. These consisted of six research articles and one systematic review. The review focused specifically on interventions using real exposure techniques for anxiety disorders in the workplace. In the research articles addressed in the current review, study populations included police officers, public transportation workers, and employees injured at work. The studies examined the effectiveness of EMDR, cognitive-behavioural techniques, and an integrative therapy approach called brief eclectic psychotherapy. Interestingly, 2 of the 6 research articles addressed add-on treatments for workplace PTSD, which were designed to treat workers with PTSD who failed to respond to traditional evidence-based psychotherapy. Conclusions Results of the current review suggest that work-related interventions show promise as effective strategies for promoting return to work in employees who acquired PTSD in the workplace. Further research is needed in this area to determine how different occupational groups with specific types of traumatic exposure might respond differently to work

  7. Satisfaction measurement instruments for healthcare service users: a systematic review

    OpenAIRE

    Almeida, Renato Santos de; Bourliataux-Lajoinie, Stephane; Martins, Mônica

    2015-01-01

    Patient satisfaction surveys can be an interesting way to improve quality and discuss the concept of patient-centered care. This study aimed to conduct a systematic review of the validated patient satisfaction measurement instruments applied in healthcare. The systematic review searched the MEDLINE/PubMed, LILACS, SciELO, Scopus and Web of Knowledge. The search strategy used the terms: "Patient Satisfaction" AND "Patient centered care" AND "Healthcare survey OR Satisfaction questionnaire" AND...

  8. Usefulness of systematic review search strategies in finding child health systematic reviews in MEDLINE

    NARCIS (Netherlands)

    Boluyt, Nicole; Tjosvold, Lisa; Lefebvre, Carol; Klassen, Terry P.; Offringa, Martin

    2008-01-01

    OBJECTIVE: To determine the sensitivity and precision of existing search strategies for retrieving child health systematic reviews in MEDLINE using PubMed. DESIGN: Filter (diagnostic) accuracy study. We identified existing search strategies for systematic reviews, combined them with a filter that

  9. Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Lu, Zhihua; Lin, Guiting; Reed-Maldonado, Amanda; Wang, Chunxi; Lee, Yung-Chin; Lue, Tom F

    2017-02-01

    As a novel therapeutic method for erectile dysfunction (ED), low-intensity extracorporeal shock wave treatment (LI-ESWT) has been applied recently in the clinical setting. We feel that a summary of the current literature and a systematic review to evaluate the therapeutic efficacy of LI-ESWT for ED would be helpful for physicians who are interested in using this modality to treat patients with ED. A systematic review of the evidence regarding LI-ESWT for patients with ED was undertaken with a meta-analysis to identify the efficacy of the treatment modality. A comprehensive search of the PubMed and Embase databases to November 2015 was performed. Studies reporting on patients with ED treated with LI-ESWT were included. The International Index of Erectile Function (IIEF) and the Erection Hardness Score (EHS) were the most commonly used tools to evaluate the therapeutic efficacy of LI-ESWT. There were 14 studies including 833 patients from 2005 to 2015. Seven studies were randomized controlled trials (RCTs); however, in these studies, the setup parameters of LI-ESWT and the protocols of treatment were variable. The meta-analysis revealed that LI-ESWT could significantly improve IIEF (mean difference: 2.00; 95% confidence interval [CI], 0.99-3.00; pwaves per treatment, and duration of LI-ESWT treatment were closely related to clinical outcome, especially regarding IIEF improvement. The number of studies of LI-ESWT for ED have increased dramatically in recent years. Most of these studies presented encouraging results, regardless of variation in LI-ESWT setup parameters or treatment protocols. These studies suggest that LI-ESWT could significantly improve the IIEF and EHS of ED patients. The publication of robust evidence from additional RCTs and longer-term follow-up would provide more confidence regarding use of LI-ESWT for ED patients. We reviewed 14 studies of men who received low-intensity extracorporeal shock wave treatment (LI-ESWT) for erectile dysfunction (ED

  10. Assessment of Fidelity in Interventions to Improve Hand Hygiene of Healthcare Workers: A Systematic Review

    Science.gov (United States)

    Musuuza, Jackson S.; Barker, Anna; Ngam, Caitlyn; Vellardita, Lia; Safdar, Nasia

    2016-01-01

    OBJECTIVE Compliance with hand hygiene in healthcare workers is fundamental to infection prevention yet remains a challenge to sustain. We examined fidelity reporting in interventions to improve hand hygiene compliance, and we assessed 5 measures of intervention fidelity: (1) adherence, (2) exposure or dose, (3) quality of intervention delivery, (4) participant responsiveness, and (5) program differentiation. DESIGN Systematic review METHODS A librarian performed searches of the literature in PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, and Web of Science of material published prior to June 19, 2015. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews, and assessment of study quality was conducted for each study reviewed. RESULTS A total of 100 studies met the inclusion criteria. Only 8 of these 100 studies reported all 5 measures of intervention fidelity. In addition, 39 of 100 (39%) failed to include at least 3 fidelity measures; 20 of 100 (20%) failed to include 4 measures; 17 of 100 (17%) failed to include 2 measures, while 16 of 100 (16%) of the studies failed to include at least 1 measure of fidelity. Participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. CONCLUSIONS Almost all hand hygiene intervention studies failed to report at least 1 fidelity measurement. To facilitate replication and effective implementation, reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene. PMID:26861117

  11. Factors contributing to chronic ankle instability: a protocol for a systematic review of systematic reviews.

    Science.gov (United States)

    Thompson, Cassandra; Schabrun, Siobhan; Romero, Rick; Bialocerkowski, Andrea; Marshall, Paul

    2016-06-07

    Ankle sprains are a significant clinical problem. Researchers have identified a multitude of factors contributing to the presence of recurrent ankle sprains including deficits in balance, postural control, kinematics, muscle activity, strength, range of motion, ligament laxity and bone/joint characteristics. Unfortunately, the literature examining the presence of these factors in chronic ankle instability (CAI) is conflicting. As a result, researchers have attempted to integrate this evidence using systematic reviews to reach conclusions; however, readers are now faced with an increasing number of systematic review findings that are also conflicting. The overall aim of this review is to critically appraise the methodological quality of previous systematic reviews and pool this evidence to identify contributing factors to CAI. A systematic review will be conducted on systematic reviews that investigate the presence of various deficits identified in CAI. Databases will be searched using pre-determined search terms. Reviews will then be assessed for inclusion based on the set eligibility criteria. Two independent reviewers will assess the articles for inclusion before evaluating the methodological quality and presence of bias of the included studies; any disagreements will be resolved by discussion between reviewers to reach consensus or by a third reviewer. Data concerning the specific research question, search strategy, inclusion/exclusion criteria, population, method and outcomes will be extracted. Findings will be analysed with respect to the methodological quality of the included reviews. It is expected that this review will clarify the cause of contradicting findings in the literature and facilitate future research directions. PROSPERO CRD42016032592 .

  12. Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review

    Directory of Open Access Journals (Sweden)

    Andrea M Bruder

    2017-10-01

    Registration: CRD42016041818. [Bruder AM, Shields N, Dodd KJ, Taylor NF (2017 Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. Journal of Physiotherapy 63: 205–220

  13. Can Communicating Personalised Disease Risk Promote Healthy Behaviour Change? A Systematic Review of Systematic Reviews.

    Science.gov (United States)

    French, David P; Cameron, Elaine; Benton, Jack S; Deaton, Christi; Harvie, Michelle

    2017-10-01

    The assessment and communication of disease risk that is personalised to the individual is widespread in healthcare contexts. Despite several systematic reviews of RCTs, it is unclear under what circumstances that personalised risk estimates promotes change in four key health-related behaviours: smoking, physical activity, diet and alcohol consumption. The present research aims to systematically identify, evaluate and synthesise the findings of existing systematic reviews. This systematic review of systematic reviews followed published guidance. A search of four databases and two-stage screening procedure with good reliability identified nine eligible systematic reviews. The nine reviews each included between three and 15 primary studies, containing 36 unique studies. Methods of personalising risk feedback included imaging/visual feedback, genetic testing, and numerical estimation from risk algorithms. The reviews were generally high quality. For a broad range of methods of estimating and communicating risk, the reviews found no evidence that risk information had strong or consistent effects on health-related behaviours. The most promising effects came from interventions using visual or imaging techniques and with smoking cessation and dietary behaviour as outcomes, but with inconsistent results. Few interventions explicitly used theory, few targeted self-efficacy or response efficacy, and a limited range of Behaviour Change Techniques were used. Presenting risk information on its own, even when highly personalised, does not produce strong effects on health-related behaviours or changes which are sustained. Future research in this area should build on the existing knowledge base about increasing the effects of risk communication on behaviour.

  14. Interventions to promote healthy eating choices when dining out: A systematic review of reviews.

    Science.gov (United States)

    Wright, Breanna; Bragge, Peter

    2018-05-01

    To synthesize review research pertaining to the effectiveness of interventions in dining-out settings to reduce food/calorie consumption. A rapid review methodology was employed to focus on synthesized research. A comprehensive search for peer-reviewed systematic reviews from 2010 to 2015 yielded 1,847 citations. Following screening, ten systematic reviews were included. The 10 included systematic reviews identified 183 primary studies evaluating evidence in three behavioural intervention areas: social models/norms, manipulation of size, and provision of health information. Three systematic reviews evaluating the use of social models/norms found this was an effective intervention for influencing food intake. Five systematic reviews that assessed manipulation of portion/dishware/cutlery size found a small-to-moderate effect on food consumption. Three systematic reviews looked at the provision of health information, which was not effective alone; however, in combination with contextual or interpretive material such as traffic lights or exercise equivalence, this was shown to reduce calorie consumption. One systematic review covered two topic areas. The results indicate that policies or interventions that aim to improve healthy choices or consumption when dining out would benefit from harnessing social norms and positive positioning of social identity. Furthermore, provision of health information should always be accompanied by an interpretative guide, such as traffic lights. Manipulation of plate/portion/cutlery size may be effective; however, the effect size is small and further research is required to investigate whether this effect is retained in overweight or obese populations. Statement of contribution What is already known on this subject? Eating behaviours (food choices, consumption) have played a role in the obesity epidemic. Behavioural 'nudges' have tried to increase healthier eating choices. What does this study add? Social norms and modelling have a

  15. Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care.

    Science.gov (United States)

    Hermenau, Katharin; Goessmann, Katharina; Rygaard, Niels Peter; Landolt, Markus A; Hecker, Tobias

    2017-12-01

    Quality of child care has been shown to have a crucial impact on children's development and psychological adjustment, particularly for orphans with a history of maltreatment and trauma. However, adequate care for orphans is often impacted by unfavorable caregiver-child ratios and poorly trained, overburdened personnel, especially in institutional care in countries with limited resources and large numbers of orphans. This systematic review investigated the effects of structural interventions and caregiver trainings on child development in institutional environments. The 24 intervention studies included in this systematic review reported beneficial effects on the children's emotional, social, and cognitive development. Yet, few studies focused on effects of interventions on the child-caregiver relationship or the general institutional environment. Moreover, our review revealed that interventions aimed at improving institutional care settings have largely neglected violence and abuse prevention. Unfortunately, our findings are partially limited by constraints of study design and methodology. In sum, this systematic review sheds light on obstacles and possibilities for the improvement in institutional care. There must be greater efforts at preventing violence, abuse, and neglect of children living in institutional care. Therefore, we advocate for combining attachment theory-based models with maltreatment prevention approaches and then testing them using rigorous scientific standards. By using approaches grounded in the evidence, it could be possible to enable more children to grow up in supportive and nonviolent environments.

  16. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

    2017-09-01

    Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

  17. Optimizing literature search in systematic reviews

    DEFF Research Database (Denmark)

    Aagaard, Thomas; Lund, Hans; Juhl, Carsten Bogh

    2016-01-01

    BACKGROUND: When conducting systematic reviews, it is essential to perform a comprehensive literature search to identify all published studies relevant to the specific research question. The Cochrane Collaborations Methodological Expectations of Cochrane Intervention Reviews (MECIR) guidelines...... of musculoskeletal disorders. METHODS: Data sources were systematic reviews published by the Cochrane Musculoskeletal Review Group, including at least five RCTs, reporting a search history, searching MEDLINE, EMBASE, CENTRAL, and adding reference- and hand-searching. Additional databases were deemed eligible...... if they indexed RCTs, were in English and used in more than three of the systematic reviews. Relative recall was calculated as the number of studies identified by the literature search divided by the number of eligible studies i.e. included studies in the individual systematic reviews. Finally, cumulative median...

  18. The Emergence of Systematic Review in Toxicology.

    Science.gov (United States)

    Stephens, Martin L; Betts, Kellyn; Beck, Nancy B; Cogliano, Vincent; Dickersin, Kay; Fitzpatrick, Suzanne; Freeman, James; Gray, George; Hartung, Thomas; McPartland, Jennifer; Rooney, Andrew A; Scherer, Roberta W; Verloo, Didier; Hoffmann, Sebastian

    2016-07-01

    The Evidence-based Toxicology Collaboration hosted a workshop on "The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology," on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology.

  19. [The Use of Telemedicine Interventions to Improve Hypertension Management Among Racial Ethnic Minorities: A Systematic Review].

    Science.gov (United States)

    Li, Wen-Wen; Lai, Wei-Shu

    2016-08-01

    Racial ethnic minorities are one of the fastest growing populations in Taiwan. In recent years, there has been an increase in literature addressing the efficacy of home blood-pressure (BP) management that uses telemedicine interventions in general healthcare and community settings. However, no study or systematic literature review has yet assessed the effectiveness of using telemedicine HTN interventions in Taiwan's indigenous, new-immigrant, and other minority populations. The purpose of the present paper is to review the current literature on the use of telemedicine interventions to assist HTN management among racial ethnic minorities. A comprehensive literature search was conducted for full-text articles that were published between January 2000 and December 2015 using the following databases: PubMed, WEB of Science, CINAHL (Cumulative Index to Nursing & Allied Health Literature), PsycINFO, Science Direct, ProQuest, Medline, Cochrane Library, National Dissertations and Theses, and airiti Library. The search used the following key search terms both alone and in combination: hypertension, blood pressure, management, telemedicine, telehealth, ehealth, and digital health. The studies were thoroughly assessed under the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 6 articles met the criteria for using keywords related to racial ethnic minority populations and were used in the present review. Findings of this systematic review show that telemedicine interventions significantly improve HTN management. The intervention that combined home telemonitoring with culturally competent nurse counseling calls was identified as the best intervention for reducing BP. As the current literature on this topic is limited to African-Americans, more research is necessary to validate our findings. Future studies should target racial ethnic minorities in Taiwan in order to better understand how to provide culturally appropriate

  20. Improving child protection: a systematic review of training and procedural interventions.

    Science.gov (United States)

    Carter, Y H; Bannon, M J; Limbert, C; Docherty, A; Barlow, J

    2006-09-01

    To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals. Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour. Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions (such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of one-group pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process. Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.

  1. Signal Quality Improvement Algorithms for MEMS Gyroscope-Based Human Motion Analysis Systems: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jiaying Du

    2018-04-01

    Full Text Available Motion sensors such as MEMS gyroscopes and accelerometers are characterized by a small size, light weight, high sensitivity, and low cost. They are used in an increasing number of applications. However, they are easily influenced by environmental effects such as temperature change, shock, and vibration. Thus, signal processing is essential for minimizing errors and improving signal quality and system stability. The aim of this work is to investigate and present a systematic review of different signal error reduction algorithms that are used for MEMS gyroscope-based motion analysis systems for human motion analysis or have the potential to be used in this area. A systematic search was performed with the search engines/databases of the ACM Digital Library, IEEE Xplore, PubMed, and Scopus. Sixteen papers that focus on MEMS gyroscope-related signal processing and were published in journals or conference proceedings in the past 10 years were found and fully reviewed. Seventeen algorithms were categorized into four main groups: Kalman-filter-based algorithms, adaptive-based algorithms, simple filter algorithms, and compensation-based algorithms. The algorithms were analyzed and presented along with their characteristics such as advantages, disadvantages, and time limitations. A user guide to the most suitable signal processing algorithms within this area is presented.

  2. Signal Quality Improvement Algorithms for MEMS Gyroscope-Based Human Motion Analysis Systems: A Systematic Review.

    Science.gov (United States)

    Du, Jiaying; Gerdtman, Christer; Lindén, Maria

    2018-04-06

    Motion sensors such as MEMS gyroscopes and accelerometers are characterized by a small size, light weight, high sensitivity, and low cost. They are used in an increasing number of applications. However, they are easily influenced by environmental effects such as temperature change, shock, and vibration. Thus, signal processing is essential for minimizing errors and improving signal quality and system stability. The aim of this work is to investigate and present a systematic review of different signal error reduction algorithms that are used for MEMS gyroscope-based motion analysis systems for human motion analysis or have the potential to be used in this area. A systematic search was performed with the search engines/databases of the ACM Digital Library, IEEE Xplore, PubMed, and Scopus. Sixteen papers that focus on MEMS gyroscope-related signal processing and were published in journals or conference proceedings in the past 10 years were found and fully reviewed. Seventeen algorithms were categorized into four main groups: Kalman-filter-based algorithms, adaptive-based algorithms, simple filter algorithms, and compensation-based algorithms. The algorithms were analyzed and presented along with their characteristics such as advantages, disadvantages, and time limitations. A user guide to the most suitable signal processing algorithms within this area is presented.

  3. Integration of existing systematic reviews into new reviews: identification of guidance needs

    Science.gov (United States)

    2014-01-01

    Background An exponential increase in the number of systematic reviews published, and constrained resources for new reviews, means that there is an urgent need for guidance on explicitly and transparently integrating existing reviews into new systematic reviews. The objectives of this paper are: 1) to identify areas where existing guidance may be adopted or adapted, and 2) to suggest areas for future guidance development. Methods We searched documents and websites from healthcare focused systematic review organizations to identify and, where available, to summarize relevant guidance on the use of existing systematic reviews. We conducted informational interviews with members of Evidence-based Practice Centers (EPCs) to gather experiences in integrating existing systematic reviews, including common issues and challenges, as well as potential solutions. Results There was consensus among systematic review organizations and the EPCs about some aspects of incorporating existing systematic reviews into new reviews. Current guidance may be used in assessing the relevance of prior reviews and in scanning references of prior reviews to identify studies for a new review. However, areas of challenge remain. Areas in need of guidance include how to synthesize, grade the strength of, and present bodies of evidence composed of primary studies and existing systematic reviews. For instance, empiric evidence is needed regarding how to quality check data abstraction and when and how to use study-level risk of bias assessments from prior reviews. Conclusions There remain areas of uncertainty for how to integrate existing systematic reviews into new reviews. Methods research and consensus processes among systematic review organizations are needed to develop guidance to address these challenges. PMID:24956937

  4. Cognitive-Based Interventions to Improve Mobility: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Marusic, Uros; Verghese, Joe; Mahoney, Jeannette R

    2018-06-01

    A strong relation between cognition and mobility has been identified in aging, supporting a role for enhancement mobility through cognitive-based interventions. However, a critical evaluation of the consistency of treatment effects of cognitive-based interventions is currently lacking. The objective of this study was 2-fold: (1) to review the existing literature on cognitive-based interventions aimed at improving mobility in older adults and (2) to assess the clinical effectiveness of cognitive interventions on gait performance. A systematic review of randomized controlled trials (RCT) of cognitive training interventions for improving simple (normal walking) and complex (dual task walking) gait was conducted in February 2018. Older adults without major cognitive, psychiatric, neurologic, and/or sensory impairments were included. Random effect meta-analyses and a subsequent meta-regression were performed to generate overall cognitive intervention effects on single- and dual-task walking conditions. Ten RCTs met inclusion criteria, with a total of 351 participants included in this meta-analysis. Cognitive training interventions revealed a small effect of intervention on complex gait [effect size (ES) = 0.47, 95% confidence interval (CI) 0.13 to 0.81, P = .007, I 2  = 15.85%], but not simple gait (ES = 0.35, 95% CI -0.01 to 0.71, P = .057, I 2  = 57.32%). Moreover, a meta-regression analysis revealed that intervention duration, training frequency, total number of sessions, and total minutes spent in intervention were not significant predictors of improvement in dual-task walking speed, though there was a suggestive trend toward a negative association between dual-task walking speed improvements and individual training session duration (P = .067). This meta-analysis provides support for the fact that cognitive training interventions can improve mobility-related outcomes, especially during challenging walking conditions requiring higher-order executive

  5. Systematic review of reviews of risk factors for intracranial aneurysms

    International Nuclear Information System (INIS)

    Clarke, Mike

    2008-01-01

    Systematic reviews of systematic reviews identify good quality reviews of earlier studies of medical conditions. This article describes a systematic review of systematic reviews performed to investigate factors that might influence the risk of rupture of an intracranial aneurysm. It exemplifies the technique of this type of research and reports the finding of a specific study. The annual incidence of subarachnoid haemorrhage resulting from the rupture of intracranial aneurysms is estimated to be nine per 100,000. A large proportion of people who have this bleed, will die or remain dependent on the care of others for some time. Reliable knowledge about the risks of subarachnoid haemorrhage in different populations will help in planning, screening and prevention strategies and in predicting the prognosis of individual patients. If the necessary data were available in the identified reviews, an estimate for the numerical relationship between a particular characteristic and the risk of subarachnoid haemorrhage was included in this report. The identification of eligible systematic reviews relied mainly on the two major bibliographic databases of the biomedical literature: PubMed and EMBASE. These were searched in 2006, using specially designed search strategies. Approximately 2,000 records were retrieved and each of these was checked carefully against the eligibility criteria for this systematic review. These criteria required that the report be a systematic review of studies assessing the risk of subarachnoid haemorrhage in patients known to have an unruptured intracranial aneurysm or of studies that had investigated the characteristics of people who experienced a subarachnoid haemorrhage without previously being known to have an unruptured aneurysm. Reports which included more than one systematic review were eligible and each of these reviews was potentially eligible. The quality of each systematic review was assessed. In this review, 16 separate reports were

  6. Do educational interventions improve nurses' clinical decision making and judgement? A systematic review.

    Science.gov (United States)

    Thompson, Carl; Stapley, Sally

    2011-07-01

    Despite the growing popularity of decision making in nursing curricula, the effectiveness of educational interventions to improve nursing judgement and decision making is unknown. We sought to synthesise and summarise the comparative evidence for educational interventions to improve nursing judgements and clinical decisions. A systematic review. Electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL and PsycINFO, Social Sciences Citation Index, OpenSIGLE conference proceedings and hand searching nursing journals. Studies published since 1960, reporting any educational intervention that aimed to improve nurses' clinical judgements or decision making were included. Studies were assessed for relevance and quality. Data extracted included study design; educational setting; the nature of participants; whether the study was concerned with the clinical application of skills or the application of theory; the type of decision targeted by the intervention (e.g. diagnostic reasoning) and whether the evaluation of the intervention focused on efficacy or effectiveness. A narrative approach to study synthesis was used due to heterogeneity in interventions, study samples, outcomes and settings and incomplete reporting of effect sizes. From 5262 initial citations 24 studies were included in the review. A variety of educational approaches were reported. Study quality and content reporting was generally poor. Pedagogical theories were widely used but use of decision theory (with the exception of subjective expected utility theory implicit in decision analysis) was rare. The effectiveness and efficacy of interventions was mixed. Educational interventions to improve nurses' judgements and decisions are complex and the evidence from comparative studies does little to reduce the uncertainty about 'what works'. Nurse educators need to pay attention to decision, as well as pedagogical, theory in the design of interventions. Study design and

  7. Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal.

    Science.gov (United States)

    Wiysonge, Charles Shey; Kamadjeu, Raoul; Tsague, Landry

    2016-01-01

    Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. In each case, one study would rarely yield sufficient evidence on which to reliably base a healthcare decision. An unbiased and transparent summary of all existing studies on a given question (i.e. a systematic review) tells a better story than any one of the included studies taken separately. A systematic review enables producers and users of research to gauge what a new study has contributed to knowledge by setting the study's findings in the context of all previous studies investigating the same question. It is therefore inappropriate to initiate a new study without first conducting a systematic review to find out what can be learnt from existing studies. There is nothing new in taking account of earlier studies in either the design or interpretation of new studies. For example, in the 18th century James Lind conducted a clinical trial followed by a systematic review of contemporary treatments for scurvy; which showed fruits to be an effective treatment for the disease. However, surveys of the peer-reviewed literature continue to provide empirical evidence that systematic reviews are seldom used in the design and interpretation of the findings of new studies. Such indifference to systematic reviews as a research function is unethical, unscientific, and uneconomical. Without systematic reviews, limited resources are very likely to be squandered on ill-conceived research and policies. In order to

  8. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review.

    Science.gov (United States)

    Swinnen, Eva; Beckwée, David; Meeusen, Romain; Baeyens, Jean-Pierre; Kerckhofs, Eric

    2014-01-01

    The aim of this systematic review was to summarize the improvements in balance after robot-assisted gait training (RAGT) in stroke patients. Two databases were searched: PubMed and Web of Knowledge. The most important key words are "stroke," "RAGT," "balance," "Lokomat," and "gait trainer." Studies were included if stroke patients were involved in RAGT protocols, and balance was determined as an outcome measurement. The articles were checked for methodological quality by 2 reviewers (Cohen's κ = 0.72). Nine studies were included (7 true experimental and 2 pre-experimental studies; methodological quality score, 56%-81%). In total, 229 subacute or chronic stroke patients (70.5% male) were involved in RAGT (3 to 5 times per week, 3 to 10 weeks, 12 to 25 sessions). In 5 studies, the gait trainer was used; in 2, the Lokomat was used; in 1 study, a single-joint wearable knee orthosis was used; and in 1 study, the AutoAmbulator was used. Eight studies compared RAGT with other gait rehabilitation methods. Significant improvements (no to large effect sizes, Cohen's d = 0.01 to 3.01) in balance scores measured with the Berg Balance Scale, the Tinetti test, postural sway tests, and the Timed Up and Go test were found after RAGT. No significant differences in balance between the intervention and control groups were reported. RAGT can lead to improvements in balance in stroke patients; however, it is not clear whether the improvements are greater compared with those associated with other gait rehabilitation methods. Because a limited number of studies are available, more specific research (eg, randomized controlled trials with larger, specific populations) is necessary to draw stronger conclusions.

  9. Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review

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    Hsiu-Ching Chiu

    2016-07-01

    Full Text Available Questions: Does constraint-induced movement therapy improve activity and participation in children with hemiplegic cerebral palsy? Does it improve activity and participation more than the same dose of upper limb therapy without restraint? Is the effect of constraint-induced movement therapy related to the duration of intervention or the age of the children? Design: Systematic review of randomised trials with meta-analysis. Participants: Children with hemiplegic cerebral palsy with any level of motor disability. Intervention: The experimental group received constraint-induced movement therapy (defined as restraint of the less affected upper limb during supervised activity practice of the more affected upper limb. The control group received no intervention, sham intervention, or the same dose of upper limb therapy. Outcome measures: Measures of upper limb activity and participation were used in the analysis. Results: Constraint-induced movement therapy was more effective than no/sham intervention in terms of upper limb activity (SMD 0.63, 95% CI 0.20 to 1.06 and participation (SMD 1.21, 95% CI 0.41 to 2.02. However, constraint-induced movement therapy was no better than the same dose of upper limb therapy without restraint either in terms of upper limb activity (SMD 0.05, 95% CI –0.21 to 0.32 or participation (SMD –0.02, 95% CI –0.34 to 0.31. The effect of constraint-induced movement therapy was not related to the duration of intervention or the age of the children. Conclusions: This review suggests that constraint-induced movement therapy is more effective than no intervention, but no more effective than the same dose of upper limb practice without restraint. Registration: PROSPERO CRD42015024665. [Chiu H-C, Ada L (2016 Constraint-induced movement therapy improves upper limb activity and participation in hemiplegic cerebral palsy: a systematic review. Journal of Physiotherapy 62: 130–137

  10. Teaching Reading for Students with Intellectual Disabilities: A Systematic Review

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    Alnahdi, Ghaleb Hamad

    2015-01-01

    A systematic review of the literature related to instructional strategies to improve reading skills for students with intellectual disabilities was conducted. Studies reviewed were within three categories; early reading approaches, comprehensive approaches, and one method approach. It was concluded that students with intellectual disabilities are…

  11. Are university rankings useful to improve research? A systematic review.

    Science.gov (United States)

    Vernon, Marlo M; Balas, E Andrew; Momani, Shaher

    2018-01-01

    Concerns about reproducibility and impact of research urge improvement initiatives. Current university ranking systems evaluate and compare universities on measures of academic and research performance. Although often useful for marketing purposes, the value of ranking systems when examining quality and outcomes is unclear. The purpose of this study was to evaluate usefulness of ranking systems and identify opportunities to support research quality and performance improvement. A systematic review of university ranking systems was conducted to investigate research performance and academic quality measures. Eligibility requirements included: inclusion of at least 100 doctoral granting institutions, be currently produced on an ongoing basis and include both global and US universities, publish rank calculation methodology in English and independently calculate ranks. Ranking systems must also include some measures of research outcomes. Indicators were abstracted and contrasted with basic quality improvement requirements. Exploration of aggregation methods, validity of research and academic quality indicators, and suitability for quality improvement within ranking systems were also conducted. A total of 24 ranking systems were identified and 13 eligible ranking systems were evaluated. Six of the 13 rankings are 100% focused on research performance. For those reporting weighting, 76% of the total ranks are attributed to research indicators, with 24% attributed to academic or teaching quality. Seven systems rely on reputation surveys and/or faculty and alumni awards. Rankings influence academic choice yet research performance measures are the most weighted indicators. There are no generally accepted academic quality indicators in ranking systems. No single ranking system provides a comprehensive evaluation of research and academic quality. Utilizing a combined approach of the Leiden, Thomson Reuters Most Innovative Universities, and the SCImago ranking systems may provide

  12. Effectiveness of teaching quality improvement to clinicians: a systematic review.

    Science.gov (United States)

    Boonyasai, Romsai T; Windish, Donna M; Chakraborti, Chayan; Feldman, Leonard S; Rubin, Haya R; Bass, Eric B

    2007-09-05

    Accreditation requirements mandate teaching quality improvement (QI) concepts to medical trainees, yet little is known about the effectiveness of teaching QI. To perform a systematic review of the effectiveness of published QI curricula for clinicians and to determine whether teaching methods influence the effectiveness of such curricula. The electronic literature databases of MEDLINE, EMBASE, CINAHL, and ERIC were searched for English-language articles published between January 1, 1980, and April 30, 2007. Experts in the field of QI were queried about relevant studies. Two independent reviewers selected studies for inclusion if the curriculum taught QI principles to clinicians and the evaluation used a comparative study design. Information about the features of each curriculum, its use of 9 principles of adult learning, and the type of educational and clinical outcomes were extracted. The relationship between the outcomes and the number of educational principles used was assessed. Of 39 studies that met eligibility criteria, 31 described team-based projects; 37 combined didactic instruction with experiential learning. The median number of adult learning principles used was 7 (range, 2-8). Evaluations included 22 controlled trials (8 randomized and 14 nonrandomized) and 17 pre/post or time series studies. Fourteen studies described educational outcomes (attitudes, knowledge, or skills or behaviors) and 28 studies described clinical process or patient outcomes. Nine of the 10 studies that evaluated knowledge reported only positive effects but only 2 of these described a validated assessment tool. The 6 assessments of attitudes found mixed results. Four of the 6 studies on skill or behavior outcomes reported only positive effects. Eight of the 28 studies of clinical outcomes reported only beneficial effects. Controlled studies were more likely than other studies to report mixed or null effects. Only 4 studies evaluated both educational and clinical outcomes

  13. Systematic reviews in bioethics: types, challenges, and value.

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    McDougall, Rosalind

    2014-02-01

    There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a systematic review, I suggest that complete comprehensiveness may not always be an appropriate goal of a literature review in bioethics, depending on the research question. In some cases, all the relevant ideas may be captured without capturing all the relevant literature. I conclude that systematic reviews in bioethics have an important role to play alongside the traditional broadbrush approach to reviewing literature in bioethics.

  14. Recommendations for reporting of systematic reviews and meta-analyses of diagnostic test accuracy: a systematic review

    NARCIS (Netherlands)

    McGrath, Trevor A.; Alabousi, Mostafa; Skidmore, Becky; Korevaar, Daniël A.; Bossuyt, Patrick M. M.; Moher, David; Thombs, Brett; McInnes, Matthew D. F.

    2017-01-01

    This study is to perform a systematic review of existing guidance on quality of reporting and methodology for systematic reviews of diagnostic test accuracy (DTA) in order to compile a list of potential items that might be included in a reporting guideline for such reviews: Preferred Reporting Items

  15. Using Multiple Types of Studies in Systematic Reviews of Health Care Interventions – A Systematic Review

    Science.gov (United States)

    Peinemann, Frank; Tushabe, Doreen Allen; Kleijnen, Jos

    2013-01-01

    Background A systematic review may evaluate different aspects of a health care intervention. To accommodate the evaluation of various research questions, the inclusion of more than one study design may be necessary. One aim of this study is to find and describe articles on methodological issues concerning the incorporation of multiple types of study designs in systematic reviews on health care interventions. Another aim is to evaluate methods studies that have assessed whether reported effects differ by study types. Methods and Findings We searched PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Methodology Register on 31 March 2012 and identified 42 articles that reported on the integration of single or multiple study designs in systematic reviews. We summarized the contents of the articles qualitatively and assessed theoretical and empirical evidence. We found that many examples of reviews incorporating multiple types of studies exist and that every study design can serve a specific purpose. The clinical questions of a systematic review determine the types of design that are necessary or sufficient to provide the best possible answers. In a second independent search, we identified 49 studies, 31 systematic reviews and 18 trials that compared the effect sizes between randomized and nonrandomized controlled trials, which were statistically different in 35%, and not different in 53%. Twelve percent of studies reported both, different and non-different effect sizes. Conclusions Different study designs addressing the same question yielded varying results, with differences in about half of all examples. The risk of presenting uncertain results without knowing for sure the direction and magnitude of the effect holds true for both nonrandomized and randomized controlled trials. The integration of multiple study designs in systematic reviews is required if patients should be informed on the many facets of patient relevant issues of health care

  16. SYSTEMATIC REVIEW SEBAGAI METODE PENELITIAN UNTUK MENSINTESIS HASIL-HASIL PENELITIAN (SEBUAH PENGANTAR

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    Siswanto Siswanto

    2012-12-01

    Full Text Available Individual research is not enough to provide inputs for policy improvement. In order that research results can be used for policy inputs, a synthesis from a number research results and packaging them into actionable messages are important methodologies that have to be mastered by researchers. By conducting synthesis of research results with the use of systematic review and packaging it in the form of actionable messages (policy brief and policy paper, a more comprehensive and balanced fact can be presented for policy makers. Systematic review comprises quantitative technique (meta-analysis and qualitative technique (meta-synthesis. However, systematic review should be distinguished with a review that is not systematic (traditional review. Both quantitative and qualitative review possess a systematic and sequential step as that of general research methodology. Quantitative approach is identified as meta-analysis, whereas qualitative approach is identified as meta-synthesis. Within meta-synthesis, there are at least two approaches, i.e. meta-ethnography and meta-aggregation. Within the perspective of research translation, meta-aggregation is an important method in comprehending a number of qualitative research results, for providing more comprehensive and balanced facts to policy makers. Key words: systematic review, meta-analysis, meta-synthesis, meta-ethnography, meta-aggregation

  17. Surgically facilitated experimental movement of teeth : systematic review

    NARCIS (Netherlands)

    Liem, A. M. L.; Hoogeveen, E. J.; Jansma, J.; Ren, Y.

    Several surgical techniques based on corticotomy and dental distraction have been developed to improve the movement of teeth and reduce the duration of orthodontic treatment. In this systematic review we have critically assessed published studies on the experimental movement of teeth to find out

  18. Twelve recommendations for integrating existing systematic reviews into new reviews: EPC guidance.

    Science.gov (United States)

    Robinson, Karen A; Chou, Roger; Berkman, Nancy D; Newberry, Sydne J; Fu, Rongwei; Hartling, Lisa; Dryden, Donna; Butler, Mary; Foisy, Michelle; Anderson, Johanna; Motu'apuaka, Makalapua; Relevo, Rose; Guise, Jeanne-Marie; Chang, Stephanie

    2016-02-01

    As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews. A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations. Discussions were informed by a literature scan and by interviews with organizations that conduct systematic reviews. Twelve recommendations were developed addressing selecting reviews, assessing risk of bias, qualitative and quantitative synthesis, and summarizing and assessing body of evidence. We provide preliminary guidance for an efficient and unbiased approach to integrating existing systematic reviews with primary studies in a new review. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A systematic review of hand hygiene improvement strategies: a behavioural approach

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    Huis Anita

    2012-09-01

    Full Text Available Abstract Background Many strategies have been designed and evaluated to address the problem of low hand hygiene (HH compliance. Which of these strategies are most effective and how they work is still unclear. Here we describe frequently used improvement strategies and related determinants of behaviour change that prompt good HH behaviour to provide a better overview of the choice and content of such strategies. Methods Systematic searches of experimental and quasi-experimental research on HH improvement strategies were conducted in Medline, Embase, CINAHL, and Cochrane databases from January 2000 to November 2009. First, we extracted the study characteristics using the EPOC Data Collection Checklist, including study objectives, setting, study design, target population, outcome measures, description of the intervention, analysis, and results. Second, we used the Taxonomy of Behavioural Change Techniques to identify targeted determinants. Results We reviewed 41 studies. The most frequently addressed determinants were knowledge, awareness, action control, and facilitation of behaviour. Fewer studies addressed social influence, attitude, self-efficacy, and intention. Thirteen studies used a controlled design to measure the effects of HH improvement strategies on HH behaviour. The effectiveness of the strategies varied substantially, but most controlled studies showed positive results. The median effect size of these strategies increased from 17.6 (relative difference addressing one determinant to 49.5 for the studies that addressed five determinants. Conclusions By focussing on determinants of behaviour change, we found hidden and valuable components in HH improvement strategies. Addressing only determinants such as knowledge, awareness, action control, and facilitation is not enough to change HH behaviour. Addressing combinations of different determinants showed better results. This indicates that we should be more creative in the application of

  20. A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns

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    Tapfuma Mudawarima

    2017-10-01

    Full Text Available Abstract Background Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves. Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement. Settings = any setting in any country. Methods/design A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. Discussion Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention

  1. Using text mining for study identification in systematic reviews: a systematic review of current approaches.

    Science.gov (United States)

    O'Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

    2015-01-14

    The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic review fills that research gap. Focusing mainly on non-technical issues, the review aims to increase awareness of the potential of these technologies and promote further collaborative research between the computer science and systematic review communities. Five research questions led our review: what is the state of the evidence base; how has workload reduction been evaluated; what are the purposes of semi-automation and how effective are they; how have key contextual problems of applying text mining to the systematic review field been addressed; and what challenges to implementation have emerged? We answered these questions using standard systematic review methods: systematic and exhaustive searching, quality-assured data extraction and a narrative synthesis to synthesise findings. The evidence base is active and diverse; there is almost no replication between studies or collaboration between research teams and, whilst it is difficult to establish any overall conclusions about best approaches, it is clear that efficiencies and reductions in workload are potentially achievable. On the whole, most suggested that a saving in workload of between 30% and 70% might be possible, though sometimes the saving in workload is accompanied by the loss of 5% of relevant studies (i.e. a 95% recall). Using text mining to prioritise the order in which items are screened should be considered safe and ready for use in 'live' reviews. The use of text mining as a 'second screener' may also be used cautiously

  2. Information sources for obesity prevention policy research: a review of systematic reviews.

    Science.gov (United States)

    Hanneke, Rosie; Young, Sabrina K

    2017-08-08

    Systematic identification of evidence in health policy can be time-consuming and challenging. This study examines three questions pertaining to systematic reviews on obesity prevention policy, in order to identify the most efficient search methods: (1) What percentage of the primary studies selected for inclusion in the reviews originated in scholarly as opposed to gray literature? (2) How much of the primary scholarly literature in this topic area is indexed in PubMed/MEDLINE? (3) Which databases index the greatest number of primary studies not indexed in PubMed, and are these databases searched consistently across systematic reviews? We identified systematic reviews on obesity prevention policy and explored their search methods and citations. We determined the percentage of scholarly vs. gray literature cited, the most frequently cited journals, and whether each primary study was indexed in PubMed. We searched 21 databases for all primary study articles not indexed in PubMed to determine which database(s) indexed the highest number of these relevant articles. In total, 21 systematic reviews were identified. Ten of the 21 systematic reviews reported searching gray literature, and 12 reviews ultimately included gray literature in their analyses. Scholarly articles accounted for 577 of the 649 total primary study papers. Of these, 495 (76%) were indexed in PubMed. Google Scholar retrieved the highest number of the remaining 82 non-PubMed scholarly articles, followed by Scopus and EconLit. The Journal of the American Dietetic Association was the most-cited journal. Researchers can maximize search efficiency by searching a small yet targeted selection of both scholarly and gray literature resources. A highly sensitive search of PubMed and those databases that index the greatest number of relevant articles not indexed in PubMed, namely multidisciplinary and economics databases, could save considerable time and effort. When combined with a gray literature search and

  3. Characteristics of Quality Improvement Champions in Nursing Homes: A Systematic Review With Implications for Evidence-Based Practice.

    Science.gov (United States)

    Woo, Kyungmi; Milworm, Gvira; Dowding, Dawn

    2017-12-01

    Improving care quality while reducing cost has always been a focus of nursing homes. Certified nursing assistants comprise the largest proportion of the workforce in nursing homes and have the potential to contribute to the quality of care provided. Quality improvement (QI) initiatives using certified nursing assistants as champions have the potential to improve job satisfaction, which has been associated with care quality. To identify the role, use and preparation of champions in a nursing home setting as a way of informing future QI strategies in nursing homes. A systematic literature review. Medical Subject Headings and text words for "quality improvement" were combined with those for "champion*" to search Medline, CINAHL, Joanna Briggs Institute, MedLine In-Process, and other Nonindexed Citations. After duplicates were removed, a total of 337 potential articles were identified for further review. After full text review, seven articles from five original studies met inclusion criteria and were included in the synthesis. Various types of QI initiatives and implementation strategies were used together with champions. Champions were identified by study authors as one of the single most effective strategies employed in all studies. The majority of studies described the champion role as that of a leader, who fosters and reinforces changes for improvement. Although all the included studies suggested that implementing nurse or aid champions in their QI initiatives were important facilitators of success, how the champions were selected and trained in their role is either missing or not described in any detail in the studies included in the review. Utilizing certified nursing assistants as QI champions can increase participation in QI projects and has the potential to improve job satisfaction and contribute to improve quality of care and improved patient outcomes in nursing homes. © 2017 Sigma Theta Tau International.

  4. Systematic reviews in Library and Information Science: analysis and evaluation of the search process

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    José Antonio Salvador-Oliván

    2018-05-01

    Full Text Available Objective: An essential component of a systematic review is the development and execution of a literature search to identify all available and relevant published studies. The main objective of this study is to analyse and evaluate whether the systematic reviews in Library and Information Science (LIS provide complete information on all the elements that make up the search process. Methods: A search was launched in WOS, Scopus, LISTA, Library Science Database, Medline databases and a wiki published from 2000 to February 2017, in order to find and identify systematic reviews. The search was designed to find those records whose titles included the words “systematic review” and/or “meta-analysis”. A list was created with the twelve items recommended from of the main publication guides, to assess the information degree on each of them. Results and conclusions: Most of the reviews in LIS are created by information professionals. From the 94 systematic reviews selected for analysis, it was found that only a 4.3% provided the complete reporting on the search method. The most frequently included item is the name of the database (95.6% and the least one is the name of the host (35.8%. It is necessary to improve and complete the information about the search processes in the complete reports from LIS systematic reviews for reproducibility, updating and quality assessment improvement.

  5. Alignment of systematic reviews published in the Cochrane Database of Systematic Reviews and the Database of Abstracts and Reviews of Effectiveness with global burden-of-disease data: a bibliographic analysis.

    Science.gov (United States)

    Yoong, Sze Lin; Hall, Alix; Williams, Christopher M; Skelton, Eliza; Oldmeadow, Christopher; Wiggers, John; Karimkhani, Chante; Boyers, Lindsay N; Dellavalle, Robert P; Hilton, John; Wolfenden, Luke

    2015-07-01

    Systematic reviews of high-quality evidence are used to inform policy and practice. To improve community health, the production of such reviews should align with burden of disease. This study aims to assess if the volume of research output from systematic reviews proportionally aligns with burden of disease assessed using percentages of mortality and disability-adjusted life years (DALYs). A cross-sectional audit of reviews published between January 2012 and August 2013 in the Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE) was undertaken. Percentages of mortality and DALYs were obtained from the 2010 Global Burden of Disease study. Standardised residual differences (SRD) based on percentages of mortality and DALYs were calculated, where conditions with SRD of more than or less than three were considered overstudied or understudied, respectively. 1029 reviews from CDSR and 1928 reviews from DARE were examined. There was a significant correlation between percentage DALYs and systematic reviews published in CDSR and DARE databases (CDSR: r=0.68, p=0.001; DARE: r=0.60, psystematic reviews published in either database (CDSR: r=0.34, p=0.14; DARE: r=0.22, p=0.34). Relative to percentage of mortality, mental and behavioural disorders, musculoskeletal conditions and other non-communicable diseases were overstudied. Maternal disorders were overstudied relative to percentages of mortality and DALYs in CDSR. The focus of systematic reviews is moderately correlated with DALYs. A number of conditions may be overstudied relative to percentage of mortality particularly in the context of health and medical reviews. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Necessity and feasibility of improving mental health services in China: A systematic qualitative review.

    Science.gov (United States)

    Zhao, Xudong; Liu, Liang; Hu, Chengping; Chen, Fazhan; Sun, Xirong

    2017-07-01

    It has been nearly 40 years since the reform and opening up of Mainland China. The mental health services system has developed rapidly as a part of the profound socioeconomic changes that ensued. However, its development has not been as substantial as other areas of medical care. For the current qualitative systematic review, we searched databases, including China Biology Medicine disc, Weipu, China National Knowledge Infrastructure, Wanfang digital periodical full text data, China's important newspaper full text database, China Statistical Yearbook database, etc. The content of primary research, literature, and policy papers about the evolution and development of Chinese mental health services was systemically reviewed and analysed by using thematic analysis. Two main themes relative to the necessity and feasibility of reforming the current mental health services system emerged. We discuss 5 corresponding subthemes under the umbrella of the necessity of improving the current treatment, rehabilitation, prevention, and service systems and 7 requirements for the feasibility of reforming the current system. We conclude that as the development of the Chinese economy and the spirit of humanistic care continue, the improvement and reformation of the mental health services system are both necessary and feasible. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Roles for librarians in systematic reviews: a scoping review

    Science.gov (United States)

    Spencer, Angela J.; Eldredge, Jonathan D.

    2018-01-01

    Objective What roles do librarians and information professionals play in conducting systematic reviews? Librarians are increasingly called upon to be involved in systematic reviews, but no study has considered all the roles librarians can perform. This inventory of existing and emerging roles aids in defining librarians’ systematic reviews services. Methods For this scoping review, the authors conducted controlled vocabulary and text-word searches in the PubMed; Library, Information Science & Technology Abstracts; and CINAHL databases. We separately searched for articles published in the Journal of the European Association for Health Information and Libraries, Evidence Based Library and Information Practice, the Journal of the Canadian Heath Libraries Association, and Hypothesis. We also text-word searched Medical Library Association annual meeting poster and paper abstracts. Results We identified 18 different roles filled by librarians and other information professionals in conducting systematic reviews from 310 different articles, book chapters, and presented papers and posters. Some roles were well known such as searching, source selection, and teaching. Other less documented roles included planning, question formulation, and peer review. We summarize these different roles and provide an accompanying bibliography of references for in-depth descriptions of these roles. Conclusion Librarians play central roles in systematic review teams, including roles that go beyond searching. This scoping review should encourage librarians who are fulfilling roles that are not captured here to document their roles in journal articles and poster and paper presentations. PMID:29339933

  8. Exercise and physical training improve physical function in older adults with visual impairments but their effect on falls is unclear: a systematic review

    Directory of Open Access Journals (Sweden)

    Michael Gleeson

    2014-09-01

    [Gleeson M, Sherrington C, Keay L (2014 Exercise and physical training improve physical function in older adults with visual impairments but their effect on falls is unclear: a systematic review. Journal of Physiotherapy 60: 130–135

  9. Built to last? The sustainability of health system improvements, interventions and change strategies: a study protocol for a systematic review.

    Science.gov (United States)

    Braithwaite, Jeffrey; Testa, Luke; Lamprell, Gina; Herkes, Jessica; Ludlow, Kristiana; McPherson, Elise; Campbell, Margie; Holt, Joanna

    2017-11-12

    The sustainability of healthcare interventions and change programmes is of increasing importance to researchers and healthcare stakeholders interested in creating sustainable health systems to cope with mounting stressors. The aim of this protocol is to extend earlier work and describe a systematic review to identify, synthesise and draw meaning from studies published within the last 5 years that measure the sustainability of interventions, improvement efforts and change strategies in the health system. The protocol outlines a method by which to execute a rigorous systematic review. The design includes applying primary and secondary data collection techniques, consisting of a comprehensive database search complemented by contact with experts, and searching secondary databases and reference lists, using snowballing techniques. The review and analysis process will occur via an abstract review followed by a full-text screening process. The inclusion criteria include English-language, peer-reviewed, primary, empirical research articles published after 2011 in scholarly journals, for which the full text is available. No restrictions on location will be applied. The review that results from this protocol will synthesise and compare characteristics of the included studies. Ultimately, it is intended that this will help make it easier to identify and design sustainable interventions, improvement efforts and change strategies. As no primary data were collected, ethical approval was not required. Results will be disseminated in conference presentations, peer-reviewed publications and among policymaker bodies interested in creating sustainable health systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Using text mining for study identification in systematic reviews: a systematic review of current approaches

    OpenAIRE

    O?Mara-Eves, Alison; Thomas, James; McNaught, John; Miwa, Makoto; Ananiadou, Sophia

    2015-01-01

    Background The large and growing number of published studies, and their increasing rate of publication, makes the task of identifying relevant studies in an unbiased way for inclusion in systematic reviews both complex and time consuming. Text mining has been offered as a potential solution: through automating some of the screening process, reviewer time can be saved. The evidence base around the use of text mining for screening has not yet been pulled together systematically; this systematic...

  11. Learning from Aviation to Improve Safety in the Operating Room - a Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Linda S. G. L. Wauben

    2012-01-01

    Full Text Available Lessons learned from other high-risk industries could improve patient safety in the operating room (OR. This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed and Scopus databases were systematically searched for relevant articles written in the English language published between 2000 and 2011. In total, 25 articles were included, all within the medical domain focusing on the comparison between surgery and aviation. In order to improve safety in the OR, multiple interventions have to be implemented. Additionally, the healthcare organization has to become a ‘learning organization’ and the OR team has to become a team with shared responsibilities and flat hierarchies. Interpersonal and technical skills can be trained by means of simulation and can be supported by implementing team briefings, debriefings and cross-checks. However, further development and research is needed to prove if these solutions are useful, practical, and actually increase safety.

  12. Asthma and obesity: does weight loss improve asthma control? a systematic review

    Directory of Open Access Journals (Sweden)

    Juel CTB

    2012-06-01

    Full Text Available Caroline Trunk-Black Juel,1 Zarqa Ali,1 Lisbeth Nilas,2 Charlotte Suppli Ulrik11Respiratory Section, Internal Medicine Unit, 2Department of Obstetrics and Gynaecology, Hvidovre Hospital and University of Copenhagen, Hvidovre, DenmarkAim and methods: Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma.Results: Weight loss in obese individuals with doctor-diagnosed asthma is associated with a 48%–100% remission of asthma symptoms and use of asthma medication. Published studies, furthermore, reveal that weight loss in obese asthmatics improves asthma control, and that especially surgically induced weight loss results in significant improvements in asthma severity, use of asthma medication, dyspnoea, exercise tolerance, and acute exacerbations, including hospitalizations due to asthma. Furthermore, weight loss in obese asthmatics is associated with improvements in level of lung function and airway responsiveness to inhaled methacholine, whereas no significant improvements have been observed in exhaled nitric oxide or other markers of eosinophilic airway inflammation.Conclusion: Overweight and obese adults with asthma experience a high symptomatic remission rate and significant improvements in asthma control, including objective measures of disease activity, after weight loss. Although these positive effects of weight loss on asthma-related health outcomes seem not to be accompanied by remission or improvements in markers of eosinophilic airway inflammation, it has potentially important implications for the future burden of asthma.Keywords: asthma, weight loss, diet, bariatric surgery, asthma control

  13. Impact of vitamin D supplementation on endothelial and inflammatory markers in adults: A systematic review.

    Science.gov (United States)

    Agbalalah, Tari; Hughes, Stephen F; Freeborn, Ellen J; Mushtaq, Sohail

    2017-10-01

    This systematic review aims to evaluate randomised controlled trials (RCTs) investigating the effect of vitamin D supplementation on endothelial function and inflammation in adults. An electronic search of published randomised controlled trials, using Cochrane, Pubmed and Medline databases was conducted, with the search terms related to vitamin D and endothelial function. Inclusion criteria were RCTs in adult humans with a measure of vitamin D status using serum/plasma 25(OH)D and studies which administered the intervention through the oral route. Among the 1107 studies retrieved, 29 studies met the full inclusion criteria for this systematic review. Overall, 8 studies reported significant improvements in the endothelial/inflammatory biomarkers/parameters measured. However, in 2 out of the 8 studies, improvements were reported at interim time points, but improvements were absent post-intervention. The remaining 21 trial studies did not show significant improvements in the markers of interest measured. Evidence from the studies included in this systematic review did not demonstrate that vitamin D supplementation in adults, results in an improvement in circulating inflammatory and endothelial function biomarkers/parameters. This systematic review does not therefore support the use of vitamin D supplementation as a therapeutic or preventative measure for CVD in this respect. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  14. Systematic Review Methodology in Higher Education

    Science.gov (United States)

    Bearman, Margaret; Smith, Calvin D.; Carbone, Angela; Slade, Susan; Baik, Chi; Hughes-Warrington, Marnie; Neumann, David L.

    2012-01-01

    Systematic review methodology can be distinguished from narrative reviews of the literature through its emphasis on transparent, structured and comprehensive approaches to searching the literature and its requirement for formal synthesis of research findings. There appears to be relatively little use of the systematic review methodology within the…

  15. Systematic review of N-acetylcysteine in cystic fibrosis

    NARCIS (Netherlands)

    Duijvestijn, YCM; Brand, PLP

    A systematic review was carried out to evaluate whether the use of N-acetylcysteine to improve lung function in patients with cystic fibrosis is supported by published evidence. Medline and the Cochrane Library were searched and the reference lists of all retrieved papers and of relevant chapters of

  16. Methodological quality of systematic reviews addressing femoroacetabular impingement.

    Science.gov (United States)

    Kowalczuk, Marcin; Adamich, John; Simunovic, Nicole; Farrokhyar, Forough; Ayeni, Olufemi R

    2015-09-01

    As the body of literature on femoroacetabular impingement (FAI) continues to grow, clinicians turn to systematic reviews to remain current with the best available evidence. The quality of systematic reviews in the FAI literature is currently unknown. The goal of this study was to assess the quality of the reporting of systematic reviews addressing FAI over the last 11 years (2003-2014) and to identify the specific methodological shortcomings and strengths. A search of the electronic databases, MEDLINE, EMBASE and PubMed, was performed to identify relevant systematic reviews. Methodological quality was assessed by two reviewers using the revised assessment of multiple systematic reviews (R-AMSTAR) scoring tool. An intraclass correlation coefficient (ICC) with 95 % confidence intervals (CI) was used to determine agreement between reviewers on R-AMSTAR quality scores. A total of 22 systematic reviews were assessed for methodological quality. The mean consensus R-AMSTAR score across all studies was 26.7 out of 40.0, indicating fair methodological quality. An ICC of 0.931, 95 % CI 0.843-0.971 indicated excellent agreement between reviewers during the scoring process. The systematic reviews addressing FAI are generally of fair methodological quality. Use of tools such as the R-AMSTAR score or PRISMA guidelines while designing future systematic reviews can assist in eliminating methodological shortcomings identified in this review. These shortcomings need to be kept in mind by clinicians when applying the current literature to their patient populations and making treatment decisions. Systematic reviews of highest methodological quality should be used by clinicians when possible to answer clinical questions.

  17. Self-Management Support Interventions for Stroke Survivors: A Systematic Meta-Review.

    Directory of Open Access Journals (Sweden)

    Hannah L Parke

    Full Text Available There is considerable policy interest in promoting self-management in patients with long-term conditions, but it remains uncertain whether these interventions are effective in stroke patients.Systematic meta-review of the evidence for self-management support interventions with stroke survivors to inform provision of healthcare services.We searched MEDLINE, EMBASE, CINAHL, PsychINFO, AMED, BNI, Database of Abstracts of Reviews for Effectiveness, and Cochrane Database of Systematic Reviews for systematic reviews of self-management support interventions for stroke survivors. Quality was assessed using the R-AMSTAR tool, and data extracted using a customised data extraction form. We undertook a narrative synthesis of the reviews' findings.From 12,400 titles we selected 13 systematic reviews (published 2003-2012 representing 101 individual trials. Although the term 'self-management' was rarely used, key elements of self-management support such as goal setting, action planning, and problem solving were core components of therapy rehabilitation interventions. We found high quality evidence that supported self-management in the context of therapy rehabilitation delivered soon after the stroke event resulted in short-term (< 1 year improvements in basic and extended activities of daily living, and a reduction in poor outcomes (dependence/death. There is some evidence that rehabilitation and problem solving interventions facilitated reintegration into the community.Self-management terminology is rarely used in the context of stroke. However, therapy rehabilitation currently successfully delivers elements of self-management support to stroke survivors and their caregivers with improved outcomes. Future research should focus on managing the emotional, medical and social tasks of long-term survivorship.

  18. Mentoring Nontenured Track Nursing Faculty: A Systematic Review.

    Science.gov (United States)

    Cullen, Deborah; Shieh, Carol; McLennon, Susan M; Pike, Caitlin; Hartman, Taylor; Shah, Hena

    The purpose of this systematic review was to evaluate the effectiveness of mentoring strategies for nursing faculty progression and productivity in the nontenure track at institutions of higher education. Sixty articles were included in the review. Findings revealed that nontenure track nursing faculty require planned programs and mentoring strategies unique to their role and abilities. Schools of nursing can improve on faculty progression, scholarship, and career growth by providing structured mentoring activity.

  19. Experiences of case management with chronic illnesses: a qualitative systematic review.

    Science.gov (United States)

    Joo, J Y; Liu, M F

    2018-03-01

    This qualitative systematic review aimed to identify and synthesize recent qualitative studies to improve understanding of the experiences and perceptions of case management interventions that individuals with chronic illnesses and their caregivers have. Case management has been shown to be effective at improving quality of care and lowering costs for individuals with chronic illnesses. However, no qualitative review has been synthesized with recent qualitative studies about case management experiences by individual with chronic illnesses. This qualitative systematic review uses a thematic synthesis method to review 10 qualitative studies published within the last 10 years, from 2007 to 2016, thereby identifying and discussing the understandings that individuals with chronic illnesses and their caregivers have about case management. From this synthesis, three themes were identified as facilitators of case management (access to healthcare resources, health status supports and emotional aid) and two themes were identified as barriers to it (low information about case management and time constraints). This is the first qualitative systematic review of the perceptions and experiences that individuals with chronic illnesses and their caregivers have about case management. The facilitators of case management can be employed to inform patients about the benefits of case management and to improve population health. The findings about barriers to case management can be used to reform case management for populations with chronic illnesses. These factors should be considered by nursing researchers and healthcare policymakers when implementing case management. © 2018 International Council of Nurses.

  20. Systematic review and meta-analysis: tools for the information age.

    Science.gov (United States)

    Weatherall, Mark

    2017-11-01

    The amount of available biomedical information is vast and growing. Natural limitations of the way clinicians and researchers approach this treasure trove of information comprise difficulties locating the information, and once located, cognitive biases may lead to inappropriate use of the information. Systematic reviews and meta-analyses represent important tools in the information age to improve knowledge and action. Systematic reviews represent a census approach to identifying literature to avoid non-response bias. They are a necessary prelude to producing combined quantitative summaries of associations or treatment effects. Meta-analysis comprises the arithmetical techniques for producing combined summaries from individual study reports. Careful, thoughtful and rigorous use of these tools is likely to enhance knowledge and action. Use of standard guidelines, such as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, or embedding these activities within collaborative groups such as the Cochrane Collaboration, are likely to lead to more useful systematic review and meta-analysis reporting. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Child maltreatment prevention: a systematic review of reviews.

    Science.gov (United States)

    Mikton, Christopher; Butchart, Alexander

    2009-05-01

    To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven - home-visiting, parent education, abusive head trauma prevention and multi-component interventions - show promise in preventing actual child maltreatment. Three of them - home visiting, parent education and child sexual abuse prevention - appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries.

  2. Reporting and Handling Missing Outcome Data in Mental Health: A Systematic Review of Cochrane Systematic Reviews and Meta-Analyses

    Science.gov (United States)

    Spineli, Loukia M.; Pandis, Nikolaos; Salanti, Georgia

    2015-01-01

    Objectives: The purpose of the study was to provide empirical evidence about the reporting of methodology to address missing outcome data and the acknowledgement of their impact in Cochrane systematic reviews in the mental health field. Methods: Systematic reviews published in the Cochrane Database of Systematic Reviews after January 1, 2009 by…

  3. A systematic review of the effectiveness of stroke self-management programs for improving function and participation outcomes: self-management programs for stroke survivors

    NARCIS (Netherlands)

    Warner, G.; Packer, T.L.; Villeneuve, M.; Audulv, A.; Versnel, J.

    2015-01-01

    PURPOSE: A systematic review of stroke self-management programs was conducted to: (i) identify how many and what self-management support strategies were included in stroke self-management interventions and (ii) describe whether self-management programs effectively improved outcomes, focusing

  4. Health Facility Staff Training for Improving Breastfeeding Outcome: A Systematic Review for Step 2 of the Baby-Friendly Hospital Initiative.

    Science.gov (United States)

    Balogun, Olukunmi O; Dagvadorj, Amarjargal; Yourkavitch, Jennifer; da Silva Lopes, Katharina; Suto, Maiko; Takemoto, Yo; Mori, Rintaro; Rayco-Solon, Pura; Ota, Erika

    2017-11-01

    The Baby-Friendly Hospital Initiative (BFHI) implemented through the "Ten Steps to Successful Breastfeeding" has been widely promoted as an intervention that improves breastfeeding rates. Step 2 requires the training of all healthcare staff in skills that are necessary to implement the policy. This systematic review provides evidence about the effect of training healthcare staff in hospitals and birth centers on breastfeeding outcomes. Randomized controlled trials (RCT), quasi-RCT, and controlled before and after (CBA) studies comparing training of healthcare staff on breastfeeding and supportive feeding practices with no training were included in this review. We searched CENTRAL PubMed, EMBASE, CINAHL, Web of Science, and the British Nursing Index for studies. Studies were screened against predetermined criteria, and risk of bias of included studies was assessed using the Risk of Bias Assessment tool for Non-Randomized Studies for non-RCT studies and the Cochrane Handbook for Systematic Reviews of Interventions for RCT studies. Of the six studies included in this review, three were RCT whereas three were CBA studies. The studies were conducted in 5 countries and involved 390 healthcare staff. Provision of educational interventions aimed at increasing knowledge and practice of BFHI and support was found to improve health worker's knowledge, attitude, and compliance with the BFHI practices. In one study, the rate of exclusive breastfeeding increased at the intervention site but no differences were found for breastfeeding initiation rates. All included studies had methodological limitations, and study designs and methodologies lacked comparability.

  5. Improving evidence based practice in postgraduate nursing programs: A systematic review: Bridging the evidence practice gap (BRIDGE project).

    Science.gov (United States)

    Hickman, Louise D; DiGiacomo, Michelle; Phillips, Jane; Rao, Angela; Newton, Phillip J; Jackson, Debra; Ferguson, Caleb

    2018-04-01

    The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. Systematic review that conforms to the PRISMA statement. Master's Nursing programs that include elements of a capstone project within a university setting. MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice. Copyright © 2018. Published by Elsevier Ltd.

  6. Using Mobile Phones to Improve Vaccination Uptake in 21 Low- and Middle-Income Countries: Systematic Review.

    Science.gov (United States)

    Oliver-Williams, Clare; Brown, Elizabeth; Devereux, Sara; Fairhead, Cassandra; Holeman, Isaac

    2017-10-04

    The benefits of vaccination have been comprehensively proven; however, disparities in coverage persist because of poor health system management, limited resources, and parental knowledge and attitudes. Evidence suggests that health interventions that engage local parties in communication strategies improve vaccination uptake. As mobile technology is widely used to improve health communication, mobile health (mHealth) interventions might be used to increase coverage. The aim of this study was to conduct a systematic review of the available literature on the use of mHealth to improve vaccination in low- and middle-income countries with large numbers of unvaccinated children. In February 2017, MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, and Web of Science, as well as three health organization websites-Communication Initiative Network, TechNet-21, and PATH-were searched to identify mHealth intervention studies on vaccination uptake in 21 countries. Ten peer-reviewed studies and 11 studies from white or gray literature were included. Nine took place in India, three in Pakistan, two each in Malawi and Nigeria, and one each in Bangladesh, Zambia, Zimbabwe, and Kenya. Ten peer-reviewed studies and 7 white or gray studies demonstrated improved vaccination uptake after interventions, including appointment reminders, mobile phone apps, and prerecorded messages. Although the potential for mHealth interventions to improve vaccination coverage seems clear, the evidence for such interventions is not. The dearth of studies in countries facing the greatest barriers to immunization impedes the prospects for evidence-based policy and practice in these settings. ©Clare Oliver-Williams, Elizabeth Brown, Sara Devereux, Cassandra Fairhead, Isaac Holeman. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 04.10.2017.

  7. Twelve myths about systematic reviews for health system policymaking rebutted.

    Science.gov (United States)

    Moat, Kaelan A; Lavis, John N; Wilson, Mike G; Røttingen, John-Arne; Bärnighausen, Till

    2013-01-01

    Systematic reviews are increasingly being viewed as important sources of information for policymakers who need to make decisions on different aspects of the health system, often under tight time constraints and with many factors competing for their attention. Unfortunately, a number of misconceptions, or 'myths', stand in the way of promoting their use. The belief that systematic review topics are not relevant to health systems policymaking, that they cannot be found quickly, and that they are not available in formats that are useful for policymakers are but three examples of such myths. This paper uses evidence drawn mainly from Health Systems Evidence, a continuously updated repository of syntheses of health systems research, to counter these and nine other common myths, with the aim of changing the constraining beliefs associated with them, while improving the prospects for the use of systematic reviews in health system policymaking.

  8. Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery

    Directory of Open Access Journals (Sweden)

    Gaetana Cognetti

    2015-03-01

    Full Text Available Introduction. Systematic reviews are fundamental sources of knowledge on the state-of-the-art interventions for various clinical problems. One of the essential components in carrying out a systematic review is that of developing a comprehensive literature search. Materials and methods. Three Cochrane systematic reviews published in 2012 were retrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respect to the information sources used and the search strategies adopted. In March 2014, an update of one of the reviews retrieved was also considered in the study. Results. The number of databases queried for each review ranged between three and seven. All the reviews reported the search strategies adopted, however some only partially. All the reviews explicitly claimed that the searches applied no language restriction although sources such as the free database Lilacs (in Spanish and Portuguese was not consulted. Conclusion. To improve the quality it is necessary to apply standards in carrying out systematic reviews (as laid down in the MECIR project. To meet these standards concerning literature searching, professional information retrieval specialist staff should be involved. The peer review committee in charge of evaluating the publication of a systematic review should also include specialists in information retrieval for assessing the quality of the literature search.

  9. Information retrieval for the Cochrane systematic reviews: the case of breast cancer surgery.

    Science.gov (United States)

    Cognetti, Gaetana; Grossi, Laura; Lucon, Antonio; Solimini, Renata

    2015-01-01

    Systematic reviews are fundamental sources of knowledge on the state-of-the-art interventions for various clinical problems. One of the essential components in carrying out a systematic review is that of developing a comprehensive literature search. Three Cochrane systematic reviews published in 2012 were retrieved using the MeSH descriptor breast neoplasms/surgery, and analyzed with respect to the information sources used and the search strategies adopted. In March 2014, an update of one of the reviews retrieved was also considered in the study. The number of databases queried for each review ranged between three and seven. All the reviews reported the search strategies adopted, however some only partially. All the reviews explicitly claimed that the searches applied no language restriction although sources such as the free database Lilacs (in Spanish and Portuguese) was not consulted. To improve the quality it is necessary to apply standards in carrying out systematic reviews (as laid down in the MECIR project). To meet these standards concerning literature searching, professional information retrieval specialist staff should be involved. The peer review committee in charge of evaluating the publication of a systematic review should also include specialists in information retrieval for assessing the quality of the literature search.

  10. Dynamic exercise therapy in rheumatoid arthritis: a systematic review.

    NARCIS (Netherlands)

    Ende, C.H.M. van den; Vliet Vlieland, T.P.M.; Munneke, M.; Hazes, J.M.W.

    1998-01-01

    The aim of this systematic review was to determine the effectiveness of dynamic exercixe therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (RA). In addition, possible unwanted effects such as an increase in pain,

  11. Interventions for improving nutrition and physical activity behaviors in adult African American populations: a systematic review, January 2000 through December 2011.

    Science.gov (United States)

    Lemacks, Jennifer; Wells, Brittny A; Ilich, Jasminka Z; Ralston, Penny A

    2013-06-20

    The incidence of preventable chronic diseases is disproportionally high among African Americans and could be reduced through diet and physical activity interventions. Our objective was to systematically review the literature on clinical outcomes of diet and physical activity interventions conducted among adult African American populations in the United States. We used the Preferred Reporting Items for Systematic Review and Meta Analysis construct in our review. We searched Medline (PubMed and Ovid), Cochrane, and DARE databases and restricted our search to articles published in English from January 2000 through December 2011. We included studies of educational interventions with clinically relevant outcomes and excluded studies that dealt with nonadult populations or populations with pre-existing catabolic or other complicated disorders, that did not focus on African Americans, that provided no quantitative baseline or follow-up data, or that included no diet or physical activity education or intervention. We report retention and attendance rates, study setting, program sustainability, behavior theory, and education components. Nineteen studies were eligible for closer analysis. These studies described interventions for improving diet or physical activity as indicators of health promotion and disease prevention and that reported significant improvement in clinical outcomes. Our review suggests that nutrition and physical activity educational interventions can be successful in improving clinically relevant outcomes among African Americans in the United States. Further research is needed to study the cost and sustainability of lifestyle interventions. Further studies should also include serum biochemical parameters to substantiate more specifically the effect of interventions on preventing chronic disease and reducing its incidence and prevalence.

  12. Systematic review

    DEFF Research Database (Denmark)

    Lødrup, Anders Bergh; Reimer, Christina; Bytzer, Peter

    2013-01-01

    in getting off acid-suppressive medication and partly explain the increase in long-term use of PPI. A number of studies addressing this issue have been published recently. The authors aimed to systematically review the existing evidence of clinically relevant symptoms caused by acid rebound following PPI...

  13. A Critical Review of Search Strategies Used in Recent Systematic Reviews Published in Selected Prosthodontic and Implant-Related Journals: Are Systematic Reviews Actually Systematic?

    Science.gov (United States)

    Layton, Danielle

    The aim of this study was to outline how search strategies can be systematic, to examine how the searches in recent systematic reviews in prosthodontic and implant-related journals were structured, and to determine whether the search strategies used in those articles were systematic. A total of 103 articles published as systematic reviews and indexed in Medline between January 2013 and May 2016 were identified from eight prosthodontic and implant journals and reviewed. The search strategies were considered systematic when they met the following criteria: (1) more than one electronic database was searched, (2) more than one searcher was clearly involved, (3) both text words and indexing terms were clearly included in the search strategy, (4) a hand search of selected journals or reference lists was undertaken, (5) gray research was specifically sought, and (6) the articles were published in English and at least one other language. The data were tallied and qualitatively assessed. The majority of articles reported on implants (54%), followed by tooth-supported fixed prosthodontics (13%). A total of 23 different electronic resources were consulted, including Medline (by 100% of articles), the Cochrane Library (52%), and Embase (37%). The majority consulted more than one electronic resource (71%), clearly included more than one searcher (73%), and employed a hand search of either selected journals or reference lists (86%). Less than half used both text words and indexing terms to identify articles (42%), while 15% actively sought gray research. Articles published in languages other than English were considered in 63 reviews, but only 14 had no language restrictions. Of the 103 articles, 5 completed search strategies that met all 6 criteria, and a further 12 met 5 criteria. Two articles did not fulfill any of the criteria. More than 95% of recent prosthodontic and implant review articles published in the selected journals failed to use search strategies that were

  14. Effectiveness of Sensory Stimulation to Improve Arousal and Alertness of People in a Coma or Persistent Vegetative State After Traumatic Brain Injury: A Systematic Review.

    Science.gov (United States)

    Padilla, René; Domina, Anna

    2016-01-01

    This systematic review evaluates the effectiveness of sensory stimulation to improve arousal and alertness of people in a coma or persistent vegetative state after traumatic brain injury (TBI). Databases searched included Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews. The search was limited to outcomes studies published in English in peer-reviewed journals between 2008 and 2013. Included studies provide strong evidence that multimodal sensory stimulation improves arousal and enhances clinical outcomes for people in a coma or persistent vegetative state after TBI. Moderate evidence was also provided for auditory stimulation, limited evidence was provided for complex stimuli, and insufficient evidence was provided for median nerve stimulation. Interventions should be tailored to client tolerance and premorbid preferences. Bimodal or multimodal stimulation should begin early, be frequent, and be sustained until more complex activity is possible. Copyright © 2016 by the American Occupational Therapy Association, Inc.

  15. β-hydroxy-β-methylbutyrate free acid supplementation may improve recovery and muscle adaptations after resistance training: a systematic review.

    Science.gov (United States)

    Silva, Vagner R; Belozo, Felipe L; Micheletti, Thayana O; Conrado, Marcelo; Stout, Jeffrey R; Pimentel, Gustavo D; Gonzalez, Adam M

    2017-09-01

    β-Hydroxy-β-methylbutyrate free acid (HMB-FA) has been suggested to accelerate the regenerative capacity of skeletal muscle after high-intensity exercise and attenuate markers of skeletal muscle damage. Herein a systematic review on the use of HMB-FA supplementation as an ergogenic aid to improve measures of muscle recovery, performance, and hypertrophy after resistance training was conducted. This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We included randomized, double-blinded, placebo-controlled trials investigating the effects of HMB-FA supplementation in conjunction with resistance exercise in humans. The search was conducted using Medline and Google Scholar databases for the terms beta-hydroxy-beta-methylbutyrate, HMB free acid, exercise, resistance exercise, strength training, and HMB supplementation. Only research articles published from 1996 to 2016 in English language were considered for the analysis. Nine studies met the criteria for inclusion in the analyses. Most studies included resistance-trained men, and the primary intervention strategy involved administration of 3g of HMB-FA per day. In conjunction with resistance training, HMB-FA supplementation may attenuate markers of muscle damage, augment acute immune and endocrine responses, and enhance training-induced muscle mass and strength. HMB-FA supplementation may also improve markers of aerobic fitness when combined with high-intensity interval training. Nevertheless, more studies are needed to determine the overall efficacy of HMB-FA supplementation as an ergogenic aid. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Using systematic review in occupational safety and health.

    Science.gov (United States)

    Howard, John; Piacentino, John; MacMahon, Kathleen; Schulte, Paul

    2017-11-01

    Evaluation of scientific evidence is critical in developing recommendations to reduce risk. Healthcare was the first scientific field to employ a systematic review approach for synthesizing research findings to support evidence-based decision-making and it is still the largest producer and consumer of systematic reviews. Systematic reviews in the field of occupational safety and health are being conducted, but more widespread use and adoption would strengthen assessments. In 2016, NIOSH asked RAND to develop a framework for applying the traditional systematic review elements to the field of occupational safety and health. This paper describes how essential systematic review elements can be adapted for use in occupational systematic reviews to enhance their scientific quality, objectivity, transparency, reliability, utility, and acceptability. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  17. Considering resistance in systematic reviews of antibiotic treatment.

    Science.gov (United States)

    Leibovici, Leonard; Soares-Weiser, Karla; Paul, Mical; Goldberg, Elad; Herxheimer, Andrew; Garner, Paul

    2003-10-01

    Microorganisms resistant to antibiotic drugs are a threat to the health and chances of survival of patients. Systematic reviews on antibiotic drugs that ignore the topic of resistance present readers with a skewed view, emphasizing short-term efficacy or effectiveness while ignoring long-term consequences. To examine whether systematic reviews of antibiotic treatment consider resistance; if not, to find out whether data on resistance were reported in the original trials; and based on that, to offer a framework for taking resistance into account in systematic reviews. The Cochrane Database of Systematic Reviews (the Cochrane Library, 2001, issue 2); and MEDLINE, 1996-2000. (i) Systematic reviews or meta-analyses of antimicrobial therapy, published during 1996-2000. (ii) Randomized, controlled trials abstracted in systematic reviews that addressed a topic highly relevant to antibiotic resistance. We examined each systematic review, and each article, to see whether the implications of resistance were discussed; and whether data on resistance were collected. Out of 111 systematic reviews, only 44 (40%) discussed resistance. Ten reviews (9%) planned or performed collection of data on the response of patients with susceptible or resistant isolates. In 22 systematic reviews (20%), collection of data on induction of resistance was planned or performed. The topic of 41 reviews was judged highly relevant to resistance, and these reviews extracted data from 337 articles, out of which we retrieved 279 articles (83%). In 201 (72%) articles, resistance was discussed or data pertaining to it were collected. Ninety-seven articles (35%) gave actual data on resistance of pathogens to the study drugs, 71 articles (25%) data on efficacy of antibiotic drugs in patients with susceptible and resistant pathogens, and 55 articles (20%) provided data on infection or colonization with resistant strains during treatment. Most systematic reviews on antibiotic treatment ignored the issue of

  18. A primer on systematic reviews in toxicology.

    Science.gov (United States)

    Hoffmann, Sebastian; de Vries, Rob B M; Stephens, Martin L; Beck, Nancy B; Dirven, Hubert A A M; Fowle, John R; Goodman, Julie E; Hartung, Thomas; Kimber, Ian; Lalu, Manoj M; Thayer, Kristina; Whaley, Paul; Wikoff, Daniele; Tsaioun, Katya

    2017-07-01

    Systematic reviews, pioneered in the clinical field, provide a transparent, methodologically rigorous and reproducible means of summarizing the available evidence on a precisely framed research question. Having matured to a well-established approach in many research fields, systematic reviews are receiving increasing attention as a potential tool for answering toxicological questions. In the larger framework of evidence-based toxicology, the advantages and obstacles of, as well as the approaches for, adapting and adopting systematic reviews to toxicology are still being explored. To provide the toxicology community with a starting point for conducting or understanding systematic reviews, we herein summarized available guidance documents from various fields of application. We have elaborated on the systematic review process by breaking it down into ten steps, starting with planning the project, framing the question, and writing and publishing the protocol, and concluding with interpretation and reporting. In addition, we have identified the specific methodological challenges of toxicological questions and have summarized how these can be addressed. Ultimately, this primer is intended to stimulate scientific discussions of the identified issues to fuel the development of toxicology-specific methodology and to encourage the application of systematic review methodology to toxicological issues.

  19. Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression

    Directory of Open Access Journals (Sweden)

    Amy M Dennett

    2016-04-01

    Full Text Available Question: Is there a dose-response effect of exercise on inflammation, fatigue and activity in cancer survivors? Design: Systematic review with meta-regression analysis of randomised trials. Participants: Adults diagnosed with cancer, regardless of specific diagnosis or treatment. Intervention: Exercise interventions including aerobic and/or resistance as a key component. Outcome measures: The primary outcome measures were markers of inflammation (including C-reactive protein and interleukins and various measures of fatigue. The secondary outcomes were: measures of activity, as defined by the World Health Organization's International Classification of Functioning, Disability and Health, including activities of daily living and measures of functional mobility (eg, 6-minute walk test, timed sit-to-stand and stair-climb tests. Risk of bias was evaluated using the PEDro scale, and overall quality of evidence was assessed using the Grades of Research, Assessment, Development and Evaluation (GRADE approach. Results: Forty-two trials involving 3816 participants were included. There was very low-quality to moderate-quality evidence that exercise results in significant reductions in fatigue (SMD 0.32, 95% CI 0.13 to 0.52 and increased walking endurance (SMD 0.77, 95% CI 0.26 to 1.28. A significant negative association was found between aerobic exercise intensity and fatigue reduction. A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance. No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes. Rates of adherence were typically high and few adverse events were reported. Conclusions: Exercise is safe, reduces fatigue and increases endurance in cancer survivors. The results support the recommendation of prescribing moderate-intensity aerobic exercise to reduce fatigue and improve activity in people with cancer. Review registration: PROSPERO CRD

  20. Methodological quality of systematic reviews on influenza vaccination.

    Science.gov (United States)

    Remschmidt, Cornelius; Wichmann, Ole; Harder, Thomas

    2014-03-26

    There is a growing body of evidence on the risks and benefits of influenza vaccination in various target groups. Systematic reviews are of particular importance for policy decisions. However, their methodological quality can vary considerably. To investigate the methodological quality of systematic reviews on influenza vaccination (efficacy, effectiveness, safety) and to identify influencing factors. A systematic literature search on systematic reviews on influenza vaccination was performed, using MEDLINE, EMBASE and three additional databases (1990-2013). Review characteristics were extracted and the methodological quality of the reviews was evaluated using the assessment of multiple systematic reviews (AMSTAR) tool. U-test, Kruskal-Wallis test, chi-square test, and multivariable linear regression analysis were used to assess the influence of review characteristics on AMSTAR-score. Fourty-six systematic reviews fulfilled the inclusion criteria. Average methodological quality was high (median AMSTAR-score: 8), but variability was large (AMSTAR range: 0-11). Quality did not differ significantly according to vaccination target group. Cochrane reviews had higher methodological quality than non-Cochrane reviews (p=0.001). Detailed analysis showed that this was due to better study selection and data extraction, inclusion of unpublished studies, and better reporting of study characteristics (all p<0.05). In the adjusted analysis, no other factor, including industry sponsorship or journal impact factor had an influence on AMSTAR score. Systematic reviews on influenza vaccination showed large differences regarding their methodological quality. Reviews conducted by the Cochrane collaboration were of higher quality than others. When using systematic reviews to guide the development of vaccination recommendations, the methodological quality of a review in addition to its content should be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Effectiveness of exercise intervention on improving fundamental movement skills and motor coordination in overweight/obese children and adolescents: A systematic review.

    Science.gov (United States)

    Han, Ahreum; Fu, Allan; Cobley, Stephen; Sanders, Ross H

    2018-01-01

    Childhood obesity is negatively associated with fundamental movement skill and motor coordination, which in turn constrains physical activity participation and adherence thereby forming a 'vicious cycle'. However, developing motor skill and coordination in childhood could help to break the vicious cycle to reduce childhood obesity. The objective of this systematic review was to determine the effectiveness of exercise and physical activity interventions on improving fundamental movement skill and motor coordination in overweight/obese children and adolescents. A systematic review with quality assessment. A comprehensive systematic search was conducted from MEDLINE, SPORTDiscus, CINAHL, Scopus, Web of Science, EMBASE without date restriction for randomized control trials, interventions or longitudinal studies of movement skill/motor skill/motor coordination in overweight/obese participants between 0-18 years of age. A total of 3944 publications were screened, and 17 published studies were included. Altogether 38 tests for locomotor, object-control, balance and complex task tests were examined in selected studies, with 33 reporting increases after interventions, while only five tests indicated no change. The evidence strongly suggests that exercise/physical activity interventions were effective in improving locomotor skill, object-control skill and complex tasks in overweight/obese peers. However, the results for balance were equivocal. Results from existing studies suggest overweight/obese peers have lower levels of fundamental movement skill than their healthy weight peers. However, exercise/physical activity interventions are effective in improving their skills. To maximize skill improvement, we recommend focused fundamental movement skill and motor coordination activities for skill development. These progressions in interventions may help break the vicious cycle of childhood obesity. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All

  2. Evidence Aid: Using Systematic Reviews to Improve Access to Evidence for Humanitarian Emergencies

    Directory of Open Access Journals (Sweden)

    Mike Clarke

    2017-10-01

    Full Text Available Evidence Aid is an international initiative to improve access to reliable evidence that will help people and organisations make well-informed decisions about interventions, actions and strategies in the disaster setting. It focuses on systematic reviews as the most reliable source of research evidence, maximising the power of existing research, avoiding undue emphasis on single studies and reducing the waste associated with research that is ignored or not accessible to decision makers. Evidence Aid is knowledge champion for influencers of the humanitarian sector, including funders, policy makers, NGOs, and humanitarian professionals. Evidence Aid was established by members of the Cochrane Collaboration after the Indian Ocean tsunami of December 2004. It provides access to information relevant to disaster risk reduction, planning, response, recovery, resilience and rehabilitation. This presentation will discuss the need for Evidence Aid, and describes its activities.Find out more about Mike.

  3. Using qualitative comparative analysis in a systematic review of a complex intervention.

    Science.gov (United States)

    Kahwati, Leila; Jacobs, Sara; Kane, Heather; Lewis, Megan; Viswanathan, Meera; Golin, Carol E

    2016-05-04

    Systematic reviews evaluating complex interventions often encounter substantial clinical heterogeneity in intervention components and implementation features making synthesis challenging. Qualitative comparative analysis (QCA) is a non-probabilistic method that uses mathematical set theory to study complex phenomena; it has been proposed as a potential method to complement traditional evidence synthesis in reviews of complex interventions to identify key intervention components or implementation features that might explain effectiveness or ineffectiveness. The objective of this study was to describe our approach in detail and examine the suitability of using QCA within the context of a systematic review. We used data from a completed systematic review of behavioral interventions to improve medication adherence to conduct two substantive analyses using QCA. The first analysis sought to identify combinations of nine behavior change techniques/components (BCTs) found among effective interventions, and the second analysis sought to identify combinations of five implementation features (e.g., agent, target, mode, time span, exposure) found among effective interventions. For each substantive analysis, we reframed the review's research questions to be designed for use with QCA, calibrated sets (i.e., transformed raw data into data used in analysis), and identified the necessary and/or sufficient combinations of BCTs and implementation features found in effective interventions. Our application of QCA for each substantive analysis is described in detail. We extended the original review findings by identifying seven combinations of BCTs and four combinations of implementation features that were sufficient for improving adherence. We found reasonable alignment between several systematic review steps and processes used in QCA except that typical approaches to study abstraction for some intervention components and features did not support a robust calibration for QCA. QCA was

  4. Fall detection with body-worn sensors : A systematic review

    NARCIS (Netherlands)

    Schwickert, L.; Becker, C.; Lindemann, U.; Marechal, C.; Bourke, A.; Chiari, L.; Helbostad, J. L.; Zijlstra, Wiebren; Aminian, K.; Todd, C.; Bandinelli, S.; Klenk, J.

    2013-01-01

    Background and aims. Falls among older people remain a major public health challenge. Body-worn sensors are needed to improve the understanding of the underlying mechanisms and kinematics of falls. The aim of this systematic review is to assemble, extract and critically discuss the information

  5. Systematic review and meta-analysis of behavioral interventions to improve child pedestrian safety.

    Science.gov (United States)

    Schwebel, David C; Barton, Benjamin K; Shen, Jiabin; Wells, Hayley L; Bogar, Ashley; Heath, Gretchen; McCullough, David

    2014-09-01

    Pedestrian injuries represent a pediatric public health challenge. This systematic review/meta-analysis evaluated behavioral interventions to teach children pedestrian safety. Multiple strategies derived eligible manuscripts (published before April 1, 2013, randomized design, evaluated behavioral child pedestrian safety interventions). Screening 1,951 abstracts yielded 125 full-text retrievals. 25 were retained for data extraction, and 6 were later omitted due to insufficient data. In all, 19 articles reporting 25 studies were included. Risk of bias and quality of evidence were assessed. Behavioral interventions generally improve children's pedestrian safety, both immediately after training and at follow-up several months later. Quality of the evidence was low to moderate. Available evidence suggested interventions targeting dash-out prevention, crossing at parked cars, and selecting safe routes across intersections were effective. Individualized/small-group training for children was the most effective training strategy based on available evidence. Behaviorally based interventions improve children's pedestrian safety. Efforts should continue to develop creative, cost-efficient, and effective interventions. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Improving the health of mental health staff through exercise interventions: a systematic review.

    Science.gov (United States)

    Fibbins, Hamish; Ward, Philip B; Watkins, Andrew; Curtis, Jackie; Rosenbaum, Simon

    2018-04-01

    Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.

  7. 10 CFR 1045.43 - Systematic review for declassification.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review of...

  8. Online Peer-to-Peer Support for Young People With Mental Health Problems: A Systematic Review

    OpenAIRE

    Ali, Kathina; Farrer, Louise; Gulliver, Amelia; Griffiths, Kathleen M

    2015-01-01

    Background Adolescence and early adulthood are critical periods for the development of mental disorders. Online peer-to-peer communication is popular among young people and may improve mental health by providing social support. Previous systematic reviews have targeted Internet support groups for adults with mental health problems, including depression. However, there have been no systematic reviews examining the effectiveness of online peer-to-peer support in improving the mental health of a...

  9. Does radiography advanced practice improve patient outcomes and health service quality? A systematic review.

    Science.gov (United States)

    Hardy, Maryann; Johnson, Louise; Sharples, Rachael; Boynes, Stephen; Irving, Donna

    2016-06-01

    To investigate the impact of radiographer advanced practice on patient outcomes and health service quality. Using the World Health Organization definition of quality, this review followed the Centre for Reviews and Dissemination guidance for undertaking reviews in healthcare. A range of databases were searched using a defined search strategy. Included studies were assessed for quality using a tool specifically developed for reviewing studies of diverse designs, and data were systematically extracted using electronic data extraction pro forma. 407 articles were identified and reviewed against the inclusion/exclusion criteria. Nine studies were included in the final review, the majority (n = 7) focusing on advanced radiography practice within the UK. Advanced practice activities considered were radiographer reporting, leading patient review clinics and barium enema examinations. The articles were generally considered to be of low-to-moderate quality, with most evaluating advanced practice within a single centre. With respect to specific quality dimensions, the included studies considered cost reduction, patient morbidity, time to treatment and patient satisfaction. No articles reported data relating to time to diagnosis, time to recovery or patient mortality. Radiographer advanced practice is an established activity both in the UK and internationally. However, evidence of the impact of advanced practice in terms of patient outcomes and service quality is limited. This systematic review is the first to examine the evidence base surrounding advanced radiography practice and its impact on patient outcomes and health service quality.

  10. Serious games for upper limb rehabilitation: a systematic review.

    Science.gov (United States)

    Proença, João Pedro; Quaresma, Cláudia; Vieira, Pedro

    2018-01-01

    The aim of this research is to carry out a systematic review of the use of technological gaming platforms with serious games in the upper limb rehabilitation of patients with neuromotor disorders. Through a systematic review, the first two authors defined the inclusion criteria and extracted the data, resulting in 38 studies collected from B-On, PubMed and Medline. Ninety-two per cent of the selected articles were published since 2010. This review documents 35 different gaming platforms types. Twenty-one of the 38 articles included in this review conducted a clinical trial and of those only eight report improvements in the target population following the use of the games and platforms. This review concludes that a new paradigm is emerging in the rehabilitation field, characterized by the systematic use of technological gaming platforms with serious games in/for rehabilitation. The use of this approach seems to be beneficial. However, to facilitate the full integration of these platforms, it is necessary to conduct more research in this area, explore new approaches and carry out in-depth clinical studies into the benefits of these platforms. Implications for rehabilitation This review states that the use serious games and gaming platforms for upper limb rehabilitation are starting a new paradigm in the rehabilitation. For a full integration of this technologies in the rehabilitation field more studies are needed.

  11. Organizational change to transfer knowledge and improve quality and outcomes of care for patients with severe mental illness: a systematic overview of reviews.

    NARCIS (Netherlands)

    Franx, G.C.; Kroon, H.; Grimshaw, J.; Drake, R.; Grol, R.P.T.M.; Wensing, M.J.P.

    2008-01-01

    OBJECTIVE: To provide a comprehensive overview of the research on organizational changes aimed at improving health care for patients with severe mental illness and to learn lessons for mental health practice from the results. METHOD: We searched for systematic literature reviews published in English

  12. 12 CFR 403.6 - Systematic review for declassification.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Systematic review for declassification. 403.6..., AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION § 403.6 Systematic review for declassification... permanent retention will be subject to systematic declassification review by the Archivist in accordance...

  13. 32 CFR 2400.20 - Systematic review for declassification.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Systematic review for declassification. 2400.20... SECURITY PROGRAM Declassification and Downgrading § 2400.20 Systematic review for declassification. (a) Permanent records. Systematic review is applicable only to those classified records, and presidential papers...

  14. Assessing the effectiveness and cost effectiveness of adaptive e-Learning to improve dietary behaviour: protocol for a systematic review.

    Science.gov (United States)

    Edwards, Phil; Felix, Lambert; Harris, Jody; Ferguson, Elaine; Free, Caroline; Landon, Jane; Lock, Karen; Michie, Susan; Miners, Alec; Murray, Elizabeth

    2010-04-21

    The composition of habitual diets is associated with adverse or protective effects on aspects of health. Consequently, UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is e-Learning, the use of interactive electronic media to facilitate teaching and learning on a range of issues, including diet and health. The aims of this systematic review are to determine the effectiveness and cost-effectiveness of adaptive e-Learning for improving dietary behaviours. The research will consist of a systematic review and a cost-effectiveness analysis. Studies will be considered for the review if they are randomised controlled trials, involving participants aged 13 or over, which evaluate the effectiveness or efficacy of interactive software programmes for improving dietary behaviour. Primary outcome measures will be those related to dietary behaviours, including estimated intakes of energy, nutrients and dietary fibre, or the estimated number of servings per day of foods or food groups. Secondary outcome measures will be objective clinical measures that are likely to respond to changes in dietary behaviours, such as anthropometry or blood biochemistry. Knowledge, self-efficacy, intention and emotion will be examined as mediators of dietary behaviour change in order to explore potential mechanisms of action. Databases will be searched using a comprehensive four-part search strategy, and the results exported to a bibliographic database. Two review authors will independently screen results to identify potentially eligible studies, and will independently extract data from included studies, with any discrepancies at each stage settled by a third author. Standardised forms and criteria will be used.A descriptive analysis of included studies will describe study design, participants, the

  15. Effectiveness of two interventions in preventing traffic accidents: a systematic review.

    Science.gov (United States)

    Porchia, B R; Baldasseroni, A; Dellisanti, C; Lorini, C; Bonaccorsi, G

    2014-01-01

    The prevention of road traffic accidents should be considered a serious public health concern, since they are the eighth leading cause of death globally and the main cause of death for young people aged 15-29. Evidences from many countries show that successes in preventing road traffic injuries can be achieved through concerted efforts at national level. The aim of our study was to assess the effectiveness of two interventions to prevent road traffic accidents: the introduction of graduated driver licensing (GDL) and the interventions to improve pedestrian and cyclist visibility. Our search started with a scoping review on the interventions to prevent road traffic accidents to allow the development of a logical framework of traffic accidents. Specific and answerable questions formulated according to PICO scheme and combinations of keywords were used to perform a systematic search in the following databases: Pubmed, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Health Evidence, Transport Research International Documentation (TRID) and Google. References of selected papers were searched. Only systematic reviews and meta-analyses were eligible. No temporal limits or linguistic filters were applied. 160 systematic reviews and meta-analyses were found for the question of the introduction of GDL program and 188 on the improvement of visibility in cyclists and pedestrians. After selection, four papers were included in qualitative synthesis for each question. All included studies underwent quality evaluation. GDL programs seem to be effective in reducing crash rates among young drivers, in particular in 16 year-old. Programs with more restrictions seem also to reduce fatal events. To improve visibility of pedestrians and cyclists, street lighting has been suggested as an intervention able to improve driver's visual capabilities and ability to detect roadway hazards and to prevent car crashes. Visibility aids (fluorescent

  16. Interventions to improve medication adherence in adult kidney transplant recipients: a systematic review.

    Science.gov (United States)

    Low, Jac Kee; Williams, Allison; Manias, Elizabeth; Crawford, Kimberley

    2015-05-01

    In kidney transplantation, adherence to immunosuppressive therapy is paramount for long-term graft survival. This systematic review aimed to assess the effectiveness of interventions to improve medication adherence in adult kidney transplantation. Eight electronic databases were searched from inception to November 2013. Only primary intervention studies, which reported measurement of adherence to immunosuppressive medications after kidney transplantation, were included. The quality of all studies was assessed using the Consolidated Standards of Reporting Trials and Transparent Reporting of Evaluations with Non-randomized Designs checklists. A synthesis was undertaken to tease out the domains targeted by interventions: (i) educational/cognitive, (ii) counselling/behavioural, (iii) psychologic/affective and (iv) financial support. For each study, key information, such as population, location, methods of measurements, comparison group, type of intervention and outcomes, were extracted and tabulated. Twelve intervention studies were identified. Quality of studies ranged from 16.0 to 80.5%. Effective interventions were implemented for 3, 6 and 12 months. Medication adherence rates were greatly enhanced when multidimensional interventions were implemented whereas one-off feedback from a nurse and financial assistance programmes offered little improvement. Dose administration aids when used in conjunction with self-monitoring also improved adherence. The number of patients who had a drug holiday (at least 1-day interval without a dose) was higher in a once-daily regimen than a twice-daily regimen. The findings of this review suggest an intervention targeting behavioural risk factors or a combination of behavioural, educational and emotional changes is effective in enhancing medication adherence. Effectiveness of an intervention may be further enhanced if patients are encouraged to participate in the development process. © The Author 2014. Published by Oxford University

  17. Impact on process results of clinical decision support systems (CDSSs) applied to medication use: overview of systematic reviews.

    Science.gov (United States)

    Reis, Wálleri C; Bonetti, Aline F; Bottacin, Wallace E; Reis, Alcindo S; Souza, Thaís T; Pontarolo, Roberto; Correr, Cassyano J; Fernandez-Llimos, Fernando

    2017-01-01

    The purpose of this overview (systematic review of systematic reviews) is to evaluate the impact of clinical decision support systems (CDSS) applied to medication use in the care process. A search for systematic reviews that address CDSS was performed on Medline following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane recommendations. Terms related to CDSS and systematic reviews were used in combination with Boolean operators and search field tags to build the electronic search strategy. There was no limitation of date or language for inclusion. We included revisions that investigated, as a main or secondary objective, changes in process outcomes. The Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) score was used to evaluate the quality of the studies. The search retrieved 954 articles. Five articles were added through manual search, totaling an initial sample of 959 articles. After screening and reading in full, 44 systematic reviews met the inclusion criteria. In the medication-use processes where CDSS was used, the most common stages were prescribing (n=38 (86.36%) and administering (n=12 (27.27%)). Most of the systematic reviews demonstrated improvement in the health care process (30/44 - 68.2%). The main positive results were related to improvement of the quality of prescription by the physicians (14/30 - 46.6%) and reduction of errors in prescribing (5/30 - 16.6%). However, the quality of the studies was poor, according to the score used. CDSSs represent a promising technology to optimize the medication-use process, especially related to improvement in the quality of prescriptions and reduction of prescribing errors, although higher quality studies are needed to establish the predictors of success in these systems.

  18. Systematic Quality Improvement in Medicine: Everyone Can Do It

    Directory of Open Access Journals (Sweden)

    Mark L. Zeidel

    2011-07-01

    Full Text Available In this brief review, written from the perspective of a physician-leader who has fostered the development of comprehensive quality improvement efforts at two academic medical centers, I review the need for improvement, some conceptual barriers that must be overcome, the goals of a comprehensive quality improvement (QI effort, some of the results we have obtained, and some observations on how to develop a culture of continuous improvement in an academic medical center. The mandate for quality improvement is clear; current healthcare is wasteful and error-prone, leading to excessive morbidity and mortality and unsustainably high costs. Successful quality improvement requires the abandonment of two paradigms: the craft model of medical practice and the notion that many forms of harm to patients are not preventable. I will describe how dramatic improvement has been achieved in reducing, by up to 10-fold, rates of central line infections, ventilator-associated pneumonias, peritonitis in peritoneal dialysis patients, and mortality due to cardiac arrest in hospital. I will describe as well how these methods can improve access to out-patient clinics dramatically and enhance the reliability and safety of hand-offs between covering physicians. To develop and maintain systematic quality improvement in all phases of medical care we must articulate a culture in which: everyone working at the medical center makes improvements every day; front-line staff, who know best how the work is done, are empowered to improve the processes of care; and multidisciplinary teams create the protocols that reduce variation that is due to physician preference, leaving only the variation required by the individual needs of patients. I will review as well the crucial elements of education of trainees and faculty members needed to guide and sustain a culture of quality. Finally, I will add some observations on how oversight boards and medical center leaders can help create

  19. Systematic quality improvement in medicine: everyone can do it.

    Science.gov (United States)

    Zeidel, Mark L

    2011-07-01

    In this brief review, written from the perspective of a physician-leader who has fostered the development of comprehensive quality improvement efforts at two academic medical centers, I review the need for improvement, some conceptual barriers that must be overcome, the goals of a comprehensive quality improvement (QI) effort, some of the results we have obtained, and some observations on how to develop a culture of continuous improvement in an academic medical center. The mandate for quality improvement is clear; current healthcare is wasteful and error-prone, leading to excessive morbidity and mortality and unsustainably high costs. Successful quality improvement requires the abandonment of two paradigms: the craft model of medical practice and the notion that many forms of harm to patients are not preventable. I will describe how dramatic improvement has been achieved in reducing, by up to 10-fold, rates of central line infections, ventilator-associated pneumonias, peritonitis in peritoneal dialysis patients, and mortality due to cardiac arrest in hospital. I will describe as well how these methods can improve access to out-patient clinics dramatically and enhance the reliability and safety of hand-offs between covering physicians. To develop and maintain systematic quality improvement in all phases of medical care we must articulate a culture in which: everyone working at the medical center makes improvements every day; front-line staff, who know best how the work is done, are empowered to improve the processes of care; and multidisciplinary teams create the protocols that reduce variation that is due to physician preference, leaving only the variation required by the individual needs of patients. I will review as well the crucial elements of education of trainees and faculty members needed to guide and sustain a culture of quality. Finally, I will add some observations on how oversight boards and medical center leaders can help create systematic quality

  20. Bringing gender sensitivity into healthcare practice: a systematic review.

    NARCIS (Netherlands)

    Celik, H.; Lagro-Janssen, T.; Widdershoven, G.G.; Abma, T.A.

    2011-01-01

    OBJECTIVE: Despite the body of literature on gender dimensions and disparities between the sexes in health, practical improvements will not be realized effectively as long as we lack an overview of the ways how to implement these ideas. This systematic review provides a content analysis of

  1. Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N).

    Science.gov (United States)

    Van der Wees, Philip; Qaseem, Amir; Kaila, Minna; Ollenschlaeger, Guenter; Rosenfeld, Richard

    2012-02-09

    Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N) aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO) initiative. G-I-N also recently launched a Data Extraction Resource (GINDER) to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

  2. A competency framework for librarians involved in systematic reviews.

    Science.gov (United States)

    Townsend, Whitney A; Anderson, Patricia F; Ginier, Emily C; MacEachern, Mark P; Saylor, Kate M; Shipman, Barbara L; Smith, Judith E

    2017-07-01

    The project identified a set of core competencies for librarians who are involved in systematic reviews. A team of seven informationists with broad systematic review experience examined existing systematic review standards, conducted a literature search, and used their own expertise to identify core competencies and skills that are necessary to undertake various roles in systematic review projects. The team identified a total of six competencies for librarian involvement in systematic reviews: "Systematic review foundations," "Process management and communication," "Research methodology," "Comprehensive searching," "Data management," and "Reporting." Within each competency are the associated skills and knowledge pieces (indicators). Competence can be measured using an adaptation of Miller's Pyramid for Clinical Assessment, either through self-assessment or identification of formal assessment instruments. The Systematic Review Competencies Framework provides a standards-based, flexible way for librarians and organizations to identify areas of competence and areas in need of development to build capacity for systematic review integration. The framework can be used to identify or develop appropriate assessment tools and to target skill development opportunities.

  3. [Visual cues as a therapeutic tool in Parkinson's disease. A systematic review].

    Science.gov (United States)

    Muñoz-Hellín, Elena; Cano-de-la-Cuerda, Roberto; Miangolarra-Page, Juan Carlos

    2013-01-01

    Sensory stimuli or sensory cues are being used as a therapeutic tool for improving gait disorders in Parkinson's disease patients, but most studies seem to focus on auditory stimuli. The aim of this study was to conduct a systematic review regarding the use of visual cues over gait disorders, dual tasks during gait, freezing and the incidence of falls in patients with Parkinson to obtain therapeutic implications. We conducted a systematic review in main databases such as Cochrane Database of Systematic Reviews, TripDataBase, PubMed, Ovid MEDLINE, Ovid EMBASE and Physiotherapy Evidence Database, during 2005 to 2012, according to the recommendations of the Consolidated Standards of Reporting Trials, evaluating the quality of the papers included with the Downs & Black Quality Index. 21 articles were finally included in this systematic review (with a total of 892 participants) with variable methodological quality, achieving an average of 17.27 points in the Downs and Black Quality Index (range: 11-21). Visual cues produce improvements over temporal-spatial parameters in gait, turning execution, reducing the appearance of freezing and falls in Parkinson's disease patients. Visual cues appear to benefit dual tasks during gait, reducing the interference of the second task. Further studies are needed to determine the preferred type of stimuli for each stage of the disease. Copyright © 2012 SEGG. Published by Elsevier Espana. All rights reserved.

  4. A Systematic Summary of Systematic Reviews on the Topic of the Anterior Cruciate Ligament

    Science.gov (United States)

    Anderson, Michael J.; Browning, William M.; Urband, Christopher E.; Kluczynski, Melissa A.; Bisson, Leslie J.

    2016-01-01

    Background: There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL). Purpose: To quantify the number of systematic reviews and meta-analyses published on the ACL in the past decade and to provide an overall summary of this literature. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of all ACL-related systematic reviews and meta-analyses published between January 2004 and September 2014 was performed using PubMed, MEDLINE, and the Cochrane Database. Narrative reviews and non-English articles were excluded. Results: A total of 1031 articles were found, of which 240 met the inclusion criteria. Included articles were summarized and divided into 17 topics: anatomy, epidemiology, prevention, associated injuries, diagnosis, operative versus nonoperative management, graft choice, surgical technique, fixation methods, computer-assisted surgery, platelet-rich plasma, rehabilitation, return to play, outcomes assessment, arthritis, complications, and miscellaneous. Conclusion: A summary of systematic reviews on the ACL can supply the surgeon with a single source for the most up-to-date synthesis of the literature. PMID:27047983

  5. Including non-public data and studies in systematic reviews and systematic maps.

    Science.gov (United States)

    Haddaway, Neal R; Collins, Alexandra M; Coughlin, Deborah; Kohl, Christian

    2017-02-01

    Systematic reviews and maps should be based on the best available evidence, and reviewers should make all reasonable efforts to source and include potentially relevant studies. However, reviewers may not be able to consider all existing evidence, since some data and studies may not be publicly available. Including non-public studies in reviews provides a valuable opportunity to increase systematic review/map comprehensiveness, potentially mitigating negative impacts of publication bias. Studies may be non-public for many reasons: some may still be in the process of being published (publication can take a long time); some may not be published due to author/publisher restrictions; publication bias may make it difficult to publish non-significant or negative results. Here, we consider what forms these non-public studies may take and the implications of including them in systematic reviews and maps. Reviewers should carefully consider the advantages and disadvantages of including non-public studies, weighing risks of bias against benefits of increased comprehensiveness. As with all systematic reviews and maps, reviewers must be transparent about methods used to obtain data and avoid risks of bias in their synthesis. We make tentative suggestions for reviewers in situations where non-public data may be present in an evidence base. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. What are the effects of teaching evidence-based health care (EBHC? Overview of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Taryn Young

    Full Text Available BACKGROUND: An evidence-based approach to health care is recognized internationally as a key competency for healthcare practitioners. This overview systematically evaluated and organized evidence from systematic reviews on teaching evidence-based health care (EBHC. METHODS/FINDINGS: We searched for systematic reviews evaluating interventions for teaching EBHC to health professionals compared to no intervention or different strategies. Outcomes covered EBHC knowledge, skills, attitudes, practices and health outcomes. Comprehensive searches were conducted in April 2013. Two reviewers independently selected eligible reviews, extracted data and evaluated methodological quality. We included 16 systematic reviews, published between 1993 and 2013. There was considerable overlap across reviews. We found that 171 source studies included in the reviews related to 81 separate studies, of which 37 are in more than one review. Studies used various methodologies to evaluate educational interventions of varying content, format and duration in undergraduates, interns, residents and practicing health professionals. The evidence in the reviews showed that multifaceted, clinically integrated interventions, with assessment, led to improvements in knowledge, skills and attitudes. Interventions improved critical appraisal skills and integration of results into decisions, and improved knowledge, skills, attitudes and behaviour amongst practicing health professionals. Considering single interventions, EBHC knowledge and attitude were similar for lecture-based versus online teaching. Journal clubs appeared to increase clinical epidemiology and biostatistics knowledge and reading behavior, but not appraisal skills. EBHC courses improved appraisal skills and knowledge. Amongst practicing health professionals, interactive online courses with guided critical appraisal showed significant increase in knowledge and appraisal skills. A short workshop using problem

  7. Exercise and reproductive function in polycystic ovary syndrome: protocol of a systematic review.

    Science.gov (United States)

    Dos Santos, Isis Kelly; de Lima Nunes, Romilson; Soares, Gustavo Mafaldo; de Oliveira Maranhão, Tecia Maria; Dantas, Paulo Moreira Silva

    2017-12-22

    Although many post-participation outcomes in different types of physical training (e.g., aerobic and strength) have been previously investigated for the treatment of polycystic ovary syndrome, there is no recent systematic review of the relationship between various types of intervention and the reproductive function of women with PCOS. The current paper describes a systematic review protocol on the benefits of physical exercise and dietary or drug interventions on endocrinological outcomes in women with PCOS. PubMed/MEDLINE, Science Direct, Bireme, Scopus, Web of Science, ProQuest, Cochrane Library (Cochrane Systematic Reviews Database, Cochrane Central Register of Controlled Studies (CENTRAL) databases will be searched. Studies randomized controlled trials reporting on intervening changes in exercise interventions with or without interventions compared such as diet, medication and acupuncture on the menstrual cycle, and fertility in women with PCOS will be included. Results will be on the decrease of the characteristics of hyperandrogenism, insulin resistance, and obesity. Studies published since 2010 and in the English language will be included. This systematic review will identify improvement strategies and types of interventions that are geared toward improving endocrine and consequently metabolic parameters. Thus, the use of such strategies may increase the types of low-cost non-drug therapies that aid in the treatment of PCOS. PROSPERO CRD42017058869.

  8. Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review.

    Science.gov (United States)

    Pugatch, Jillian; Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather

    2018-03-21

    The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users' ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on

  9. Manual therapy and exercise for neck pain: A systematic review

    NARCIS (Netherlands)

    Miller, Jordan; Gross, Anita; D'Sylva, Jonathan; Burnie, Stephen J.; Goldsmith, Charles H.; Graham, Nadine; Haines, Ted; Brønfort, Gert; Hoving, Jan L.

    2010-01-01

    Manual therapy is often used with exercise to treat neck pain. This cervical overview group systematic review update assesses if manual therapy, including manipulation or mobilisation, combined with exercise improves pain, function/disability, quality of life, global perceived effect, and patient

  10. Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: A systematic review of systematic reviews and meta-analyses

    NARCIS (Netherlands)

    N.J. Elbert (Niels); H. van Os-Medendorp (Harmieke); W. van Renselaar (Wilco); A.G. Ekeland (Anne G); L. van Hakkaart-van Roijen (Leona); H. Raat (Hein); T.E.C. Nijsten (Tamar); S.G.M.A. Pasmans (Suzanne)

    2014-01-01

    textabstractEHealth potentially enhances quality of care and may reduce health care costs. However, a review of systematic reviews published in 2010 concluded that high-quality evidence on the benefits of eHealth interventions was still lacking. Objective: We conducted a systematic review of

  11. Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Alireza Salehi

    2015-10-01

    Full Text Available Abstract Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention, diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data, scientific electronic databases, such as Cochrane, Medline, Google Scholar, and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment, included evidence from at least one clinical trial, included randomized studies and focused on a specific disease. The research data including the article’s first author’s name, type of disease, intervention type, number and types of research used, meta-analysis, number of participants, and overall results of the study, were extracted, studied and analyzed. Totally, 23 chiropractic systematic reviews were found, and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain, shoulder and neck trigger points, and sport injuries. In the cases of asthma, infant colic, autism spectrum disorder, gastrointestinal problems, fibromyalgia, back pain and carpal tunnel syndrome, there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus, conducting comprehensive studies based on more reliable study designs are highly recommended.

  12. The use of joint mobilization to improve clinical outcomes in hand therapy: a systematic review of the literature.

    Science.gov (United States)

    Heiser, Rick; O'Brien, Virginia H; Schwartz, Deborah A

    2013-01-01

    Systematic review. Joint mobilizations are used as an intervention for improving range of motion, decreasing pain and ultimately improving function in patients with a wide variety of upper extremity diagnoses. However, there are only a limited number of studies describing this treatment for conditions affecting the elbow, wrist, and hand. Furthermore, it is unclear as to the most effective joint mobilization technique utilized and the most beneficial functional outcomes gained. Examine the current evidence describing joint mobilizations for treatment of conditions of the elbow, wrist and hand, and offer informative practical clinical guidance. Twenty-two studies dated between 1980 and 2011 were included in the systematic review for analysis. The current evidence provides moderate support for the inclusion of joint mobilizations in the treatment of lateral epicondylalgia (LE). In particular, mobilization with movement as described by Mulligan is supported with evidence from nine randomized clinical trials as an effective technique for the treatment of pain. Other described techniques include those known as Kaltenborn, Cyriax physical therapy, and Maitland, but the evidence for these techniques is limited. There is also limited evidence for the joint mobilizations in the treatment of wrist and hand conditions. The current literature offers limited support for joint mobilizations of the wrist and hand, and moderate support for joint mobilizations of the elbow for LE. There is moderate support for mobilization with movement. . Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  13. Omega-3 polyunsaturated fatty acid supplementation for improving peripheral nerve health: protocol for a systematic review.

    Science.gov (United States)

    Zhang, Alexis Ceecee; MacIsaac, Richard J; Roberts, Leslie; Kamel, Jordan; Craig, Jennifer P; Busija, Lucy; Downie, Laura E

    2018-03-25

    Damage to peripheral nerves occurs in a variety of health conditions. Preserving nerve integrity, to prevent progressive nerve damage, remains a clinical challenge. Omega-3 polyunsaturated fatty acids (PUFAs) are implicated in the development and maintenance of healthy nerves and may be beneficial for promoting peripheral nerve health. The aim of this systematic review is to assess the effects of oral omega-3 PUFA supplementation on peripheral nerve integrity, including both subjective and objective measures of peripheral nerve structure and/or function. A systematic review of randomised controlled trials that have evaluated the effects of omega-3 PUFA supplementation on peripheral nerve assessments will be conducted. Comprehensive electronic database searches will be performed in Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), US National Institutes of Health Clinical Trials Registry and the WHO International Clinical Trials Registry Platform. The title, abstract and keywords of identified articles will be assessed for eligibility by two reviewers. Full-text articles will be obtained for all studies judged as eligible or potentially eligible; these studies will be independently assessed by two reviewers to determine eligibility. Disagreements will be resolved by consensus. Risk of bias assessment will be performed using the Cochrane Collaboration risk of bias tool to appraise the quality of included studies. If clinically meaningful, and there are a sufficient number of eligible studies, a meta-analysis will be conducted and a summary of findings table will be provided. This is a systematic review that will involve the analysis of previously published data, and therefore ethics approval is not required. A manuscript reporting the results of this systematic review will be published in a peer-reviewed journal and may also be presented at relevant scientific conferences. CRD42018086297. © Article author(s) (or their employer

  14. [Improving patient safety through voluntary peer review].

    Science.gov (United States)

    Kluge, S; Bause, H

    2015-01-01

    The intensive care unit (ICU) is one area of the hospital in which processes and communication are of primary importance. Errors in intensive care units can lead to serious adverse events with significant consequences for patients. Therefore quality and risk-management are important measures when treating critically ill patients. A pragmatic approach to support quality and safety in intensive care is peer review. This approach has gained significant acceptance over the past years. It consists of mutual visits by colleagues who conduct standardised peer reviews. These reviews focus on the systematic evaluation of the quality of an ICU's structure, its processes and outcome. Together with different associations, the State Chambers of Physicians and the German Medical Association have developed peer review as a standardized tool for quality improvement. The common goal of all stakeholders is the continuous and sustainable improvement in intensive care with peer reviews significantly increasing and improving communication between professions and disciplines. Peer reviews secure the sustainability of planned change processes and consequently lead the way to an improved culture of quality and safety.

  15. Searching the Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) database improves systematic reviews.

    Science.gov (United States)

    Clark, Otavio Augusto Camara; Castro, Aldemar Araujo

    2002-02-01

    An unbiased systematic review (SR) should analyse as many articles as possible in order to provide the best evidence available. However, many SR use only databases with high English-language content as sources for articles. Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) indexes 670 journals from the Latin American and Caribbean health literature but is seldom used in these SR. Our objective is to evaluate if LILACS should be used as a routine source of articles for SR. First we identified SR published in 1997 in five medical journals with a high impact factor. Then we searched LILACS for articles that could match the inclusion criteria of these SR. We also checked if the authors had already identified these articles located in LILACS. In all, 64 SR were identified. Two had already searched LILACS and were excluded. In 39 of 62 (63%) SR a LILACS search identified articles that matched the inclusion criteria. In 5 (8%) our search was inconclusive and in 18 (29%) no articles were found in LILACS. Therefore, in 71% (44/72) of cases, a LILACS search could have been useful to the authors. This proportion remains the same if we consider only the 37 SR that performed a meta-analysis. In only one case had the article identified in LILACS already been located elsewhere by the authors' strategy. LILACS is an under-explored and unique source of articles whose use can improve the quality of systematic reviews. This database should be used as a routine source to identify studies for systematic reviews.

  16. Hematology journals do not sufficiently adhere to reporting guidelines: a systematic review.

    Science.gov (United States)

    Wayant, C; Smith, C; Sims, M; Vassar, M

    2017-04-01

    Essentials Reporting guidelines and trial/review registration aim to limit bias in research. We systematically reviewed hematology journals to examine the use of these policies. Forty-eight percent of journals made no use of these policies. Improving the use of reporting guidelines will improve research for all stakeholders. Background Reporting guidelines and trial/review registration policies have been instituted in order to minimize bias and improve research practices. Objective The objective of this study was to investigate the policies of hematology journals concerning reporting guideline adoption and trial/review registration. Methods We performed a web-based data abstraction from the Instructions for Authors of 67 hematology journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports to identify whether each journal required, recommended or made no mention of the following reporting guidelines: EQUATOR, ICMJE, CONSORT, MOOSE, QUOROM, PRISMA, STARD, STROBE, ARRIVE and CARE. We also extracted whether journals required or recommended trial or systematic review registration. We e-mailed editors three times to determine which types of studies their journal accepts. Results Forty-eight per cent (32/67) of hematology journals do not adhere to any reporting guidelines. For responding journals, the QUOROM statement, MOOSE, CARE and PROSPERO were the least often mentioned, whereas the ICMJE guidelines, CONSORT statement and general trial registration were most often mentioned. Discussion Reporting guidelines are infrequently required or recommended by hematology journals. Furthermore, few require clinical trial or systematic review database registration. A higher rate of adherence to reporting guidelines can prevent bias from entering the literature. Participation from all stakeholders, including authors and journal editors, to improve reporting guideline and policy practices is required. © 2017 International Society on Thrombosis

  17. Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews.

    Science.gov (United States)

    Kitsiou, Spyros; Paré, Guy; Jaana, Mirou; Gerber, Ben

    2017-01-01

    Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes. The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers. A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR. Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect. Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.

  18. Prospective systematic review registration: perspective from the Guidelines International Network (G-I-N

    Directory of Open Access Journals (Sweden)

    Van der Wees Philip

    2012-02-01

    Full Text Available Abstract Clinical practice and public health guidelines are important tools for translating research findings into practice with the aim of assisting health practitioners as well as patients and consumers in health behavior and healthcare decision-making. Numerous programs for guideline development exist around the world, with growing international collaboration to improve their quality. One of the key features in developing trustworthy guidelines is that recommendations should be based on high-quality systematic reviews of the best available evidence. The review process used by guideline developers to identify and grade relevant evidence for developing recommendations should be systematic, transparent and unbiased. In this paper, we provide an overview of current international developments in the field of practice guidelines and methods to develop guidelines, with a specific focus on the role of systematic reviews. The Guidelines International Network (G-I-N aims to stimulate collaboration between guideline developers and systematic reviewers to optimize the use of available evidence in guideline development and to increase efficiency in the guideline development process. Considering the significant benefit of systematic reviews for the guideline community, the G-I-N Board of Trustees supports the international prospective register of systematic reviews (PROSPERO initiative. G-I-N also recently launched a Data Extraction Resource (GINDER to present and share data extracted from individual studies in a standardized template. PROSPERO and GINDER are complementary tools to enhance collaboration between guideline developers and systematic reviewers to allow for alignment of activities and a reduction in duplication of effort.

  19. Gray literature: An important resource in systematic reviews.

    Science.gov (United States)

    Paez, Arsenio

    2017-08-01

    Systematic reviews aide the analysis and dissemination of evidence, using rigorous and transparent methods to generate empirically attained answers to focused research questions. Identifying all evidence relevant to the research questions is an essential component, and challenge, of systematic reviews. Gray literature, or evidence not published in commercial publications, can make important contributions to a systematic review. Gray literature can include academic papers, including theses and dissertations, research and committee reports, government reports, conference papers, and ongoing research, among others. It may provide data not found within commercially published literature, providing an important forum for disseminating studies with null or negative results that might not otherwise be disseminated. Gray literature may thusly reduce publication bias, increase reviews' comprehensiveness and timeliness, and foster a balanced picture of available evidence. Gray literature's diverse formats and audiences can present a significant challenge in a systematic search for evidence. However, the benefits of including gray literature may far outweigh the cost in time and resource needed to search for it, and it is important for it to be included in a systematic review or review of evidence. A carefully thought out gray literature search strategy may be an invaluable component of a systematic review. This narrative review provides guidance about the benefits of including gray literature in a systematic review, and sources for searching through gray literature. An illustrative example of a search for evidence within gray literature sources is presented to highlight the potential contributions of such a search to a systematic review. Benefits and challenges of gray literature search methods are discussed, and recommendations made. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  20. Grey literature: An important resource in systematic reviews.

    Science.gov (United States)

    Paez, Arsenio

    2017-12-21

    Systematic reviews aid the analysis and dissemination of evidence, using rigorous and transparent methods to generate empirically attained answers to focused research questions. Identifying all evidence relevant to the research questions is an essential component, and challenge, of systematic reviews. Grey literature, or evidence not published in commercial publications, can make important contributions to a systematic review. Grey literature can include academic papers, including theses and dissertations, research and committee reports, government reports, conference papers, and ongoing research, among others. It may provide data not found within commercially published literature, providing an important forum for disseminating studies with null or negative results that might not otherwise be disseminated. Grey literature may thusly reduce publication bias, increase reviews' comprehensiveness and timeliness and foster a balanced picture of available evidence. Grey literature's diverse formats and audiences can present a significant challenge in a systematic search for evidence. However, the benefits of including grey literature may far outweigh the cost in time and resource needed to search for it, and it is important for it to be included in a systematic review or review of evidence. A carefully thought out grey literature search strategy may be an invaluable component of a systematic review. This narrative review provides guidance about the benefits of including grey literature in a systematic review, and sources for searching through grey literature. An illustrative example of a search for evidence within grey literature sources is presented to highlight the potential contributions of such a search to a systematic review. Benefits and challenges of grey literature search methods are discussed, and recommendations made. © 2017 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  1. Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review.

    Science.gov (United States)

    Lam, Freddy Mh; Huang, Mei-Zhen; Liao, Lin-Rong; Chung, Raymond Ck; Kwok, Timothy Cy; Pang, Marco Yc

    2018-01-01

    Does physical exercise training improve physical function and quality of life in people with cognitive impairment and dementia? Which training protocols improve physical function and quality of life? How do cognitive impairment and other patient characteristics influence the outcomes of exercise training? Systematic review with meta-analysis of randomised trials. People with mild cognitive impairment or dementia as the primary diagnosis. Physical exercise. Strength, flexibility, gait, balance, mobility, walking endurance, dual-task ability, activities of daily living, quality of life, and falls. Forty-three clinical trials (n=3988) were included. According to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system, the meta-analyses revealed strong evidence in support of using supervised exercise training to improve the results of 30-second sit-to-stand test (MD 2.1 repetitions, 95% CI 0.3 to 3.9), step length (MD 5cm, 95% CI 2 to 8), Berg Balance Scale (MD 3.6 points, 95% CI 0.3 to 7.0), functional reach (3.9cm, 95% CI 2.2 to 5.5), Timed Up and Go test (-1second, 95% CI -2 to 0), walking speed (0.13m/s, 95% CI 0.03 to 0.24), and 6-minute walk test (50m, 95% CI 18 to 81) in individuals with mild cognitive impairment or dementia. Weak evidence supported the use of exercise in improving flexibility and Barthel Index performance. Weak evidence suggested that non-specific exercise did not improve dual-tasking ability or activity level. Strong evidence indicated that exercise did not improve quality of life in this population. The effect of exercise on falls remained inconclusive. Poorer physical function was a determinant of better response to exercise training, but cognitive performance did not have an impact. People with various levels of cognitive impairment can benefit from supervised multi-modal exercise for about 60minutes a day, 2 to 3days a week to improve physical function. [Lam FMH , Huang MZ, Liao LR, Chung RCK, Kwok TCY, Pang MYC

  2. A Systematic Review: Using Habits of Mind to Improve Student's Thinking in Class

    Science.gov (United States)

    Alhamlan, Suad; Aljasser, Haya; Almajed, Asma; Almansour, Haila; Alahmad, Nidhal

    2018-01-01

    This review article aims to explore how habits of mind as the concept defined under the recent Framework for Success in Postsecondary Writing contributes to the development of critical thinking in the classroom. The application of a systematic review and a meta-analysis approach allows investigating the selected habits of mind and comparing them…

  3. Interventions to Improve Follow-Up of Laboratory Test Results Pending at Discharge: A Systematic Review.

    Science.gov (United States)

    Whitehead, Nedra S; Williams, Laurina; Meleth, Sreelatha; Kennedy, Sara; Epner, Paul; Singh, Hardeep; Wooldridge, Kathleene; Dalal, Anuj K; Walz, Stacy E; Lorey, Tom; Graber, Mark L

    2018-02-28

    Failure to follow up test results pending at discharge (TPAD) from hospitals or emergency departments is a major patient safety concern. The purpose of this review is to systematically evaluate the effectiveness of interventions to improve follow-up of laboratory TPAD. We conducted literature searches in PubMed, CINAHL, Cochrane, and EMBASE using search terms for relevant health care settings, transition of patient care, laboratory tests, communication, and pending or missed tests. We solicited unpublished studies from the clinical laboratory community and excluded articles that did not address transitions between settings, did not include an intervention, or were not related to laboratory TPAD. We also excluded letters, editorials, commentaries, abstracts, case reports, and case series. Of the 9,592 abstracts retrieved, 8 met the inclusion criteria and reported the successful communication of TPAD. A team member abstracted predetermined data elements from each study, and a senior scientist reviewed the abstraction. Two experienced reviewers independently appraised the quality of each study using published LMBP™ A-6 scoring criteria. We assessed the body of evidence using the A-6 methodology, and the evidence suggested that electronic tools or one-on-one education increased documentation of pending tests in discharge summaries. We also found that automated notifications improved awareness of TPAD. The interventions were supported by suggestive evidence; this type of evidence is below the level of evidence required for LMBP™ recommendations. We encourage additional research into the impact of these interventions on key processes and health outcomes. © 2018 Society of Hospital Medicine.

  4. Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review.

    Science.gov (United States)

    Snowdon, David A; Leggat, Sandra G; Taylor, Nicholas F

    2017-11-28

    To ensure quality of care delivery clinical supervision has been implemented in health services. While clinical supervision of health professionals has been shown to improve patient safety, its effect on other dimensions of quality of care is unknown. The purpose of this systematic review is to determine whether clinical supervision of health professionals improves effectiveness of care and patient experience. Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking. Two reviewers independently applied inclusion and exclusion criteria. The quality of each study was rated using the Medical Education Research Study Quality Instrument. Data were extracted on effectiveness of care (process of care and patient health outcomes) and patient experience. Seventeen studies across multiple health professions (medical (n = 4), nursing (n = 7), allied health (n = 2) and combination of nursing, medical and/or allied health (n = 4)) met the inclusion criteria. The clinical heterogeneity of the included studies precluded meta-analysis. Twelve of 14 studies investigating 38,483 episodes of care found that clinical supervision improved the process of care. This effect was most predominant in cardiopulmonary resuscitation and African health settings. Three of six studies investigating 1756 patients found that clinical supervision improved patient health outcomes, namely neurological recovery post cardiopulmonary resuscitation (n = 1) and psychological symptom severity (n = 2). None of three studies investigating 1856 patients found that clinical supervision had an effect on patient experience. Clinical supervision of health professionals is associated with effectiveness of care. The review found significant improvement in the process of care that may improve compliance with processes that are associated with enhanced patient health

  5. The effectiveness of physical activity interventions in improving well-being across office-based workplace settings: a systematic review.

    Science.gov (United States)

    Abdin, S; Welch, R K; Byron-Daniel, J; Meyrick, J

    2018-07-01

    Although the benefits of regular physical activity (PA) are widely accepted, most of the population fails to meet the recommended levels of activity. Public health bodies such as the World Health Organisation emphasise promoting PA within workplaces as a key intervention setting to reach the health and well-being of the working population. Given the importance of well-being in workplace settings, it seems worthwhile to explore the evidence of effectiveness in the literature. This systematic review aims to assess the effectiveness of PA interventions for improving psychological well-being in working adults. It provides a review of current evidence, assesses the quality of the research into this topic area and identifies issues and recommendations for future research. A systematic review guided by the Cochrane Handbook was conducted. PsycINFO, PubMed, ScienceDirect, Web of Science, Embase, MEDLINE and Cochrane Library literature searches were conducted from 2007 to April 2017. Using the keywords 'Physical Activity'; 'Exercise'; 'Wellbeing'; 'Employee' and 'Workplace', five articles were obtained that fit the inclusion criteria. Inclusion criteria were a workplace setting, an intervention including a PA intervention and an outcome measure including well-being. Extraction of articles and quality assessment of the articles were performed independently by two authors using the Cochrane's data extraction form and the Cochrane's risk of bias. Owing to heterogeneity in population characteristics, intervention components, outcome measures and the durations of interventions, a narrative synthesis was conducted. The review identified five office-based workplace PA interventions in promoting psychological well-being in 1326 participants. The included studies varied substantially in sample size characteristics, methodological quality, duration of follow-up, types of interventions and assessed outcomes. Three of the five included studies were of high quality. The types of PA

  6. Can life coaching improve health outcomes?--A systematic review of intervention studies.

    Science.gov (United States)

    Ammentorp, Jette; Uhrenfeldt, Lisbeth; Angel, Flemming; Ehrensvärd, Martin; Carlsen, Ebbe B; Kofoed, Poul-Erik

    2013-10-22

    In recent years, coaching has received special attention as a method to improve healthy lifestyle behaviours. The fact that coaching has found its way into healthcare and may provide new ways of engaging the patients and making them accountable for their health, justifies the need for an overview of the evidence regarding coaching interventions used in patient care, the effect of the interventions, and the quality of the studies published. However, in order to provide a clear definition of the coaching interventions selected for this review, we have found it necessary to distinguish between health coaching and life coaching. In this review, we will only focus on the latter method and on that basis assess the health related outcomes of life coaching. Intervention studies using quantitative or qualitative methods to evaluate the outcome of the life coach interventions were identified through systematic literature searches in PubMed, Embase, Psycinfo, and CINAHL. The quality of the methodology was independently assessed by three of the authors using a criteria list. A total of 4359 citations were identified in the electronic search and five studies were included; two of them were randomized controlled trials and met all quality criteria. The two studies investigating objective health outcomes (HbA1c) showed mixed but promising results, especially concerning the patient group that usually does not benefit from intensified interventions. Because of the very limited number of solid studies, this review can only present tendencies for patient outcomes and a preliminary description of an effective life coaching intervention.The coaching method used in these studies aims to improve self-efficacy and self-empowerment. This may explain why the studies including disadvantaged patients showed the most convincing results. The findings also indicate that some patients benefit from being met with an alternative approach and a different type of communication than they are used to

  7. Motor Rehabilitation Using Kinect: A Systematic Review.

    Science.gov (United States)

    Da Gama, Alana; Fallavollita, Pascal; Teichrieb, Veronica; Navab, Nassir

    2015-04-01

    Interactive systems are being developed with the intention to help in the engagement of patients on various therapies. Amid the recent technological advances, Kinect™ from Microsoft (Redmond, WA) has helped pave the way on how user interaction technology facilitates and complements many clinical applications. In order to examine the actual status of Kinect developments for rehabilitation, this article presents a systematic review of articles that involve interactive, evaluative, and technical advances related to motor rehabilitation. Systematic research was performed in the IEEE Xplore and PubMed databases using the key word combination "Kinect AND rehabilitation" with the following inclusion criteria: (1) English language, (2) page number >4, (3) Kinect system for assistive interaction or clinical evaluation, or (4) Kinect system for improvement or evaluation of the sensor tracking or movement recognition. Quality assessment was performed by QualSyst standards. In total, 109 articles were found in the database research, from which 31 were included in the review: 13 were focused on the development of assistive systems for rehabilitation, 3 in evaluation, 3 in the applicability category, 7 on validation of Kinect anatomic and clinical evaluation, and 5 on improvement techniques. Quality analysis of all included articles is also presented with their respective QualSyst checklist scores. Research and development possibilities and future works with the Kinect for rehabilitation application are extensive. Methodological improvements when performing studies on this area need to be further investigated.

  8. Quality improvement initiatives for hospitalised small and sick newborns in low- and middle-income countries: a systematic review.

    Science.gov (United States)

    Zaka, Nabila; Alexander, Emma C; Manikam, Logan; Norman, Irena C F; Akhbari, Melika; Moxon, Sarah; Ram, Pavani Kalluri; Murphy, Georgina; English, Mike; Niermeyer, Susan; Pearson, Luwei

    2018-01-25

    An estimated 2.6 million newborns died in 2016; over 98.5% of deaths occurred in low- and middle-income countries (LMICs). Neonates born preterm and small for gestational age are particularly at risk given the high incidence of infectious complications, cardiopulmonary, and neurodevelopmental disorders in this group. Quality improvement (QI) initiatives can reduce the burden of mortality and morbidity for hospitalised newborns in these settings. We undertook a systematic review to synthesise evidence from LMICs on QI approaches used, outcome measures employed to estimate effects, and the nature of implementation challenges. We searched Medline, EMBASE, WHO Global Health Library, Cochrane Library, WHO ICTRP, and ClinicalTrials.gov and scanned the references of identified studies and systematic reviews. Searches covered January 2000 until April 2017. Search terms were "quality improvement", "newborns", "hospitalised", and their derivatives. Studies were excluded if they took place in high-income countries, did not include QI interventions, or did not include small and sick hospitalised newborns. Cochrane Risk of Bias tools were used to quality appraise the studies. From 8110 results, 28 studies were included, covering 23 LMICs and 65,642 participants. Most interventions were meso level (district and clinic level); fewer were micro (patient-provider level) or macro (above district level). In-service training was the most common intervention subtype; service organisation and distribution of referencing materials were also frequently identified. The most commonly assessed outcome was mortality, followed by length of admission, sepsis rates, and infection rates. Key barriers to implementation of quality improvement initiatives included overburdened staff and lack of sufficient equipment. The frequency of meso level, single centre, and educational interventions suggests that these interventions may be easier for programme planners to implement. The success of some

  9. Performance-based financing for improving HIV/AIDS service delivery: a systematic review.

    Science.gov (United States)

    Suthar, Amitabh B; Nagata, Jason M; Nsanzimana, Sabin; Bärnighausen, Till; Negussie, Eyerusalem K; Doherty, Meg C

    2017-01-04

    Although domestic HIV/AIDS financing is increasing, international HIV/AIDS financing has plateaued. Providing incentives for the health system (i.e. performance-based financing [PBF]) may help countries achieve more with available resources. We systematically reviewed effects of PBF on HIV/AIDS service delivery to inform WHO guidelines. PubMed, WHO Index Medicus, conference databases, and clinical trial registries were searched in April 2015 for randomised trials, comparative contemporaneous studies, or time-series studies. Studies evaluating PBF in people with HIV were included when they reported service quality, access, or cost. Meta-analyses were not possible due to limited data. This study is registered with PROSPERO, number CRD42015023207. Four studies, published from 2009 to 2015 and including 173,262 people, met the eligibility criteria. All studies were from Sub-Saharan Africa. PBF did not improve individual testing coverage (relative risk [RR], 1.00, 95% confidence interval [CI] 0.89 to 1.13), improved couples testing coverage (RR 1.11, 95% CI 1.02 to 1.20), and improved pregnant women testing coverage (RR 1.29, 95% CI 1.28-1.30). PBF improved coverage of antiretrovirals in pregnant women (RR 1.55, 95% CI 1.50 to 1.59), infants (RR 1.92, 95% CI 1.84 to 2.01), and adults (RR 1.74, 1.64 to 1.85). PBF reduced attrition (RR 0.84, 95% CI 0.74 to 0.96) and treatment failure (odds ratio 0.55, 95% CI 0.32 to 0.97). Potential harms were not reported. Although the limited data suggests PBF positively affected HIV service access and quality, critical health system and governance knowledge gaps remain. More research is needed to inform national policymaking.

  10. Lobar lung transplantation from deceased donors: A systematic review.

    Science.gov (United States)

    Eberlein, Michael; Reed, Robert M; Chahla, Mayy; Bolukbas, Servet; Blevins, Amy; Van Raemdonck, Dirk; Stanzi, Alessia; Inci, Ilhan; Marasco, Silvana; Shigemura, Norihisa; Aigner, Clemens; Deuse, Tobias

    2017-02-24

    To systematically review reports on deceased-donor-lobar lung transplantation (ddLLTx) and uniformly describe size matching using the donor-to-recipient predicted-total lung-capacity (pTLC) ratio. We set out to systematically review reports on ddLLTx and uniformly describe size matching using the donor-to-recipient pTLC ratio and to summarize reported one-year survival data of ddLLTx and conventional-LTx. We searched in PubMed, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley (CDSR), Database of Abstracts of Reviews of Effects via Wiley (DARE), Cochrane Central Register of Controlled Trials via Wiley (CENTRAL), Scopus (which includes EMBASE abstracts), and Web of Science for original reports on ddLLTx. Nine observational cohort studies reporting on 301 ddLLTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The ddLLTx-group was often characterized by high acuity; however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pTLC ratio was available for 242 ddLLTx (80%). The mean pTLCratio before lobar resection was 1.25 ± 0.3 and the transplanted pTLCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddLLTx-group ranged from 50%-100%, compared to 72%-88% in the conventional-LTx group. In the largest study ddLLTx ( n = 138) was associated with a lower one-year-survival compared to conventional-LTx ( n = 539) (65.1% vs 84.1%, P < 0.001). Further investigations of optimal donor-to-recipient size matching parameters for ddLLTx could improve outcomes of this important surgical option.

  11. A mixed-methods approach to systematic reviews.

    Science.gov (United States)

    Pearson, Alan; White, Heath; Bath-Hextall, Fiona; Salmond, Susan; Apostolo, Joao; Kirkpatrick, Pamela

    2015-09-01

    There are an increasing number of published single-method systematic reviews that focus on different types of evidence related to a particular topic. As policy makers and practitioners seek clear directions for decision-making from systematic reviews, it is likely that it will be increasingly difficult for them to identify 'what to do' if they are required to find and understand a plethora of syntheses related to a particular topic.Mixed-methods systematic reviews are designed to address this issue and have the potential to produce systematic reviews of direct relevance to policy makers and practitioners.On the basis of the recommendations of the Joanna Briggs Institute International Mixed Methods Reviews Methodology Group in 2012, the Institute adopted a segregated approach to mixed-methods synthesis as described by Sandelowski et al., which consists of separate syntheses of each component method of the review. Joanna Briggs Institute's mixed-methods synthesis of the findings of the separate syntheses uses a Bayesian approach to translate the findings of the initial quantitative synthesis into qualitative themes and pooling these with the findings of the initial qualitative synthesis.

  12. Biceps Autograft Augmentation for Rotator Cuff Repair : A Systematic Review

    NARCIS (Netherlands)

    Veen, Egbert J D; Stevens, Martin; Diercks, Ronald L

    Purpose: To improve surgical outcomes in patients with massive cuff defects, different techniques and augmentations are proposed. The biceps tendon is easily available as an autograft. Our aim was to conduct a qualitative systematic review of various methods and surgical techniques that use a biceps

  13. Systematic Review: Family Resilience After Pediatric Cancer Diagnosis.

    Science.gov (United States)

    Van Schoors, Marieke; Caes, Line; Verhofstadt, Lesley L; Goubert, Liesbet; Alderfer, Melissa A

    2015-10-01

    A systematic review was conducted to (1) investigate family resilience in the context of pediatric cancer, and (2) examine theoretical, methodological, and statistical issues in this literature. Family resilience was operationalized as competent family functioning after exposure to a significant risk. Following guidelines for systematic reviews, searches were performed using Web of Science, Pubmed, Cochrane, PsycInfo, and Embase. After screening 5,563 articles, 85 fulfilled inclusion criteria and were extracted for review. Findings indicated that most families are resilient, adapting well to the crisis of cancer diagnosis. However, a subset still experiences difficulties. Methodological issues in the current literature hamper strong nuanced conclusions. We suggest future research with a greater focus on family resilience and factors predicting it, based on available theory, and conducted with attention toward unit of measurement and use of appropriate statistical analyses. Improvements in research are needed to best inform family-based clinical efforts. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. How Well Is Quality Improvement Described in the Perioperative Care Literature? A Systematic Review

    Science.gov (United States)

    Jones, Emma L.; Lees, Nicholas; Martin, Graham; Dixon-Woods, Mary

    2016-01-01

    Abstract Background Quality improvement (QI) approaches are widely used across health care, but how well they are reported in the academic literature is not clear. A systematic review was conducted to assess the completeness of reporting of QI interventions and techniques in the field of perioperative care. Methods Searches were conducted using Medline, Scopus, the Cochrane Central Register of Controlled Trials, the Cochrane Effective Practice and Organization of Care database, and PubMed. Two independent reviewers used the Template for Intervention Description and Replication (TIDieR) checklist, which identifies 12 features of interventions that studies should describe (for example, How: the interventions were delivered [e.g., face to face, internet]), When and how much: duration, dose, intensity), to assign scores for each included article. Articles were also scored against a small number of additional criteria relevant to QI. Results The search identified 16,103 abstracts from databases and 19 from other sources. Following review, full-text was obtained for 223 articles, 100 of which met the criteria for inclusion. Completeness of reporting of QI in the perioperative care literature was variable. Only one article was judged fully complete against the 11 TIDieR items used. The mean TIDieR score across the 100 included articles was 6.31 (of a maximum 11). More than a third (35%) of the articles scored 5 or lower. Particularly problematic was reporting of fidelity (absent in 74% of articles) and whether any modifications were made to the intervention (absent in 73% of articles). Conclusions The standard of reporting of quality interventions and QI techniques in surgery is often suboptimal, making it difficult to determine whether an intervention can be replicated and used to deliver a positive effect in another setting. This suggests a need to explore how reporting practices could be improved. PMID:27066922

  15. Assessing the effectiveness and cost effectiveness of adaptive e-Learning to improve dietary behaviour: protocol for a systematic review

    Directory of Open Access Journals (Sweden)

    Michie Susan

    2010-04-01

    Full Text Available Abstract Background The composition of habitual diets is associated with adverse or protective effects on aspects of health. Consequently, UK public health policy strongly advocates dietary change for the improvement of population health and emphasises the importance of individual empowerment to improve health. A new and evolving area in the promotion of dietary behavioural change is e-Learning, the use of interactive electronic media to facilitate teaching and learning on a range of issues, including diet and health. The aims of this systematic review are to determine the effectiveness and cost-effectiveness of adaptive e-Learning for improving dietary behaviours. Methods/Design The research will consist of a systematic review and a cost-effectiveness analysis. Studies will be considered for the review if they are randomised controlled trials, involving participants aged 13 or over, which evaluate the effectiveness or efficacy of interactive software programmes for improving dietary behaviour. Primary outcome measures will be those related to dietary behaviours, including estimated intakes of energy, nutrients and dietary fibre, or the estimated number of servings per day of foods or food groups. Secondary outcome measures will be objective clinical measures that are likely to respond to changes in dietary behaviours, such as anthropometry or blood biochemistry. Knowledge, self-efficacy, intention and emotion will be examined as mediators of dietary behaviour change in order to explore potential mechanisms of action. Databases will be searched using a comprehensive four-part search strategy, and the results exported to a bibliographic database. Two review authors will independently screen results to identify potentially eligible studies, and will independently extract data from included studies, with any discrepancies at each stage settled by a third author. Standardised forms and criteria will be used. A descriptive analysis of included

  16. Diabetes-related information-seeking behaviour: a systematic review.

    Science.gov (United States)

    Kuske, Silke; Schiereck, Tim; Grobosch, Sandra; Paduch, Andrea; Droste, Sigrid; Halbach, Sarah; Icks, Andrea

    2017-10-24

    Information-seeking behaviour is necessary to improve knowledge on diabetes therapy and complications. Combined with other self-management skills and autonomous handling of the disease, it is essential for achieving treatment targets. However, a systematic review addressing this topic is lacking. The aims of this systematic review were to identify and analyse existing knowledge of information-seeking behaviour: (1) types information-seeking behaviour, (2) information sources, (3) the content of searched information, and (4) associated variables that may affect information-seeking behaviour. The systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) requirements. MEDLINE, CINAHL, EMBASE, ScienceDirect, PsycInfo, Cochrane Library, Web of Science, CCMed, ERIC, Journals@OVID, Deutsches Ärzteblatt and Karlsruher virtueller Katalog (KvK) databases were searched. Publications dealing with information-seeking behaviour of people with diabetes mellitus published up to June 2015 were included. A forward citation tracking was performed in September 2016 and June 2017. Additionally, an update of the two main databases (MEDLINE, CINAHL) was conducted, considering studies published up to July 2017. Studies published in languages other than English or German were excluded, as well as letters, short reports, editorials, comments and discussion papers. A study selection and the critical appraisal of the selected studies were performed independently by two reviewers. A third reviewer was consulted if any disagreement was found. Data extraction and content analysis were performed using selected dimensions of Wilson's 'model of information behaviour'. Twenty-six studies were included. Five 'types of information-seeking behaviour' were identified, e.g. passive and active search. The 'Internet' and 'healthcare professionals' were the most frequently reported sources. 'Diet', 'complications', 'exercise' and 'medications and

  17. Psychopathology in Young People Experiencing Homelessness: A Systematic Review

    Science.gov (United States)

    Shelton, Katherine H.; van den Bree, Marianne B. M.; Los, Férenc J.

    2013-01-01

    Understanding mental health issues faced by young homeless persons is instrumental to the development of successful targeted interventions. No systematic review of recent published literature on psychopathology in this group has been completed. We conducted a systematic review of published research examining the prevalence of psychiatric problems among young homeless people. We examined the temporal relationship between homelessness and psychopathology. We collated 46 articles according to the PRISMA Statement. All studies that used a full psychiatric assessment consistently reported a prevalence of any psychiatric disorder from 48% to 98%. Although there was a lack of longitudinal studies of the temporal relationship between psychiatric disorders and homelessness, findings suggested a reciprocal link. Supporting young people at risk for homelessness could reduce homelessness incidence and improve mental health. PMID:23597340

  18. Varicocele management for infertility and pain: A systematic review

    Directory of Open Access Journals (Sweden)

    Scott D. Lundy

    2018-03-01

    Full Text Available Despite being first described two thousand years ago, the varicocele remains a controversial multifaceted disease process with numerous biological consequences including infertility, hypogonadism, and chronic orchidalgia. The underlying mechanisms remain poorly understood and likely include hypoxia, oxidative stress, hyperthermia, anatomical aberrations, and genetics as primary components. Despite a high prevalence amongst asymptomatic fertile men, varicoceles paradoxically also represent the most common correctable cause for male infertility. In this systematic review we discuss the rich historical aspects of the varicocele and the contemporary data regarding its clinical manifestations. We performed a systematic literature review with the goal of comparing outcomes and complication rates of each of the major surgical approaches as they relate to infertility and pain. We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-compliant systematic literature review for manuscripts focused on varicocele and its biological consequences. We identified 112 studies suitable for qualitative analysis and included 56 of these for quantitative analysis, with an emphasis on infertility and chronic pain outcomes. Taken together, the clinical work to date suggests that the highest fertility rates and the lowest complication rates are associated with the microsurgical subinguinal surgical approach to varicocelectomy. In all, 26–40% of patients undergoing varicocelectomy will successfully achieve short-term spontaneous pregnancy, and up to 90% of all patients undergoing varicocelectomy for pain will have improvement and/or resolution of their symptoms. Taken together, the data support an ongoing role for varicocelectomy in both of these clinical arenas. Keywords: Varicocele, Infertility, Orchidalgia, Hypogonadism, Pampiniform plexus

  19. Eligibility criteria in systematic reviews published in prominent medical journals: a methodological review.

    Science.gov (United States)

    McCrae, Niall; Purssell, Edward

    2015-12-01

    Clear and logical eligibility criteria are fundamental to the design and conduct of a systematic review. This methodological review examined the quality of reporting and application of eligibility criteria in systematic reviews published in three leading medical journals. All systematic reviews in the BMJ, JAMA and The Lancet in the years 2013 and 2014 were extracted. These were assessed using a refined version of a checklist previously designed by the authors. A total of 113 papers were eligible, of which 65 were in BMJ, 17 in The Lancet and 31 in JAMA. Although a generally high level of reporting was found, eligibility criteria were often problematic. In 67% of papers, eligibility was specified after the search sources or terms. Unjustified time restrictions were used in 21% of reviews, and unpublished or unspecified data in 27%. Inconsistency between journals was apparent in the requirements for systematic reviews. The quality of reviews in these leading medical journals was high; however, there were issues that reduce the clarity and replicability of the review process. As well as providing a useful checklist, this methodological review informs the continued development of standards for systematic reviews. © 2015 John Wiley & Sons, Ltd.

  20. A Systematic Review of Psychosocial Interventions for Adults with Autism Spectrum Disorders

    Science.gov (United States)

    Bishop-Fitzpatrick, Lauren; Minshew, Nancy J.; Eack, Shaun M.

    2013-01-01

    Individuals with autism spectrum disorders (ASD) spend the majority of their lives as adults, and psychosocial interventions show promise for improving outcomes in this population. This research conducted a systematic review of all peer-review studies evaluating psychosocial interventions for adults with ASD. A total of 1,217 studies were…

  1. A review on systematic reviews of health information system studies.

    Science.gov (United States)

    Lau, Francis; Kuziemsky, Craig; Price, Morgan; Gardner, Jesse

    2010-01-01

    The purpose of this review is to consolidate existing evidence from published systematic reviews on health information system (HIS) evaluation studies to inform HIS practice and research. Fifty reviews published during 1994-2008 were selected for meta-level synthesis. These reviews covered five areas: medication management, preventive care, health conditions, data quality, and care process/outcome. After reconciliation for duplicates, 1276 HIS studies were arrived at as the non-overlapping corpus. On the basis of a subset of 287 controlled HIS studies, there is some evidence for improved quality of care, but in varying degrees across topic areas. For instance, 31/43 (72%) controlled HIS studies had positive results using preventive care reminders, mostly through guideline adherence such as immunization and health screening. Key factors that influence HIS success included having in-house systems, developers as users, integrated decision support and benchmark practices, and addressing such contextual issues as provider knowledge and perception, incentives, and legislation/policy.

  2. [Characteristics of systematic reviews about the impact of pharmacists].

    Science.gov (United States)

    Tanguay, C; Guérin, A; Bussières, J-F

    2014-11-01

    The pharmacists' role is varied and numerous articles evaluate the outcomes of pharmaceutical interventions. The main objectives of this study were to establish the characteristics of systematic reviews about pharmacists' interventions that were published in the last five years. A literature search was performed on Pubmed for French and English articles published between 01-01-2008 and 31-05-2013. Systematic reviews that presented the role, the interventions and the impact of pharmacists were selected by two research assistants. A total of 46 systematic reviews was identified, amongst which one third (n=15/46, 33 %) were meta-analyses. A quarter of systematic reviews did not evaluate the quality of included articles (n=13/46, 28 %). Twelve themes were identified. A median [min-max] of 16 [2-298] articles was included per systematic review. The most frequent pharmaceutical activities were patient counseling (n=41 systematic reviews), patient chart review (n=29), pharmacotherapy evaluation (n=27) and recommendations (n=26). The least frequent activities were teaching others than patients (n=12) and medical rounds participation (n=7). Many elements can influence the completion of pharmacy practice research projects; however, there exists no link between the presence of systematic reviews and the importance of pharmacists in a given healthcare program. This study presents the characteristics of 46 systematic reviews about pharmacists interventions published since 2008. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Systematic Reviews Published in Emergency Medicine Journals Do Not Routinely Search Clinical Trials Registries: A Cross-Sectional Analysis.

    Science.gov (United States)

    Keil, Lukas G; Platts-Mills, Timothy F; Jones, Christopher W

    2015-10-01

    Publication bias compromises the validity of systematic reviews. This problem can be addressed in part through searching clinical trials registries to identify unpublished studies. This study aims to determine how often systematic reviews published in emergency medicine journals include clinical trials registry searches. We identified all systematic reviews published in the 6 highest-impact emergency medicine journals between January 1 and December 31, 2013. Systematic reviews that assessed the effects of an intervention were further examined to determine whether the authors described searching a clinical trials registry and whether this search identified relevant unpublished studies. Of 191 articles identified through PubMed search, 80 were confirmed to be systematic reviews. Our sample consisted of 41 systematic reviews that assessed a specific intervention. Eight of these 41 (20%) searched a clinical trials registry. For 4 of these 8 reviews, the registry search identified at least 1 relevant unpublished study. Systematic reviews published in emergency medicine journals do not routinely include searches of clinical trials registries. By helping authors identify unpublished trial data, the addition of registry searches may improve the validity of systematic reviews. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  4. Arthroscopic Debridement for Primary Degenerative Osteoarthritis of the Elbow Leads to Significant Improvement in Range of Motion and Clinical Outcomes: A Systematic Review.

    Science.gov (United States)

    Sochacki, Kyle R; Jack, Robert A; Hirase, Takashi; McCulloch, Patrick C; Lintner, David M; Liberman, Shari R; Harris, Joshua D

    2017-12-01

    The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates. A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates. Systematic review of level IV studies. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Use of Machine-Learning Approaches to Predict Clinical Deterioration in Critically Ill Patients: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Tadashi Kamio

    2017-06-01

    Full Text Available Introduction: Early identification of patients with unexpected clinical deterioration is a matter of serious concern. Previous studies have shown that early intervention on a patient whose health is deteriorating improves the patient outcome, and machine-learning-based approaches to predict clinical deterioration may contribute to precision improvement. To date, however, no systematic review in this area is available. Methods: We completed a search on PubMed on January 22, 2017 as well as a review of the articles identified by study authors involved in this area of research following the preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines for systematic reviews. Results: Twelve articles were selected for the current study from 273 articles initially obtained from the PubMed searches. Eleven of the 12 studies were retrospective studies, and no randomized controlled trials were performed. Although the artificial neural network techniques were the most frequently used and provided high precision and accuracy, we failed to identify articles that showed improvement in the patient outcome. Limitations were reported related to generalizability, complexity of models, and technical knowledge. Conclusions: This review shows that machine-learning approaches can improve prediction of clinical deterioration compared with traditional methods. However, these techniques will require further external validation before widespread clinical acceptance can be achieved.

  6. Contribution of systematic reviews to management decisions.

    Science.gov (United States)

    Cook, Carly N; Possingham, Hugh P; Fuller, Richard A

    2013-10-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. © 2013 The Authors. Conservation Biology published by Wiley

  7. Systematic reviews of diagnostic test accuracy

    DEFF Research Database (Denmark)

    Leeflang, Mariska M G; Deeks, Jonathan J; Gatsonis, Constantine

    2008-01-01

    More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies....... Restrictive electronic search filters are discouraged, as is the use of summary quality scores. Methods for meta-analysis should take into account the paired nature of the estimates and their dependence on threshold. Authors of these reviews are advised to use the hierarchical summary receiver...

  8. Governance arrangements for health systems in low-income countries: an overview of systematic reviews.

    Science.gov (United States)

    Herrera, Cristian A; Lewin, Simon; Paulsen, Elizabeth; Ciapponi, Agustín; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Wiysonge, Charles S; Bastías, Gabriel; Garcia Marti, Sebastian; Okwundu, Charles I; Peñaloza, Blanca; Oxman, Andrew D

    2017-09-12

    Governance arrangements include changes in rules or processes that determine authority and accountability for health policies, organisations, commercial products and health professionals, as well as the involvement of stakeholders in decision-making. Changes in governance arrangements can affect health and related goals in numerous ways, generally through changes in authority, accountability, openness, participation and coherence. A broad overview of the findings of systematic reviews can help policymakers, their technical support staff and other stakeholders to identify strategies for addressing problems and improving the governance of their health systems. To provide an overview of the available evidence from up-to-date systematic reviews about the effects of governance arrangements for health systems in low-income countries. Secondary objectives include identifying needs and priorities for future evaluations and systematic reviews on governance arrangements and informing refinements of the framework for governance arrangements outlined in the overview. We searched Health Systems Evidence in November 2010 and PDQ Evidence up to 17 December 2016 for systematic reviews. We did not apply any date, language or publication status limitations in the searches. We included well-conducted systematic reviews of studies that assessed the effects of governance arrangements on patient outcomes (health and health behaviours), the quality or utilisation of healthcare services, resource use (health expenditures, healthcare provider costs, out-of-pocket payments, cost-effectiveness), healthcare provider outcomes (such as sick leave), or social outcomes (such as poverty, employment) and that were published after April 2005. We excluded reviews with limitations that were important enough to compromise the reliability of the findings of the review. Two overview authors independently screened reviews, extracted data and assessed the certainty of evidence using GRADE. We prepared

  9. Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis.

    Science.gov (United States)

    Walklet, Elaine; Muse, Kate; Meyrick, Jane; Moss, Tim

    2016-08-30

    Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.

  10. Communication partner training in aphasia: a systematic review.

    Science.gov (United States)

    Simmons-Mackie, Nina; Raymer, Anastasia; Armstrong, Elizabeth; Holland, Audrey; Cherney, Leora R

    2010-12-01

    To describe the effects of communication partner training on persons with aphasia and their communication partners. Specifically the systematic review addressed 3 clinical questions regarding the impact of partner training on language, communication activity and participation, psychosocial adjustment, and quality of life for adults with aphasia and their communication partners. Twenty-three terms were used to search 12 electronic databases (eg, PubMed, CINAHL, PsychINFO, PsychArticles, CSA Linguistics and Language Behavior Abstracts, Social Sciences Citation Index [Web of Science], SUMSearch, TRIP, EMBASE, REHABDATA, National Library for Health, Cochrane Database of Systematic Reviews) and the journal "Aphasiology." References from all relevant articles were hand-searched. Two reviewers independently applied inclusion criteria to select potential relevant articles from the titles and abstracts of references retrieved by the literature search. The full text of the remaining articles was reviewed by a 5-member panel, resulting in a corpus of 31 studies that met the final inclusion criteria. Two independent reviewers extracted the descriptive data related to the participants, the intervention, the outcome measures, and the results. The 5-member review team by consensus classified the studies using the American Academy of Neurology system for classification of evidence (2004). Evidence shows that communication partner training is effective in improving communication activities and/or participation of the communication partner and is probably effective in improving communication activities and/or participation of persons with chronic aphasia when they are interacting with trained communication partners. There is insufficient evidence to make recommendations related to the impact of partner training on persons with acute aphasia or the impact of training on language impairment, psychosocial adjustment, or quality of life for either the person with aphasia or the

  11. Systematic review to understand and improve care after stillbirth: a review of parents' and healthcare professionals' experiences.

    Science.gov (United States)

    Ellis, Alison; Chebsey, Caroline; Storey, Claire; Bradley, Stephanie; Jackson, Sue; Flenady, Vicki; Heazell, Alexander; Siassakos, Dimitrios

    2016-01-25

    2.7 million babies were stillborn in 2015 worldwide; behind these statistics lie the experiences of bereaved parents. The first Lancet series on stillbirth in 2011 described stillbirth as one of the "most shamefully neglected" areas of public health, recommended improving interaction between families and frontline caregivers and made a plea for increased investment in relevant research. A systematic review of qualitative, quantitative and mixed-method studies researching parents and healthcare professionals experiences of care after stillbirth in high-income westernised countries (Europe, North America, Australia and South Africa) was conducted. The review was designed to inform research, training and improve care for parents who experience stillbirth. Four thousand four hundred eighty eight abstracts were identified; 52 studies were eligible for inclusion. Synthesis and quantitative aggregation (meta-summary) was used to extract findings and calculate frequency effect sizes (FES%) for each theme (shown in italics), a measure of the prevalence of that finding in the included studies. Researchers' areas of interest may influence reporting of findings in the literature and result in higher FES sizes, such as; support memory making (53%) and fathers have different needs (18%). Other parental findings were more unexpected; Parents want increased public awareness (20%) and for stillbirth care to be prioritised (5%). Parental findings highlighted lessons for staff; prepare parents for vaginal birth (23%), discuss concerns (13%), give options & time (20%), privacy not abandonment (30%), tailored post-mortem discussions (20%) and post-natal information (30%). Parental and staff findings were often related; behaviours and actions of staff have a memorable impact on parents (53%) whilst staff described emotional, knowledge and system-based barriers to providing effective care (100%). Parents reported distress being caused by midwives hiding behind 'doing' and ritualising

  12. Prevention of Internet addiction: A systematic review.

    Science.gov (United States)

    Vondráčková, Petra; Gabrhelík, Roman

    2016-12-01

    Background and aims Out of a large number of studies on Internet addiction, only a few have been published on the prevention of Internet addiction. The aim of this study is provide a systematic review of scientific articles regarding the prevention of Internet addiction and to identify the relevant topics published in this area of interest. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted. The EBSCO, ProQuest Central, and PubMed databases were searched for texts published in English and Spanish between January 1995 and April 2016. A total of 179 original texts were obtained. After de-duplication and topic-relevance review, 108 texts were systematically classified and subjected to descriptive analysis and subsequent content analysis. Results The results of the content analysis yielded the following thematic areas: (a) target groups, (b) the improvement of specific skills, (c) program characteristics, and (d) environmental interventions. Discussion and conclusion Literature on the prevention of Internet addiction is scarce. There is an urgent need to introduce and implement new interventions for different at-risk populations, conduct well-designed research, and publish data on the effectiveness of these interventions. Developing prevention interventions should primarily target children and adolescents at risk of Internet addiction but also parents, teachers, peers, and others who are part of the formative environment of children and adolescents at risk of Internet addiction. Newly designed interventions focused on Internet addiction should be rigorously evaluated and the results published.

  13. Systematic review of peer education intervention programmes among individuals with type 2 diabetes.

    Science.gov (United States)

    Gatlin, Tricia K; Serafica, Reimund; Johnson, Michael

    2017-12-01

    To systematically review published randomised controlled trials of peer education interventions among adults with type 2 diabetes. Systematic reviews have shown mixed results for peer support interventions to improve diabetes self-management. Given the effectiveness of diabetes education by healthcare professionals, peer education interventions may be a useful alternative approach. This review addressed that gap. Systematic review. A systematic search of published randomised controlled trials between 2006-2016 was conducted using the keywords diabetes, type 2 diabetes, randomised controlled trials, self-management, peer education and peer support. The methodological quality of each study was assessed using the Jadad scale. Seven studies were included in the final review, and the Jadad scores ranged from 8-10 of a possible 13 points. There was no consistent design, setting, or outcome measurement among the studies. There were two types of peer education interventions compared to traditional diabetes education: face-to-face or a combination of face-to-face and telephone/texting. The most common clinical outcome measure was HbA1c. Two of six studies showed statistically significant improvement in HbA1c between intervention and control groups. An increase in diabetes knowledge was also statistically significant in two of five studies. Peer education could be successful in improving clinical outcomes. No evidence was found indicating that healthcare provider education was superior in regard to clinical knowledge or behavioural or psychological outcome measures than peer education. HbA1c was statistically significantly lower in some peer education groups compared to control groups. There is evidence that peer education can be useful in achieving positive clinical outcomes such as decreasing HbA1c levels and increasing diabetes knowledge. A certified diabetes educator or a trained healthcare professional should not be overlooked though when using peer educators. © 2017

  14. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-04-13

    Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

  15. Eye movements in patients with Whiplash Associated Disorders: A systematic review

    NARCIS (Netherlands)

    B.K. Ischebeck (B.); J. de Vries (Jurryt); J.N. van der Geest (Jos); M. Janssen (Malou); J.-P. van Wingerden (Jan-Paul); G.J. Kleinrensink (Gert Jan); M.A. Frens (Maarten)

    2016-01-01

    textabstractBackground: Many people with Whiplash Associated Disorders (WAD) report problems with vision, some of which may be due to impaired eye movements. Better understanding of such impaired eye movements could improve diagnostics and treatment strategies. This systematic review surveys the

  16. Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

    Directory of Open Access Journals (Sweden)

    Stanistreet Debbi

    2014-08-01

    Full Text Available Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus.

  17. Improving the wellbeing of staff who work in palliative care settings: A systematic review of psychosocial interventions.

    Science.gov (United States)

    Hill, Rebecca C; Dempster, Martin; Donnelly, Michael; McCorry, Noleen K

    2016-10-01

    Staff in palliative care settings perform emotionally demanding roles which may lead to psychological distress including stress and burnout. Therefore, interventions have been designed to address these occupational risks. To investigate quantitative studies exploring the effectiveness of psychosocial interventions that attempt to improve psychological wellbeing of palliative care staff. A systematic review was conducted according to methodological guidance from UK Centre for Reviews and Dissemination. A search strategy was developed based on the initial scans of palliative care studies. Potentially eligible research articles were identified by searching the following databases: CINAHL, MEDLINE (Ovid), PsycINFO and Web of Science. Two reviewers independently screened studies against pre-set eligibility criteria. To assess quality, both researchers separately assessed the remaining studies using the Quality Assessment Tool for Quantitative Studies. A total of 1786 potentially eligible articles were identified - nine remained following screening and quality assessment. Study types included two randomised controlled trials, two non-randomised controlled trial designs, four one-group pre-post evaluations and one process evaluation. Studies took place in the United States and Canada (5), Europe (3) and Hong Kong (1). Interventions comprised a mixture of relaxation, education, support and cognitive training and targeted stress, fatigue, burnout, depression and satisfaction. The randomised controlled trial evaluations did not improve psychological wellbeing of palliative care staff. Only two of the quasi-experimental studies appeared to show improved staff wellbeing although these studies were methodologically weak. There is an urgent need to address the lack of intervention development work and high-quality research in this area. © The Author(s) 2016.

  18. Abdominal binders may reduce pain and improve physical function after major abdominal surgery - a systematic review

    DEFF Research Database (Denmark)

    Rothman, Josephine Philip; Gunnarsson, Ulf; Bisgaard, Thue

    2014-01-01

    INTRODUCTION: Evidence for the effect of post-operative abdominal binders on post-operative pain, seroma formation, physical function, pulmonary function and increased intra-abdominal pressure among patients after surgery remains largely un-investigated. METHODS: A systematic review was conducted...... formation and physical function. RESULTS: A total of 50 publications were identified; 42 publications were excluded leaving eight publications counting a total of 578 patients for analysis. Generally, the scientific quality of the studies was poor. Use of abdominal binder revealed a non-significant tendency...... to reduce seroma formation after laparoscopic ventral herniotomy and a non-significant reduction in pain. Physical function was improved, whereas evidence supports a beneficial effect on psychological distress after open abdominal surgery. Evidence also supports that intra-abdominal pressure increases...

  19. Quadriceps Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A Systematic Review.

    Science.gov (United States)

    Hurley, Eoghan T; Calvo-Gurry, Manuel; Withers, Dan; Farrington, Shane K; Moran, Ray; Moran, Cathal J

    2018-05-01

    To systematically review the current evidence to ascertain whether quadriceps tendon autograft (QT) is a viable option in anterior cruciate ligament reconstruction. A literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Cohort studies comparing QT with bone-patellar tendon-bone autograft (BPTB) or hamstring tendon autograft (HT) were included. Clinical outcomes were compared, with all statistical analyses performed using IBM SPSS Statistics for Windows, version 22.0, with P < .05 being considered statistically significant. We identified 15 clinical trials with 1,910 patients. In all included studies, QT resulted in lower rates of anterior knee pain than BPTB. There was no difference in the rate of graft rupture between QT and BPTB or HT in any of the studies reporting this. One study found that QT resulted in greater knee stability than BPTB, and another study found increased stability compared with HT. One study found that QT resulted in improved functional outcomes compared with BPTB, and another found improved outcomes compared with HT, but one study found worse outcomes compared with BPTB. Current literature suggests QT is a viable option in anterior cruciate ligament reconstruction, with published literature showing comparable knee stability, functional outcomes, donor-site morbidity, and rerupture rates compared with BPTB and HT. Level III, systematic review of Level I, II, and III studies. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. Do Web-based Mental Health Literacy Interventions Improve the Mental Health Literacy of Adult Consumers? Results From a Systematic Review.

    Science.gov (United States)

    Brijnath, Bianca; Protheroe, Joanne; Mahtani, Kamal Ram; Antoniades, Josefine

    2016-06-20

    Low levels of mental health literacy (MHL) have been identified as an important contributor to the mental health treatment gap. Interventions to improve MHL have used traditional media (eg, community talks, print media) and new platforms (eg, the Internet). Evaluations of interventions using conventional media show improvements in MHL improve community recognition of mental illness as well as knowledge, attitude, and intended behaviors toward people having mental illness. However, the potential of new media, such as the Internet, to enhance MHL has yet to be systematically evaluated. Study aims were twofold: (1) To systematically appraise the efficacy of Web-based interventions in improving MHL. (2) To establish if increases in MHL translated into improvement in individual health seeking and health outcomes as well as reductions in stigma toward people with mental illness. We conducted a systematic search and appraisal of all original research published between 2000 and 2015 that evaluated Web-based interventions to improve MHL. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to report findings. Fourteen studies were included: 10 randomized controlled trials and 4 quasi-experimental studies. Seven studies were conducted in Australia. A variety of Web-based interventions were identified ranging from linear, static websites to highly interactive interventions such as social media games. Some Web-based interventions were specifically designed for people living with mental illness whereas others were applicable to the general population. Interventions were more likely to be successful if they included "active ingredients" such as a structured program, were tailored to specific populations, delivered evidenced-based content, and promoted interactivity and experiential learning. Web-based interventions targeting MHL are more likely to be successful if they include active ingredients. Improvements in MHL see concomitant

  1. 5 CFR 1312.10 - Systematic review guidelines.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Systematic review guidelines. 1312.10... Declassification of National Security Information § 1312.10 Systematic review guidelines. The EOP Security Officer will prepare and keep current such guidelines as are required by Executive Order 12958 for the...

  2. The effects of aromatherapy on sleep improvement: a systematic literature review and meta-analysis.

    Science.gov (United States)

    Hwang, Eunhee; Shin, Sujin

    2015-02-01

    To evaluate the existing data on aromatherapy interventions for improvement of sleep quality. Systematic literature review and meta-analysis on the effects of aromatherapy. Study Sources: Electronic databases, including the Korea Education and Research Information Service (KERIS), Korean studies Information Service System (KISS), National Assembly Library, and eight academies within the Korean Society of Nursing Science, were searched to identify studies published between 2000 and August 2013. Randomized controlled and quasi-experimental trials that included aromatherapy for the improvement of sleep quality. Of the 245 publications identified, 13 studies met the inclusion and exclusion criteria, and 12 studies were used in the meta-analysis. Meta-analysis of the 12 studies using a random-effects model revealed that the use of aromatherapy was effective in improving sleep quality (95% confidence interval [CI], 0.540-1.745; Z=3.716). Subgroup analysis revealed that inhalation aromatherapy (95% CI, 0.792-1.541; Z=6.107) was more effective than massage therapy (95% CI, 0.128-2.166; Z=2.205) in unhealthy (95% CI, 0.248-1.100; Z=3.100) and healthy (95% CI, 0.393-5.104; Z=2.287) participants, respectively. Readily available aromatherapy treatments appear to be effective and promote sleep. Thus, it is essential to develop specific guidelines for the efficient use of aromatherapy.

  3. Systematic reviews of diagnostic tests in endocrinology: an audit of methods, reporting, and performance.

    Science.gov (United States)

    Spencer-Bonilla, Gabriela; Singh Ospina, Naykky; Rodriguez-Gutierrez, Rene; Brito, Juan P; Iñiguez-Ariza, Nicole; Tamhane, Shrikant; Erwin, Patricia J; Murad, M Hassan; Montori, Victor M

    2017-07-01

    Systematic reviews provide clinicians and policymakers estimates of diagnostic test accuracy and their usefulness in clinical practice. We identified all available systematic reviews of diagnosis in endocrinology, summarized the diagnostic accuracy of the tests included, and assessed the credibility and clinical usefulness of the methods and reporting. We searched Ovid MEDLINE, EMBASE, and Cochrane CENTRAL from inception to December 2015 for systematic reviews and meta-analyses reporting accuracy measures of diagnostic tests in endocrinology. Experienced reviewers independently screened for eligible studies and collected data. We summarized the results, methods, and reporting of the reviews. We performed subgroup analyses to categorize diagnostic tests as most useful based on their accuracy. We identified 84 systematic reviews; half of the tests included were classified as helpful when positive, one-fourth as helpful when negative. Most authors adequately reported how studies were identified and selected and how their trustworthiness (risk of bias) was judged. Only one in three reviews, however, reported an overall judgment about trustworthiness and one in five reported using adequate meta-analytic methods. One in four reported contacting authors for further information and about half included only patients with diagnostic uncertainty. Up to half of the diagnostic endocrine tests in which the likelihood ratio was calculated or provided are likely to be helpful in practice when positive as are one-quarter when negative. Most diagnostic systematic reviews in endocrine lack methodological rigor, protection against bias, and offer limited credibility. Substantial efforts, therefore, seem necessary to improve the quality of diagnostic systematic reviews in endocrinology.

  4. Fluoropyrimidine and platinum toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses.

    Science.gov (United States)

    Campbell, Jared M; Bateman, Emma; Peters, Micah Dj; Bowen, Joanne M; Keefe, Dorothy M; Stephenson, Matthew D

    2016-03-01

    Fluoropyrimidine (FU) and platinum-based chemotherapies are greatly complicated by their associated toxicities. This umbrella systematic review synthesized all systematic reviews that investigated associations between germline variations and toxicity, with the aim of informing personalized medicine. Systematic reviews are important in pharmacogenetics where false positives are common. Four systematic reviews were identified for FU-induced toxicity and three for platinum. Polymorphisms of DPYD and TYMS, but not MTHFR, were statistically significantly associated with FU-induced toxicity (although only DPYD had clinical significance). For platinum, GSTP1 was found to not be associated with toxicity. This umbrella systematic review has synthesized the best available evidence on the pharmacogenetics of FU and platinum toxicity. It provides a useful reference for clinicians and identifies important research gaps.

  5. Improving understanding in the research informed consent process: a systematic review of 54 interventions tested in randomized control trials.

    Science.gov (United States)

    Nishimura, Adam; Carey, Jantey; Erwin, Patricia J; Tilburt, Jon C; Murad, M Hassan; McCormick, Jennifer B

    2013-07-23

    Obtaining informed consent is a cornerstone of biomedical research, yet participants comprehension of presented information is often low. The most effective interventions to improve understanding rates have not been identified. To systematically analyze the random controlled trials testing interventions to research informed consent process. The primary outcome of interest was quantitative rates of participant understanding; secondary outcomes were rates of information retention, satisfaction, and accrual. Interventional categories included multimedia, enhanced consent documents, extended discussions, test/feedback quizzes, and miscellaneous methods. The search spanned from database inception through September 2010. It was run on Ovid MEDLINE, Ovid EMBASE, Ovid CINAHL, Ovid PsycInfo and Cochrane CENTRAL, ISI Web of Science and Scopus. Five reviewers working independently and in duplicate screened full abstract text to determine eligibility. We included only RCTs. 39 out of 1523 articles fulfilled review criteria (2.6%), with a total of 54 interventions. A data extraction form was created in Distiller, an online reference management system, through an iterative process. One author collected data on study design, population, demographics, intervention, and analytical technique. Meta-analysis was possible on 22 interventions: multimedia, enhanced form, and extended discussion categories; all 54 interventions were assessed by review. Meta-analysis of multimedia approaches was associated with a non-significant increase in understanding scores (SMD 0.30, 95% CI, -0.23 to 0.84); enhanced consent form, with significant increase (SMD 1.73, 95% CI, 0.99 to 2.47); and extended discussion, with significant increase (SMD 0.53, 95% CI, 0.21 to 0.84). By review, 31% of multimedia interventions showed significant improvement in understanding; 41% for enhanced consent form; 50% for extended discussion; 33% for test/feedback; and 29% for miscellaneous.Multiple sources of variation

  6. Systematic reviews: a cross-sectional study of location and citation counts

    Directory of Open Access Journals (Sweden)

    Morgan Douglas

    2003-11-01

    Full Text Available Abstract Background Systematic reviews summarize all pertinent evidence on a defined health question. They help clinical scientists to direct their research and clinicians to keep updated. Our objective was to determine the extent to which systematic reviews are clustered in a large collection of clinical journals and whether review type (narrative or systematic affects citation counts. Methods We used hand searches of 170 clinical journals in the fields of general internal medicine, primary medical care, nursing, and mental health to identify review articles (year 2000. We defined 'review' as any full text article that was bannered as a review, overview, or meta-analysis in the title or in a section heading, or that indicated in the text that the intention of the authors was to review or summarize the literature on a particular topic. We obtained citation counts for review articles in the five journals that published the most systematic reviews. Results 11% of the journals concentrated 80% of all systematic reviews. Impact factors were weakly correlated with the publication of systematic reviews (R2 = 0.075, P = 0.0035. There were more citations for systematic reviews (median 26.5, IQR 12 – 56.5 than for narrative reviews (8, 20, P Conclusions A few clinical journals published most systematic reviews. Authors cited systematic reviews more often than narrative reviews, an indirect endorsement of the 'hierarchy of evidence'.

  7. Roles for librarians in systematic reviews: a scoping review

    Directory of Open Access Journals (Sweden)

    Angela J. Spencer

    2018-01-01

    Results: We identified 18 different roles filled by librarians and other information professionals in conducting systematic reviews from 310 different articles, book chapters, and presented papers and posters. Some roles were well known such as searching, source selection, and teaching. Other less documented roles included planning, question formulation, and peer review. We summarize these different roles and provide an accompanying bibliography of references for in-depth descriptions of these roles. Conclusion: Librarians play central roles in systematic review teams, including roles that go beyond searching. This scoping review should encourage librarians who are fulfilling roles that are not captured here to document their roles in journal articles and poster and paper presentations.  This article has been approved for the Medical Library Association’s Independent Reading Program.

  8. The role of mHealth for improving medication adherence in patients with cardiovascular disease: a systematic review.

    Science.gov (United States)

    Gandapur, Yousuf; Kianoush, Sina; Kelli, Heval M; Misra, Satish; Urrea, Bruno; Blaha, Michael J; Graham, Garth; Marvel, Francoise A; Martin, Seth S

    2016-10-01

    Cardiovascular disease is a leading cause of morbidity and mortality worldwide, and a key barrier to improved outcomes is medication non-adherence. The aim of this study is to review the role of mobile health (mHealth) tools for improving medication adherence in patients with cardiovascular disease. We performed a systematic search for randomized controlled trials that primarily investigated mHealth tools for improving adherence to cardiovascular disease medications in patients with hypertension, coronary artery disease, heart failure, peripheral arterial disease, and stroke. We extracted and reviewed data on the types of mHealth tools used, preferences of patients and healthcare providers, the effect of the mHealth interventions on medication adherence, and the limitations of trials. We identified 10 completed trials matching our selection criteria, mostly with mHealth tools included text messages, Bluetooth-enabled electronic pill boxes, online messaging platforms, and interactive voice calls. Patients and healthcare providers generally preferred mHealth to other interventions. All 10 studies reported that mHealth interventions improved medication adherence, though the magnitude of benefit was not consistently large and in one study was not greater than a telehealth comparator. Limitations of trials included small sample sizes, short duration of follow-up, self-reported outcomes, and insufficient assessment of unintended harms and financial implications. Current evidence suggests that mHealth tools can improve medication adherence in patients with cardiovascular diseases. However, high-quality clinical trials of sufficient size and duration are needed to move the field forward and justify use in routine care.

  9. Maximizing the Impact of Systematic Reviews in Health Care Decision Making: A Systematic Scoping Review of Knowledge-Translation Resources

    Science.gov (United States)

    Chambers, Duncan; Wilson, Paul M; Thompson, Carl A; Hanbury, Andria; Farley, Katherine; Light, Kate

    2011-01-01

    Context: Barriers to the use of systematic reviews by policymakers may be overcome by resources that adapt and present the findings in formats more directly tailored to their needs. We performed a systematic scoping review to identify such knowledge-translation resources and evaluations of them. Methods: Resources were eligible for inclusion in this study if they were based exclusively or primarily on systematic reviews and were aimed at health care policymakers at the national or local level. Resources were identified by screening the websites of health technology assessment agencies and systematic review producers, supplemented by an email survey. Electronic databases and proceedings of the Cochrane Colloquium and HTA International were searched as well for published and unpublished evaluations of knowledge-translation resources. Resources were classified as summaries, overviews, or policy briefs using a previously published classification. Findings: Twenty knowledge-translation resources were identified, of which eleven were classified as summaries, six as overviews, and three as policy briefs. Resources added value to systematic reviews by, for example, evaluating their methodological quality or assessing the reliability of their conclusions or their generalizability to particular settings. The literature search found four published evaluation studies of knowledge-translation resources, and the screening of abstracts and contact with authors found three more unpublished studies. The majority of studies reported on the perceived usefulness of the service, although there were some examples of review-based resources being used to assist actual decision making. Conclusions: Systematic review producers provide a variety of resources to help policymakers, of which focused summaries are the most common. More evaluations of these resources are required to ensure users’ needs are being met, to demonstrate their impact, and to justify their funding. PMID:21418315

  10. Does provision of extrinsic feedback result in improved motor learning in the upper limb poststroke? A systematic review of the evidence.

    Science.gov (United States)

    Subramanian, Sandeep K; Massie, Crystal L; Malcolm, Matthew P; Levin, Mindy F

    2010-02-01

    Recovery of the upper limb (UL) after a stroke occurs well into the chronic stage. Stroke survivors can benefit from adaptive plasticity to improve UL movement through motor relearning. The provision of feedback has been shown to decrease the use of compensatory UL movement patterns. However, the effectiveness of feedback in improving UL motor recovery after a stroke has not yet been systematically reviewed. The objective of this review was to systematically examine the role of extrinsic feedback on implicit motor learning after stroke, focusing on UL movement and functional recovery. The authors retrieved 9 studies that examined the role of feedback on UL motor recovery. Of these, 6 were randomized controlled trials (RCTs), 1 was a single-subject design, 1 was a pre-post design, and 1 was a cohort study. The studies were rated on the basis of Sackett's levels of evidence and PEDro (Physiotherapy Evidence Database) scores for RCTs. Levels of evidence were limited (level 2b) for UL motor learning of the less-affected extremity and strong (level 1a) for the more-affected extremity. The results suggest that people with stroke may be capable of using extrinsic feedback for implicit motor learning and improving UL motor recovery. Emergent questions regarding the advantages of using different media for feedback delivery and the optimal type and schedule of feedback to enhance motor learning in patient populations still need to be addressed.

  11. Living systematic reviews: 2. Combining human and machine effort.

    Science.gov (United States)

    Thomas, James; Noel-Storr, Anna; Marshall, Iain; Wallace, Byron; McDonald, Steven; Mavergames, Chris; Glasziou, Paul; Shemilt, Ian; Synnot, Anneliese; Turner, Tari; Elliott, Julian

    2017-11-01

    New approaches to evidence synthesis, which use human effort and machine automation in mutually reinforcing ways, can enhance the feasibility and sustainability of living systematic reviews. Human effort is a scarce and valuable resource, required when automation is impossible or undesirable, and includes contributions from online communities ("crowds") as well as more conventional contributions from review authors and information specialists. Automation can assist with some systematic review tasks, including searching, eligibility assessment, identification and retrieval of full-text reports, extraction of data, and risk of bias assessment. Workflows can be developed in which human effort and machine automation can each enable the other to operate in more effective and efficient ways, offering substantial enhancement to the productivity of systematic reviews. This paper describes and discusses the potential-and limitations-of new ways of undertaking specific tasks in living systematic reviews, identifying areas where these human/machine "technologies" are already in use, and where further research and development is needed. While the context is living systematic reviews, many of these enabling technologies apply equally to standard approaches to systematic reviewing. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Selective reporting bias of harm outcomes within studies: findings from a cohort of systematic reviews.

    Science.gov (United States)

    Saini, Pooja; Loke, Yoon K; Gamble, Carrol; Altman, Douglas G; Williamson, Paula R; Kirkham, Jamie J

    2014-11-21

    To determine the extent and nature of selective non-reporting of harm outcomes in clinical studies that were eligible for inclusion in a cohort of systematic reviews. Cohort study of systematic reviews from two databases. Outcome reporting bias in trials for harm outcomes (ORBIT II) in systematic reviews from the Cochrane Library and a separate cohort of systematic reviews of adverse events. 92 systematic reviews of randomised controlled trials and non-randomised studies published in the Cochrane Library between issue 9, 2012 and issue 2, 2013 (Cochrane cohort) and 230 systematic reviews published between 1 January 2007 and 31 December 2011 in other publications, synthesising data on harm outcomes (adverse event cohort). A 13 point classification system for missing outcome data on harm was developed and applied to the studies. 86% (79/92) of reviews in the Cochrane cohort did not include full data from the main harm outcome of interest of each review for all of the eligible studies included within that review; 76% (173/230) for the adverse event cohort. Overall, the single primary harm outcome was inadequately reported in 76% (705/931) of the studies included in the 92 reviews from the Cochrane cohort and not reported in 47% (4159/8837) of the 230 reviews in the adverse event cohort. In a sample of primary studies not reporting on the single primary harm outcome in the review, scrutiny of the study publication revealed that outcome reporting bias was suspected in nearly two thirds (63%, 248/393). The number of reviews suspected of outcome reporting bias as a result of missing or partially reported harm related outcomes from at least one eligible study is high. The declaration of important harms and the quality of the reporting of harm outcomes must be improved in both primary studies and systematic reviews. © Saini et al 2014.

  13. Does Indigenous health research have impact? A systematic review of reviews.

    Science.gov (United States)

    Kinchin, Irina; Mccalman, Janya; Bainbridge, Roxanne; Tsey, Komla; Lui, Felecia Watkin

    2017-03-21

    Aboriginal and Torres Strait Islander Australians (hereafter respectfully Indigenous Australians) claim that they have been over-researched without corresponding research benefit. This claim raises two questions. The first, which has been covered to some extent in the literature, is about what type(s) of research are likely to achieve benefits for Indigenous people. The second is how researchers report the impact of their research for Indigenous people. This systematic review of Indigenous health reviews addresses the second enquiry. Fourteen electronic databases were systematically searched for Indigenous health reviews which met eligibility criteria. Two reviewers assessed their characteristics and methodological rigour using an a priori protocol. Three research hypotheses were stated and tested: (1) reviews address Indigenous health priority needs; (2) reviews adopt best practice guidelines on research conduct and reporting in respect to methodological transparency and rigour, as well as acceptability and appropriateness of research implementation to Indigenous people; and (3) reviews explicitly report the incremental impacts of the included studies and translation of research. We argue that if review authors explicitly address each of these three hypotheses, then the impact of research for Indigenous peoples' health would be explicated. Seventy-six reviews were included; comprising 55 journal articles and 21 Australian Government commissioned evidence review reports. While reviews are gaining prominence and recognition in Indigenous health research and increasing in number, breadth and complexity, there is little reporting of the impact of health research for Indigenous people. This finding raises questions about the relevance of these reviews for Indigenous people, their impact on policy and practice and how reviews have been commissioned, reported and evaluated. The findings of our study serve two main purposes. First, we have identified knowledge and

  14. The effects of psychological interventions on wound healing: A systematic review of randomized trials.

    Science.gov (United States)

    Robinson, Hayley; Norton, Sam; Jarrett, Paul; Broadbent, Elizabeth

    2017-11-01

    Psychological stress has been shown to delay wound healing. Several trials have investigated whether psychological interventions can improve wound healing, but to date, this evidence base has not been systematically synthesized. The objective was to conduct a systematic review of randomized controlled trials in humans investigating whether psychological interventions can enhance wound healing. A systematic review was performed using PsychINFO, CINAHL, Web of Science, and MEDLINE. The searches included all papers published in English up until September 2016. The reference lists of relevant papers were screened manually to identify further review articles or relevant studies. Nineteen studies met inclusion criteria and were included in the review. Fifteen of nineteen studies were of high methodological quality. Six studies were conducted with acute experimentally created wounds, five studies with surgical patients, two studies with burn wounds, two studies with fracture wounds, and four studies were conducted with ulcer wounds. Post-intervention standardized mean differences (SMD) between groups across all intervention types ranged from 0.13 to 3.21, favouring improved healing, particularly for surgical patients and for relaxation interventions. However, there was some evidence for publication bias suggesting negative studies may not have been reported. Due to the heterogeneity of wound types, population types, and intervention types, it is difficult to pool effect sizes across studies. Current evidence suggests that psychological interventions may aid wound healing. Although promising, more research is needed to assess the efficacy of each intervention on different wound types. Statement of contribution What is already known on this subject? Psychological stress negatively affects wound healing. A number of studies have investigated whether psychological interventions can improve healing. However, no systematic reviews have been conducted. What does this study add

  15. Do Bedside Visual Tools Improve Patient and Caregiver Satisfaction? A Systematic Review of the Literature.

    Science.gov (United States)

    Goyal, Anupama A; Tur, Komalpreet; Mann, Jason; Townsend, Whitney; Flanders, Scott A; Chopra, Vineet

    2017-11-01

    Although common, the impact of low-cost bedside visual tools, such as whiteboards, on patient care is unclear. To systematically review the literature and assess the influence of bedside visual tools on patient satisfaction. Medline, Embase, SCOPUS, Web of Science, CINAHL, and CENTRAL. Studies of adult or pediatric hospitalized patients reporting physician identification, understanding of provider roles, patient-provider communication, and satisfaction with care from the use of visual tools were included. Outcomes were categorized as positive, negative, or neutral based on survey responses for identification, communication, and satisfaction. Two reviewers screened studies, extracted data, and assessed the risk of study bias. Sixteen studies met the inclusion criteria. Visual tools included whiteboards (n = 4), physician pictures (n = 7), whiteboard and picture (n = 1), electronic medical record-based patient portals (n = 3), and formatted notepads (n = 1). Tools improved patients' identification of providers (13/13 studies). The impact on understanding the providers' roles was largely positive (8/10 studies). Visual tools improved patient-provider communication (4/5 studies) and satisfaction (6/8 studies). In adults, satisfaction varied between positive with the use of whiteboards (2/5 studies) and neutral with pictures (1/5 studies). Satisfaction related to pictures in pediatric patients was either positive (1/3 studies) or neutral (1/3 studies). Differences in tool format (individual pictures vs handouts with pictures of all providers) and study design (randomized vs cohort) may explain variable outcomes. The use of bedside visual tools appears to improve patient recognition of providers and patient-provider communication. Future studies that include better design and outcome assessment are necessary before widespread use can be recommended. © 2017 Society of Hospital Medicine

  16. Implementing guidelines in nursing homes: a systematic review.

    Science.gov (United States)

    Diehl, Heinz; Graverholt, Birgitte; Espehaug, Birgitte; Lund, Hans

    2016-07-25

    Research on guideline implementation strategies has mostly been conducted in settings which differ significantly from a nursing home setting and its transferability to the nursing home setting is therefore limited. The objective of this study was to systematically review the effects of interventions to improve the implementation of guidelines in nursing homes. A systematic literature search was conducted in the Cochrane Library, CINAHL, Embase, MEDLINE, DARE, HTA, CENTRAL, SveMed + and ISI Web of Science from their inception until August 2015. Reference screening and a citation search were performed. Studies were eligible if they evaluated any type of guideline implementation strategy in a nursing home setting. Eligible study designs were systematic reviews, randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted-time-series studies. The EPOC risk of bias tool was used to evaluate the risk of bias in the included studies. The overall quality of the evidence was rated using GRADE. Five cluster-randomised controlled trials met the inclusion criteria, evaluating a total of six different multifaceted implementation strategies. One study reported a small statistically significant effect on professional practice, and two studies demonstrated small to moderate statistically significant effects on patient outcome. The overall quality of the evidence for all comparisons was low or very low using GRADE. Little is known about how to improve the implementation of guidelines in nursing homes, and the evidence to support or discourage particular interventions is inconclusive. More implementation research is needed to ensure high quality of care in nursing homes. PROSPERO 2014: CRD42014007664.

  17. Computerised clinical decision support systems to improve medication safety in long-term care homes: a systematic review.

    Science.gov (United States)

    Marasinghe, Keshini Madara

    2015-05-12

    Computerised clinical decision support systems (CCDSS) are used to improve the quality of care in various healthcare settings. This systematic review evaluated the impact of CCDSS on improving medication safety in long-term care homes (LTC). Medication safety in older populations is an important health concern as inappropriate medication use can elevate the risk of potentially severe outcomes (ie, adverse drug reactions, ADR). With an increasing ageing population, greater use of LTC by the growing ageing population and increasing number of medication-related health issues in LTC, strategies to improve medication safety are essential. Databases searched included MEDLINE, EMBASE, Scopus and Cochrane Library. Three groups of keywords were combined: those relating to LTC, medication safety and CCDSS. One reviewer undertook screening and quality assessment. Overall findings suggest that CCDSS in LTC improved the quality of prescribing decisions (ie, appropriate medication orders), detected ADR, triggered warning messages (ie, related to central nervous system side effects, drug-associated constipation, renal insufficiency) and reduced injury risk among older adults. CCDSS have received little attention in LTC, as attested by the limited published literature. With an increasing ageing population, greater use of LTC by the ageing population and increased workload for health professionals, merely relying on physicians' judgement on medication safety would not be sufficient. CCDSS to improve medication safety and enhance the quality of prescribing decisions are essential. Analysis of review findings indicates that CCDSS are beneficial, effective and have potential to improve medication safety in LTC; however, the use of CCDSS in LTC is scarce. Careful assessment on the impact of CCDSS on medication safety and further modifications to existing CCDSS are recommended for wider acceptance. Due to scant evidence in the current literature, further research on implementation and

  18. Searching for qualitative research for inclusion in systematic reviews: a structured methodological review.

    Science.gov (United States)

    Booth, Andrew

    2016-05-04

    Qualitative systematic reviews or qualitative evidence syntheses (QES) are increasingly recognised as a way to enhance the value of systematic reviews (SRs) of clinical trials. They can explain the mechanisms by which interventions, evaluated within trials, might achieve their effect. They can investigate differences in effects between different population groups. They can identify which outcomes are most important to patients, carers, health professionals and other stakeholders. QES can explore the impact of acceptance, feasibility, meaningfulness and implementation-related factors within a real world setting and thus contribute to the design and further refinement of future interventions. To produce valid, reliable and meaningful QES requires systematic identification of relevant qualitative evidence. Although the methodologies of QES, including methods for information retrieval, are well-documented, little empirical evidence exists to inform their conduct and reporting. This structured methodological overview examines papers on searching for qualitative research identified from the Cochrane Qualitative and Implementation Methods Group Methodology Register and from citation searches of 15 key papers. A single reviewer reviewed 1299 references. Papers reporting methodological guidance, use of innovative methodologies or empirical studies of retrieval methods were categorised under eight topical headings: overviews and methodological guidance, sampling, sources, structured questions, search procedures, search strategies and filters, supplementary strategies and standards. This structured overview presents a contemporaneous view of information retrieval for qualitative research and identifies a future research agenda. This review concludes that poor empirical evidence underpins current information practice in information retrieval of qualitative research. A trend towards improved transparency of search methods and further evaluation of key search procedures offers

  19. How effective are family-based and institutional nutrition interventions in improving children's diet and health? A systematic review.

    Science.gov (United States)

    Black, Andrew P; D'Onise, Katina; McDermott, Robyn; Vally, Hassan; O'Dea, Kerin

    2017-10-17

    Effective strategies to improve dietary intake in young children are a priority to reduce the high prevalence of chronic non-communicable diseases in adulthood. This study aimed to assess the impact of family-based and school/preschool nutrition programs on the health of children aged 12 or younger, including the sustainability of these impacts and the relevance to socio-economic inequalities. A systematic review of literature published from 1980 to December 2014 was undertaken. Randomised controlled trials involving families with children aged up to 12 years in high income countries were included. The primary outcomes were dietary intake and health status. Results were presented in a narrative synthesis due to the heterogeneity of the interventions and outcomes. The systematic search and assessment identified 39 eligible studies. 82% of these studies were set in school/preschools. Only one school study assessed the impact of involving parents systematically. The family-based programs which provided simple positive dietary advice to parents and regular follow-up reduced fat intake significantly. School and family-based studies, if designed and implemented well, increased F&V intake, particularly fruit. Effective school-based programs have incorporated role-models including peers, teachers and heroic figures, rewards and increased access to healthy foods. School nutrition programs in disadvantaged communities were as effective as programs in other communities. Family and school nutrition programs can improve dietary intake, however evidence of the long-term sustainability of these impacts is limited. The modest overall impact of even these successful programs suggest complementary nutrition interventions are needed to build a supportive environment for healthy eating generally.

  20. Performing Systematic Literature Reviews with Novices: An Iterative Approach

    Science.gov (United States)

    Lavallée, Mathieu; Robillard, Pierre-N.; Mirsalari, Reza

    2014-01-01

    Reviewers performing systematic literature reviews require understanding of the review process and of the knowledge domain. This paper presents an iterative approach for conducting systematic literature reviews that addresses the problems faced by reviewers who are novices in one or both levels of understanding. This approach is derived from…

  1. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews.

    Science.gov (United States)

    Kumar, Saravana; Beaton, Kate; Hughes, Tricia

    2013-09-04

    The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent) although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an effective treatment option when compared to placebo and some active treatment options (such as relaxation), especially in the short term. There is conflicting and contradictory findings for the effectiveness of massage therapy for the treatment of nonspecific low back pain when compared against other manual therapies (such as

  2. Does Surgical Repair of Moderate Ischemic Mitral Regurgitation Improve Survival? A Systematic Review.

    Science.gov (United States)

    Chatterjee, Saurav; Tripathi, Byomesh; Virk, Hafeez Ul Hassan; Ahmed, Mohammed; Bavishi, Chirag; Krishnamoorthy, Parasuram; Sardar, Partha; Giri, Jay; Omidvari, Karan; Chikwe, Joanna

    2016-03-01

    Mitral regurgitation (MR) is one of the common complications in myocardial infarction (MI) patients. Almost half of the post MI patients have MR (ischemic MR)(17) which is moderate to severe (grade II-IV). Whether there is a mortality benefit of performing mitral valve repair (MVR) along with coronary artery bypass grafting (CABG) in patients with post MI moderate MR remains inconclusive. Literature search was done from PubMed, Google scholar, Ovid, and Medline databases. Studies which included post MI patients with moderate ischemic MR and reported mortality outcomes of performing CABG and MVR were chosen for the systematic review. Our preliminary literature search identified 194 studies, of which 11 studies met our inclusion criteria. Nine studies showed no survival benefit of performing simultaneous MVR and CABG. One study demonstrated survival benefit of performing CABG plus MVR only in the New York Heart Association (NYHA) class III-IV, and one study suggested survival benefit of performing CABG plus MVR as compared to CABG alone in patient with ischemic MR irrespective of preoperative NYHA functional class. Review of current literature showed mixed results in terms of improvement in functional status but failed to show any survival benefit of performing MVR along with CABG. Limitations of studies include small sample size, difference in baseline demographic variables, and short follow-up period which might influence the outcome of the study. Prospective randomized studies are required to establish clear benefit of performing MVR simultaneously with CABG.

  3. Does Methylphenidate Improve Academic Performance? A Systematic Review and Meta‑analysis

    NARCIS (Netherlands)

    Kortekaas-Rijlaarsdam, Anne Fleur; Luman, Marjolein; Sonuga-Barke, Edmund; Oosterlaan, J.

    2018-01-01

    Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD.Previous reviews on stimulant-related academic improvements are inconclusive and focus on task engagement. Recentliterature suggests outcome-domain-specific medication effects that are

  4. Does methylphenidate improve academic performance? A systematic review and meta-analysis

    NARCIS (Netherlands)

    Kortekaas-Rijlaarsdam, Anne Fleur; Luman, Marjolein; Sonuga-Barke, Edmund; Oosterlaan, Jaap

    2018-01-01

    Academic improvement is amongst the most common treatment targets when prescribing stimulants to children with ADHD. Previous reviews on stimulant-related academic improvements are inconclusive and focus on task engagement. Recent literature suggests outcome-domain-specific medication effects that

  5. A bibliometric analysis of systematic reviews on vaccines and immunisation.

    Science.gov (United States)

    Fernandes, Silke; Jit, Mark; Bozzani, Fiammetta; Griffiths, Ulla K; Scott, J Anthony G; Burchett, Helen E D

    2018-04-19

    SYSVAC is an online bibliographic database of systematic reviews and systematic review protocols on vaccines and immunisation compiled by the London School of Hygiene & Tropical Medicine and hosted by the World Health Organization (WHO) through their National Immunization Technical Advisory Groups (NITAG) resource centre (www.nitag-resource.org). Here the development of the database and a bibliometric review of its content is presented, describing trends in the publication of policy-relevant systematic reviews on vaccines and immunisation from 2008 to 2016. Searches were conducted in seven scientific databases according to a standardized search protocol, initially in 2014 with the most recent update in January 2017. Abstracts and titles were screened according to specific inclusion criteria. All included publications were coded into relevant categories based on a standardized protocol and subsequently analysed to look at trends in time, topic, area of focus, population and geographic location. After screening for inclusion criteria, 1285 systematic reviews were included in the database. While in 2008 there were only 34 systematic reviews on a vaccine-related topic, this increased to 322 in 2016. The most frequent pathogens/diseases studied were influenza, human papillomavirus and pneumococcus. There were several areas of duplication and overlap. As more systematic reviews are published it becomes increasingly time-consuming for decision-makers to identify relevant information among the ever-increasing volume available. The risk of duplication also increases, particularly given the current lack of coordination of systematic reviews on vaccine-related questions, both in terms of their commissioning and their execution. The SYSVAC database offers an accessible catalogue of vaccine-relevant systematic reviews with, where possible access or a link to the full-text. SYSVAC provides a freely searchable platform to identify existing vaccine-policy-relevant systematic

  6. Google Scholar is not enough to be used alone for systematic reviews.

    Science.gov (United States)

    Giustini, Dean; Boulos, Maged N Kamel

    2013-01-01

    Google Scholar (GS) has been noted for its ability to search broadly for important references in the literature. Gehanno et al. recently examined GS in their study: 'Is Google scholar enough to be used alone for systematic reviews?' In this paper, we revisit this important question, and some of Gehanno et al.'s other findings in evaluating the academic search engine. The authors searched for a recent systematic review (SR) of comparable size to run search tests similar to those in Gehanno et al. We selected Chou et al. (2013) contacting the authors for a list of publications they found in their SR on social media in health. We queried GS for each of those 506 titles (in quotes "), one by one. When GS failed to retrieve a paper, or produced too many results, we used the allintitle: command to find papers with the same title. Google Scholar produced records for ~95% of the papers cited by Chou et al. (n=476/506). A few of the 30 papers that were not in GS were later retrieved via PubMed and even regular Google Search. But due to its different structure, we could not run searches in GS that were originally performed by Chou et al. in PubMed, Web of Science, Scopus and PsycINFO®. Identifying 506 papers in GS was an inefficient process, especially for papers using similar search terms. Has Google Scholar improved enough to be used alone in searching for systematic reviews? No. GS' constantly-changing content, algorithms and database structure make it a poor choice for systematic reviews. Looking for papers when you know their titles is a far different issue from discovering them initially. Further research is needed to determine when and how (and for what purposes) GS can be used alone. Google should provide details about GS' database coverage and improve its interface (e.g., with semantic search filters, stored searching, etc.). Perhaps then it will be an appropriate choice for systematic reviews.

  7. Systematic review of randomized trials on vasoconstrictor drugs for hepatorenal syndrome

    DEFF Research Database (Denmark)

    Gluud, Lise L; Christensen, Kurt; Christensen, Erik

    2010-01-01

    Vasoconstrictor drugs may improve renal function in hepatorenal syndrome (HRS), but the effect on mortality has not been established. We therefore performed a systematic review of randomized trials on vasoconstrictor drugs for type 1 or type 2 HRS. Mortality was the primary outcome measure...

  8. The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

    Directory of Open Access Journals (Sweden)

    Vasconcelos Belmiro CE

    2008-09-01

    Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

  9. A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns.

    Science.gov (United States)

    Mudawarima, Tapfuma; Chiwaridzo, Matthew; Jelsma, Jennifer; Grimmer, Karen; Muchemwa, Faith Chengetayi

    2017-10-23

    Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves). Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement). Settings = any setting in any country. A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention programmes aimed at improving the function of patients with burns

  10. Text Messaging and Mobile Phone Apps as Interventions to Improve Adherence in Adolescents With Chronic Health Conditions: A Systematic Review.

    Science.gov (United States)

    Badawy, Sherif M; Barrera, Leonardo; Sinno, Mohamad G; Kaviany, Saara; O'Dwyer, Linda C; Kuhns, Lisa M

    2017-05-15

    The number of adolescents with chronic health conditions (CHCs) continues to increase. Medication nonadherence is a global challenge among adolescents across chronic conditions and is associated with poor health outcomes. While there has been growing interest in the use of mHealth technology to improve medication adherence among adolescents with CHCs, particularly text messaging and mobile phone apps, there has been no prior systematic review of their efficacy. The purpose of this review was to systematically evaluate the most recent evidence for the efficacy of text messaging and mobile phone apps as interventions to promote medication adherence among adolescents with CHCs. PubMed, Embase, CENTRAL, PsycINFO, Web of Science, Google Scholar, and additional databases were searched from 1995 until November 2015. An additional hand search of related themes in the Journal of Medical Internet Research was also conducted. The Preferred Reporting Results of Systematic Reviews and Meta-Analyses guidelines were followed. Two reviewers independently screened titles/abstracts, assessed full-text articles, extracted data from included articles, and assessed their quality using Grades of Recommendation, Assessment, Development, and Evaluation criteria. Included studies were described in original research articles that targeted adherence in adolescents with CHCs (12-24 years-old). Of the 1423 records examined, 15 met predefined criteria: text messaging (n=12) and mobile phone apps (n=3). Most studies were performed in the United States (11/15, 73%), were randomized-controlled trials (8/15, 53%), had a sample size <50 (11/15, 73%), and included adherence self-report and/or biomarkers (9/15, 60%). Only four studies were designed based on a theoretical framework. Approaches for text messaging and mobile phone app interventions varied across studies. Seven articles (7/15, 47%) reported significant improvement in adherence with moderate to large standardized mean differences. Most of

  11. Case-only designs in pharmacoepidemiology: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sandra Nordmann

    Full Text Available BACKGROUND: Case-only designs have been used since late 1980's. In these, as opposed to case-control or cohort studies for instance, only cases are required and are self-controlled, eliminating selection biases and confounding related to control subjects, and time-invariant characteristics. The objectives of this systematic review were to analyze how the two main case-only designs - case-crossover (CC and self-controlled case series (SCCS - have been applied and reported in pharmacoepidemiology literature, in terms of applicability assumptions and specificities of these designs. METHODOLOGY/PRINCIPAL FINDINGS: We systematically selected all reports in this field involving case-only designs from MEDLINE and EMBASE up to September 15, 2010. Data were extracted using a standardized form. The analysis included 93 reports 50 (54% of CC and 45 (48% SCCS, 2 reports combined both designs. In 12 (24% CC and 18 (40% SCCS articles, all applicable validity assumptions of the designs were fulfilled, respectively. Fifty (54% articles (15 CC (30% and 35 (78% SCCS adequately addressed the specificities of the case-only analyses in the way they reported results. CONCLUSIONS/SIGNIFICANCE: Our systematic review underlines that implementation of CC and SCCS designs needs to be more rigorous with regard to validity assumptions, as well as improvement in results reporting.

  12. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach.

    Science.gov (United States)

    Aromataris, Edoardo; Fernandez, Ritin; Godfrey, Christina M; Holly, Cheryl; Khalil, Hanan; Tungpunkom, Patraporn

    2015-09-01

    With the increase in the number of systematic reviews available, a logical next step to provide decision makers in healthcare with the evidence they require has been the conduct of reviews of existing systematic reviews. Syntheses of existing systematic reviews are referred to by many different names, one of which is an umbrella review. An umbrella review allows the findings of reviews relevant to a review question to be compared and contrasted. An umbrella review's most characteristic feature is that this type of evidence synthesis only considers for inclusion the highest level of evidence, namely other systematic reviews and meta-analyses. A methodology working group was formed by the Joanna Briggs Institute to develop methodological guidance for the conduct of an umbrella review, including diverse types of evidence, both quantitative and qualitative. The aim of this study is to describe the development and guidance for the conduct of an umbrella review. Discussion and testing of the elements of methods for the conduct of an umbrella review were held over a 6-month period by members of a methodology working group. The working group comprised six participants who corresponded via teleconference, e-mail and face-to-face meeting during this development period. In October 2013, the methodology was presented in a workshop at the Joanna Briggs Institute Convention. Workshop participants, review authors and methodologists provided further testing, critique and feedback on the proposed methodology. This study describes the methodology and methods developed for the conduct of an umbrella review that includes published systematic reviews and meta-analyses as the analytical unit of the review. Details are provided regarding the essential elements of an umbrella review, including presentation of the review question in a Population, Intervention, Comparator, Outcome format, nuances of the inclusion criteria and search strategy. A critical appraisal tool with 10 questions to

  13. School-Based Interventions Going Beyond Health Education to Promote Adolescent Health: Systematic Review of Reviews.

    Science.gov (United States)

    Shackleton, Nichola; Jamal, Farah; Viner, Russell M; Dickson, Kelly; Patton, George; Bonell, Christopher

    2016-04-01

    Health education in school classrooms can be effective in promoting sexual health and preventing violence and substance use but effects are patchy and often short term. Classroom education is also challenging because of schools' increasing focus on academic-performance metrics. Other school-based approaches are possible, such as healthy school policies, improving how schools respond to bullying, and parent outreach, which go beyond health education to address broader health determinants. Existing systematic reviews include such interventions but often alongside traditional health education. There is scope for a systematic review of reviews to assess and synthesize evidence across existing reviews to develop an overview of the potential of alternative school-based approaches. We searched 12 databases to identify reviews published after 1980. Data were reviewed by two researchers. Quality was assessed using a modified Assessing the Methodological Quality of Systematic Reviews checklist and results were synthesized narratively. We screened 7,544 unique references and included 22 reviews. Our syntheses suggest that multicomponent school-based interventions, for example, including school policy changes, parent involvement, and work with local communities, are effective for promoting sexual health and preventing bullying and smoking. There is less evidence that such intervention can reduce alcohol and drug use. Economic incentives to keep girls in school can reduce teenage pregnancies. School clinics can promote smoking cessation. There is little evidence that, on their own, sexual-health clinics, antismoking policies, and various approaches targeting at-risk students are effective. There is good evidence that various whole-school health interventions are effective in preventing teenage pregnancy, smoking, and bullying. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Kumar S

    2013-09-01

    Full Text Available Saravana Kumar,1 Kate Beaton,1 Tricia Hughes2 1International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; 2Australian Association of Massage Therapists, Adelaide, South Australia, Australia Introduction: The last decade has seen a growth in the utilization of complementary and alternative medicine therapies, and one of the most popular and sought-after complementary and alternative medicine therapies for nonspecific low back pain is massage. Massage may often be perceived as a safe therapeutic modality without any significant risks or side effects. However, despite its popularity, there continues to be ongoing debate on the effectiveness of massage in treating nonspecific low back pain. With a rapidly evolving research evidence base and access to innovative means of synthesizing evidence, it is time to reinvestigate this issue. Methods: A systematic, step-by-step approach, underpinned by best practice in reviewing the literature, was utilized as part of the methodology of this umbrella review. A systematic search was conducted in the following databases: Embase, MEDLINE, AMED, ICONDA, Academic Search Premier, Australia/New Zealand Reference Centre, CINAHL, HealthSource, SPORTDiscus, PubMed, The Cochrane Library, Scopus, Web of Knowledge/Web of Science, PsycINFO, and ProQuest Nursing and Allied Health Source, investigating systematic reviews and meta-analyses from January 2000 to December 2012, and restricted to English-language documents. Methodological quality of included reviews was undertaken using the Centre for Evidence Based Medicine critical appraisal tool. Results: Nine systematic reviews were found. The methodological quality of the systematic reviews varied (from poor to excellent although, overall, the primary research informing these systematic reviews was generally considered to be weak quality. The findings indicate that massage may be an

  15. Reducing Recreational Sedentary Screen Time: A Community Guide Systematic Review.

    Science.gov (United States)

    Ramsey Buchanan, Leigh; Rooks-Peck, Cherie R; Finnie, Ramona K C; Wethington, Holly R; Jacob, Verughese; Fulton, Janet E; Johnson, Donna B; Kahwati, Leila C; Pratt, Charlotte A; Ramirez, Gilbert; Mercer, Shawna L; Glanz, Karen

    2016-03-01

    Sedentary time spent with screen media is associated with obesity among children and adults. Obesity has potentially serious health consequences, such as heart disease and diabetes. This Community Guide systematic review examined the effectiveness and economic efficiency of behavioral interventions aimed at reducing recreational (i.e., neither school- nor work-related) sedentary screen time, as measured by screen time, physical activity, diet, and weight-related outcomes. For this review, an earlier ("original") review (search period, 1966 through July 2007) was combined with updated evidence (search period, April 2007 through June 2013) to assess effectiveness of behavioral interventions aimed at reducing recreational sedentary screen time. Existing Community Guide systematic review methods were used. Analyses were conducted in 2013-2014. The review included 49 studies. Two types of behavioral interventions were evaluated that either (1) focus on reducing recreational sedentary screen time only (12 studies); or (2) focus equally on reducing recreational sedentary screen time and improving physical activity or diet (37 studies). Most studies targeted children aged ≤13 years. Children's composite screen time (TV viewing plus other forms of recreational sedentary screen time) decreased 26.4 (interquartile interval= -74.4, -12.0) minutes/day and obesity prevalence decreased 2.3 (interquartile interval= -4.5, -1.2) percentage points versus a comparison group. Improvements in physical activity and diet were reported. Three study arms among adults found composite screen time decreased by 130.2 minutes/day. Among children, these interventions demonstrated reduced screen time, increased physical activity, and improved diet- and weight-related outcomes. More research is needed among adolescents and adults. Published by Elsevier Inc.

  16. Support for reporting guidelines in surgical journals needs improvement: A systematic review.

    Science.gov (United States)

    Agha, Riaz A; Barai, Ishani; Rajmohan, Shivanchan; Lee, Seon; Anwar, Mohammed O; Fowler, Alexander J; Orgill, Dennis P; Altman, Douglas G

    2017-09-01

    Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047-8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the 73 (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Text mining for search term development in systematic reviewing: A discussion of some methods and challenges.

    Science.gov (United States)

    Stansfield, Claire; O'Mara-Eves, Alison; Thomas, James

    2017-09-01

    Using text mining to aid the development of database search strings for topics described by diverse terminology has potential benefits for systematic reviews; however, methods and tools for accomplishing this are poorly covered in the research methods literature. We briefly review the literature on applications of text mining for search term development for systematic reviewing. We found that the tools can be used in 5 overarching ways: improving the precision of searches; identifying search terms to improve search sensitivity; aiding the translation of search strategies across databases; searching and screening within an integrated system; and developing objectively derived search strategies. Using a case study and selected examples, we then reflect on the utility of certain technologies (term frequency-inverse document frequency and Termine, term frequency, and clustering) in improving the precision and sensitivity of searches. Challenges in using these tools are discussed. The utility of these tools is influenced by the different capabilities of the tools, the way the tools are used, and the text that is analysed. Increased awareness of how the tools perform facilitates the further development of methods for their use in systematic reviews. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Empirical methods for systematic reviews and evidence-based medicine

    NARCIS (Netherlands)

    van Enst, W.A.

    2014-01-01

    Evidence-Based Medicine is the integration of best research evidence with clinical expertise and patient values. Systematic reviews have become the cornerstone of evidence-based medicine, which is reflected in the position systematic reviews have in the pyramid of evidence-based medicine. Systematic

  19. Interventions for postoperative pain in children: An overview of systematic reviews.

    Science.gov (United States)

    Boric, Krste; Dosenovic, Svjetlana; Jelicic Kadic, Antonia; Batinic, Marijan; Cavar, Marija; Urlic, Marjan; Markovina, Nikolina; Puljak, Livia

    2017-09-01

    The aim of this study was to conduct an overview of systematic reviews that summarizes the results about efficacy and safety from randomized controlled trials involving the various strategies used for postoperative pain management in children. We searched the Cochrane Database of Systematic Reviews, CINAHL, Database of Reviews of Effect, Embase, MEDLINE, and PsycINFO from the earliest date to January 24, 2016. This overview included 45 systematic reviews that evaluated interventions for postoperative pain in children. Out of 45 systematic reviews that investigated various interventions for postoperative pain in children, 19 systematic reviews (42%) presented conclusive evidence of efficacy. Positive conclusive evidence was reported in 18 systematic reviews (40%) for the efficacy of diclofenac, ketamine, caudal analgesia, dexmedetomidine, music therapy, corticosteroid, epidural analgesia, paracetamol, and/or nonsteroidal anti-inflammatory drugs and transversus abdominis plane block. Only one systematic review reported conclusive evidence of equal efficacy that involved a comparison of dexmedetomidine vs morphine and fentanyl. Safety of interventions was reported as conclusive in 14 systematic reviews (31%), with positive conclusive evidence for dexmedetomidine, corticosteroid, epidural analgesia, transversus abdominis plane block, and clonidine. Seven systematic reviews reported equal conclusive safety for epidural infusion, diclofenac intravenous vs ketamine added to opioid analgesia, bupivacaine, ketamine, paracetamol, and dexmedetomidine vs intravenous infusions of various opioid analgesics, oral suspension and suppository of diclofenac, only opioid, normal saline, no treatment, placebo, and midazolam. Negative conclusive statement for safety was reported in one systematic review for caudal analgesia vs noncaudal regional analgesia. More than half of systematic reviews included in this overview were rated as having medium methodological quality. Of 45 included

  20. Does targeting manual therapy and/or exercise improve patient outcomes in nonspecific low back pain? A systematic review

    DEFF Research Database (Denmark)

    Kent, Peter; Mjøsund, Hanne L; Petersen, Ditte H D

    2010-01-01

    A central element in the current debate about best practice management of non-specific low back pain (NSLBP) is the efficacy of targeted versus generic (non-targeted) treatment. Many clinicians and researchers believe that tailoring treatment to NSLBP subgroups positively impacts on patient outco...... outcomes. Despite this, there are no systematic reviews comparing the efficacy of targeted versus non-targeted manual therapy and/or exercise. This systematic review was undertaken in order to determine the efficacy of such targeted treatment in adults with NSLBP....

  1. Multisensory Stimulation to Improve Low- and Higher-Level Sensory Deficits after Stroke : A Systematic Review

    NARCIS (Netherlands)

    Tinga, A.M.; Visser-Meily, Johanna M a; van der Smagt, M.J.; van der Stigchel, S.; van Ee, R.; Nijboer, T.C.W.

    The aim of this systematic review was to integrate and assess evidence for the effectiveness of multisensory stimulation (i.e., stimulating at least two of the following sensory systems: visual, auditory, and somatosensory) as a possible rehabilitation method after stroke. Evidence was considered

  2. The Effectiveness of Dance Interventions to Improve Older Adults' Health: A Systematic Literature Review.

    Science.gov (United States)

    Hwang, Phoebe Woei-Ni; Braun, Kathryn L

    2015-01-01

    Physical inactivity is commonly observed among individuals aged ≥ 60 y. Identified barriers to sedentary older adults beginning activity include low self-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture. Dancing has the potential to be an attractive physical activity that can be adjusted to fit a target population's age, physical limitations, and culture. This review examined the benefits to physical health of dance interventions among older adults. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search using the PubMed database was conducted. Eighteen studies met the inclusion and exclusion criteria and were analyzed for type of intervention, the study's design, participants' demographics, and outcomes, including attrition. The 18 articles reported on studies conducted in North America, South America, Europe, and Asia. Of the styles of dancing, 6 studies used ballroom, 5 used contemporary, 4 used cultural, 1 used pop, and 2 used jazz. Two studies targeted older adults with pre-existing medical conditions. The average age of participants ranged from 52-87 y. Researchers used a variety of measures to assess effectiveness: (1) 3 of 5 (60%) that used measures to assess flexibility showed significant positive results; (2) 23 of 28 (82%) that used measures of muscular strength and endurance showed significant positive changes; (3) 8 of 9 (89%) that used measures of balance showed significant positive changes; (4) 8 of 10 (80%) that used measures of cognitive ability showed significant positive changes; and (5) the one that measured cardiovascular endurance showed significant positive changes. Only 6 studies reported participation, and they found low attrition. The findings suggest that dance, regardless of its style, can significantly improve muscular strength and endurance, balance, and other aspects of functional fitness in older adults. Future

  3. The Effectiveness of Dance Interventions to Improve Older Adults’ Health: A Systematic Literature Review

    Science.gov (United States)

    Hwang, Phoebe Woei-Ni; Braun, Kathryn L.

    2017-01-01

    Background Physical inactivity is commonly observed among individuals aged ≥60 y. Identified barriers to sedentary older adults beginning activity include low self-efficacy, pre-existing medical conditions, physical limitations, time constraints, and culture. Dancing has the potential to be an attractive physical activity that can be adjusted to fit a target populations age, physical limitations, and culture. Objectives This review examined the benefits to physical health of dance interventions among older adults. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search using the PubMed database was conducted. Eighteen studies met the inclusion and exclusion criteria and were analyzed for type of intervention, the study’s design, participants’ demographics, and outcomes, including attrition. Results The 18 articles reported on studies conducted in North America, South America, Europe, and Asia. Of the styles of dancing, 6 studies used ballroom, 5 used contemporary, 4 used cultural, 1 used pop, and 2 used jazz. Two studies targeted older adults with pre-existing medical conditions. The average age of participants ranged from 52–87 y. Researchers used a variety of measures to assess effectiveness; (1) 3 of 5 (60%) that used measures to assess flexibility showed significant positive results; (2) 23 of 28 (82%) that used measures of muscular strength and endurance showed significant positive changes; (3) 8 of 9 (89%) that used measures of balance showed significant positive changes; (4) 8 of 10 (80%) that used measures of cognitive ability showed significant positive changes; and (5) the one that measured cardiovascular endurance showed significant positive changes. Only 6 studies reported participation, and they found low attrition. Conclusions The findings suggest that dance, regardless of its style, can significantly improve muscular strength and endurance, balance, and other aspects of

  4. Applicable or non-applicable: investigations of clinical heterogeneity in systematic reviews

    Directory of Open Access Journals (Sweden)

    Laura E. Chess

    2016-02-01

    Full Text Available Abstract Background Clinical heterogeneity can be defined as differences in participant characteristics, types or timing of outcome measurements and intervention characteristics. Clinical heterogeneity in systematic reviews has the possibility to significantly affect statistical heterogeneity leading to inaccurate conclusions and misled decision making. The aim of this study is to identify to what extent investigators are assessing clinical heterogeneity in both Cochrane and non-Cochrane systematic reviews. Methods The most recent 100 systematic reviews from the top five journals in medicine—JAMA, Archives of Internal Medicine, British Medical Journal, The Lancet, and PLOS Medicine—and the 100 most recently published and/or updated systematic reviews from Cochrane were collected. Various defined items of clinical heterogeneity were extracted from the included reviews. Investigators used chi-squared tests, logarithmic modeling and linear regressions to determine if the presence of such items served as a predictor for clinical heterogeneity when comparing Cochrane to non-Cochrane reviews. Extracted variables include number of studies, number of participants, presence of quantitative synthesis, exploration of clinical heterogeneity, heterogeneous characteristics explored, basis and methods used for investigating clinical heterogeneity, plotting/visual aids, author contact, inferences from clinical heterogeneity investigation, reporting assessment, and the presence of a priori or post-hoc analysis. Results A total of 317 systematic reviews were considered, of which 199 were in the final analysis. A total of 81 % of Cochrane reviews and 90 % of non-Cochrane reviews explored characteristics that are considered aspects of clinical heterogeneity and also described the methods they planned to use to investigate the influence of those characteristics. Only 1 % of non-Cochrane reviews and 8 % of Cochrane reviews explored the clinical

  5. Depression screening and patient outcomes in pregnancy or postpartum : A systematic review

    NARCIS (Netherlands)

    Thombs, Brett D.; Arthurs, Erin; Coronado-Montoya, Stephanie; Roseman, Michelle; Delisle, Vanessa C.; Leavens, Allison; Levis, Brooke; Azoulay, Laurent; Smith, Cheri; Ciofani, Luisa; Coyne, James C.; Feeley, Nancy; Gilbody, Simon; Schinazi, Joy; Stewart, Donna E.; Zelkowitz, Phyllis

    Objective: Clinical practice guidelines disagree on whether health care professionals should screen women for depression during pregnancy or postpartum. The objective of this systematic review was to determine whether depression screening improves depression outcomes among women during pregnancy or

  6. Methotrexate-induced toxicity pharmacogenetics: an umbrella review of systematic reviews and meta-analyses.

    Science.gov (United States)

    Campbell, Jared M; Bateman, Emma; Stephenson, Matthew D; Bowen, Joanne M; Keefe, Dorothy M; Peters, Micah D J

    2016-07-01

    Methotrexate chemotherapy is associated with various toxicities which can result in the interruption or discontinuation of treatment and a subsequently raised risk of relapse. This umbrella systematic review was conducted to synthesize the results of all existing systematic reviews that investigate the pharmacogenetics of methotrexate-induced toxicity, with the aim of developing a comprehensive reference for personalized medicine. Databases searched were PubMed, Embase, JBI Database of Systematic Reviews and Implementation Reports, DARE, and ProQuest. Papers were critically appraised by two reviewers, and data were extracted using a standardized tool. Three systematic reviews on methotrexate-induced toxicity were included in the review. Meta-analyses were reported across Asian, Caucasian, pediatric and adult patients for the MTHFR C677T and A1298C polymorphisms. Toxicity outcomes included different forms of hematologic, ectodermal and hepatic toxicities. Results varied considerably depending on the patient groups and subgroups investigated in the different systematic reviews, as well as the genetic models utilized. However, significant associations were found between the MTHFR C677T allele and; hepatic toxicity, myelosuppression, oral mucositis, gastrointestinal toxicity, and skin toxicity. Additionally, limited evidence suggests that the MTHFR A1298C polymorphism may be associated with decreased risk of skin toxicity and leukopenia. This umbrella systematic review has synthesized the best available evidence on the pharmacogenetics of methotrexate toxicity. The next step in making personalized medicine for methotrexate therapy a clinical reality is research on the effectiveness and cost-effectiveness of MTHFR genotype testing to enable the close monitoring of at-risk patients for the timely initiation of rescue therapies.

  7. Peer review of health research funding proposals: A systematic map and systematic review of innovations for effectiveness and efficiency.

    Science.gov (United States)

    Shepherd, Jonathan; Frampton, Geoff K; Pickett, Karen; Wyatt, Jeremy C

    2018-01-01

    To investigate methods and processes for timely, efficient and good quality peer review of research funding proposals in health. A two-stage evidence synthesis: (1) a systematic map to describe the key characteristics of the evidence base, followed by (2) a systematic review of the studies stakeholders prioritised as relevant from the map on the effectiveness and efficiency of peer review 'innovations'. Standard processes included literature searching, duplicate inclusion criteria screening, study keyword coding, data extraction, critical appraisal and study synthesis. A total of 83 studies from 15 countries were included in the systematic map. The evidence base is diverse, investigating many aspects of the systems for, and processes of, peer review. The systematic review included eight studies from Australia, Canada, and the USA, evaluating a broad range of peer review innovations. These studies showed that simplifying the process by shortening proposal forms, using smaller reviewer panels, or expediting processes can speed up the review process and reduce costs, but this might come at the expense of peer review quality, a key aspect that has not been assessed. Virtual peer review using videoconferencing or teleconferencing appears promising for reducing costs by avoiding the need for reviewers to travel, but again any consequences for quality have not been adequately assessed. There is increasing international research activity into the peer review of health research funding. The studies reviewed had methodological limitations and variable generalisability to research funders. Given these limitations it is not currently possible to recommend immediate implementation of these innovations. However, many appear promising based on existing evidence, and could be adapted as necessary by funders and evaluated. Where feasible, experimental evaluation, including randomised controlled trials, should be conducted, evaluating impact on effectiveness, efficiency and quality.

  8. Peer review of health research funding proposals: A systematic map and systematic review of innovations for effectiveness and efficiency

    Science.gov (United States)

    Frampton, Geoff K.; Pickett, Karen; Wyatt, Jeremy C.

    2018-01-01

    Objective To investigate methods and processes for timely, efficient and good quality peer review of research funding proposals in health. Methods A two-stage evidence synthesis: (1) a systematic map to describe the key characteristics of the evidence base, followed by (2) a systematic review of the studies stakeholders prioritised as relevant from the map on the effectiveness and efficiency of peer review ‘innovations’. Standard processes included literature searching, duplicate inclusion criteria screening, study keyword coding, data extraction, critical appraisal and study synthesis. Results A total of 83 studies from 15 countries were included in the systematic map. The evidence base is diverse, investigating many aspects of the systems for, and processes of, peer review. The systematic review included eight studies from Australia, Canada, and the USA, evaluating a broad range of peer review innovations. These studies showed that simplifying the process by shortening proposal forms, using smaller reviewer panels, or expediting processes can speed up the review process and reduce costs, but this might come at the expense of peer review quality, a key aspect that has not been assessed. Virtual peer review using videoconferencing or teleconferencing appears promising for reducing costs by avoiding the need for reviewers to travel, but again any consequences for quality have not been adequately assessed. Conclusions There is increasing international research activity into the peer review of health research funding. The studies reviewed had methodological limitations and variable generalisability to research funders. Given these limitations it is not currently possible to recommend immediate implementation of these innovations. However, many appear promising based on existing evidence, and could be adapted as necessary by funders and evaluated. Where feasible, experimental evaluation, including randomised controlled trials, should be conducted, evaluating impact

  9. Comparative Effectiveness of Dental Anatomy Carving Pedagogy: A Systematic Review.

    Science.gov (United States)

    de Azevedo, Renato de A; da Rosa, Wellington Luiz de O; da Silva, Adriana F; Correa, Marcos B; Torriani, Marcos A; Lund, Rafael G

    2015-08-01

    The aim of this study was to review the effectiveness of methods used for teaching dental anatomy carving to dental students in operative dentistry as evaluated in published studies. This systematic review is described in accordance with the PRISMA statement. Two independent reviewers performed a systematic literature search of research published from January 1945 until May 2014. Seven databases were screened: MedLine (PubMed), Lilacs, IBECS, Web of Science, Scopus, SciELO, and The Cochrane Library. After removing duplicates, only studies using dental carving to assess the practical knowledge of anatomy were selected. The tabulated data were organized by title of article, names of authors, number of students assessed, assessment method, material used, groups tested, main results, and conclusions. The methodology quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Initially, 2,258 studies were identified in all databases. Five articles met the eligibility criteria and were included in this review. According to these studies, the geometric method, teaching step-by-step along with the teacher, and adjuvant methods such as the use of tutors and teaching through digital media with DVDs proved to be effective in improving learning. There is no standard technique that is widely accepted for the teaching of dental carving, nor is there an appropriately validated method of evaluation to verify whether the teaching methods used are effective for the acquisition of skills and expertise in dental anatomy by students.

  10. Systematic Literature Review Terhadap Evaluasi Perangkat Lunak Tentang Serious Game

    Directory of Open Access Journals (Sweden)

    Andhik Ampuh Yunanto

    2017-04-01

    Game is a software that is popular among children, adolescents, and adults. In addition, there are games that have a specific purpose other than as a medium of entertainment which called Serious Games. The amount of research on serious games can help developers in research, management, and software development in game. So it is necessary to Review the literature about the serious game so that information can be classified and categorized systematically. This study aims to provide an update by the Systematic Literature Review (SLR to the recent studies on the evaluation of serious games from 2015 until October 2016. The proposed SLR method has three stages of Review that is external, internal, and nine quality assessment (QA. The final results obtained in this study indicate there are 34 research on serious games. From the studies that were Reviewed also show that research on the evaluation of serious games have educational applications domain, the type of computer games, methods of evaluation questionnaires, evaluation of the quality of learning outcomes, evaluation procedures are simple, and the number of populations ranging from 1 to 50 people. The results that have been obtained SLR is expected to contribute and important information to the researcher or developer interested in the field of serious games. This research can also improve the quality of the serious game for education and counseling in community. Keywords: Serious game, Evaluation, Systematic Literature Review

  11. Effective interventions to improve young adults' linkage to HIV care in Sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Mavegam, Bertille Octavie; Pharr, Jennifer R; Cruz, Patricia; Ezeanolue, Echezona E

    2017-10-01

    HIV/AIDS remains a major public health problem despite the efforts to prevent and decrease its spread. Sub-Saharan Africa (SSA) represents 70% of the global number of people living with HIV and 73% of all HIV/AIDS-related deaths. Young adults age 15-24 years are disproportionately impacted by HIV/AIDS in SSA with 34% of people living with HIV (PLWHIV) and 37% of newly diagnosed individuals being in this age group. It is important that PLWHIV be linked to care to facilitate antiretroviral therapy (ART) initiation and limit the spread of infection. We conducted a systematic literature review to identify effective interventions designed to improve linkage to care among HIV-infected young adults in SSA. One hundred and forty-six titles and abstracts were screened, 28 full-texts were reviewed, and 6 articles met the inclusion and exclusion criteria. Home-based HIV counseling and testing, home-based HIV self-testing, and mobile HIV counseling and testing followed by proper referral of HIV-positive patients to HIV care were effective for improving linkage of young adults to care. Other factors such as referral forms, transportation allowance, home initiation of HIV care, and volunteer escort to the HIV treatment clinic were effective in reducing time to linkage to care. There is a vast need for research and interventions that target HIV-positive young adults in SSA which aim to improve their linkage and access to HIV care. The results of this study illustrate effective interventions in improving linkage to care and reducing time to linkage to care of young adults in SSA.

  12. EMDR beyond PTSD: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Alicia Valiente-Gómez

    2017-09-01

    Full Text Available Background: Eye Movement Desensitization and Reprocessing (EMDR is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD through several randomized controlled trials (RCT. Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain.Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions.Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement.Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions.

  13. A Systematic Review of Digital Interventions for Improving the Diet and Physical Activity Behaviors of Adolescents.

    Science.gov (United States)

    Rose, Taylor; Barker, Mary; Maria Jacob, Chandni; Morrison, Leanne; Lawrence, Wendy; Strömmer, Sofia; Vogel, Christina; Woods-Townsend, Kathryn; Farrell, David; Inskip, Hazel; Baird, Janis

    2017-12-01

    Many adolescents have poor diet and physical activity behaviors, which can lead to the development of noncommunicable diseases in later life. Digital platforms offer inexpensive means of delivering health interventions, but little is known about their effectiveness. This systematic review was conducted to synthesize evidence on the effectiveness of digital interventions to improve diet quality and increase physical activity in adolescents, to effective intervention components and to assess the cost-effectiveness of these interventions. Following a systematic search, abstracts were assessed against inclusion criteria, and data extraction and quality assessment were performed for included studies. Data were analyzed to identify key features that are associated with significant improvement in behavior. A total of 27 studies met inclusion criteria. Most (n = 15) were Web site interventions. Other delivery methods were text messages, games, multicomponent interventions, emails, and social media. Significant behavior change was often seen when interventions included education, goal setting, self-monitoring, and parental involvement. None of the publications reported cost-effectiveness. Due to heterogeneity of studies, meta-analysis was not feasible.It is possible to effect significant health behavior change in adolescents through digital interventions that incorporate education, goal setting, self-monitoring, and parental involvement. Most of the evidence relates to Web sites and further research into alternate media is needed, and longer term outcomes should be evaluated. There is a paucity of data on the cost-effectiveness of digital health interventions, and future trials should report these data. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Use of programme theory to understand the differential effects of interventions across socio-economic groups in systematic reviews-a systematic methodology review.

    Science.gov (United States)

    Maden, Michelle; Cunliffe, Alex; McMahon, Naoimh; Booth, Andrew; Carey, Gina Michelle; Paisley, Suzy; Dickson, Rumona; Gabbay, Mark

    2017-12-29

    Systematic review guidance recommends the use of programme theory to inform considerations of if and how healthcare interventions may work differently across socio-economic status (SES) groups. This study aimed to address the lack of detail on how reviewers operationalise this in practice. A methodological systematic review was undertaken to assess if, how and the extent to which systematic reviewers operationalise the guidance on the use of programme theory in considerations of socio-economic inequalities in health. Multiple databases were searched from January 2013 to May 2016. Studies were included if they were systematic reviews assessing the effectiveness of an intervention and included data on SES. Two reviewers independently screened all studies, undertook quality assessment and extracted data. A narrative approach to synthesis was adopted. A total of 37 systematic reviews were included, 10 of which were explicit in the use of terminology for 'programme theory'. Twenty-nine studies used programme theory to inform both their a priori assumptions and explain their review findings. Of these, 22 incorporated considerations of both what and how interventions do/do not work in SES groups to both predict and explain their review findings. Thirteen studies acknowledged 24 unique theoretical references to support their assumptions of what or how interventions may have different effects in SES groups. Most reviewers used supplementary evidence to support their considerations of differential effectiveness. The majority of authors outlined a programme theory in the "Introduction" and "Discussion" sections of the review to inform their assumptions or provide explanations of what or how interventions may result in differential effects within or across SES groups. About a third of reviews used programme theory to inform the review analysis and/or synthesis. Few authors used programme theory to inform their inclusion criteria, data extraction or quality assessment. Twenty

  15. Effects οf Yoga οn cancer patients: Secondary analysis οf Systematic Reviews/Meta-Analyses

    Directory of Open Access Journals (Sweden)

    Dimos Mastrogiannis

    2016-09-01

    Full Text Available Introduction: Western medicine’s model has been enriched with alternative management and treatment methods. Yoga is a technique that incorporates physical exercises, breathing methods, meditation and relaxation which has been proposed to have positive effects on cancer patients. Aim: The aim of the present study is to critically review findings of systematic reviews/meta-analyses that are available in the international literature, regarding the effects of yoga on cancer patients. Methodology: Literature review was performed in five (5 databases: PubMed, Scopus, EMBASE, Web of Science and Cochrane Database of systematic Reviews. Authors adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analysis model in order to perform a critical review of the existing literature. Methodological assessment of papers under review was performed according to criteria of the Assessment of Multiple Systematic Reviews instrument. Inclusion criteria were the English language, research undertaken in adults and evaluation of effects of yoga as the primary intervention. Results: Although there is a lack of guidelines regarding the assessment of systematic reviews using the above mentioned instruments, 16 papers were included in the present study. Findings are confounding, even though there is evidence supporting the use of yoga in certain types of cancer. Specifically, improvements in quality of life and psychological wellbeing, anxiety, however, not pain reduction, have been reported in women suffering from breast cancer, however, no statistically significant effect has been documented in patients with haematological malignancies. Conclusions: The majority of studies about the effects of yoga on quality of life, fatigue, sleep quality, anxiety, and depression have small samples. There is a trend towards an overall quality of life improvement, nonetheless, the lack of sufficiently powered randomized controlled trials prevents the extraction of a safe

  16. Treatment, Therapy and Management of Metabolic Epilepsy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Vanessa Lin Lin Lee

    2018-03-01

    Full Text Available Metabolic epilepsy is a metabolic abnormality which is associated with an increased risk of epilepsy development in affected individuals. Commonly used antiepileptic drugs are typically ineffective against metabolic epilepsy as they do not address its root cause. Presently, there is no review available which summarizes all the treatment options for metabolic epilepsy. Thus, we systematically reviewed literature which reported on the treatment, therapy and management of metabolic epilepsy from four databases, namely PubMed, Springer, Scopus and ScienceDirect. After applying our inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, we reviewed a total of 43 articles. Based on the reviewed articles, we summarized the methods used for the treatment, therapy and management of metabolic epilepsy. These methods were tailored to address the root causes of the metabolic disturbances rather than targeting the epilepsy phenotype alone. Diet modification and dietary supplementation, alone or in combination with antiepileptic drugs, are used in tackling the different types of metabolic epilepsy. Identification, treatment, therapy and management of the underlying metabolic derangements can improve behavior, cognitive function and reduce seizure frequency and/or severity in patients.

  17. Type and extent of trans-disciplinary co-operation to improve food security, health and household environment in low and middle income countries: systematic review

    Directory of Open Access Journals (Sweden)

    Santosh Gaihre

    2016-10-01

    Full Text Available Abstract Background Although linkages have been found between agricultural interventions and nutritional health, and the development of clean fuels and improved solid fuel stoves in reducing household air pollution and adverse health effects, the extent of the potential of combined household interventions to improve health, nutrition and the environment has not been investigated. A systematic review was conducted to identify the extent and type of community-based agricultural and household interventions aimed at improving food security, health and the household environment in low and middle income countries. Methods A systematic search of Ovid MEDLINE, PUBMED, EMBASE and SCOPUS databases was performed. Key search words were generated reflecting the “participants, interventions, comparators, outcomes and study design” approach and a comprehensive search strategy was developed following “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” recommendations. Any community-based agricultural and/or household interventions were eligible for inclusion if the focus was to improve at least one of the outcome measures of interest. All relevant study designs employing any of these interventions (alone/in combination were included if conducted in Low and middle income countries. Review articles, and clinical and occupational studies were excluded. Results A total of 123 studies were included and grouped into four intervention domains; agricultural (n = 27, air quality (n = 34, water quality (n = 32, and nutritional (n = 30. Most studies were conducted in Asia (39.2 % or Africa (34.6 % with the remaining 26.1 % in Latin America. Very few studies (n = 11 combined interventions across more than one domain. The majority of agricultural and nutritional studies were conducted in Africa and Asia, whereas the majority of interventions to improve household air quality were conducted in Latin America. Conclusions It is

  18. Does prehospital ultrasound improve treatment of the trauma patient? A systematic review

    DEFF Research Database (Denmark)

    Jørgensen, Henrik; Jensen, Carsten H; Dirks, Jesper

    2010-01-01

    an important role, as initial life support and early surgical care influences the outcome of the severely injured patient. Time is especially crucial in blunt abdominal trauma and penetrating truncal injuries. Several studies in this review showed that prehospital US is feasible and that the procedure...... created the possibility of bringing US to the prehospital setting, thus gaining a potential for early diagnosis and treatment. The objective of this study was to systematically search the literature for evidence that prehospital US of the abdomen or thorax increases survival of trauma patients. The data...... regarding the use of US in the prehospital setting is sparse, often of low quality and describing a broad variety of patients and clinical challenges. Therefore, from an evidence point of view it is not possible to answer the objectives in this review. In the prehospital setting, rapid assessment plays...

  19. The effectiveness of external sensory cues in improving functional performance in individuals with Parkinson's disease: a systematic review with meta-analysis.

    Science.gov (United States)

    Cassimatis, Constantine; Liu, Karen P Y; Fahey, Paul; Bissett, Michelle

    2016-09-01

    A systematic review with meta-analysis was performed to investigate the effect external sensory cued therapy on activities of daily living (ADL) performance that include walking and daily tasks such as dressing for individuals with Parkinson's disease (PD). A detailed computer-aided search of the literature was applied to MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE and PubMed. Studies investigating the effects of external sensory cued therapy on ADL performance for individuals with PD in all stages of disease progression were collected. Relevant articles were critically reviewed and study results were synthesized by two independent researchers. A data-analysis method was used to extract data from selected articles. A meta-analysis was carried out for all randomized-controlled trials. Six studies with 243 individuals with PD were included in this review. All six studies yielded positive findings in favour of external sensory cues. The meta-analysis showed that external sensory cued therapy improved statistically after treatment (P=0.011) and at follow-up (Psensory into a training programme focused on improving daily task performance.

  20. A Systematic Review of Oral Health Behavior Research in American Adolescents

    Science.gov (United States)

    Calderon, Susana J.; Mallory, Caroline

    2014-01-01

    Despite improvements in prevention, oral diseases are a problem among adolescents, linked to poor health outcomes and poor school performance. Little is known about adolescent oral health behavior. This systematic review describes factors that influence oral health behavior in adolescents. Inclusion criteria for the literature search were American…

  1. Probiotic supplementation in children with cystic fibrosis-a systematic review.

    Science.gov (United States)

    Ananthan, Anitha; Balasubramanian, Haribalakrishna; Rao, Shripada; Patole, Sanjay

    2016-10-01

    Probiotics may benefit in cystic fibrosis (CF) as gut dysbiosis is associated with gastrointestinal symptoms and exacerbation of respiratory symptoms in CF. We conducted a systematic review of randomized controlled trials (RCTs) and non-RCTs of probiotic supplementation in children with CF, using the Cochrane methodology, preferred reporting items for systematic reviews (PRISMA) statement, and meta-analysis of observational studies in epidemiology (MOOSE) guidelines. Primary outcomes were pulmonary exacerbations, duration of hospitalization and antibiotics, and all-cause mortality. Secondary outcomes included gastrointestinal symptoms, markers of gut inflammation, and intestinal microbial balance. A total of nine studies (RCTs, 6, non-RCTs, 3; N = 275) with some methodological weaknesses were included in the review. The pooled estimate showed significant reduction in the rate of pulmonary exacerbation (fixed effects model, two parallel group RCTs and one cross-over trial: relative risk (RR) 0.25, (95 % confidence interval (95 % CI) 0.15,0.41); p probiotic supplementation. Probiotic supplementation significantly improved gastrointestinal symptoms (one RCT, one non-RCT) and gut microbial balance (decreased Proteobacteria, increased Firmicutes, and Bacteroides in one RCT, one non-RCT). Limited low-quality evidence exists on the effects of probiotics in children with CF. Well-designed adequately powered RCTs assessing clinically meaningful outcomes are required to study this important issue. • Gut dysbiosis is frequent in children with cystic fibrosis due to frequent exposure to pathogens and antibiotics. • Probiotics decrease gut dysbiosis and improve gut maturity and function. What is New: • This comprehensive systematic review shows that current evidence on the safety and efficacy of probiotics in children with cystic fibrosis is limited and of low quality. • Well-designed and adequately powered trials assessing clinically important outcomes are

  2. Effectiveness of mHealth Interventions Targeting Health Care Workers to Improve Pregnancy Outcomes in Low- and Middle-Income Countries : A Systematic Review

    OpenAIRE

    Amoakoh-Coleman, Mary; Borgstein, Alexander Berend-Jan; Sondaal, Stephanie F V; Grobbee, Diederick E; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Ansah, Evelyn K; Browne, Joyce L; Klipstein-Grobusch, Kerstin

    2016-01-01

    BACKGROUND: Low- and middle-income countries (LMICs) face the highest burden of maternal and neonatal deaths. Concurrently, they have the lowest number of physicians. Innovative methods such as the exchange of health-related information using mobile devices (mHealth) may support health care workers in the provision of antenatal, delivery, and postnatal care to improve maternal and neonatal outcomes in LMICs. OBJECTIVE: We conducted a systematic review evaluating the effectiveness of mHealth i...

  3. Assessing the Effect of mHealth Interventions in Improving Maternal and Neonatal Care in Low- and Middle-Income Countries: A Systematic Review

    OpenAIRE

    Sondaal, Stephanie Felicie Victoria; Browne, Joyce Linda; Amoakoh-Coleman, Mary; Borgstein, Alexander; Miltenburg, Andrea Solnes; Verwijs, Mirjam; Klipstein-Grobusch, Kerstin

    2016-01-01

    INTRODUCTION: Maternal and neonatal mortality remains high in many low- and middle-income countries (LMIC). Availability and use of mobile phones is increasing rapidly with 90% of persons in developing countries having a mobile-cellular subscription. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This systematic review assessed the effect of mHealth interventions that support pregnant women during the antenatal, birth a...

  4. Workplace interventions to improve work ability: A systematic review and meta-analysis of their effectiveness.

    Science.gov (United States)

    Oakman, Jodi; Neupane, Subas; Proper, Karin I; Kinsman, Natasha; Nygård, Clas-Håkan

    2018-03-01

    Objective Extended working lives due to an ageing population will necessitate the maintenance of work ability across the life course. This systematic review aimed to analyze whether workplace interventions positively impact work ability. Methods We searched Medline, PsycINFO, CINAHL and Embase databases using relevant terms. Work-based interventions were those focused on individuals, the workplace, or multilevel (combination). Work ability - measured using the work ability index (WAI) or the single-item work ability score (WAS) - was the outcome measure. Grading of Recommendations Assessment, Development & Evaluation (GRADE) criteria was used to assess evidence quality, and impact statements were developed to synthesize the results. Meta-analysis was undertaken where appropriate. Results We reviewed 17 randomized control trials (comprising 22 articles). Multilevel interventions (N=5) included changes to work arrangements and liaisons with supervisors, whilst individual-focused interventions (N=12) involved behavior change or exercise programs. We identified only evidence of a moderate quality for either individual or multilevel interventions aiming to improve work ability. The meta-analysis of 13 studies found a small positive significant effect for interventions on work ability [overall pooled mean 0.12, 95% confidence interval (CI) 0.03-0.21] with no heterogeneity for the effect size (Chi 2 =11.28, P=0.51; I 2 =0%). Conclusions The meta-analysis showed a small positive effect, suggesting that workplace interventions might improve work ability. However, the quality of the evidence base was only moderate, precluding any firm conclusion. Further high quality studies are require to establish the role of interventions on work ability.

  5. Pregnancy outcome and ultraviolet radiation; A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Megaw, Lauren, E-mail: lauren.megaw@ed.ac.uk [School of Women' s and Infants Health, University of Western Australia, 35 Crawley Ave, Crawley, Perth, Western Australia (Australia); Edinburgh Tommy' s Centre for Reproductive Health, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh (United Kingdom); Clemens, Tom, E-mail: Tom.clemens@ed.ac.uk [School of Geosciences, University of Edinburgh, Drummond St, Edinburgh, Midlothian (United Kingdom); Dibben, Chris, E-mail: Chris.dibben@ed.ac.uk [School of Geosciences, University of Edinburgh, Drummond St, Edinburgh, Midlothian (United Kingdom); Weller, Richard, E-mail: Richard.weller@ed.ac.uk [MRC Centre for Inflammation Research, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh (United Kingdom); Stock, Sarah, E-mail: Sarah.stock@ed.ac.uk [School of Women' s and Infants Health, University of Western Australia, 35 Crawley Ave, Crawley, Perth, Western Australia (Australia); Edinburgh Tommy' s Centre for Reproductive Health, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh (United Kingdom)

    2017-05-15

    Background: Season and vitamin D are indirect and direct correlates of ultraviolet (UV) radiation and are associated with pregnancy outcomes. Further to producing vitamin D, UV has positive effects on cardiovascular and immune health that may support a role for UV directly benefitting pregnancy. Objectives: To investigate the effects of UV exposure on pregnancy; specifically fetal growth, preterm birth and hypertensive complications. Methods: We conducted a systematic review of Medline, EMBASE, DoPHER, Global Health, ProQuest Public Health, AustHealth Informit, SCOPUS and Google Scholar to identify 537 citations, 8 of which are included in this review. This review was registered on PROSPERO and a. narrative synthesis is presented following PRISMA guidance. Results: All studies were observational and assessed at high risk of bias. Higher first trimester UV was associated with and improved fetal growth and increased hypertension in pregnancy. Interpretation is limited by study design and quality. Meta-analysis was precluded by the variety of outcomes and methods. Discussion: The low number of studies and risk of bias limit the validity of any conclusions. Environmental health methodological issues are discussed with consideration given to design and analytical improvements to further address this reproductive environmental health question. Conclusions: The evidence for UV having benefits for pregnancy hypertension and fetal growth is limited by the methodological approaches utilized. Future epidemiological efforts should focus on improving the methods of modeling and linking widely available environmental data to reproductive health outcomes. - Highlights: • Biologically plausible pathways support an association between ultraviolet radiation (UV) and pregnancy outcomes. • This study is the first systematic review of prevailing literature on the relationship between UV and singleton pregnancy outcomes. • It focuses on both substantive findings and the

  6. Pregnancy outcome and ultraviolet radiation; A systematic review

    International Nuclear Information System (INIS)

    Megaw, Lauren; Clemens, Tom; Dibben, Chris; Weller, Richard; Stock, Sarah

    2017-01-01

    Background: Season and vitamin D are indirect and direct correlates of ultraviolet (UV) radiation and are associated with pregnancy outcomes. Further to producing vitamin D, UV has positive effects on cardiovascular and immune health that may support a role for UV directly benefitting pregnancy. Objectives: To investigate the effects of UV exposure on pregnancy; specifically fetal growth, preterm birth and hypertensive complications. Methods: We conducted a systematic review of Medline, EMBASE, DoPHER, Global Health, ProQuest Public Health, AustHealth Informit, SCOPUS and Google Scholar to identify 537 citations, 8 of which are included in this review. This review was registered on PROSPERO and a. narrative synthesis is presented following PRISMA guidance. Results: All studies were observational and assessed at high risk of bias. Higher first trimester UV was associated with and improved fetal growth and increased hypertension in pregnancy. Interpretation is limited by study design and quality. Meta-analysis was precluded by the variety of outcomes and methods. Discussion: The low number of studies and risk of bias limit the validity of any conclusions. Environmental health methodological issues are discussed with consideration given to design and analytical improvements to further address this reproductive environmental health question. Conclusions: The evidence for UV having benefits for pregnancy hypertension and fetal growth is limited by the methodological approaches utilized. Future epidemiological efforts should focus on improving the methods of modeling and linking widely available environmental data to reproductive health outcomes. - Highlights: • Biologically plausible pathways support an association between ultraviolet radiation (UV) and pregnancy outcomes. • This study is the first systematic review of prevailing literature on the relationship between UV and singleton pregnancy outcomes. • It focuses on both substantive findings and the

  7. Do systematic reviews address community healthcare professionals' wound care uncertainties? Results from evidence mapping in wound care.

    Science.gov (United States)

    Christie, Janice; Gray, Trish A; Dumville, Jo C; Cullum, Nicky A

    2018-01-01

    Complex wounds such as leg and foot ulcers are common, resource intensive and have negative impacts on patients' wellbeing. Evidence-based decision-making, substantiated by high quality evidence such as from systematic reviews, is widely advocated for improving patient care and healthcare efficiency. Consequently, we set out to classify and map the extent to which up-to-date systematic reviews containing robust evidence exist for wound care uncertainties prioritised by community-based healthcare professionals. We asked healthcare professionals to prioritise uncertainties based on complex wound care decisions, and then classified 28 uncertainties according to the type and level of decision. For each uncertainty, we searched for relevant systematic reviews. Two independent reviewers screened abstracts and full texts of reviews against the following criteria: meeting an a priori definition of a systematic review, sufficiently addressing the uncertainty, published during or after 2012, and identifying high quality research evidence. The most common uncertainty type was 'interventions' 24/28 (85%); the majority concerned wound level decisions 15/28 (53%) however, service delivery level decisions (10/28) were given highest priority. Overall, we found 162 potentially relevant reviews of which 57 (35%) were not systematic reviews. Of 106 systematic reviews, only 28 were relevant to an uncertainty and 18 of these were published within the preceding five years; none identified high quality research evidence. Despite the growing volume of published primary research, healthcare professionals delivering wound care have important clinical uncertainties which are not addressed by up-to-date systematic reviews containing high certainty evidence. These are high priority topics requiring new research and systematic reviews which are regularly updated. To reduce clinical and research waste, we recommend systematic reviewers and researchers make greater efforts to ensure that research

  8. Does integrated management of childhood illness (IMCI training improve the skills of health workers? A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Duyen Thi Kim Nguyen

    Full Text Available An estimated 6.9 million children die annually in low and middle-income countries because of treatable illneses including pneumonia, diarrhea, and malaria. To reduce morbidity and mortality, the Integrated Management of Childhood Illness strategy was developed, which included a component to strengthen the skills of health workers in identifying and managing these conditions. A systematic review and meta-analysis were conducted to determine whether IMCI training actually improves performance.Database searches of CIHAHL, CENTRAL, EMBASE, Global Health, Medline, Ovid Healthstar, and PubMed were performed from 1990 to February 2013, and supplemented with grey literature searches and reviews of bibliographies. Studies were included if they compared the performance of IMCI and non-IMCI health workers in illness classification, prescription of medications, vaccinations, and counseling on nutrition and admistration of oral therapies. Dersminion-Laird random effect models were used to summarize the effect estimates.The systematic review and meta-analysis included 46 and 26 studies, respectively. Four cluster-randomized controlled trials, seven pre-post studies, and 15 cross-sectional studies were included. Findings were heterogeneous across performance domains with evidence of effect modification by health worker performance at baseline. Overall, IMCI-trained workers were more likely to correctly classify illnesses (RR = 1.93, 95% CI: 1.66-2.24. Studies of workers with lower baseline performance showed greater improvements in prescribing medications (RR = 3.08, 95% CI: 2.04-4.66, vaccinating children (RR = 3.45, 95% CI: 1.49-8.01, and counseling families on adequate nutrition (RR = 10.12, 95% CI: 6.03-16.99 and administering oral therapies (RR = 3.76, 95% CI: 2.30-6.13. Trends toward greater training benefits were observed in studies that were conducted in lower resource settings and reported greater supervision.Findings suggest that

  9. Psychosocial Benefits of Cooking Interventions: A Systematic Review

    Science.gov (United States)

    Farmer, Nicole; Touchton-Leonard, Katherine; Ross, Alyson

    2018-01-01

    Objectives: Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. Methods: A systematic review of the…

  10. Mediating Policy-Relevant Evidence at Speed: Are Systematic Reviews of Systematic Reviews a Useful Approach?

    Science.gov (United States)

    Caird, Jenny; Sutcliffe, Katy; Kwan, Irene; Dickson, Kelly; Thomas, James

    2015-01-01

    When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the…

  11. A systematic review of interventions to improve postpartum retention of women in PMTCT and ART care

    Science.gov (United States)

    Geldsetzer, Pascal; Yapa, H Manisha N; Vaikath, Maria; Ogbuoji, Osondu; Fox, Matthew P; Essajee, Shaffiq M; Negussie, Eyerusalem K; Bärnighausen, Till

    2016-01-01

    Introduction The World Health Organization recommends lifelong antiretroviral therapy (ART) for all pregnant and breastfeeding women living with HIV. Effective transitioning from maternal and child health to ART services, and long-term retention in ART care postpartum is crucial to the successful implementation of lifelong ART for pregnant women. This systematic review aims to determine which interventions improve (1) retention within prevention of mother-to-child HIV transmission (PMTCT) programmes after birth, (2) transitioning from PMTCT to general ART programmes in the postpartum period, and (3) retention of postpartum women in general ART programmes. Methods We searched Medline, Embase, ISI Web of Knowledge, the regional World Health Organization databases and conference abstracts for data published between 2002 and 2015. The quality of all included studies was assessed using the GRADE criteria. Results and Discussion After screening 8324 records, we identified ten studies for inclusion in this review, all of which were from sub-Saharan Africa except for one from the United Kingdom. Two randomized trials found that phone calls and/or text messages improved early (six to ten weeks) postpartum retention in PMTCT. One cluster-randomized trial and three cohort studies found an inconsistent impact of different levels of integration between antenatal care/PMTCT and ART care on postpartum retention. The inconsistent results of the four identified studies on care integration are likely due to low study quality, and heterogeneity in intervention design and outcome measures. Several randomized trials on postpartum retention in HIV care are currently under way. Conclusions Overall, the evidence base for interventions to improve postpartum retention in HIV care is weak. Nevertheless, there is some evidence that phone-based interventions can improve retention in PMTCT in the first one to three months postpartum. PMID:27118443

  12. The effectiveness of e-Interventions on reducing social isolation in older persons: A systematic review of systematic reviews.

    Science.gov (United States)

    Chipps, Jennifer; Jarvis, Mary Ann; Ramlall, Suvira

    2017-12-01

    As the older adult population group has been increasing in size, there has been evidence of growing social isolation and loneliness in their lives. The increased use of information communication technology and Internet-supported interventions has stimulated an interest in the benefits of e-Interventions for older people and specifically in having a role in increasing social networks and decreasing loneliness. A systematic review of e-Interventions to reduce loneliness in older people was conducted with the aim to synthesize high quality evidence on the effectiveness of e-Interventions to decrease social isolation/loneliness for older people living in community/residential care. A systematic search of 12 databases for reviews published between 2000-2017 was conducted using search term synonyms for older people, social isolation and interventions. Three independent researchers screened articles and two reviewers extracted data. The Revised-Assessment of Multiple Systematic Reviews was used to assess the quality of reviews. The final search identified 12 reviews, which included 22 unique primary research studies evaluating e-Interventions for social isolation or loneliness. The reviews were of moderate quality and the primary studies showed a lack of rigor. Loneliness was most frequently measured using the University California Los Angeles Loneliness Scale. Despite the limitations of the reviewed studies, there is inconsistent and weak evidence on using e-Interventions for loneliness in older people.

  13. The limited prosocial effects of meditation: A systematic review and meta-analysis

    NARCIS (Netherlands)

    Kreplin, U.; Farias, M.; Brazil, I.A.

    2018-01-01

    Many individuals believe that meditation has the capacity to not only alleviate mental-illness but to improve prosociality. This article systematically reviewed and meta-analysed the effects of meditation interventions on prosociality in randomized controlled trials of healthy adults. Five types of

  14. Association between prospective registration and overall reporting and methodological quality of systematic reviews: a meta-epidemiological study.

    Science.gov (United States)

    Ge, Long; Tian, Jin-Hui; Li, Ya-Nan; Pan, Jia-Xue; Li, Ge; Wei, Dang; Xing, Xin; Pan, Bei; Chen, Yao-Long; Song, Fu-Jian; Yang, Ke-Hu

    2018-01-01

    The aim of this study was to investigate the differences in main characteristics, reporting and methodological quality between prospectively registered and nonregistered systematic reviews. PubMed was searched to identify systematic reviews of randomized controlled trials published in 2015 in English. After title and abstract screening, potentially relevant reviews were divided into three groups: registered non-Cochrane reviews, Cochrane reviews, and nonregistered reviews. For each group, random number tables were generated in Microsoft Excel, and the first 50 eligible studies from each group were randomly selected. Data of interest from systematic reviews were extracted. Regression analyses were conducted to explore the association between total Revised Assessment of Multiple Systematic Review (R-AMSTAR) or Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) scores and the selected characteristics of systematic reviews. The conducting and reporting of literature search in registered reviews were superior to nonregistered reviews. Differences in 9 of the 11 R-AMSTAR items were statistically significant between registered and nonregistered reviews. The total R-AMSTAR score of registered reviews was higher than nonregistered reviews [mean difference (MD) = 4.82, 95% confidence interval (CI): 3.70, 5.94]. Sensitivity analysis by excluding the registration-related item presented similar result (MD = 4.34, 95% CI: 3.28, 5.40). Total PRISMA scores of registered reviews were significantly higher than nonregistered reviews (all reviews: MD = 1.47, 95% CI: 0.64-2.30; non-Cochrane reviews: MD = 1.49, 95% CI: 0.56-2.42). However, the difference in the total PRISMA score was no longer statistically significant after excluding the item related to registration (item 5). Regression analyses showed similar results. Prospective registration may at least indirectly improve the overall methodological quality of systematic reviews, although its impact

  15. How to get started with a systematic review in epidemiology: an introductory guide for early career researchers.

    Science.gov (United States)

    Denison, Hayley J; Dodds, Richard M; Ntani, Georgia; Cooper, Rachel; Cooper, Cyrus; Sayer, Avan Aihie; Baird, Janis

    2013-08-07

    Systematic review is a powerful research tool which aims to identify and synthesize all evidence relevant to a research question. The approach taken is much like that used in a scientific experiment, with high priority given to the transparency and reproducibility of the methods used and to handling all evidence in a consistent manner.Early career researchers may find themselves in a position where they decide to undertake a systematic review, for example it may form part or all of a PhD thesis. Those with no prior experience of systematic review may need considerable support and direction getting started with such a project. Here we set out in simple terms how to get started with a systematic review. Advice is given on matters such as developing a review protocol, searching using databases and other methods, data extraction, risk of bias assessment and data synthesis including meta-analysis. Signposts to further information and useful resources are also given. A well-conducted systematic review benefits the scientific field by providing a summary of existing evidence and highlighting unanswered questions. For the individual, undertaking a systematic review is also a great opportunity to improve skills in critical appraisal and in synthesising evidence.

  16. Methodological quality of systematic reviews in subfertility: a comparison of two different approaches.

    Directory of Open Access Journals (Sweden)

    Ivor Popovich

    Full Text Available BACKGROUND: Systematic reviews are used widely to guide health care decisions. Several tools have been created to assess systematic review quality. The measurement tool for assessing the methodological quality of systematic reviews known as the AMSTAR tool applies a yes/no score to eleven relevant domains of review methodology. This tool has been reworked so that each domain is scored based on a four point scale, producing R-AMSTAR. METHODS AND FINDINGS: We aimed to compare the AMSTAR and R-AMSTAR tools in assessing systematic reviews in the field of assisted reproduction for subfertility. All published systematic reviews on assisted reproductive technology, with the latest search for studies taking place from 2007-2011, were considered. Reviews that contained no included studies or considered diagnostic outcomes were excluded. Thirty each of Cochrane and non-Cochrane reviews were randomly selected from a search of relevant databases. Both tools were then applied to all sixty reviews. The results were converted to percentage scores and all reviews graded and ranked based on this. AMSTAR produced a much wider variation in percentage scores and achieved higher inter-rater reliability than R-AMSTAR according to kappa statistics. The average rating for Cochrane reviews was consistent between the two tools (88.3% for R-AMSTAR versus 83.6% for AMSTAR but inconsistent for non-Cochrane reviews (63.9% R-AMSTAR vs. 38.5% AMSTAR. In comparing the rankings generated between the two tools Cochrane reviews changed an average of 4.2 places, compared to 2.9 for non-Cochrane. CONCLUSION: R-AMSTAR provided greater guidance in the assessment of domains and produced quantitative results. However, there were many problems with the construction of its criteria and AMSTAR was much easier to apply consistently. We recommend that AMSTAR incorporates the findings of this study and produces additional guidance for its application in order to improve its reliability and

  17. Lean and Six Sigma in acute care: a systematic review of reviews.

    Science.gov (United States)

    Deblois, Simon; Lepanto, Luigi

    2016-01-01

    The purpose of this paper is to present a systematic review of literature reviews, summarizing how Lean and Six Sigma management techniques have been implemented in acute care settings to date, and assessing their impact. To aid decision makers who wish to use these techniques by identifying the sectors of activity most often targeted, the main results of the interventions, as well as barriers and facilitators involved. To identify areas of future research. A literature search was conducted, using eight databases. The methodological quality of the selected reviews was appraised with AMSTAR. A narrative synthesis was performed according to the guidelines proposed by Popay et al. (2006). Data were reported according to PRISMA. The literature search identified 149 publications published from 1999 to January 2015. Seven literature reviews were included into the systematic review, upon appraisal. The overall quality of the evidence was poor to fair. The clinical settings most described were specialized health care services, including operating suites, intensive care units and emergency departments. The outcomes most often appraised related to processes and quality. The evidence suggests that Lean and Six Sigma are better adapted to settings where processes involve a linear sequence of events. There is a need for more studies of high methodological quality to better understand the effects of these approaches as well as the factors of success and barriers to their implementation. Field studies comparing the effects of Lean and Six Sigma to those of other process redesign or quality improvement efforts would bring a significant contribution to the body of knowledge. Lean and Six Sigma can be considered valuable process optimization approaches in acute health care settings. The success of their implementation requires significant participation of clinical personnel from the frontline as well as clinical leaders and managers. More research is needed to better understand the

  18. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

    Manders, M.; Groot, de C.P.G.M.; Staveren, van W.A.; Wouters-Wesseling, W.; Mulders, A.J.M.J.; Schols, J.M.G.A.; Hoefnagels, W.H.L.

    2004-01-01

    Background. The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. Methods. The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  19. Effectiveness of nutritional supplements on cognitive functioning in elderly persons: a systematic review.

    NARCIS (Netherlands)

    Manders, M.; Groot, L.C.P.G.M. de; Staveren, W.A. van; Wouters-Wesseling, W.; Mulders, A.; Schols, J.M.G.A.; Hoefnagels, W.H.L.

    2004-01-01

    BACKGROUND: The effectiveness of nutritional supplementation in improving cognitive functioning is evaluated in elderly people. METHODS: The authors systematically reviewed randomized controlled trials that compared nutritional supplementation with a placebo treatment. Trials were identified from a

  20. Rational decision-making in mental health: the role of systematic reviews.

    Science.gov (United States)

    Gilbody, Simon M.; Petticrew, Mark

    1999-09-01

    BACKGROUND: "Systematic reviews" have come to be recognized as the most rigorous method of summarizing confusing and often contradictory primary research in a transparent and reproducible manner. Their greatest impact has been in the summarization of epidemiological literature - particularly that relating to clinical effectiveness. Systematic reviews also have a potential to inform rational decision-making in healthcare policy and to form a component of economic evaluation. AIMS OF THE STUDY: This article aims to introduce the rationale behind systematic reviews and, using examples from mental health, to introduce the strengths and limitations of systematic reviews, particularly in informing mental health policy and economic evaluation. METHODS: Examples are selected from recent controversies surrounding the introduction of new psychiatric drugs (anti-depressants and anti-schizophrenia drugs) and methods of delivering psychiatric care in the community (case management and assertive community treatment). The potential for systematic reviews to (i) produce best estimates of clinical efficacy and effectiveness, (ii) aid economic evaluation and policy decision-making and (iii) highlight gaps in the primary research knowledge base are discussed. Lastly examples are selected from outside mental health to show how systematic reviews have a potential to be explicitly used in economic and health policy evaluation. RESULTS: Systematic reviews produce the best estimates of clinical efficacy, which can form an important component of economic evaluation. Importantly, serious methodological flaws and areas of uncertainty in the primary research literature are identified within an explicit framework. Summary indices of clinical effectiveness can be produced, but it is difficult to produce such summary indices of cost effectiveness by pooling economic data from primary studies. Modelling is commonly used in economic and policy evaluation. Here, systematic reviews can provide the

  1. Systematic reviews with meta-analysis: Why, when, and how?

    NARCIS (Netherlands)

    Crocetti, E.

    2016-01-01

    Systematic reviews with meta-analysis represent the gold standard for conducting reliable and transparent reviews of the literature. The purpose of this article is threefold: (a) to address why and when it is worthwhile to conduct a systematic review with meta-analysis, covering advantages of this

  2. Tranexamic acid in epistaxis: a systematic review.

    Science.gov (United States)

    Kamhieh, Y; Fox, H

    2016-12-01

    The role of tranexamic acid in the management of epistaxis remains unclear. There is uncertainty about its safety and about the contraindications for its use. We performed a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties. This review assesses and summarises the existing evidence for the efficacy and safety of tranexamic acid in the management of epistaxis. Systematic review. MEDLINE and EMBASE were searched for 'epistaxis' and equivalent MESH terms, combined with the Boolean operator 'OR' and 'tranexamic acid'. The Cochrane library and society guidelines were reviewed for evidence regarding the use of tranexamic acid in other specialties. All five relevant RCTs were included in the review and were evaluated according to the recommendations of the Cochrane Handbook for Systematic Reviews. Three RCTS pertained to spontaneous epistaxis; of these, one trial found no benefit of oral tranexamic acid in acute epistaxis, one trial found no significant benefit of topical tranexamic acid, but the largest of the trials showed significant benefit of topical tranexamic acid in acute epistaxis management. Two RCTs examined oral tranexamic acid for prophylaxis of recurrent epistaxes in patients with hereditary haemorrhagic telangiectasia; both showed significant reduction in severity and frequency. Tranexamic acid, as a WHO 'essential medicine', is a powerful, readily available tool, the use of which in epistaxis has been limited by uncertainty over its efficacy and its safety profile. This systematic review summarises the existing evidence and extrapolates from the wealth of data for other specialties to address the clinical question - does TXA have a role in epistaxis management? © 2016 John Wiley & Sons Ltd.

  3. Effectiveness of UK provider financial incentives on quality of care: a systematic review.

    Science.gov (United States)

    Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias

    2017-11-01

    Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

  4. Neuraxial blockade for external cephalic version: a systematic review.

    Science.gov (United States)

    Sultan, P; Carvalho, B

    2011-10-01

    The desire to decrease the number of cesarean deliveries has renewed interest in external cephalic version. The rationale for using neuraxial blockade to facilitate external cephalic version is to provide abdominal muscular relaxation and reduce patient discomfort during the procedure, so permitting successful repositioning of the fetus to a cephalic presentation. This review systematically examined the current evidence to determine the safety and efficacy of neuraxial anesthesia or analgesia when used for external cephalic version. A systematic literature review of studies that examined success rates of external cephalic version with neuraxial anesthesia was performed. Published articles written in English between 1945 and 2010 were identified using the Medline, Cochrane, EMBASE and Web of Sciences databases. Six, randomized controlled studies were identified. Neuraxial blockade significantly improved the success rate in four of these six studies. A further six non-randomized studies were identified, of which four studies with control groups found that neuraxial blockade increased the success rate of external cephalic version. Despite over 850 patients being included in the 12 studies reviewed, placental abruption was reported in only one patient with a neuraxial block, compared with two in the control groups. The incidence of non-reassuring fetal heart rate requiring cesarean delivery in the anesthesia groups was 0.44% (95% CI 0.15-1.32). Neuraxial blockade improved the likelihood of success during external cephalic version, although the dosing regimen that provides optimal conditions for successful version is unclear. Anesthetic rather than analgesic doses of local anesthetics may improve success. The findings suggest that neuraxial blockade does not compromise maternal or fetal safety during external cephalic version. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  5. The impact of mHealth interventions on health systems: a systematic review protocol.

    Science.gov (United States)

    Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

    2016-11-25

    Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

  6. E-learning in orthopedic surgery training: A systematic review.

    Science.gov (United States)

    Tarpada, Sandip P; Morris, Matthew T; Burton, Denver A

    2016-12-01

    E-learning is the use of internet-based resources in education. In the field of surgical education, this definition includes the use of virtual patient cases, digital modeling, online tutorials, as well as video recordings of surgical procedures and lectures. In recent years, e-learning has increasingly been considered a viable alternative to traditional teaching within a number of surgical fields. Here we present (1) a systematic review of literature assessing the efficacy of e-learning modules for orthopedic education and (2) a discussion of their relevance. A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted according to the guidelines defined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). The search yielded a total of 255 non-duplicate citations that were screened using predetermined inclusion/exclusion criteria. A total of 9 full text articles met inclusion criteria, which included the use of an objective outcome measure to evaluate an orthopedic e-learning module. Six studies assessed knowledge using a multiple-choice test and 4 assessed skills using a clinical exam. All studies showed positive score improvement pre- to post-intervention, and a majority showed greater score improvement than standard teaching methods in both knowledge (4/6 studies) and clinical skills (3/4 studies). E-learning represents an effective supplement or even alternative to standard teaching techniques within orthopedic education for both medical students and residents. Future work should focus on validating specific e-learning programs using standardized outcome measures and assessing long-term knowledge retention using e-learning platforms.

  7. The use of simulation in neurosurgical education and training. A systematic review.

    Science.gov (United States)

    Kirkman, Matthew A; Ahmed, Maria; Albert, Angelique F; Wilson, Mark H; Nandi, Dipankar; Sevdalis, Nick

    2014-08-01

    There is increasing evidence that simulation provides high-quality, time-effective training in an era of resident duty-hour restrictions. Simulation may also permit trainees to acquire key skills in a safe environment, important in a specialty such as neurosurgery, where technical error can result in devastating consequences. The authors systematically reviewed the application of simulation within neurosurgical training and explored the state of the art in simulation within this specialty. To their knowledge this is the first systematic review published on this topic to date. The authors searched the Ovid MEDLINE, Embase, and PsycINFO databases and identified 4101 articles; 195 abstracts were screened by 2 authors for inclusion. The authors reviewed data on study population, study design and setting, outcome measures, key findings, and limitations. Twenty-eight articles formed the basis of this systematic review. Several different simulators are at the neurosurgeon's disposal, including those for ventriculostomy, neuroendoscopic procedures, and spinal surgery, with evidence for improved performance in a range of procedures. Feedback from participants has generally been favorable. However, study quality was found to be poor overall, with many studies hampered by nonrandomized design, presenting normal rather than abnormal anatomy, lack of control groups and long-term follow-up, poor study reporting, lack of evidence of improved simulator performance translating into clinical benefit, and poor reliability and validity evidence. The mean Medical Education Research Study Quality Instrument score of included studies was 9.21 ± 1.95 (± SD) out of a possible score of 18. The authors demonstrate qualitative and quantitative benefits of a range of neurosurgical simulators but find significant shortfalls in methodology and design. Future studies should seek to improve study design and reporting, and provide long-term follow-up data on simulated and ideally patient outcomes.

  8. Training to Perform Ankle-Brachial Index: Systematic Review and Perspectives to Improve Teaching and Learning.

    Science.gov (United States)

    Chaudru, S; de Müllenheim, P-Y; Le Faucheur, A; Kaladji, A; Jaquinandi, V; Mahé, G

    2016-02-01

    To conduct a systematic review focusing on the impact of training programs on ankle-brachial index (ABI) performance by medical students, doctors and primary care providers. Lower extremity peripheral artery disease (PAD) is a highly prevalent disease affecting ∼202 million people worldwide. ABI is an essential component of medical education because of its ability to diagnose PAD, and as it is a powerful prognostic marker for overall and cardiovascular related mortality. A systematic search was conducted (up to May 2015) using Medline, Embase, and Web of Science databases. Five studies have addressed the impact of a training program on ABI performance by either medical students, doctors or primary care providers. All were assigned a low GRADE system quality. The components of the training vary greatly either in substance (what was taught) or in form (duration of the training, and type of support which was used). No consistency was found in the outcome measures. According to this systematic review, only few studies, with a low quality rating, have addressed which training program should be performed to provide the best way of teaching how to perform ABI. Future high quality researches are required to define objectively the best training program to facilitate ABI teaching and learning. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Communication Partner Training in Aphasia: An Updated Systematic Review.

    Science.gov (United States)

    Simmons-Mackie, Nina; Raymer, Anastasia; Cherney, Leora R

    2016-12-01

    To update a previous systematic review describing the effect of communication partner training on individuals with aphasia and their communication partners, with clinical questions addressing effects of partner training on language, communication activity/participation, psychosocial adjustment, and quality of life. Twelve electronic databases were searched using 23 search terms. References from relevant articles were hand searched. Three reviewers independently reviewed abstracts, excluding those that failed to meet inclusion criteria. Thirty-two full text articles were reviewed by 2 independent reviewers. Articles not meeting inclusion criteria were eliminated, resulting in a corpus of 25 articles for full review. For the 25 articles, 1 reviewer extracted descriptive data regarding participants, intervention, outcome measures, and results. A second reviewer verified the accuracy of the extracted data. The 3-member review team classified studies using the American Academy of Neurology levels of evidence. Two independent reviewers evaluated each article using design-specific tools to assess research quality. All 25 of the current review articles reported positive changes from partner training. Therefore, to date, 56 studies across 2 systematic reviews have reported positive outcomes from communication partner training in aphasia. The results of the current review are consistent with the previous review and necessitate no change to the earlier recommendations, suggesting that communication partner training should be conducted to improve partner skill in facilitating the communication of people with chronic aphasia. Additional high-quality research is needed to strengthen the original 2010 recommendations and expand recommendations to individuals with acute aphasia. High-quality clinical trials are also needed to demonstrate implementation of communication partner training in complex environments (eg, health care). Copyright © 2016 American Congress of

  10. A Systematic Review of Psychosocial Interventions to Cancer Caregivers

    Directory of Open Access Journals (Sweden)

    Fang Fu

    2017-05-01

    Full Text Available Objective: To systematically review the effect of psychosocial interventions on improving QoL, depression and anxiety of cancer caregivers.Methods: We conducted a systematic review of psychosocial interventions among adult cancer caregivers published from 2011 to 2016. PsycINFO, PubMed, Proquest, Cochrane Library, Embase, Applied Social Sciences Index and Abstracts (ASSIA, Cumulative Index to Nursing and Allied Health Literature, Social Sciences Citation Index (SSCI and EBSCO, China National Knowledge Infrastructure (CNKI and WANFANG were searched. Inclusion criteria were: randomized controlled trails (RCTs; psychosocial intervention to cancer caregivers; psychosocial health indicators including quality of life, depression or anxiety.Results: 21 studies out of 4,666 identified abstracts met inclusion criteria, including 19 RCTs. The intervention modes fell into the following nine categories: family connect intervention, self-determination theory-based intervention (SDT, cognitive behavioral therapy (CBT, emotion-focused therapy (EFT, comprehensive health enhancement support system (CHESS, FOCUS programme, existential behavioral therapy (EBT, telephone interpersonal counseling (TIP-C, problem-solving intervention (COPE.Conclusion: paired-intervention targeting self-care and interpersonal connections of caregivers and symptom management of patients is effective in improving quality of life and alleviating depression of cancer caregivers while music therapy is helpful for reducing anxiety of cancer caregivers.

  11. The effects on student health of interventions modifying the school environment: systematic review.

    Science.gov (United States)

    Bonell, C; Wells, H; Harden, A; Jamal, F; Fletcher, A; Thomas, J; Campbell, R; Petticrew, M; Whitehead, M; Murphy, S; Moore, L

    2013-08-01

    Owing to the limited effectiveness of traditional health education curricula in schools, there is increasing interest in interventions aiming to promote young people's health by modifying the school environment. Existing systematic reviews cannot determine whether environmental intervention is effective because they examine interventions combining environmental modifications and traditional health education. This gap is significant because school-environment interventions are complex to implement and may be sidelined in underfunded and attainment-focused school systems without evidence to support such an approach. This systematic review examined the effectiveness of school-environment interventions without health-education components on student health and inequalities. This was a systematic review of experimental/quasi-experimental studies of school-environment interventions. Sixteen databases were searched, eliciting 62 329 references which were screened, with included studies quality assessed, data extracted and narratively synthesised. Sixteen reports of 10 studies were included, all from the USA and the UK. Five evaluations of interventions aiming to develop a stronger sense of community and/or improve relationships between staff and students suggested potential benefits particularly regarding violence and aggression. Two trials of interventions enabling students to advocate for changes in school catering and physical activity reported benefits for physical activity but not diet. Three evaluations of improvements to school playgrounds offered weak evidence of effects on physical activity. School environment interventions show the potential to improve young people's health particularly regarding violence, aggression and physical activity. Further trials are required to provide a stronger and more generalisable evidence base.

  12. Do problem-solving interventions improve psychosocial outcomes in vision impaired adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Holloway, Edith E; Xie, Jing; Sturrock, Bonnie A; Lamoureux, Ecosse L; Rees, Gwyneth

    2015-05-01

    To evaluate the effectiveness of problem-solving interventions on psychosocial outcomes in vision impaired adults. A systematic search of randomised controlled trials (RCTs), published between 1990 and 2013, that investigated the impact of problem-solving interventions on depressive symptoms, emotional distress, quality of life (QoL) and functioning was conducted. Two reviewers independently selected and appraised study quality. Data permitting, intervention effects were statistically pooled and meta-analyses were performed, otherwise summarised descriptively. Eleven studies (reporting on eight trials) met inclusion criteria. Pooled analysis showed problem-solving interventions improved vision-related functioning (standardised mean change [SMC]: 0.15; 95% CI: 0.04-0.27) and emotional distress (SMC: -0.36; 95% CI: -0.54 to -0.19). There was no evidence to support improvements in depressive symptoms (SMC: -0.27, 95% CI: -0.66 to 0.12) and insufficient evidence to determine the effectiveness of problem-solving interventions on QoL. The small number of well-designed studies and narrow inclusion criteria limit the conclusions drawn from this review. However, problem-solving skills may be important for nurturing daily functioning and reducing emotional distress for adults with vision impairment. Given the empirical support for the importance of effective problem-solving skills in managing chronic illness, more well-designed RCTs are needed with diverse vision impaired samples. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. How effects on health equity are assessed in systematic reviews of interventions.

    Science.gov (United States)

    Welch, Vivian; Tugwell, Peter; Petticrew, Mark; de Montigny, Joanne; Ueffing, Erin; Kristjansson, Betsy; McGowan, Jessie; Benkhalti Jandu, Maria; Wells, George A; Brand, Kevin; Smylie, Janet

    2010-12-08

    and analysis in original trials (12/34 studies); 3) analytic approaches (10/34 studies); and 4) applicability assessment (11/34 studies). Both analytic and applicability approaches were not reported transparently nor in sufficient detail to judge their credibility. There is a need for improvement in conceptual clarity about the definition of health equity, describing sufficient detail about analytic approaches (including subgroup analyses) and transparent reporting of judgments required for applicability assessments in order to assess and report effects on health equity in systematic reviews.

  14. How reliable are case formulations? A systematic literature review.

    Science.gov (United States)

    Flinn, Lucinda; Braham, Louise; das Nair, Roshan

    2015-09-01

    This systematic literature review investigated the inter-rater and test-retest reliability of case formulations. We considered the reliability of case formulations across a range of theoretical modalities and the general quality of the primary research studies. A systematic search of five electronic databases was conducted in addition to reference list trawling to find studies that assessed the reliability of case formulation. This yielded 18 studies for review. A methodological quality assessment tool was developed to assess the quality of studies, which informed interpretation of the findings. Results indicated inter-rater reliability mainly ranging from slight (.1-.4) to substantial (.81-1.0). Some studies highlighted that training and increased experience led to higher levels of agreement. In general, psychodynamic formulations appeared to generate somewhat increased levels of reliability than cognitive or behavioural formulations; however, these studies also included methods that may have served to inflate reliability, for example, pooling the scores of judges. Only one study investigated the test-retest reliability of case formulations yielding support for the stability of formulations over a 3-month period. Reliability of case formulations is varied across a range of theoretical modalities, but can be improved; however, further research is required to strengthen our conclusions. Clinical implications: The findings from the review evidence some support for case formulation being congruent with the scientist-practitioner approach. The reliability of case formulation is likely to be improved through training and clinical experience. Limitations: The broad inclusion criteria may have introduced heterogeneity into the sample, which may have affected the results. Studies reviewed were limited to peer-reviewed journal articles written in the English language, which may represent a source of publication and selection bias. © 2014 The British Psychological Society.

  15. Effective non-drug interventions for improving outcomes and quality of maternal health care in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Wekesah, Frederick M; Mbada, Chidozie E; Muula, Adamson S; Kabiru, Caroline W; Muthuri, Stella K; Izugbara, Chimaraoke O

    2016-08-15

    Many interventions have been implemented to improve maternal health outcomes in sub-Saharan Africa (SSA). Currently, however, systematic information on the effectiveness of these interventions remains scarce. We conducted a systematic review of published evidence on non-drug interventions that reported effectiveness in improving outcomes and quality of care in maternal health in SSA. African Journals Online, Bioline, MEDLINE, Ovid, Science Direct, and Scopus databases were searched for studies published in English between 2000 and 2015 and reporting on the effectiveness of interventions to improve quality and outcomes of maternal health care in SSA. Articles focusing on interventions that involved drug treatments, medications, or therapies were excluded. We present a narrative synthesis of the reported impact of these interventions on maternal morbidity and mortality outcomes as well as on other dimensions of the quality of maternal health care (as defined by the Institute of Medicine 2001 to comprise safety, effectiveness, efficiency, timeliness, patient centeredness, and equitability). Seventy-three studies were included in this review. Non-drug interventions that directly or indirectly improved quality of maternal health and morbidity and mortality outcomes in SSA assumed a variety of forms including mobile and electronic health, financial incentives on the demand and supply side, facility-based clinical audits and maternal death reviews, health systems strengthening interventions, community mobilization and/or peer-based programs, home-based visits, counseling and health educational and promotional programs conducted by health care providers, transportation and/or communication and referrals for emergency obstetric care, prevention of mother-to-child transmission of HIV, and task shifting interventions. There was a preponderance of single facility and community-based studies whose effectiveness was difficult to assess. Many non-drug interventions have been

  16. Cutaneous lichen planus: A systematic review of treatments.

    Science.gov (United States)

    Fazel, Nasim

    2015-06-01

    Various treatment modalities are available for cutaneous lichen planus. Pubmed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Health Technology Assessment Database were searched for all the systematic reviews and randomized controlled trials related to cutaneous lichen planus. Two systematic reviews and nine relevant randomized controlled trials were identified. Acitretin, griseofulvin, hydroxychloroquine and narrow band ultraviolet B are demonstrated to be effective in the treatment of cutaneous lichen planus. Sulfasalazine is effective, but has an unfavorable safety profile. KH1060, a vitamin D analogue, is not beneficial in the management of cutaneous lichen planus. Evidence from large scale randomized trials demonstrating the safety and efficacy for many other treatment modalities used to treat cutaneous lichen planus is simply not available.

  17. Systematic review of physical activity and exercise interventions to improve health, fitness and well-being of children and young people who use wheelchairs.

    Science.gov (United States)

    O'Brien, Thomas D; Noyes, Jane; Spencer, Llinos Haf; Kubis, Hans-Peter; Hastings, Richard P; Whitaker, Rhiannon

    2016-01-01

    To perform a systematic review establishing the current evidence base for physical activity and exercise interventions that promote health, fitness and well-being, rather than specific functional improvements, for children who use wheelchairs. A systematic review using a mixed methods design. A wide range of databases, including Web of Science, PubMed, BMJ Best Practice, NHS EED, CINAHL, AMED, NICAN, PsychINFO, were searched for quantitative, qualitative and health economics evidence. participants: children/young people aged >25 years who use a wheelchair, or parents and therapists/carers. Intervention: home-based or community-based physical activity to improve health, fitness and well-being. Thirty quantitative studies that measured indicators of health, fitness and well-being and one qualitative study were included. Studies were very heterogeneous preventing a meta-analysis, and the risk of bias was generally high. Most studies focused on children with cerebral palsy and used an outcome measure of walking or standing, indicating that they were generally designed for children with already good motor function and mobility. Improvements in health, fitness and well-being were found across the range of outcome types. There were no reports of negative changes. No economics evidence was found. It was found that children who use wheelchairs can participate in physical activity interventions safely. The paucity of robust studies evaluating interventions to improve health and fitness is concerning. This hinders adequate policymaking and guidance for practitioners, and requires urgent attention. However, the evidence that does exist suggests that children who use wheelchairs are able to experience the positive benefits associated with appropriately designed exercise. CRD42013003939.

  18. Search and selection methodology of systematic reviews in orthodontics (2000-2004).

    Science.gov (United States)

    Flores-Mir, Carlos; Major, Michael P; Major, Paul W

    2006-08-01

    More systematic reviews related to orthodontic topics are published each year, although little has been done to evaluate their search and selection methodologies. Systematic reviews related to orthodontics published between January 1, 2000, and December 31, 2004, were searched for their use of multiple electronic databases and secondary searches. The search and selection methods of identified systematic reviews were evaluated against the Cochrane Handbook's guidelines. Sixteen orthodontic systematic reviews were identified in this period. The percentage of reviews documenting and using each criterion of article searching has changed over the last 5 years, with no recognizable directional trend. On average, most systematic reviews documented their electronic search terms (88%) and inclusion-exclusion criteria (100%), and used secondary searching (75%). Many still failed to search more than MEDLINE (56%), failed to document the database names and search dates (37%), failed to document the search strategy (62%), did not use several reviewers for selecting studies (75%), and did not include all languages (81%). The methodology of systematic reviews in orthodontics is still limited, with key methodological components frequently absent or not appropriately described.

  19. Situational Factors in Focus Group Studies: A Systematic Review

    OpenAIRE

    Arne Orvik MPolSc; Lillebeth Larun PhD; Astrid Berland MSc; Karin C. Ringsberg PhD

    2013-01-01

    The aim of this study was to see how contextual factors are expressed, used, and analyzed in data collected in focus group discussions (FGDs). The study includes an assessment of how the methodological reporting of contextual factors might influence and improve the trustworthiness of articles. Articles reporting workplace health, stress, and coping among health professionals were identified in a systematic review and used in the analysis. By using Vicsek's framework of situational factors for...

  20. Financial arrangements for health systems in low-income countries: an overview of systematic reviews

    Science.gov (United States)

    Wiysonge, Charles S; Paulsen, Elizabeth; Lewin, Simon; Ciapponi, Agustín; Herrera, Cristian A; Opiyo, Newton; Pantoja, Tomas; Rada, Gabriel; Oxman, Andrew D

    2017-01-01

    completion of tuberculosis prophylaxis, and it is uncertain whether they improve completion of treatment for active tuberculosis. Conditional cash transfer programmes probably lead to an increase in service utilisation (moderate-certainty evidence), but their effects on health outcomes are uncertain. Vouchers may improve health service utilisation (low-certainty evidence), but the effects on health outcomes are uncertain (very low-certainty evidence). Introducing a restrictive cap may decrease use of medicines for symptomatic conditions and overall use of medicines, may decrease insurers' expenditures on medicines (low-certainty evidence), and has uncertain effects on emergency department use, hospitalisations, and use of outpatient care (very low-certainty evidence). Reference pricing, maximum pricing, and index pricing for drugs have mixed effects on drug expenditures by patients and insurers as well as the use of brand and generic drugs. Provider incentives: the effects of provider incentives are uncertain (very low-certainty evidence), including: the effects of provider incentives on the quality of care provided by primary care physicians or outpatient referrals from primary to secondary care, incentives for recruiting and retaining health professionals to serve in remote areas, and the effects of pay-for-performance on provider performance, the utilisation of services, patient outcomes, or resource use in low-income countries. Authors' conclusions Research based on sound systematic review methods has evaluated numerous financial arrangements relevant to low-income countries, targeting different levels of the health systems and assessing diverse outcomes. However, included reviews rarely reported social outcomes, resource use, equity impacts, or undesirable effects. We also identified gaps in primary research because of uncertainty about applicability of the evidence to low-income countries. Financial arrangements for which the effects are uncertain include external

  1. Systematic Review Workshop (August 2013)

    Science.gov (United States)

    The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.

  2. Effectiveness of technologies in the treatment of post-stroke anomia: A systematic review

    Directory of Open Access Journals (Sweden)

    Monica Lavoie

    2015-04-01

    Procedures and analyses: The PRISMA statement(1 for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions was used as a guideline to conduct the present review. A systematic search of publications on PubMed and PsycInfo was conducted. Experimental studies designed to assess the effectiveness of an intervention delivered by a technology, namely computer, smart tablet or teletreatment, to specifically improve anomia in post-stroke participants were selected, without limitations as to the dates of publication. The main outcomes studied were improvement in naming skills and generalization to untreated items and daily communication. The Downs and Black checklist for randomised and non-randomised studies of health care interventions(2 was used by two reviewers (ML and JM to conduct the methodological quality assessment. Results: A total of 20 studies were included in this review. Up to now, computer is by far the most popular technology, whereas only a few studies aimed at exploring the effectiveness of smart tablet or teletreatment. In some studies, technology was used as a therapy tool in a clinical setting, in the presence of the clinician, while in others, therapy with technology was self-administered at home, without the clinician. All studies confirmed the effectiveness of therapy provided by technology to improve naming of trained items. However, generalization to untrained items is unclear and assessment of generalization to daily communication is scarce. Conclusions: The results of this systematic review confirm that technology is a promising avenue in the management of post-stroke anomia. Self-administered therapies are particularly interesting since they allow increasing significantly the intensity and frequency of therapeutic activities, a factor that has been explicitly recognized as a positive determinant of the efficacy of language treatment(3. In future studies, ecological tasks aiming to evaluate therapy

  3. Relation between chronic rhinosinusitis and gastroesophageal reflux in adults: systematic review

    Directory of Open Access Journals (Sweden)

    Guilherme Constante Preis Sella

    Full Text Available Abstract Introduction: The relationship between gastroesophageal reflux disease (GERD and chronic rhinosinusitis (CRS is still a controversial issue in literature. Objective: A systematic review of the association between these two diseases in adult patients. Methods: Systematic review in PubMed and Cochrane Database with articles published between 1951 and 2015. We included all articles that specifically studied the relationship between CRS and GERD. Results: Of the 436 articles found, only 12 met the inclusion criteria. Eight cross-sectional articles suggest a relation between CRS and GERD, especially on CRS that is refractory to clinical or surgical treatment. However, the groups are small and methodologies are different. Four other longitudinal studies have assessed the effect of treatment with proton pump inhibitors (PPIs on the improvement of symptoms of CRS, but the results were conflicting. Conclusions: There seems to be relative prevalence of reflux with intractable CRS. There is still a lack of controlled studies with a significant number of patients to confirm this hypothesis. Few studies specifically assess the impact of treatment of reflux on symptom improvement in patients with CRS.

  4. Does manual therapy improve pain and function in patients with plantar fasciitis? A systematic review.

    Science.gov (United States)

    Fraser, John J; Corbett, Revay; Donner, Chris; Hertel, Jay

    2018-05-01

    To assess if manual therapy (MT) in the treatment of plantar fasciitis (PF) patients improves pain and function more effectively than other interventions. A systematic review of all randomized control trials (RCTs) investigating the effects of MT in the treatment of human patients with PF, plantar fasciosis, and heel pain published in English on PubMed, CINAHL, Cochrane, and Web of Science databases was conducted. Research quality was appraised utilizing the PEDro scale. Cohen's d effect sizes (ES) and associated 95% confidence intervals (CI) were calculated between treatment groups. Seven RCTs were selected that employed MT as a primary independent variable and pain and function as dependent variables. Inclusion of MT in treatment yielded greater improvement in function (6 of 7 studies, CI that did not cross zero in 14 of 25 variables, ES = 0.5-21.5) and algometry (3 of 3 studies, CI that did not cross zero in 9 of 10 variables, ES = 0.7-3.0) from 4 weeks to 6 months when compared to interventions such as stretching, strengthening, or modalities. Though pain improved with the inclusion of MT, ES calculations favored MT in only 2 of 6 studies (3 of 13 variables) and was otherwise equivalent in effectiveness to comparison interventions. MT is clearly associated with improved function and may be associated with pain reduction in PF patients. It is recommended that clinicians consider use of both joint and soft tissue mobilization techniques in conjunction with stretching and strengthening when treating patients with PF. Treatment, level 1a.

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