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Neoplasias Encefálicas , Glioblastoma , Temozolomida , Glioblastoma/tratamiento farmacológico , Glioblastoma/mortalidad , Temozolomida/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/mortalidad , Humanos , Biguanidas/uso terapéutico , Animales , Antineoplásicos Alquilantes/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Metaanálisis como AsuntoAsunto(s)
Acetazolamida , Accidente Cerebrovascular Isquémico , Humanos , Acetazolamida/uso terapéutico , Accidente Cerebrovascular Isquémico/tratamiento farmacológico , Metaanálisis como Asunto , Resultado del Tratamiento , Inhibidores de Anhidrasa Carbónica/uso terapéutico , Revisiones Sistemáticas como AsuntoAsunto(s)
Neuroendoscopía , Pinealoma , Ventriculostomía , Humanos , Ventriculostomía/métodos , Pinealoma/cirugía , Neuroendoscopía/métodos , Tercer Ventrículo/cirugía , Biopsia/métodos , Glándula Pineal/cirugía , Revisiones Sistemáticas como Asunto , Metaanálisis como Asunto , Neoplasias Encefálicas/cirugíaAsunto(s)
Accidente Cerebrovascular Isquémico , Humanos , Accidente Cerebrovascular Isquémico/cirugía , Accidente Cerebrovascular Isquémico/terapia , Reperfusión/métodos , Metaanálisis como Asunto , Presión Sanguínea/efectos de los fármacos , Antihipertensivos/uso terapéutico , Revisiones Sistemáticas como Asunto , Resultado del TratamientoAsunto(s)
Anestesia General , Sedación Consciente , Procedimientos Endovasculares , Accidente Cerebrovascular Isquémico , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Sedación Consciente/métodos , Procedimientos Endovasculares/métodos , Accidente Cerebrovascular Isquémico/cirugía , Accidente Cerebrovascular Isquémico/terapia , Anestesia General/métodos , Metaanálisis como Asunto , Accidente Cerebrovascular/cirugía , Accidente Cerebrovascular/terapiaRESUMEN
Meta-analysis is a powerful tool to synthesize findings from multiple studies. The normal-normal random-effects model is widely used to account for between-study heterogeneity. However, meta-analyses of sparse data, which may arise when the event rate is low for binary or count outcomes, pose a challenge to the normal-normal random-effects model in the accuracy and stability in inference since the normal approximation in the within-study model may not be good. To reduce bias arising from data sparsity, the generalized linear mixed model can be used by replacing the approximate normal within-study model with an exact model. Publication bias is one of the most serious threats in meta-analysis. Several quantitative sensitivity analysis methods for evaluating the potential impacts of selective publication are available for the normal-normal random-effects model. We propose a sensitivity analysis method by extending the likelihood-based sensitivity analysis with the $t$-statistic selection function of Copas to several generalized linear mixed-effects models. Through applications of our proposed method to several real-world meta-analyses and simulation studies, the proposed method was proven to outperform the likelihood-based sensitivity analysis based on the normal-normal model. The proposed method would give useful guidance to address publication bias in the meta-analysis of sparse data.
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Simulación por Computador , Metaanálisis como Asunto , Sesgo de Publicación , Sesgo de Publicación/estadística & datos numéricos , Humanos , Funciones de Verosimilitud , Modelos Lineales , Interpretación Estadística de Datos , Modelos Estadísticos , Sensibilidad y Especificidad , Biometría/métodosAsunto(s)
Derivaciones del Líquido Cefalorraquídeo , Hidrocefalia , Hemorragia Subaracnoidea , Humanos , Hidrocefalia/cirugía , Hidrocefalia/etiología , Estudios Observacionales como Asunto , Factores de Riesgo , Hemorragia Subaracnoidea/complicaciones , Hemorragia Subaracnoidea/cirugía , Derivación Ventriculoperitoneal , Metaanálisis como Asunto , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND: Obesity, characterized by excessive fat accumulation, poses a significant public health challenge globally. Recent advancements in medical technology have heralded the emergence of endoscopic bariatric treatments (EBTs) as innovative alternatives to conventional obesity interventions. Despite previous systematic reviews and network meta-analyses, they also highlighted discrepancies in outcomes and efficacy among different EBTs. Here, we will update a systematic review and network meta-analysis of randomized controlled trials (RCTs) focusing on EBTs and presents a protocol for the reproducibility and transparency. METHODS: The core protocol of this study was registered at PROSPERO database (CRD42024514249) on Jan 2024. Core databases including MEDLINE through PubMed, Embase, and Cochrane library will be searched relevant studies, and a systematic review with network meta-analysis will be performed. Two evaluators (EJ Gong and CS Bang) will independently screen the titles and abstracts following the eligibility criteria; (1) RCTs investigated the compared the efficacy of EBTs and controls; (2) studies published in English; and (3) studies in full-text format. We will exclude studies meeting the following criteria; (1) studies that did not report the treatment outcomes, such as percent excess weight loss or percent total body weight loss; (2) case reports and review articles; (3) ineligible research objects, for example, animals or children; and (4) insufficient data regarding treatment outcome. The primary outcomes will be the common efficacy metric found after systematic review of relevant studies, such as percent excess weight loss or percent total body weight loss with a follow-up of at least 6 months. Narrative (descriptive) synthesis is planned and quantitative synthesis will be used if the included studies are sufficiently homogenous. The quality of the identified studies will be assessed using the Cochrane Risk of Bias assessment tool version 2.0 (ROB 2.0). All the systematic review and network meta-analysis process will be undertaken keeping the principles of the Preferred Reporting Items for a Systematic Review and Meta-analysis for systematic review protocols (PRISMA-P) and PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA). DISCUSSION: This updated systematic review and network meta-analysis will provide information about comparative efficacy of various EBTs and this will help physicians in the decision-making process for the selection of treatment modalities in the clinical practice.
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Metaanálisis en Red , Obesidad , Ensayos Clínicos Controlados Aleatorios como Asunto , Revisiones Sistemáticas como Asunto , Humanos , Obesidad/cirugía , Cirugía Bariátrica/métodos , Endoscopía/métodos , Metaanálisis como Asunto , Pérdida de Peso , Resultado del TratamientoRESUMEN
Background: An abundance of rapidly accumulating scientific evidence presents novel opportunities for researchers and practitioners alike, yet such advantages are often overshadowed by resource demands associated with finding and aggregating a continually expanding body of scientific information. Data extraction activities associated with evidence synthesis have been described as time-consuming to the point of critically limiting the usefulness of research. Across social science disciplines, the use of automation technologies for timely and accurate knowledge synthesis can enhance research translation value, better inform key policy development, and expand the current understanding of human interactions, organizations, and systems. Ongoing developments surrounding automation are highly concentrated in research for evidence-based medicine with limited evidence surrounding tools and techniques applied outside of the clinical research community. The goal of the present study is to extend the automation knowledge base by synthesizing current trends in the application of extraction technologies of key data elements of interest for social scientists. Methods: We report the baseline results of a living systematic review of automated data extraction techniques supporting systematic reviews and meta-analyses in the social sciences. This review follows PRISMA standards for reporting systematic reviews. Results: The baseline review of social science research yielded 23 relevant studies. Conclusions: When considering the process of automating systematic review and meta-analysis information extraction, social science research falls short as compared to clinical research that focuses on automatic processing of information related to the PICO framework. With a few exceptions, most tools were either in the infancy stage and not accessible to applied researchers, were domain specific, or required substantial manual coding of articles before automation could occur. Additionally, few solutions considered extraction of data from tables which is where key data elements reside that social and behavioral scientists analyze.
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Ciencias Sociales , Ciencias Sociales/métodos , Humanos , Metaanálisis como Asunto , Automatización , Almacenamiento y Recuperación de la Información/métodosRESUMEN
Meta-analyses are commonly performed based on random-effects models, while in certain cases one might also argue in favor of a common-effect model. One such case may be given by the example of two "study twins" that are performed according to a common (or at least very similar) protocol. Here we investigate the particular case of meta-analysis of a pair of studies, for example, summarizing the results of two confirmatory clinical trials in phase III of a clinical development program. Thereby, we focus on the question of to what extent homogeneity or heterogeneity may be discernible and include an empirical investigation of published ("twin") pairs of studies. A pair of estimates from two studies only provide very little evidence of homogeneity or heterogeneity of effects, and ad hoc decision criteria may often be misleading.
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Biometría , Biometría/métodos , Humanos , Metaanálisis como Asunto , Estudios en Gemelos como Asunto , Modelos EstadísticosRESUMEN
The summary receiver operating characteristic (SROC) curve has been recommended as one important meta-analytical summary to represent the accuracy of a diagnostic test in the presence of heterogeneous cutoff values. However, selective publication of diagnostic studies for meta-analysis can induce publication bias (PB) on the estimate of the SROC curve. Several sensitivity analysis methods have been developed to quantify PB on the SROC curve, and all these methods utilize parametric selection functions to model the selective publication mechanism. The main contribution of this article is to propose a new sensitivity analysis approach that derives the worst-case bounds for the SROC curve by adopting nonparametric selection functions under minimal assumptions. The estimation procedures of the worst-case bounds use the Monte Carlo method to approximate the bias on the SROC curves along with the corresponding area under the curves, and then the maximum and minimum values of PB under a range of marginal selection probabilities are optimized by nonlinear programming. We apply the proposed method to real-world meta-analyses to show that the worst-case bounds of the SROC curves can provide useful insights for discussing the robustness of meta-analytical findings on diagnostic test accuracy.
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Metaanálisis como Asunto , Método de Montecarlo , Sesgo de Publicación , Curva ROC , Sesgo de Publicación/estadística & datos numéricos , Humanos , Simulación por Computador , Pruebas Diagnósticas de Rutina/estadística & datos numéricos , Modelos Estadísticos , Estadísticas no Paramétricas , Interpretación Estadística de DatosRESUMEN
INTRODUCTION: Skin tear (ST) will prolong the hospitalisation time of an older person, increase the cost of medical expenses and the difficulty in care for nursing staff, and seriously affect the quality of life of the older person. Early identification and intervention of the elderly at risk of ST are key factors in preventing the occurrence of ST in older persons. At present, risk factors for ST in older persons have not been systematically evaluated, let alone summarised to analyse risk factors for ST in older persons. Therefore, this systematic review and meta-analysis aims to synthesise existing research on risk factors for ST in older populations. METHODS AND ANALYSIS: The protocol is being reported by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement. On 17 September 2023, we will start literature search in PubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Medline, Chinese Scientific Journal Database, Wan Fang Data Knowledge Service Platform, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database. The language of the included literature is Chinese or English. Using RevMan V.5.4 software, we will perform a systematic review and meta-analysis of the final set of included studies to synthesise the data and draw meaningful conclusions. The Newcastle-Ottawa Quality Assessment Scale and the Agency for Healthcare Research and Quality will be used to assess the quality of the literature. The I2 test will be used to test heterogeneity. ETHICS AND DISSEMINATION: Ethical approval is not needed for this systematic review, as the study will not directly use information from human participants, and the data we use will be extracted from original studies. This systematic review and meta-analysis has been registered at the International Prospective Register of Systematic Reviews (PROSPERO). Once the systematic review and meta-analysis have been completed, we will publish our study in an academic journal. PROSPERO REGISTRATION NUMBER: CRD42023460810.
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Metaanálisis como Asunto , Piel , Revisiones Sistemáticas como Asunto , Humanos , Factores de Riesgo , Piel/lesiones , Anciano , Proyectos de Investigación , Laceraciones/epidemiología , Calidad de VidaRESUMEN
BACKGROUND: In recent studies, receipt of chiropractic care has been associated with lower odds of receiving prescription opioids and, among those already prescribed, reduced doses of opioids among patients with non-cancer spine pain. These findings suggest that access to chiropractic services may reduce reliance on opioids for musculoskeletal pain. OBJECTIVE: To assess the impact of chiropractic care on initiation, or continued use, of prescription opioids among patients with non-cancer spine pain. METHODS: We will search for eligible randomized controlled trials (RCTs) and observational studies indexed in MEDLINE, Embase, AMED, CINAHL, Web of Science, and the Index to Chiropractic Literature from database inception to June 2024. Article screening, data extraction, and risk-of-bias assessment will be conducted independently by pairs of reviewers. We will conduct separate analyses for RCTs and observational studies and pool binary outcomes (e.g. prescribed opioid receipt, long-term opioid use, and higher versus lower opioid dose) as odds ratios (ORs) with associated 95% confidence intervals (CIs). When studies provide hazard ratios (HRs) or relative risks (RRs) for time-to-event data (e.g. time-to-first opioid prescription) or incidence rates (number of opioid prescriptions over time), we will first convert them to an OR before pooling. Continuous outcomes such as pain intensity, sleep quality, or morphine equivalent dose will be pooled as weighted mean differences with associated 95% CIs. We will conduct meta-analyses using random-effects models and explore sources of heterogeneity using subgroup analyses and meta-regression. We will evaluate the certainty of evidence of all outcomes using the GRADE approach and the credibility of all subgroup effects with ICEMAN criteria. Our systematic review will follow the PRISMA statement and MOOSE guidelines. DISCUSSION: Our review will establish the current evidence informing the impact of chiropractic care on new or continued prescription opioid use for non-cancer spine pain. We will disseminate our results through peer-reviewed publication and conference presentations. The findings of our review will be of interest to patients, health care providers, and policy-makers. TRIAL REGISTRATION: Systematic review registration: PROSPERO CRD42023432277.
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Analgésicos Opioides , Manipulación Quiropráctica , Humanos , Analgésicos Opioides/uso terapéutico , Dolor de Espalda/tratamiento farmacológico , Dolor de Espalda/terapia , Metaanálisis como Asunto , Dolor Musculoesquelético/tratamiento farmacológico , Dolor Musculoesquelético/terapia , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND: Cardiovascular diseases remain a leading global cause of mortality worldwide especially in older adults. Although it is known that regular exercise reduces cardiovascular diseases incidence, its effects on specific cardiovascular aging parameters considering the influence of sex and different exercise designs are still not fully understood. Therefore, this systematic review and meta-analysis aims to evaluate the effects of different physical exercise protocols on age-related cardiovascular outcomes in older adults. METHODS: This systematic review and meta-analysis will be reported in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles will be eligible if they are randomized controlled trials with a primary objective of evaluating the chronic effects of exercise interventions on cardiovascular aging parameters. Search strategy will be performed from the inception to September 30th, 2023, in the following electronic databases: MEDLINE (Ovid), SCOPUS (Elsevier), Embase, Sport Discus (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science Core Collection (Clarivate Analytics). Data will be extracted and managed through Research Electronic Data Capture (REDCap) software. The Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) will be used to assess the methodological quality of included studies. Additionally, the quality of the findings will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) profiler. Meta-analysis based on the random-effects model will be performed (if deemed suitable, considering the methodological and clinical heterogeneity of the studies) to estimate the effects of exercise training on cardiovascular aging variables (i.e., cardiac output; arterial stiffness; stroke volume; endothelial function; and carotid intima-media thickness). Heterogeneity will be assessed with the I2 statistics, while the publication bias will be assessed based on Egger's test. DISCUSSION: To the best of our knowledge, this will be the first systematic review and meta-analysis to investigate the impact of sex and training protocols on the cardiovascular aging parameters. Moreover, the findings of this systematic review and meta-analysis will provide evidence for health professionals in the management of elderly patients in order to optimize the exercise prescription to face the cardiovascular alterations related to the aging process, considering the effects of different protocols according to sex. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023441015 .