CINAHL
2005 to 2015 inclusive
English language,
publication type: 'review' or 'systematic review'
abstract: 'meta-analysis' and 'Bayesian'

Record: 1
Title:
A Bayesian method for the synthesis of evidence from qualitative and quantitative reports: the example of antiretroviral medication adherence.
Authors:
Voils C; Hassselblad V; Crandell J; Chang Y; Lee E; Sandelowski M
Affiliation:
Health Services Research & Development Service, Durham Veterans Affairs Medical Center, Durham
Source:
Journal of Health Services Research & Policy (J HEALTH SERV RES POLICY), 2009 Oct; 14 (4): 226-33. (33 ref)
Publication Type:
journal article - equations & formulas, research, systematic review, tables/charts
Language:
English
Major Subjects:
Antiviral Agents -- Administration and Dosage
HIV Infections -- Drug Therapy
Medication Compliance -- Evaluation
Minor Subjects:
Chi Square Test; Data Analysis Software; Data Analysis, Statistical; Descriptive Statistics; Female; Funding Source; Meta Analysis; P-Value; Human
Abstract:
OBJECTIVES: Bayesian meta-analysis is a frequently cited but very little-used method for synthesizing qualitative and quantitative research findings. The only example published to date used qualitative data to generate an informative prior probability and quantitative data to generate the likelihood. We developed a method to incorporate both qualitative and quantitative evidence in the likelihood in a Bayesian synthesis of evidence about the relationship between regimen complexity and medication adherence. METHODS: Data were from 11 qualitative and six quantitative studies. We updated two different non-informative prior distributions with qualitative and quantitative findings to find the posterior distribution for the probabilities that a more complex regimen was associated with lower adherence and that a less complex regimen was associated with greater adherence. RESULTS: The posterior mode for the qualitative findings regarding more complex regimen and lesser adherence (using the uniform prior with Jeffreys' prior yielding highly similar estimates) was 0.588 (95% credible set limits 0.519, 0.663) and for the quantitative findings was 0.224 (0.203, 0.245); due to non-overlapping credible sets, we did not combine them. The posterior mode for the qualitative findings regarding less complex regimen and greater adherence was 0.288 (0.214, 0.441) and for the quantitative findings was 0.272 (0.118, 0.437); the combined estimate was 0.299 (0.267, 0.334). CONCLUSIONS: The utility of Bayesian methods for synthesizing qualitative and quantitative research findings at the participant level may depend on the nature of the relationship being synthesized and on how well the findings are represented in the individual reports.
Journal Subset:
Editorial Board Reviewed; Europe; Expert Peer Reviewed; Health Services Administration; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1355-8196
MEDLINE Info:
PMID: 19770121 NLM UID: 9604936
Grant Information:
National Institute of Nursing Research, National Institutes of Health (5R01NR004907).
Entry Date:
20091211
Revision Date:
20110520
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1258/jhsrp.2009.008186
Accession Number:
2010442427
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010442427&site=ehost-live">A Bayesian method for the synthesis of evidence from qualitative and quantitative reports: the example of antiretroviral medication adherence.</A>
Database:
CINAHL Plus
Record: 2
Title:
A bayesian network meta-analysis on comparisons of enamel matrix derivatives, guided tissue regeneration and their combination therapies.
Authors:
Tu, Yu-Kang; Needleman, Ian; Chambrone, Leandro; Lu, Hsein-Kun; Faggion, Clovis Mariano
Affiliation:
jcpe1844-aff-0001
jcpe1844-aff-0003
jcpe1844-aff-0004
jcpe1844-aff-0005
jcpe1844-aff-0006
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2012 Mar; 39 (3): 303-14.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Dental Enamel -- Anatomy and Histology
Guided Tissue Regeneration
Minor Subjects:
Meta Analysis; Dental Enamel Hypoplasia -- Therapy; Combined Modality Therapy; Medline; Embase; PubMed; Systematic Review
Abstract:
Aims Guided tissue regeneration ( GTR) and enamel matrix derivatives ( EMD) are two popular regenerative treatments for periodontal infrabony lesions. Both have been used in conjunction with other regenerative materials. We conducted a Bayesian network meta-analysis of randomized controlled trials on treatment effects of GTR, EMD and their combination therapies. Material and Methods A systematic literature search was conducted using the Medline, EMBASE, LILACS and CENTRAL databases up to and including June 2011. Treatment outcomes were changes in probing pocket depth ( PPD), clinical attachment level ( CAL) and infrabony defect depth. Different types of bone grafts were treated as one group and so were barrier membranes. Results A total of 53 studies were included in this review, and we found small differences between regenerative therapies which were non-significant statistically and clinically. GTR and GTR-related combination therapies achieved greater PPD reduction than EMD and EMD-related combination therapies. Combination therapies achieved slightly greater CAL gain than the use of EMD or GTR alone. GTR with BG achieved greatest defect fill. Conclusion Combination therapies performed better than single therapies, but the additional benefits were small. Bayesian network meta-analysis is a promising technique to compare multiple treatments. Further analysis of methodological characteristics will be required prior to clinical recommendations.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
PMID: 22393565 NLM UID: 0425123
Entry Date:
20120302
Revision Date:
20140829
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/j.1600-051X.2011.01844.x
Accession Number:
2011438766
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011438766&site=ehost-live">A bayesian network meta-analysis on comparisons of enamel matrix derivatives, guided tissue regeneration and their combination therapies.</A>
Database:
CINAHL Plus
Record: 3
Title:
A network meta-analysis of progression free survival and overall survival in first-line treatment of chronic lymphocytic leukemia.
Authors:
Ladyzynski, Piotr; Molik, Maria; Foltynski, Piotr
Affiliation:
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 4 Trojdena Street, 02-109 Warsaw, Poland. Electronic address: pladyzynski@ibib.waw.pl
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 4 Trojdena Street, 02-109 Warsaw, Poland. Electronic address: mmolik@ibib.waw.pl
Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, 4 Trojdena Street, 02-109 Warsaw, Poland. Electronic address: pfoltynski@ibib.waw.pl
Source:
Cancer Treatment Reviews (CANCER TREAT REV), 2015 Feb; 41 (2): 77-93.
Publication Type:
journal article - meta analysis, research, review
Language:
English
Major Subjects:
Antineoplastic Agents, Combined -- Therapeutic Use
Leukemia, Lymphocytic, Chronic -- Drug Therapy
Leukemia, Lymphocytic, Chronic -- Mortality
Minor Subjects:
Age Factors; Antibodies, Monoclonal -- Administration and Dosage; Probability; Chlorambucil -- Administration and Dosage; Cyclophosphamide -- Administration and Dosage; Prognosis; Human; Kaplan-Meier Estimator; Nitrogen Mustard Compounds -- Administration and Dosage; Enzyme Inhibitors -- Administration and Dosage; Physical Fitness; Cox Proportional Hazards Model; Clinical Trials; Vidarabine -- Administration and Dosage; Vidarabine -- Analogs and Derivatives
Abstract:
BACKGROUND: A limited evidence exists regarding comparisons of clinical effectiveness of available therapies for first-line treatment of chronic lymphocytic leukemia (CLL). METHODS: We compared available therapies for treatment-naïve, symptomatic CLL regarding progression free survival (PFS) and overall survival (OS) in all the identified random control trials and in subgroups composed of younger/fit and older/unfit patients, using a Bayesian network meta-analysis. RESULTS: In younger/fit patients we obtained median of projected mean PFS of: 19, 26, 31, 43, 51 and 75months for chlorambucil, fludarabine, alemtuzumab, fludarabine with cyclophosphamide (FC), bendamustine and fludarabine with cyclophosphamide and rituximab (FCR), respectively. We noted median OS of: 59, 66, 66, 70months for FC, chlorambucil, FCR and fludarabine, respectively. In older/unfit patients we noted PFS of: 16, 17, 24, 30, 60months for chlorambucil, fludarabine and chlorambucil with ofatumumab (OClb) or rituximab (RClb) or obinutuzumab (GClb), respectively. We obtained median OS of: 44, 58, 59 and 90months for fludarabine, RClb, chlorambucil and GClb, respectively. CONCLUSIONS: Our results suggest that: (1) FCR has higher potential of preventing CLL progression in younger/fit patients over four therapy options, which were subject of previous meta-analysis but also over bendamustine; (2) in these patients FCR does not entail prolonging of OS in comparison with chlorambucil and it is outperformed by fludarabine; (3) in older/unfit patients GClb demonstrates longer projected PFS than all assessed comparators; (4) in this group GClb has also the highest potential of increasing OS.
Journal Subset:
Biomedical; Double Blind Peer Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Oncologic Care
ISSN:
0305-7372
MEDLINE Info:
PMID: 25512118 NLM UID: 7502030
Entry Date:
20150417
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/j.ctrv.2014.11.004
Accession Number:
2012944050
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012944050&site=ehost-live">A network meta-analysis of progression free survival and overall survival in first-line treatment of chronic lymphocytic leukemia.</A>
Database:
CINAHL Plus
Record: 4
Title:
A network meta-analysis of the efficacy of belatacept, cyclosporine and tacrolimus for immunosuppression therapy in adult renal transplant recipients.
Authors:
Goring, Sarah M; Levy, Adrian R; Ghement, Isabella; Kalsekar, Anupama; Eyawo, Oghenowede; L'Italien, Gilbert J; Kasiske, Bertram
Affiliation:
Oxford Outcomes Ltd , Vancouver, BC , Canada
Source:
Current Medical Research & Opinion (CURR MED RES OPIN), 2014 Aug; 30 (8): 1473-87.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Antibodies -- Therapeutic Use
Cyclosporine -- Therapeutic Use
Graft Rejection
Immunosuppression -- Methods
Immunosuppressive Agents -- Therapeutic Use
Kidney Transplantation -- Mortality
Tacrolimus -- Therapeutic Use
Minor Subjects:
Adult; Cochrane Library; Drug Therapy, Combination; Embase; Graft Survival; Human; Medline; Meta Analysis; Probability; Professional Practice, Evidence-Based; Systematic Review; Treatment Outcomes
Abstract:
Abstract Belatacept is a first in-class co-stimulation blocker developed for primary maintenance immunosuppression following renal transplantation. The objective of this study was to estimate the efficacy of belatacept relative to tacrolimus and cyclosporine among adults receiving a single kidney transplant. A systematic review was conducted of randomized clinical trials (RCTs) published between January 1990 and December 2013 using EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials, and unpublished study reports from two belatacept RCTs. Bayesian network meta-analysis (NMA) methods were used to compare the efficacy measures, mortality, graft loss, acute rejection and glomerular filtration rate (GFR). Heterogeneity was quantified using statistical metrics and potential sources were evaluated using meta-regression and subgroup analysis. A total of 28 RCTs comparing tacrolimus with cyclosporine, and three comparing belatacept with cyclosporine, were identified. All three agents provided comparable graft and patient survival, despite a higher risk of acute rejection associated with belatacept and cyclosporine. Belatacept was associated with significant improvement in GFR versus cyclosporine. Compared with tacrolimus, this difference was clinically meaningful yet statistically non-significant. The probability of being the best treatment was highest for belatacept for graft survival (68%), patient survival (97%) and renal function (89%), and highest for tacrolimus for acute rejection (99%).Variability in donor, recipient, and trial characteristics was present in the included RCTs; however, minimal statistical heterogeneity was detected in the analysis of acute rejection, graft or patient survival, and none of the characteristics were found to be significantly associated with relative effect. Although the direction of effect of immunosuppressants on GFR was consistent across RCTs, precise estimation of its magnitude was limited by a small number of RCTs and heterogeneity in relative effect sizes. Clinicians often seek an alternative to CNIs due to their nephrotoxic effects. The results of this indirect comparison indicate that belatacept is an effective immunosuppressive agent in renal transplantation among adults.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
0300-7995
MEDLINE Info:
PMID: 24628478 NLM UID: 0351014
Entry Date:
20150612
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1185/03007995.2014.898140
Accession Number:
2012656718
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012656718&site=ehost-live">A network meta-analysis of the efficacy of belatacept, cyclosporine and tacrolimus for immunosuppression therapy in adult renal transplant recipients.</A>
Database:
CINAHL Plus
Record: 5
Title:
A network meta-analysis on comparative efficacy and all-cause discontinuation of antimanic treatments in acute bipolar mania.
Authors:
Yildiz, A.; Nikodem, M.; Vieta, E.; Correll, C. U.; Baldessarini, R. J.
Affiliation:
Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey
Faculty of Applied Mathematics, AGH University of Science and Technology, Krakow, Poland
International Consortium for Bipolar Disorder Research & Psychopharmacology Program, McLean Division of Massachusetts General Hospital, Boston, MA, USA
Division of Psychiatry Research, Department of Psychiatry, Zucker Hillside Hospital, New York, NY, USA
International Consortium for Bipolar Disorder Research & Psychopharmacology Program, McLean Division of Massachusetts General Hospital, Boston, MA, USA
Source:
Psychological Medicine (PSYCHOL MED), 2015 Jan; 45 (2): 299-317.
Publication Type:
journal article - equations & formulas, meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Bipolar Disorder -- Drug Therapy
Treatment Duration
Treatment Outcomes
Minor Subjects:
Human; Systematic Review; Meta Analysis; PubMed; Embase; Psycinfo; Cochrane Library; Databases; Bipolar Disorder -- Epidemiology; Randomized Controlled Trials
Abstract:
BackgroundEvidence synthesis methods enabling direct and indirect comparisons over the entire set of relevant clinical data produce quantitative point estimates for the treatments contrasts between competing interventions, and provide a hierarchical rank ordering between them. We aimed to provide evidence-based guidance on the efficacy and all-cause discontinuation of antimanic treatments.MethodWe conducted a network meta-analysis within a Bayesian framework. We searched all standard literature databases without language restrictions up to 15 January 2014 to identify reports of short-term, randomized, blinded trials of putative antimanic drugs as monotherapy for adults with bipolar-I mania.ResultsAltogether, 14256 manic patients randomized to one of 18 active treatments or placebo provided 95 direct comparisons on 128 data points. For the primary outcome, standardized mean difference as Hedges’ g (standardized mean difference; SMD), the hierarchies indicated by surface under the cumulative ranking (SUCRA) probabilities were in agreement with the point estimates for all antimanic drugs identified as effective. For the 12 effective antimanic drugs on clinical use, SMDs against placebo ranged from 0.32 to 0.66 without superiority of one over another, except for risperidone v. aripiprazole and valproate. Aripiprazole, olanzapine, quetiapine, risperidone, and valproate had less all-cause discontinuation rates than placebo. Sensitivity analysis by drug class indicated similar efficacy profiles for haloperidol, second-generation antipsychotics, and mood stabilizers.ConclusionsHierarchical rank ordering by comparative efficacy and risk of all-cause discontinuations should help to guide antimanic treatment choices by clinicians, healthcare policy makers, and guideline developers.
Journal Subset:
Biomedical; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Psychiatry/Psychology
ISSN:
0033-2917
MEDLINE Info:
NLM UID: 1254142
Entry Date:
20150320
Revision Date:
20150327
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1017/S0033291714001305
Accession Number:
2012921503
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012921503&site=ehost-live">A network meta-analysis on comparative efficacy and all-cause discontinuation of antimanic treatments in acute bipolar mania.</A>
Database:
CINAHL Plus
Record: 6
Title:
A new statistical trend in clinical research - Bayesian statistics.
Authors:
Wong AYL; Warren S; Kawchuk GN
Affiliation:
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Canada
Source:
Physical Therapy Reviews (PHYS THER REV), 2010 Oct; 15 (5): 372-81. (39 ref)
Publication Type:
journal article - review, tables/charts
Language:
English
Major Subjects:
Research, Physical Therapy -- Trends
Statistics -- Utilization
Minor Subjects:
P-Value; Confidence Intervals
Abstract:
Background: The emphasis on evidence-based practice in physical therapy has increased the number of clinicians who perform and interpret clinical research. Unfortunately, the traditional statistical analysis (frequentist approach) used most often in clinical research (except meta-analysis) has been criticized by biostatisticians for potential bias and misleading results if used with data from single studies. Alternatively, Bayesian inference can be used instead of the traditional frequentist approach although this trend has yet to be seen in rehabilitation research. Used for at least three decades, the Bayesian approach provides a formal framework for researchers to incorporate prior knowledge and current evidence to derive new probabilities for various hypotheses. Since the results are presented in terms of probability, clinicians can interpret and apply research findings to clinical practice directly. Objectives: The objectives of this review are to discuss the common misconceptions among users of the frequentist approach, the inherent limitations of the frequentist approach, as well as to introduce the characteristics and limitations of the Bayesian approach using illustrated examples. Conclusions: The Bayesian approach can be used as an alternative or adjunct to the frequentist method in future studies. This approach is also robust in situations that are unfavourable to traditional statistics such as sequential clinical trials. However, biostatisticians may have to be consulted for some sophisticated Bayesian analysis. As the Bayesian approach may gain popularity, a good understanding of this method will benefit clinicians in interpreting research papers and planning their future clinical studies.
Journal Subset:
Allied Health; Europe; Peer Reviewed; UK & Ireland
Special Interest:
Physical Therapy
ISSN:
1083-3196
MEDLINE Info:
NLM UID: 9708265
Entry Date:
20110121
Revision Date:
20111014
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1179/174328810X12786297204756
Accession Number:
2010896953
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Database:
CINAHL Plus
Record: 7
Title:
A Primer on Network Meta-Analysis for Dental Research.
Authors:
Tu, Yu-Kang; Faggion Jr., Clovis Mariano
Affiliation:
Department of Oral Biology, Leeds Dental Institute, Leeds LS2 9JT, UK
Department of Oral Sciences, Faculty of Dentistry, University of Otago, P.O. Box 647, Dunedin 9054, New Zealand
Source:
ISRN Dentistry (ISRN DENT), 2012: 1-10.
Publication Type:
journal article - equations & formulas, review
Language:
English
Major Subjects:
Dental Care
Research, Medical
Meta Analysis -- Methods
Minor Subjects:
Statistics; Models, Statistical
Abstract:
In the last decade, a new statistical methodology, namely, network meta-analysis, has been developed to address limitations in traditional pairwise meta-analysis. Network meta-analysis incorporates all available evidence into a general statistical framework for comparisons of all available treatments. A further development in the network meta-analysis is to use a Bayesian statistical approach, which provides a more flexible modelling framework to take into account heterogeneity in the evidence and complexity in the data structure. The aim of this paper is therefore to provide a nontechnical introduction to network meta-analysis for dental research community and raise the awareness of it. An example was used to demonstrate how to conduct a network meta-analysis and the differences between it and traditional meta-analysis. The statistical theory behind network meta-analysis is nevertheless complex, so we strongly encourage close collaboration between dental researchers and experienced statisticians when planning and conducting a network meta-analysis. The use of more sophisticated statistical approaches such as network meta-analysis will improve the efficiency in comparing the effectiveness between multiple treatments across a set of trials.
Journal Subset:
Biomedical; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
2090-4371
MEDLINE Info:
PMID: 22919506 NLM UID: 101560640
Entry Date:
20130426
Revision Date:
20140321
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.5402/2012/276520
Accession Number:
2012074860
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012074860&site=ehost-live">A Primer on Network Meta-Analysis for Dental Research.</A>
Database:
CINAHL Plus
Record: 8
Title:
A systematic review and Bayesian network meta-analysis of randomized clinical trials on non-surgical treatments for peri-implantitis.
Authors:
Faggion, Clovis M.; Listl, Stefan; Frühauf, Nadine; Chang, Huei-Ju; Tu, Yu-Kang
Affiliation:
Department of Periodontology, Faculty of Dentistry, University of Münster
Department of Conservative Dentistry, Dental School Ruprecht-Karls-University of Heidelberg
Department of Conservative Dentistry, Dental School Ruprecht-Karls-University of Heidelberg
Institute of Epidemiology and Preventive Medicine, College of Public Health National Taiwan University
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2014 Oct; 41 (10): 1015-25.
Publication Type:
journal article - equations & formulas, meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Dental Implants
Inflammation -- Therapy
Case Management
Minor Subjects:
Human; Systematic Review; Meta Analysis; Randomized Controlled Trials; PubMed -- Utilization; CINAHL Database -- Utilization; Databases -- Utilization; Funding Source
Abstract:
Background/Aim It remains unclear which type of non-surgical treatment is most appropriate as first-line intervention against peri-implantitis. This systematic review and Bayesian network meta-analysis aimed to compare the clinical effect of various non-surgical peri-implantitis therapies. Methods The PubMed, SCOPUS, CINAHL, DARE and Web of Knowledge databases were searched in duplicate for randomized controlled trials ( RCTs) up to and including 01 January 2014. Additional relevant literature was identified using handsearching of reference lists within published systematic reviews, and screenings of OpenGrey, ClinicalTrials.gov and Controlled-Trials.com. Probing pocket depth ( PPD) was the outcome measure assessed. Multilevel mixed modelling was used to perform the network meta-analysis, and Markov Chain Monte Carlo simulation to obtain random effects. Results Eleven studies were included in the network meta-analysis. Debridement in conjunction with antibiotics achieved the greatest additional PPD reduction in comparison to debridement only (0.490 mm; 95% credible interval: −0.647;1.252). The highest probabilities of being the most effective interventions were achieved by Vector system ( p = 20.60%), debridement plus periochip ( p = 20.00%) and photodynamic therapy ( p = 18.90%). Conclusion The differences between various non-surgical treatments were relatively small with large credible intervals. On the basis of currently available RCTs, there is insufficient evidence to support that any particular non-surgical treatment for peri-implantitis showed better performance than debridement alone.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
PMID: 25039292 NLM UID: 0425123
Grant Information:
YKT is supported by a grant from the National Science Council in Taiwan (Grant No. NSC 101-2314-B-002-197-MY2). All other authors were funded by their institutions for the purpose of this study.
Entry Date:
20141003
Revision Date:
20150605
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jcpe.12292
Accession Number:
2012736311
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012736311&site=ehost-live">A systematic review and Bayesian network meta-analysis of randomized clinical trials on non-surgical treatments for peri-implantitis.</A>
Database:
CINAHL Plus
Record: 9
Title:
A Systematic Review and Mixed Treatment Comparison of the Efficacy of Pharmacological Treatments for Fibromyalgia.
Authors:
Choy, Ernest; Marshall, David; Gabriel, Zahava L.; Mitchell, Stephen A.; Gylee, Elizabeth; Dakin, Helen A.
Affiliation:
Cardiff University School of Medicine, Cardiff, UK
Inverclyde Royal Hospital, Greenock, UK
Pfizer Ltd, Surrey, UK
Abacus International, Oxfordshire, UK
Health Economics Research Centre, University of Oxford, Oxford, UK
Source:
Seminars in Arthritis & Rheumatism (SEMIN ARTHRITIS RHEUM), 2011 Dec; 41 (3): 335-345.e6.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Fibromyalgia -- Drug Therapy
Outcomes (Health Care)
Pregabalin -- Therapeutic Use
Serotonin Uptake Inhibitors -- Therapeutic Use
Minor Subjects:
Human; Cochrane Library; Medline; Embase; Randomized Controlled Trials; Descriptive Statistics; Questionnaires; Meta Analysis; Scales
Abstract:
Objectives: To review the literature on pharmacological treatments for fibromyalgia. Methods: Relative efficacy was estimated in terms of outcome measures highlighted by the Outcome Measures in Rheumatology Network using a Bayesian mixed treatment comparison (MTC) meta-analysis. Randomized controlled trials reporting treatments for fibromyalgia were identified by systematically reviewing electronic databases (Cochrane Library, Medline, EMBASE; accessed February 2008) and conducting manual bibliographic searches. Results: Forty-five randomized controlled trials met the prespecified inclusion criteria for the systematic review. There were limited robust clinical data for some therapeutic classes (tricyclic antidepressants, analgesics, sedative hypnotics, monoamine oxidase inhibitors) and only 21 studies met the more stringent criteria for inclusion in the MTC. The majority of studies included in the MTC assessed the anticonvulsant pregabalin (n = 5) or the serotonin norepinephrine reuptake inhibitors (SNRIs) duloxetine (n = 3) and milnacipran (n = 3). Licensed doses of pregabalin and duloxetine were significantly (P < 0.05) more efficacious than placebo in terms of absolute reduction in pain, number of “responders” (≥30% reduction in pain), or change in Fibromyalgia Impact Questionnaire score (pregabalin 450 mg/d only). There was no significant difference between licensed doses of pregabalin and duloxetine for these outcomes. However licensed doses of pregabalin produced significantly greater improvements in sleep compared with milnacipran (as measured by Medical Outcomes Study Sleep Scale). Conclusions: The current study confirms the therapeutic efficacy of pregabalin and the SNRIs, duloxetine and milnacipran, in the treatment of fibromyalgia. Given their different modes of action, combination therapy with pregabalin plus an SNRI should be investigated in future research.
Journal Subset:
Biomedical; Double Blind Peer Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
Instrumentation:
Fibromyalgia Impact Questionnaire
Medical Outcomes Study Sleep Scale
ISSN:
0049-0172
MEDLINE Info:
PMID: 21868065 NLM UID: 1306053
Entry Date:
20120203
Revision Date:
20141226
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/j.semarthrit.2011.06.003
Accession Number:
2011396412
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011396412&site=ehost-live">A Systematic Review and Mixed Treatment Comparison of the Efficacy of Pharmacological Treatments for Fibromyalgia.</A>
Database:
CINAHL Plus
Record: 10
Title:
Accounting for model uncertainty in estimating global burden of disease.
Authors:
Vock, David M.; Atchison, Elizabeth A.; Legler, Julie M.; McClure, David R. J.; Carlyle, Jamie C.; Jeavons, Elysia N.; Burton, Anthony H.
Affiliation:
Department of Statistics, North Carolina State University, 2311 Stinson Drive (Campus Box 8203), Raleigh, NC, 27695-8203, United States of America (USA)
Feinberg School of Medicine, Northwestern University, Chicago, USA
Department of Mathematics, Statistics and Computer Science, St Olaf College, Northfield, USA
Department of Statistical Science, Duke University, Durham, USA
Carver College of Medicine, University of Iowa, Iowa City, USA
Department of Health Sciences Research, Mayo Clinic, Rochester, USA
World Health Organization, Geneva, Switzerland
Source:
Bulletin of the World Health Organization (BULL WORLD HEALTH ORGAN), 2011 Feb; 89 (2): 112-20.
Publication Type:
journal article - research, systematic review, tables/charts
Language:
English
Major Subjects:
Rotavirus Infections -- Epidemiology -- In Infancy and Childhood
Rotavirus Infections -- Mortality -- In Infancy and Childhood
Disease Surveillance
Minor Subjects:
Funding Source; Human; Male; Female; Infant; Child, Preschool; Descriptive Statistics; Systematic Review; Meta Analysis; Regression; Confidence Intervals
Abstract:
Objective To illustrate the effects of failing to account for model uncertainty when modelling is used to estimate the global burden of disease, with specific application to childhood deaths from rotavirus infection. Methods To estimate the global burden of rotavirus infection, different random-effects meta-analysis and meta-regression models were constructed by varying the stratification criteria and including different combinations of covariates. Bayesian model averaging was used to combine the results across models and to provide a measure of uncertainty that reflects the choice of model and the sampling variability. Findings In the models examined, the estimated number of child deaths from rotavirus infection varied between 492 000 and 664 000. While averaging over the different models' estimates resulted in a modest increase in the estimated number of deaths (541 000 as compared with the World Health Organization's estimate of 527 000), the width of the 95% confidence interval increased from 105 000 to 198000 deaths when model uncertainty was taken into account. Conclusion Sampling variability explains only a portion of the overall uncertainty in a modelled estimate. The uncertainty owing to both the sampling variability and the choice of model(s) should be given when disease burden results are presented. Failure to properly account for uncertainty in disease burden estimates may lead to inappropriate uses of the estimates and inaccurate prioritization of global health needs.
Journal Subset:
Biomedical; Continental Europe; Europe; Peer Reviewed; Public Health
Special Interest:
Evidence-Based Practice; Pediatric Care; Public Health
ISSN:
0042-9686
MEDLINE Info:
PMID: 21346922 NLM UID: 7507052
Grant Information:
United States National Science Foundation Grant No. 0354308.
Entry Date:
20110325
Revision Date:
20120106
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.2471 /BLT.09.073577
Accession Number:
2010970643
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Database:
CINAHL Plus
Record: 11
Title:
Adjuvant treatments for resected pancreatic adenocarcinoma: a systematic review and network meta-analysis.
Authors:
Liao, Wei-Chih; Chien, Kuo-Liong; Lin, Yu-Lin; Wu, Ming-Shiang; Lin, Jaw-Town; Wang, Hsiu-Po; Tu, Yu-Kang
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
Source:
Lancet Oncology (LANCET ONCOL), 2013 Oct; 14 (11): 1095-103.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Adenocarcinoma -- Therapy
Chemotherapy, Adjuvant
Pancreatic Neoplasms -- Therapy
Radiotherapy, Adjuvant
Minor Subjects:
Clinical Trials; Human; Meta Analysis; Prognosis; PubMed; Systematic Review
Abstract:
BACKGROUND: Major adjuvant treatments for pancreatic adenocarcinoma include fluorouracil, gemcitabine, chemoradiation, and chemoradiation plus fluorouracil or gemcitabine. Since the optimum regimen remains inconclusive, we aimed to compare these treatments in terms of overall survival after tumour resection and in terms of grade 3-4 toxic effects with a systematic review and random-effects Bayesian network meta-analysis. METHODS: We searched PubMed, trial registries, and related reviews and abstracts for randomised controlled trials comparing the above five treatments with each other or observation alone before April 30, 2013. We estimated relative hazard ratios (HRs) for death and relative odds ratios (ORs) for toxic effects among different therapies by combining HRs for death and survival durations and ORs for toxic effects of included trials. We assessed the effects of prognostic factors on survival benefits of adjuvant therapies with meta-regression. FINDINGS: Ten eligible articles reporting nine trials were included. Compared with observation, the HRs for death were 0·62 (95% credible interval 0·42-0·88) for fluorouracil, 0·68 (0·44-1·07) for gemcitabine, 0·91 (0·55-1·46) for chemoradiation, 0·54 (0·15-1·80) for chemoradiation plus fluorouracil, and 0·44 (0·10-1·81) for chemoradiation plus gemcitabine. The proportion of patients with positive lymph nodes was inversely associated with the survival benefit of adjuvant treatments. After adjustment for this factor, fluorouracil (HR 0·65, 0·49-0·84) and gemcitabine (0·59, 0·41-0·83) improved survival compared with observation, whereas chemoradiation resulted in worse survival than fluorouracil (1·69, 1·12-2·54) or gemcitabine (1·86, 1·04-3·23). Chemoradiation plus gemcitabine was ranked the most toxic, with significantly higher haematological toxic effects than second-ranked chemoradiation plus fluorouracil (OR 13·33, 1·01-169·36). INTERPRETATION: Chemotherapy with fluorouracil or gemcitabine is the optimum adjuvant treatment for pancreatic adenocarcinoma and reduces mortality after surgery by about a third. Chemoradiation plus chemotherapy is less effective in prolonging survival and is more toxic than chemotherapy. FUNDING: None.
Journal Subset:
Biomedical; Europe; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
1470-2045
MEDLINE Info:
PMID: 24035532 NLM UID: 100957246
Entry Date:
20140207
Revision Date:
20140207
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/S1470-2045(13)70388-7
Accession Number:
2012331351
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012331351&site=ehost-live">Adjuvant treatments for resected pancreatic adenocarcinoma: a systematic review and network meta-analysis.</A>
Database:
CINAHL Plus
Record: 12
Title:
An indirect comparison of the efficacy and safety of desvenlafaxine and venlafaxine using placebo as the common comparator.
Authors:
Coleman KA; Xavier VY; Palmer TL; Meaney JV; Radalj LM; Canny LM
Affiliation:
1 Health Technology Analysts, Sydney, NSW, Australia
Source:
CNS Spectrums: The International Journal of Neuropsychiatric Medicine (CNS SPECTRUMS), 2012 Sep; 17 (3): 131-41.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Alcohols -- Therapeutic Use
Antidepressive Agents -- Therapeutic Use
Depression -- Drug Therapy
Minor Subjects:
Adult; Aged; Australia; Clinical Trials; Double-Blind Studies; Female; Human; Male; Meta Analysis; Middle Age; Nausea -- Chemically Induced; Probability; Psychological Tests; Resource Databases; Systematic Review; Treatment Outcomes; Young Adult
Abstract:
BACKGROUND: This meta-analysis compared the efficacy and safety of desvenlafaxine and venlafaxine at the Australian approved doses. METHODS: A systematic literature search was conducted to identify all placebo-controlled studies of desvenlafaxine and venlafaxine in the treatment of major depression. The pivotal outcome measure used to assess comparative efficacy was the mean change in Hamilton Rating Scale for Depression-17 score from baseline. Tolerability and safety were compared by an evaluation of reported adverse events. Standard and Bayesian methods were used to conduct the indirect comparisons. Findings Using a mixed model repeated measures analysis, the pooled weighted mean difference for the mean change in Hamilton Rating Scale for Depression-17 score from baseline was -2.81 (-3.72, -1.91; p < 0.001) for desvenlafaxine and -2.61 (-3.17, -2.05; p < 0.001) for venlafaxine. An indirect Bayesian analysis adjusted for baseline Hamilton Rating Scale for Depression-17 score showed no significant difference between the two treatments (weighted mean difference -0.27; -1.17, 0.65). A standard indirect comparison of any adverse events showed no significant difference between desvenlafaxine and venlafaxine (relative risk 1.01; 0.96, 1.06; p = 0.70 and risk difference -0.01; -0.05, 0.03; p = 0.59). Standard indirect comparisons of both nausea and drop-outs identified potential differences between treatments, with the risk difference analyses suggesting a trend in favor of desvenlafaxine (nausea: relative risk 0.97; 0.77, 1.22; p = 0.80/RD -0.07; -0.12, -0.01; p = 0.02; and drop-outs due to adverse events: RR 0.86; 0.58, 1.29; p = 0.48/RD -0.04; -0.08, 0.00; p = 0.06). CONCLUSIONS: Based on the results of this meta-analysis, desvenlafaxine was shown to be non-inferior to venlafaxine in terms of efficacy, and has an advantage in terms of less nausea.
Journal Subset:
Biomedical; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Psychiatry/Psychology
ISSN:
1092-8529
MEDLINE Info:
PMID: 22883424 NLM UID: 9702877
Entry Date:
20130830
Revision Date:
20130913
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1017/S1092852912000648
Accession Number:
2011669007
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011669007&site=ehost-live">An indirect comparison of the efficacy and safety of desvenlafaxine and venlafaxine using placebo as the common comparator.</A>
Database:
CINAHL Plus
Record: 13
Title:
Aspirin for the Primary Prevention of Cardiovascular Events: A systematic review and meta-analysis comparing patients with and without diabetes.
Authors:
Calvin AD; Aggarwal NR; Murad MH; Shi Q; Elamin MB; Geske JB; Fernandez-Balsells MM; Albuquerque FN; Lampropulos JF; Erwin PJ; Smith SA; Montori VM
Source:
Diabetes Care (DIABETES CARE), 2009 Dec; 32 (12): 2300-6.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Aspirin -- Therapeutic Use
Cardiovascular Diseases -- Prevention and Control
Diabetic Angiopathies -- Prevention and Control
Preventive Health Care -- Methods
Minor Subjects:
Cochrane Library; Embase; Female; Fibrinolytic Agents -- Therapeutic Use; Human; Hypertension -- Prevention and Control; Male; Medline; Meta Analysis; Myocardial Infarction -- Prevention and Control; Observer Bias; Stroke -- Prevention and Control; Systematic Review
Abstract:
OBJECTIVE The negative results of two randomized controlled trials (RCTs) have challenged current guideline recommendations for using aspirin for primary prevention of cardiovascular events among patients with diabetes. We therefore sought to determine if the effect of aspirin for primary prevention of cardiovascular events and mortality differs between patients with and without diabetes. RESEARCH DESIGN AND METHODS We conducted a systematic search of MEDLINE, EMBASE, Cochrane Library, Web of Science, and Scopus since their inceptions until November 2008 for RCTs of aspirin for primary prevention of cardiovascular events. Blinded pairs of reviewers evaluated studies and extracted data. Random-effects meta-analysis and Bayesian logistic regression were used to estimate the ratios of relative risks (RRs) of outcomes of interest among patients with and without diabetes. A 95% CI that crosses 1.00 indicates that the effect of aspirin does not differ between patients with and without diabetes. RESULTS Nine RCTs with moderate to high methodological quality contributed data to the analyses. The ratios of RRs comparing the benefit of aspirin among patients with diabetes compared with patients without diabetes for mortality, myocardial infarction, and ischemic stroke were 1.12 (95% CI 0.92-1.35), 1.19 (0.82-1.17), and 0.70 (0.25-1.97), respectively. CONCLUSIONS Whereas estimates of benefit among patients with diabetes remain imprecise, our analysis suggests that the relative benefit of aspirin is similar in patients with and without diabetes.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
ISSN:
0149-5992
MEDLINE Info:
PMID: 19741185 NLM UID: 7805975
Entry Date:
20100226
Revision Date:
20110520
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.2337/dc09-1297
Accession Number:
2010489445
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010489445&site=ehost-live">Aspirin for the Primary Prevention of Cardiovascular Events: A systematic review and meta-analysis comparing patients with and without diabetes.</A>
Database:
CINAHL Plus
Record: 14
Title:
Bayesian bivariate meta-analysis of sensitivity and specificity: summary of quantitative findings in 50 meta-analyses.
Authors:
Menke, Jan
Affiliation:
Radiology Center, University Hospital Goettingen
Source:
Journal of Evaluation in Clinical Practice (J EVAL CLIN PRACT), 2014 Dec; 20 (6): 844-52.
Publication Type:
journal article - equations & formulas, meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Diagnosis -- Standards
Diagnostic Tests, Routine -- Standards
Meta Analysis
Sensitivity and Specificity
Minor Subjects:
Human; Descriptive Statistics; Random Sample; Systematic Review; PubMed; Data Analysis Software; Spearman's Rank Correlation Coefficient; Confidence Intervals
Abstract:
Rationale, aims and objectives Meta-analyses of diagnostic test accuracy are important elements in evidence-based medicine. However, currently there is no overview of related quantitative findings that were obtained in a large number of real meta-analyses. This study aimed at providing such empirical summary. Methods From the literature 50 meta-analyses were randomly selected that had reported their 2 × 2 count data of sensitivity and specificity. Descriptive statistics, assessment of between-study heterogeneity and bivariate random-effects meta-analysis of sensitivity and specificity were performed with a novel Bayesian program code. The bivariate model parameters were also converted to the parameters of the closely related hierarchical summary receiver operating characteristic ( HSROC) model. Results Among the 50 meta-analyses, the studies per meta-analysis ranged from 5 to 45 and the disease prevalence from 2.3 to 71%. Significant between-study heterogeneity was found in 43 of 50 meta-analyses, favouring a random-effects model over a fixed-effects model. Empirical distributions of sensitivity and specificity, positive and negative likelihood ratios, and other model results are presented in the full text numerically and graphically. Conclusions Studies of diagnostic test accuracy can be well meta-analysed within a Bayesian framework, and the presented quantitative findings provide an orientation when interpreting the results of the standard bivariate/ HSROC model.
Journal Subset:
Biomedical; Blind Peer Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; Public Health; UK & Ireland
Special Interest:
Evidence-Based Practice; Public Health
ISSN:
1356-1294
MEDLINE Info:
PMID: 24828853 NLM UID: 9609066
Entry Date:
20150213
Revision Date:
20150327
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jep.12173
Accession Number:
2012881527
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012881527&site=ehost-live">Bayesian bivariate meta-analysis of sensitivity and specificity: summary of quantitative findings in 50 meta-analyses.</A>
Database:
CINAHL Plus
Record: 15
Title:
Bayesian network meta-analysis of root coverage procedures: ranking efficacy and identification of best treatment.
Authors:
Buti, Jacopo; Baccini, Michela; Nieri, Michele; La Marca, Michele; Pini-Prato, Giovan P.
Affiliation:
Department of Public Health, University of Florence
Department of Statistics, University of Florence
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2013 Apr; 40 (4): 372-86.
Publication Type:
journal article - equations & formulas, meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Root Canal Therapy -- Methods
Gingival Recession
Treatment Outcomes
Minor Subjects:
Human; Meta Analysis; Italy; PubMed; Cochrane Library; Embase; Randomized Controlled Trials; Systematic Review; Data Analysis Software
Abstract:
Aims The aim of this work was to conduct a Bayesian network meta-analysis ( NM) of randomized controlled trials ( RCTs) to establish a ranking in efficacy and the best technique for coronally advanced flap ( CAF)-based root coverage procedures. Material and Methods A literature search on PubMed, Cochrane libraries, EMBASE, and hand-searched journals until June 2012 was conducted to identify RCTs on treatments of Miller Class I and II gingival recessions with at least 6 months of follow-up. The treatment outcomes were recession reduction (RecRed), clinical attachment gain ( CALgain), keratinized tissue gain ( KTgain), and complete root coverage ( CRC). Results Twenty-nine studies met the inclusion criteria, 20 of which were classified as at high risk of bias. The CAF+connective tissue graft ( CTG) combination ranked highest in effectiveness for RecRed (Probability of being the best = 40%) and CALgain (Pr = 33%); CAF+enamel matrix derivative ( EMD) was slightly better for CRC; CAF+Collagen Matrix ( CM) appeared effective for KTgain (Pr = 69%). Network inconsistency was low for all outcomes excluding CALgain. Conclusion CAF+ CTG might be considered the gold standard in root coverage procedures. The low amount of inconsistency gives support to the reliability of the present findings.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
PMID: 23346965 NLM UID: 0425123
Entry Date:
20130329
Revision Date:
20140411
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jcpe.12028
Accession Number:
2012041678
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012041678&site=ehost-live">Bayesian network meta-analysis of root coverage procedures: ranking efficacy and identification of best treatment.</A>
Database:
CINAHL Plus
Record: 16
Title:
Cancer incidence among female flight attendants: a meta-analysis of published data.
Authors:
Buja A; Mastrangelo G; Perissinotto E; Grigoletto F; Frigo AC; Rausa G; Marin V; Canova C; Dominici F
Affiliation:
Dept of Environmental Medicine and Public Health, University of Padua Via Loredan 18, 35128 Padua, Italy, alessandra.buja@unipd.it
Source:
Journal of Women's Health (15409996) (J WOMENS HEALTH (15409996)), 2006 Jan; 15 (1): 98-105. (45 ref)
Publication Type:
journal article - equations & formulas, research, systematic review, tables/charts
Language:
English
Major Subjects:
Aircraft
Neoplasms -- Epidemiology
Occupational Diseases -- Epidemiology
Occupational Exposure
Women's Health
Women, Working
Minor Subjects:
Medline; Data Analysis Software; Databases; Female; Incidence; Meta Analysis; Neoplasms, Radiation-Induced -- Epidemiology; Radiation, Ionizing; Human
Abstract:
BACKGROUND: Flight attendants are exposed to cosmic ionizing radiation and other potential cancer risk factors, but only recently have epidemiological studies been performed to assess the risk of cancer among these workers. The aim of the present work was to evaluate the incidence of various types of cancer among female cabin attendants by combining cancer incidence estimates reported in published studies. METHODS: All follow-up studies reporting standardized incidence ratio (SIR) for cancer among female flight attendants were obtained from online databases and analyzed. A meta-analysis was performed by applying Bayesian hierarchical models, which take into account studies that reported SIR = 0 and natural heterogeneity of study-specific SIRs. RESULTS: A total of seven published studies reporting SIR for several cancer types were extracted. Meta-analysis showed a significant excess of melanoma (meta-SIR 2.15, 95% posterior interval [PI] 1.56-2.88) and breast carcinoma (meta-SIR 1.40; PI 1.19-1.65) and a slight but not significant excess of cancer incidence across types (meta-SIR 1.11, PI 0.98-1.25). CONCLUSIONS: Although further studies are necessary to clarify the exact role of occupational exposure, all airlines should, as some companies do, estimate radiation dose, organize the schedules of crew members in order to reduce further exposure in highly exposed flight attendants, inform crew members about health risks, and give special protection to pregnant women.
Journal Subset:
Biomedical; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care; Women's Health
ISSN:
1540-9996
MEDLINE Info:
PMID: 16417424 NLM UID: 101159262
Entry Date:
20060602
Revision Date:
20120302
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1089/jwh.2006.15.98
Accession Number:
2009115266
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2009115266&site=ehost-live">Cancer incidence among female flight attendants: a meta-analysis of published data.</A>
Database:
CINAHL Plus
Record: 17
Title:
Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis.
Authors:
Ford, John A.; MacLennan, Graeme S.; Avenell, Alison; Bolland, Mark; Grey, Andrew; Witham, Miles
Affiliation:
Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
Department of Medicine, University of Auckland, Auckland, New Zealand
Section of Aging and Health, University of Dundee, Dundee, United Kingdom
Source:
American Journal of Clinical Nutrition (AM J CLIN NUTR), 2014 Sep; 100 (3): 746-55. (50 ref)
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Stroke -- Epidemiology
Myocardial Infarction -- Epidemiology
Heart Failure -- Epidemiology
Vitamin D -- Administration and Dosage
Dietary Supplementation
Minor Subjects:
Professional Practice, Evidence-Based; Medline; Embase; Systematic Review; Meta Analysis; Confidence Intervals; Aged; Female; Male; Funding Source; Human
Abstract:
Background: Low 25-hydroxyvitamin D status has been associated with increased cardiovascular events in epidemiologic studies. Objective: We assessed whether vitamin D supplementation reduces cardiac failure, myocardial infarction (MI), and stroke through an analysis of the Randomised Evaluation of Calcium Or vitamin D (RECORD) randomized controlled trial (RCT), a systematic review, and a meta-analysis. Design: Two analyses were undertaken. The first analysis was a trial analysis. The RECORD was a factorial RCT that compared vitamin D<sub>3</sub> (800 IU/d), calcium (1000 mg/d), vitamin D plus calcium, and a placebo. Cardiovascular events were collected throughout the trial and 3-y posttrial follow-up. Data were analyzed by using Cox regression. The second analysis was a systematic review. MEDLINE, EMBASE, CENTRAL, conference abstracts, and ongoing trials were searched for RCTs that evaluated vitamin D from 1980 to 2013. RCTs with ≥ 1 y of follow-up and participants mean or median age ≥ 60 y were included. Meta-analyses were based on a Bayesian fixed-effects model by using a complementary log-log link function to account for varying lengths of follow-up. Results: In the trial analysis, we showed that, for the 5292 participants in the RECORD trial, HRs (95% CIs) for vitamin D compared with no vitamin D for cardiac failure, MI, and stroke were 0.75 (0.58, 0.97), 0.97 (0.75,1.26), and 1.06 (0.8, 1.32), respectively. Twenty-one studies met the inclusion criteria for the systematic review (n = 13,033). Estimated HRs (credible intervals) for vitamin D compared with the placebo or control for on-study events for cardiac failure, MI, and stroke were 0.82 (0.58, 1.15), 0.96 ( 0.83, 1.10), and 1.07 (0.91, 1.29), respectively. Conclusion: Vitamin D supplementation might protect against cardiac failure in older people but does not appear to protect against MI or stroke.
Journal Subset:
Allied Health; Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Nutrition
ISSN:
0002-9165
MEDLINE Info:
PMID: 25057156 NLM UID: 0376027
Grant Information:
The Medical Research Council funded the central organization of RECORD, and Shire Pharmaceuticals funded the drugs, which were cofunded and manufactured by Nycomed. The Health Services Research Unit, University of Aberdeen, is funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates.
Entry Date:
20140912
Revision Date:
20150605
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.3945/ajcn.113.082602
Accession Number:
2012695813
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012695813&site=ehost-live">Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis.</A>
Database:
CINAHL Plus
Record: 18
Title:
Comparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.
Authors:
Bannuru, Raveendhara R; Schmid, Christopher H; Kent, David M; Vaysbrot, Elizaveta E; Wong, John B; McAlindon, Timothy E
Source:
Annals of Internal Medicine (ANN INTERN MED), 2015 Jan 6; 162 (1): 46-54.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Adrenal Cortex Hormones -- Therapeutic Use
Analgesics, Nonnarcotic -- Therapeutic Use
Antiinflammatory Agents, Non-Steroidal -- Therapeutic Use
Osteoarthritis, Knee -- Drug Therapy
Solutions -- Therapeutic Use
Minor Subjects:
Acetaminophen -- Therapeutic Use; Cochrane Library; Cox-2 Inhibitors -- Therapeutic Use; Diclofenac -- Therapeutic Use; Embase; Heterocyclic Compounds -- Therapeutic Use; Human; Hyaluronic Acid -- Therapeutic Use; Ibuprofen -- Therapeutic Use; Injections, Intraarticular; Medline; Meta Analysis; Naproxen -- Therapeutic Use; Osteoarthritis, Knee -- Complications; Pain -- Drug Therapy; Pain -- Etiology; Professional Practice, Evidence-Based; Sulfonamides -- Therapeutic Use; Systematic Review; Treatment Outcomes
Abstract:
BACKGROUND: The relative efficacy of available treatments of knee osteoarthritis (OA) must be determined for rational treatment algorithms to be formulated. PURPOSE: To examine the efficacy of treatments of primary knee OA using a network meta-analysis design, which estimates relative effects of all treatments against each other. DATA SOURCES: MEDLINE, EMBASE, Web of Science, Google Scholar, Cochrane Central Register of Controlled Trials from inception through 15 August 2014, and unpublished data. STUDY SELECTION: Randomized trials of adults with knee OA comparing 2 or more of the following: acetaminophen, diclofenac, ibuprofen, naproxen, celecoxib, intra-articular (IA) corticosteroids, IA hyaluronic acid, oral placebo, and IA placebo. DATA EXTRACTION: Two reviewers independently abstracted study data and assessed study quality. Standardized mean differences were calculated for pain, function, and stiffness at 3-month follow-up. DATA SYNTHESIS: Network meta-analysis was performed using a Bayesian random-effects model; 137 studies comprising 33 243 participants were identified. For pain, all interventions significantly outperformed oral placebo, with effect sizes from 0.63 (95% credible interval [CrI], 0.39 to 0.88) for the most efficacious treatment (hyaluronic acid) to 0.18 (CrI, 0.04 to 0.33) for the least efficacious treatment (acetaminophen). For function, all interventions except IA corticosteroids were significantly superior to oral placebo. For stiffness, most of the treatments did not significantly differ from one another. LIMITATION: Lack of long-term data, inadequate reporting of safety data, possible publication bias, and few head-to-head comparisons. CONCLUSION: This method allowed comparison of common treatments of knee OA according to their relative efficacy. Intra-articular treatments were superior to nonsteroidal anti-inflammatory drugs, possibly because of the integrated IA placebo effect. Small but robust differences were observed between active treatments. All treatments except acetaminophen showed clinically significant improvement from baseline pain. This information, along with the safety profiles and relative costs of included treatments, will be helpful for individualized patient care decisions. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
Journal Subset:
Biomedical; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
ISSN:
0003-4819
MEDLINE Info:
PMID: 25560713 NLM UID: 0372351
Entry Date:
20150403
Revision Date:
20150403
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.7326/M14-1231
Accession Number:
2012870293
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012870293&site=ehost-live">Comparative Effectiveness of Pharmacologic Interventions for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.</A>
Database:
CINAHL Plus
Record: 19
Title:
Comparative Efficacy and Risk of Harms of Immediate- versus Extended-Release Second-Generation Antidepressants: A Systematic Review with Network Meta-Analysis.
Authors:
Nussbaumer, Barbara; Morgan, Laura C; Reichenpfader, Ursula; Greenblatt, Amy; Hansen, Richard A; Van Noord, Megan; Lux, Linda; Gaynes, Bradley N; Gartlehner, Gerald
Affiliation:
Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Dr.-Karl-Dorrek Strasse 30, 3500, Krems, Austria, barbara.nussbaumer@donau-uni.ac.at
Source:
CNS Drugs (CNS DRUGS), 2014 Aug; 28 (8): 699-712.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Antidepressive Agents, Second Generation -- Administration and Dosage
Delayed-Action Preparations -- Administration and Dosage
Depression -- Drug Therapy
Minor Subjects:
Antidepressive Agents, Second Generation -- Adverse Effects; Clinical Trials; Cochrane Library; Delayed-Action Preparations -- Adverse Effects; Embase; Human; Meta Analysis; Professional Practice, Evidence-Based; Psycinfo; PubMed; Relative Risk; Systematic Review
Abstract:
BACKGROUND: Major depressive disorder (MDD) has detrimental effects on an individual's personal life, leads to increased risk of comorbidities, and places an enormous economic burden on society. Several 'second-generation' antidepressants are available as both immediate-release (IR) and extended-release formulations. The advantage of extended-release formulations may be the potentially improved adherence and a lower risk of adverse events. OBJECTIVE: We conducted a systematic review to assess the comparative efficacy, risk of harms, and patients' adherence of IR and extended-release antidepressants for the treatment of MDD. DATA SOURCE: English-language abstracts were retrieved from PubMed, EMBASE, the Cochrane Library, PsycINFO, and International Pharmaceutical Abstracts from 1980 to October 2012, as well as from reference lists of pertinent review articles and grey literature searches. ELIGIBILITY CRITERIA: We included head-to-head randomized controlled trials (RCTs) of at least 6 weeks' duration that compared an IR formulation with an extended-release formulation of the same antidepressant in adult patients with MDD. We also included placebo-controlled trials to conduct a network meta-analysis. To assess harms and adherence, in addition to RCTs, we searched for observational studies with >=1,000 participants and a follow-up of >=12 weeks. STUDY APPRAISAL AND SYNTHESIS METHODS: We dually reviewed abstracts and full texts and assessed quality ratings. Lacking head-to-head evidence for many comparisons of interest, we conducted network meta-analyses using Bayesian methods. Our outcome measure of choice was response on the Hamilton Depression Rating Scale. RESULTS: We located seven head-to-head trials and 94 placebo- and active-controlled trials for network meta-analysis. Overall, our analyses indicate that IR and extended-release formulations do not differ substantially with respect to efficacy and risk of harms. The evidence is mixed with respect to differences in adherence, indicating lower adherence for IR formulations. LIMITATIONS: The lack of head-to-head comparisons for many drugs compromises our conclusions. Network meta-analyses have methodological limitations that need to be taken into consideration when interpreting findings. CONCLUSION: Available evidence currently shows no clear differences between the two formulations and therefore we cannot recommend a first choice. However, if adherence or compliance with one medication is an issue, then clinicians and patients should consider the alternative medication. If adherence or costs are a problem with one formulation, consideration of the other formulation to provide an adequate treatment trial is reasonable.
Journal Subset:
Australia & New Zealand; Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Evidence-Based Practice
ISSN:
1172-7047
MEDLINE Info:
PMID: 24794101 NLM UID: 9431220
Entry Date:
20150410
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1007/s40263-014-0169-z
Accession Number:
2012659542
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012659542&site=ehost-live">Comparative Efficacy and Risk of Harms of Immediate- versus Extended-Release Second-Generation Antidepressants: A Systematic Review with Network Meta-Analysis.</A>
Database:
CINAHL Plus
Record: 20
Title:
Comparative Efficacy and Safety of Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors in Older Adults: A Network Meta-Analysis.
Authors:
Thorlund, Kristian; Druyts, Eric; Wu, Ping; Balijepalli, Chakrapani; Keohane, Denis; Mills, Edward
Affiliation:
Stanford Prevention Research Center, Stanford University
Redwood Outcomes
Redwood Outcomes
Pfizer Inc
Stanford Prevention Research Center, Stanford University
Source:
Journal of the American Geriatrics Society (J AM GERIATR SOC), 2015 May; 63 (5): 1002-9.
Publication Type:
journal article - meta analysis, pictorial, research, systematic review, tables/charts
Language:
English
Major Subjects:
Serotonin Uptake Inhibitors -- Therapeutic Use -- In Old Age
Minor Subjects:
Human; Male; Female; Middle Age; Aged; Meta Analysis; Systematic Review; Medline; Embase; Cochrane Library; Psycinfo; Hamilton Rating Scale for Depression; Scales; Funding Source
Abstract:
Objectives To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. Design Systematic review and network meta-analysis. Participants Individuals aged 60 and older. Measurements Data on partial response (defined as at least 50% reduction in depression score from baseline) and safety (dizziness, vertigo, syncope, falls, loss of consciousness) were extracted. A Bayesian network meta-analysis was performed on the efficacy and safety outcomes, and relative risks ( RRs) with 95% credible intervals (CrIs) were produced. Results Fifteen randomized controlled trials were eligible for inclusion in the analysis. Citalopram, escitalopram, paroxetine, duloxetine, venlafaxine, fluoxetine, and sertraline were represented. Reporting on partial response and dizziness was sufficient to conduct a network meta-analysis. Reporting on other outcomes was sparse. For partial response, sertraline ( RR = 1.28), paroxetine ( RR = 1.48), and duloxetine ( RR = 1.62) were significantly better than placebo. The remaining interventions yielded RRs lower than 1.20. For dizziness, duloxetine ( RR = 3.18) and venlafaxine ( RR = 2.94) were statistically significantly worse than placebo. Compared with placebo, sertraline had the lowest RR for dizziness (1.14) and fluoxetine the second lowest (1.31). Citalopram, escitalopram, and paroxetine all had RRs between 1.4 and 1.7. Conclusion There was clear evidence of the effectiveness of sertraline, paroxetine, and duloxetine. There also appears to be a hierarchy of safety associated with the different antidepressants, although there appears to be a dearth of reporting of safety outcomes.
Journal Subset:
Biomedical; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Gerontologic Care; Patient Safety
Instrumentation:
Montgomery-Asberg Depression Rating Scale (MADRS)
Hamilton Rating Scale for Depression (HRSD)
ISSN:
0002-8614
MEDLINE Info:
PMID: 25945410 NLM UID: 7503062
Grant Information:
This study received unrestricted funding from Pfizer Inc.
Entry Date:
20150529
Revision Date:
20150807
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jgs.13395
Accession Number:
2013010547
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2013010547&site=ehost-live">Comparative Efficacy and Safety of Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors in Older Adults: A Network Meta-Analysis.</A>
Database:
CINAHL Plus
Record: 21
Title:
Comparative Efficacy of Biologic Therapy in Biologic-Naïve Patients With Crohn Disease: A Systematic Review and Network Meta-analysis.
Authors:
Singh, Siddharth; Garg, Sushil Kumar; Pardi, Darrell S; Wang, Zhen; Hassan Murad, Mohammad; Loftus Jr, Edward V
Affiliation:
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. Electronic address: singh.siddharth2@mayo.edu
Department of Surgery, University of Minnesota, Minneapolis
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
Knowledge and Evaluation Research Unit, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
Knowledge and Evaluation Research Unit, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
Source:
Mayo Clinic Proceedings (MAYO CLIN PROC), 2014 Dec; 89 (12): 1621-35.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Antibodies, Monoclonal -- Therapeutic Use
Crohn Disease -- Drug Therapy
Immunoglobulins, Fab -- Therapeutic Use
Immunosuppressive Agents -- Therapeutic Use
Polyethylene Glycols -- Therapeutic Use
Minor Subjects:
Adult; Disease Remission; Human; Meta Analysis; Professional Practice, Evidence-Based; Systematic Review; Treatment Outcomes
Abstract:
OBJECTIVE: To study the comparative efficacy of biologic therapy in the management of biologic-naïve patients with Crohn disease (CD). PATIENTS AND METHODS: We conducted a systematic review of randomized controlled trials published from January 1, 1985, through September 30, 2013, comparing biologic agents (infliximab [IFX], adalimumab [ADA], certolizumab pegol, natalizumab, vedolizumab, and ustekinumab) with each other or placebo for inducing and maintaining clinical remission in adults with moderate to severe CD. To increase comparability across trials, we focused on a subset of biologic-naïve patients for the induction end point and on responders to induction therapy for the maintenance end point. We followed a Bayesian network meta-analysis approach. RESULTS: We identified 17 randomized controlled trials of good methodological quality comparing 6 biologic agents with placebo, with no direct comparison of biologic agents. In network meta-analysis, we observed that IFX (relative risk [RR], 6.11; 95% credible interval [CrI], 2.49-18.29) and ADA (RR, 2.98; 95% CrI, 1.12-8.18), but not certolizumab pegol (RR, 1.48; 95% CrI, 0.76-2.93), natalizumab (RR, 1.36; 95% CrI, 0.69-2.86), vedolizumab (RR, 1.40; 95% CrI, 0.63-3.28), and ustekinumab (RR, 0.61; 95% CrI, 0.15-2.49), were more likely to induce remission than placebo. Similar results were observed for maintenance of remission. Infliximab had the highest probability of being ranked as the most efficacious agent for induction (86%) and ADA for maintenance of remission (48%). CONCLUSION: On the basis of network meta-analysis, IFX may be most efficacious agent for inducing remission in CD in biologic-naïve patients. In the absence of head-to-head treatment comparison, the confidence in these estimates is low. Future comparative efficacy studies are warranted.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
ISSN:
0025-6196
MEDLINE Info:
PMID: 25441399 NLM UID: 0405543
Entry Date:
20150508
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/j.mayocp.2014.08.019
Accession Number:
2012822851
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012822851&site=ehost-live">Comparative Efficacy of Biologic Therapy in Biologic-Naïve Patients With Crohn Disease: A Systematic Review and Network Meta-analysis.</A>
Database:
CINAHL Plus
Record: 22
Title:
Comparing the effectiveness of competing tests for reducing colorectal cancer mortality: a network meta-analysis.
Authors:
Elmunzer, B. Joseph; Singal, Amit G.; Sussman, Jeremy B.; Deshpande, Amar R.; Sussman, Daniel A.; Conte, Marisa L.; Dwamena, Ben A.; Rogers, Mary A.M.; Schoenfeld, Philip S.; Inadomi, John M.; Saini, Sameer D.; Waljee, Akbar K.
Affiliation:
Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan, USA
Department of Internal Medicine, Division of Digestive and Liver Diseases and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Center for Clinical Management Research, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan, USA
Department of Internal Medicine, Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, Florida, USA
University of Michigan School of Medicine, Ann Arbor, Michigan, USA
Department of Radiology, Division of Nuclear Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
Department of Internal Medicine, Division of General Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA
Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan Health System, Ann Arbor, Michigan, USA
Department of Medicine, Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington, USA
Source:
Gastrointestinal Endoscopy (GASTROINTEST ENDOSC), 2015 Mar; 81 (3): 700-709.e3.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Colorectal Neoplasms -- Mortality
Minor Subjects:
Human; Systematic Review; Meta Analysis; Sensitivity and Specificity; Multivariate Analysis; Relative Risk; Confidence Intervals; Randomized Controlled Trials
Abstract:
Background Comparative effectiveness data pertaining to competing colorectal cancer (CRC) screening tests do not exist but are necessary to guide clinical decision making and policy. Objective To perform a comparative synthesis of clinical outcomes studies evaluating the effects of competing tests on CRC-related mortality. Design Traditional and network meta-analyses. Two reviewers identified studies evaluating the effect of guaiac-based fecal occult blood testing (gFOBT), flexible sigmoidoscopy (FS), or colonoscopy on CRC-related mortality. Interventions gFOBT, FS, colonoscopy. Main Outcome Measurements Traditional meta-analysis was performed to produce pooled estimates of the effect of each modality on CRC mortality. Bayesian network meta-analysis (NMA) was performed to indirectly compare the effectiveness of screening modalities. Multiple sensitivity analyses were performed. Results Traditional meta-analysis revealed that, compared with no intervention, colonoscopy reduced CRC-related mortality by 57% (relative risk [RR] 0.43; 95% confidence interval [CI], 0.33-0.58), whereas FS reduced CRC-related mortality by 40% (RR 0.60; 95% CI, 0.45-0.78), and gFOBT reduced CRC-related mortality by 18% (RR 0.82; 95% CI, 0.76-0.88). NMA demonstrated nonsignificant trends favoring colonoscopy over FS (RR 0.71; 95% CI, 0.45-1.11) and FS over gFOBT (RR 0.74; 95% CI, 0.51-1.09) for reducing CRC-related deaths. NMA-based simulations, however, revealed that colonoscopy has a 94% probability of being the most effective test for reducing CRC mortality and a 99% probability of being most effective when the analysis is restricted to screening studies. Limitations Randomized trials and observational studies were combined within the same analysis. Conclusion Clinical outcomes studies demonstrate that gFOBT, FS, and colonoscopy are all effective in reducing CRC-related mortality. Network meta-analysis suggests that colonoscopy is the most effective test.
Journal Subset:
Biomedical; Double Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care; Perioperative Care
ISSN:
0016-5107
MEDLINE Info:
PMID: 25708757 NLM UID: 0010505
Entry Date:
20150313
Revision Date:
20150605
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/j.gie.2014.10.033
Accession Number:
2012911144
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012911144&site=ehost-live">Comparing the effectiveness of competing tests for reducing colorectal cancer mortality: a network meta-analysis.</A>
Database:
CINAHL Plus
Record: 23
Title:
Comparison of the efficacy and safety of low molecular weight heparins for venous thromboembolism prophylaxis in medically ill patients.
Authors:
Dooley, Christopher; Kaur, Rajbir; Sobieraj, Diana M
Affiliation:
Hartford Hospital, Pharmacy , Hartford, CT , USA
Source:
Current Medical Research & Opinion (CURR MED RES OPIN), 2014 Mar; 30 (3): 367-80.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Heparin, Low-Molecular-Weight -- Therapeutic Use
Venous Thromboembolism -- Prevention and Control
Minor Subjects:
Heparin, Low-Molecular-Weight -- Adverse Effects; Human; Meta Analysis; Probability; Systematic Review; Venous Thromboembolism -- Etiology
Abstract:
Abstract Objective: To conduct a systematic review and mixed-treatment comparison (MTC) meta-analysis to compare the efficacy and safety of low molecular weight heparins (LMWHs) for venous thromboembolism (VTE) prophylaxis in hospitalized medically ill patients. As a secondary objective we compared all therapies within the network to each other. Methods: We conducted a systematic literature search for randomized trials that evaluated pharmacologic VTE prophylaxis in hospitalized medically ill patients. We conducted a traditional meta-analysis for all pairwise comparisons using a random effects model, reporting relative risks (RRs) and 95% confidence intervals for each outcome. To determine the relative efficacy and safety of included therapies we conducted a MTC meta-analysis using a Bayesian framework, reporting odds ratios (OR) and 95% credible intervals. Results: Twenty trials met inclusion criteria. Enoxaparin, dalteparin, nadroparin and certoparin were the LMWHs evaluated although none in direct comparative trials. Upon MTC, the relative efficacy of all LMWHs was similar in preventing mortality and VTE as well as in the odds of major and minor bleeding. Dalteparin was not included in the network to evaluate deep vein thrombosis (DVT) and pulmonary embolism (PE) due to lack of reported data and the remaining LMWHs were found to be similar in relative efficacy in preventing these outcomes. Limitations: Traditional meta-analysis was not possible for many drug comparisons made within the MTC. Heterogeneity was observed in several of the traditional meta-analyses although this may be an inherent limitation of the studied population. Overall rarity of events contributed to imprecise estimates demonstrated by the wide confidence intervals. Conclusions: Enoxaparin, dalteparin, nadroparin and certoparin are similar in relative efficacy for the prevention of mortality and VTE and in the odds of major or minor bleeding while enoxaparin, nadroparin and certoparin are similar in relative efficacy for the prevention of PE and DVT in hospitalized medical patients.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
0300-7995
MEDLINE Info:
PMID: 23971722 NLM UID: 0351014
Entry Date:
20150116
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1185/03007995.2013.837818
Accession Number:
2012486987
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012486987&site=ehost-live">Comparison of the efficacy and safety of low molecular weight heparins for venous thromboembolism prophylaxis in medically ill patients.</A>
Database:
CINAHL Plus
Record: 24
Title:
Coronally Advanced Flaps (CAF) Plus Connective Tissue Graft (CTG) Is the Gold Standard for Treatment of Miller Class I and II Gingival Defects.
Authors:
Nunn, Martha E.; Miyamoto, Takanari
Affiliation:
Director, Center for Oral Health Research, School of Dentistry, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
Chair, Department of Periodontics, School of Dentistry, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
Source:
Journal of Evidence-Based Dental Practice (J EVID BASED DENT PRACT), 2013 Dec; 13 (4): 157-9.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Root Canal Therapy -- Methods
Root Canal Filling Materials -- Therapeutic Use
Root Planing -- Methods
Dental Scaling -- Methods
Minor Subjects:
Human; Systematic Review; Meta Analysis; Databases -- Utilization
Abstract:
Article title and bibliographic information: Bayesian network meta-analysis of root coverage procedures: ranking efficacy and identification of best treatment. Buti J, Baccini M, Nieri M, La Marca M, Pini-Prato GP. J Clin Periodontol 2013;40(4):372-86. Reviewers: Martha E. Nunn, DDS, PhD, Takanari Miyamoto, DDS, MSD, PhD Purpose/Question: What is the ranking efficacy and identification of the best treatment among basic root coverage procedures? Source of funding: No external funding for this study beyond the authors' respective institutions Type of study/Design: Systematic review with Bayesian network meta-analysis of data Level of evidence: Level 1: Good-quality, patient-oriented evidence Strength of recommendation Grade: Grade A: Consistent, good-quality patient-oriented evidence
Journal Subset:
Biomedical; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
1532-3382
MEDLINE Info:
PMID: 24237738 NLM UID: 101083101
Entry Date:
20131129
Revision Date:
20131220
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/j.jebdp.2013.10.012
Accession Number:
2012378751
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012378751&site=ehost-live">Coronally Advanced Flaps (CAF) Plus Connective Tissue Graft (CTG) Is the Gold Standard for Treatment of Miller Class I and II Gingival Defects.</A>
Database:
CINAHL Plus
Record: 25
Title:
Coronary Revascularization in Diabetic Patients: A Systematic Review and Bayesian Network Meta-analysis.
Authors:
Tu, Benny; Rich, Ben; Labos, Christopher; Brophy, James M
Source:
Annals of Internal Medicine (ANN INTERN MED), 2014 Nov 18; 161 (10): 724-32.
Commentary:
Hlatky, Mark A. Review: In diabetes with multivessel or left main CAD, PCI increases death/MI/stroke combo compared with CABG. ANN INTERN MED 2015 Mar 17; 162(6): JC8 (commentary) (2012940966)
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Cardiovascular Care
Coronary Arteriosclerosis -- Therapy
Coronary Artery Bypass
Diabetes Mellitus -- Complications
Stents
Minor Subjects:
Cochrane Library; Coronary Arteriosclerosis -- Surgery; Embase; Human; Meta Analysis; Mortality; Probability; Professional Practice, Evidence-Based; Prospective Studies; PubMed; Systematic Review
Abstract:
BACKGROUND: The optimal revascularization technique in diabetic patients is an important unresolved question. PURPOSE: To compare long-term outcomes between the revascularization techniques of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). DATA SOURCES: English-language publications in PubMed, the Cochrane Central Register of Controlled Trials, Ovid, and EMBASE between 1 January 1990 and 1 June 2014. STUDY SELECTION: Two investigators independently reviewed randomized, controlled trials comparing PCI (with drug-eluting or bare-metal stents) with CABG in adults with diabetes with multivessel or left main coronary artery disease. DATA EXTRACTION: Study design, quality, patient characteristics, length of follow-up, and outcomes were extracted. For duplicate publications, outcomes were obtained from the publication with the longest follow-up. DATA SYNTHESIS: 40 studies were combined using a Bayesian network meta-analysis that accounted for the variation in stent choice. The primary outcome, a composite of all-cause mortality, nonfatal myocardial infarction, and stroke, increased with PCI (odds ratio [OR], 1.33 [95% credible interval {CrI}, 1.01 to 1.65]). Percutaneous coronary intervention resulted in increased mortality (OR, 1.44 [CrI, 1.05 to 1.91]), no change in the number of myocardial infarctions (OR, 1.33 [CrI, 0.86 to 1.95]), and fewer strokes (OR, 0.56 [CrI, 0.36 to 0.88]). LIMITATIONS: Study design and length of follow-up were heterogeneous, and results were driven primarily by a single study. Costs and nonvascular complications of the interventions were not examined. CONCLUSION: Coronary artery bypass grafting seems to be the preferred revascularization technique in diabetics, especially if long-term survival is anticipated. However, because of residual uncertainties and increased risk for stroke with CABG, clinical judgment is required when choosing a revascularization technique in patients with diabetes. PRIMARY FUNDING SOURCE: Fonds de recherche du Québec-Santé.
Journal Subset:
Biomedical; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
ISSN:
0003-4819
MEDLINE Info:
PMID: 25402514 NLM UID: 0372351
Entry Date:
20150501
Revision Date:
20150731
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.7326/M14-0808
Accession Number:
2012799367
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012799367&site=ehost-live">Coronary Revascularization in Diabetic Patients: A Systematic Review and Bayesian Network Meta-analysis.</A>
Database:
CINAHL Plus
Record: 26
Title:
Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom.
Authors:
McKenna C; Palmer S; Rodgers M; Chambers D; Hawkins N; Golder S; Van Hout S; Pepper C; Todd D; Woolacott N
Affiliation:
Centre for Health Economics, University of York, Heslington, UK. cm535@york.ac.uk
Source:
Heart (HEART), 2009 Apr; 95 (7): 542-9.
Publication Type:
journal article - research, systematic review
Language:
English
Major Subjects:
Atrial Fibrillation -- Therapy
Catheter Ablation -- Economics
Life Table Method
Minor Subjects:
Antiarrhythmia Agents -- Economics; Antiarrhythmia Agents -- Therapeutic Use; Atrial Fibrillation -- Economics; Cost Benefit Analysis; Great Britain; Health Care Costs; Meta Analysis; Probability; Stroke -- Economics; Stroke -- Prevention and Control; Treatment Outcomes; Human
Abstract:
OBJECTIVE: To assess the cost-effectiveness of radiofrequency catheter ablation (RFCA) compared with anti-arrhythmic drug (AAD) therapy for the treatment of atrial fibrillation (AF) from the perspective of the UK NHS. DESIGN: Bayesian evidence synthesis and decision analytical model. METHODS: A systematic review and meta-analysis was conducted and Bayesian statistical methods used to synthesise the effectiveness evidence from randomised control trials. A decision analytical model was developed to assess the costs and consequences associated with the primary outcome of the trials over a lifetime time horizon. MAIN OUTCOME MEASURE: Costs from a health service perspective and outcomes measured as quality-adjusted life years (QALYs). RESULTS: The incremental cost-effectiveness ratio of RFCA varied between pound7763 and pound7910 for each additional QALY according to baseline risk of stroke, with a probability of being cost-effective from 0.98 to 0.99 for a cost-effectiveness threshold of pound20 000. Results were sensitive to the duration of quality of life benefits from treatment. CONCLUSIONS: RFCA is potentially cost-effective for the treatment of paroxysmal AF in patients' predominantly refractory to AAD therapy provided the quality-of-life benefits from treatment are maintained for more than 5 years. These findings remain subject to limitations in the existing evidence regarding the nature of life benefits and the prognostic importance of restoring normal sinus rhythm conferred using RFCA.
Journal Subset:
Biomedical; Blind Peer Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1355-6037
MEDLINE Info:
PMID: 19095714 NLM UID: 9602087
Entry Date:
20090508
Revision Date:
20110513
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1136/hrt.2008.147165
Accession Number:
2010223233
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010223233&site=ehost-live">Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom.</A>
Database:
CINAHL Plus
Record: 27
Title:
Diagnostic accuracy of endoscopic ultrasonography (EUS) for the preoperative locoregional staging of primary gastric cancer.
Authors:
Mocellin S; Pasquali S
Source:
Cochrane Database of Systematic Reviews (COCHRANE DATABASE SYST REV), 2015 (2): N.PAG.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Endosonography
Neoplasm Staging
Stomach Neoplasms -- Diagnosis
Minor Subjects:
Cochrane Library; Confidence Intervals; Embase; Human; Medline; Meta Analysis; Sensitivity and Specificity
Abstract:
Endoscopic ultrasound (EUS) is proposed as an accurate diagnostic device for the locoregional staging of gastric cancer, which is crucial to developing a correct therapeutic strategy and ultimately to providing patients with the best chance of cure. However, despite a number of studies addressing this issue, there is no consensus on the role of EUS in routine clinical practice. To provide both a comprehensive overview and a quantitative analysis of the published data regarding the ability of EUS to preoperatively define the locoregional disease spread (i.e., primary tumor depth (T-stage) and regional lymph node status (N-stage)) in people with primary gastric carcinoma. We performed a systematic search to identify articles that examined the diagnostic accuracy of EUS (the index test) in the evaluation of primary gastric cancer depth of invasion (T-stage, according to the AJCC/UICC TNM staging system categories T1, T2, T3 and T4) and regional lymph node status (N-stage, disease-free (N0) versus metastatic (N+)) using histopathology as the reference standard. To this end, we searched the following databases: the Cochrane Library (the Cochrane Central Register of Controlled Trials (CENTRAL)), MEDLINE, EMBASE, NIHR Prospero Register, MEDION, Aggressive Research Intelligence Facility (ARIF), ClinicalTrials.gov, Current Controlled Trials MetaRegister, and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), from 1988 to January 2015. We included studies that met the following main inclusion criteria: 1) a minimum sample size of 10 patients with histologically-proven primary carcinoma of the stomach (target condition); 2) comparison of EUS (index test) with pathology evaluation (reference standard) in terms of primary tumor (T-stage) and regional lymph nodes (N-stage). We excluded reports with possible overlap with the selected studies. For each study, two review authors extracted a standard set of data, using a dedicated data extraction form. We assessed data quality using a standard procedure according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) criteria. We performed diagnostic accuracy meta-analysis using the hierarchical bivariate method. We identified 66 articles (published between 1988 and 2012) that were eligible according to the inclusion criteria. We collected the data on 7747 patients with gastric cancer who were staged with EUS. Overall the quality of the included studies was good: in particular, only five studies presented a high risk of index test interpretation bias and two studies presented a high risk of selection bias.For primary tumor (T) stage, results were stratified according to the depth of invasion of the gastric wall. The meta-analysis of 50 studies (n = 4397) showed that the summary sensitivity and specificity of EUS in discriminating T1 to T2 (superficial) versus T3 to T4 (advanced) gastric carcinomas were 0.86 (95% confidence interval (CI) 0.81 to 0.90) and 0.90 (95% CI 0.87 to 0.93) respectively. For the diagnostic capacity of EUS to distinguish T1 (early gastric cancer, EGC) versus T2 (muscle-infiltrating) tumors, the meta-analysis of 46 studies (n = 2742) showed that the summary sensitivity and specificity were 0.85 (95% CI 0.78 to 0.91) and 0.90 (95% CI 0.85 to 0.93) respectively. When we addressed the capacity of EUS to distinguish between T1a (mucosal) versus T1b (submucosal) cancers the meta-analysis of 20 studies (n = 3321) showed that the summary sensitivity and specificity were 0.87 (95% CI 0.81 to 0.92) and 0.75 (95% CI 0.62 to 0.84) respectively. Finally, for the metastatic involvement of lymph nodes (N-stage), the meta-analysis of 44 studies (n = 3573) showed that the summary sensitivity and specificity were 0.83 (95% CI 0.79 to 0.87) and 0.67 (95% CI 0.61 to 0.72), respectively.Overall, as demonstrated also by the Bayesian nomograms, which enable readers to calculate post-test probabilities for any target condition prevalence, the EUS accuracy can be considered clinically useful to guide physicians in the locoregional staging of people with gastric cancer. However, it should be noted that between-study heterogeneity was not negligible: unfortunately, we could not identify any consistent source of the observed heterogeneity. Therefore, all accuracy measures reported in the present work and summarizing the available evidence should be interpreted cautiously. Moreover, we must emphasize that the analysis of positive and negative likelihood values revealed that EUS diagnostic performance cannot be considered optimal either for disease confirmation or for exclusion, especially for the ability of EUS to distinguish T1a (mucosal) versus T1b (submucosal) cancers and positive versus negative lymph node status. By analyzing the data from the largest series ever considered, we found that the diagnostic accuracy of EUS might be considered clinically useful to guide physicians in the locoregional staging of people with gastric carcinoma. However, the heterogeneity of the results warrants special caution, as well as further investigation for the identification of factors influencing the outcome of this diagnostic tool. Moreover, physicians should be warned that EUS performance is lower in diagnosing superficial tumors (T1a versus T1b) and lymph node status (positive versus negative). Overall, we observed large heterogeneity and its source needs to be understood before any definitive conclusion can be drawn about the use of EUS can be proposed in routine clinical settings.
Journal Subset:
Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Oncologic Care; Perioperative Care
ISSN:
1469-493X
MEDLINE Info:
NLM UID: 100909747
Cochrane AN:
CD009944
Entry Date:
20150626
Accession Number:
2013053799
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2013053799&site=ehost-live">Diagnostic accuracy of endoscopic ultrasonography (EUS) for the preoperative locoregional staging of primary gastric cancer.</A>
Database:
CINAHL Plus
Record: 28
Title:
Diagnostic accuracy of noninvasive fetal Rh genotyping from maternal blood--a meta-analysis.
Authors:
Geifman-Holtzman O; Grotegut CA; Gaughan JP
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Philadelphia, PA, USA. geifmao@tuhs.temple.edu
Source:
American Journal of Obstetrics & Gynecology (AM J OBSTET GYNECOL), 2006 Oct; 195 (4): 1163-73. (52 ref)
Publication Type:
journal article - research, systematic review, tables/charts
Language:
English
Major Subjects:
Genotype
RH Isoimmunization -- Diagnosis
Rh-Hr Blood-Group System
Minor Subjects:
CINAHL Database; Cochrane Library; Confidence Intervals; Diagnostic Errors; DNA -- Blood; Female; Meta Analysis; Predictive Value of Tests; Pregnancy; Pregnancy Trimesters; Prenatal Diagnosis; PubMed; Sensitivity and Specificity; Human
Abstract:
OBJECTIVE: The purpose of this study was to determine the reported diagnostic accuracy, the validity, and the current limitations of fetal Rh genotyping from peripheral maternal blood based on the existing English-written publications. STUDY DESIGN: A search of the English literature describing fetal RhD determination from maternal blood was conducted. From each study, we determined the number of samples tested, fetal RhD genotype, the source of the fetal DNA (maternal plasma, serum, or fetal cells), gestational age, and confirmation of fetal Rh type. The presence of alloimmunization and exclusions of tested samples were noted. For the meta-analysis we calculated composite estimates using 2 random effects models, weighted GLM and Bayesian. Sensitivity, specificity, positive and negative predictive values were calculated. RESULTS: We identified 37 English-written publications that included 44 protocols reporting noninvasive Rh genotyping using fetal DNA obtained from maternal blood on a total of 3261 samples. A total of 183 (183/3261, 5.6%) samples were excluded from the meta-analysis. The overall diagnostic accuracy after exclusions was 94.8%. The gestational ages ranged between 8 and 42 weeks gestation. Maternal serum and plasma were found to be the best source for accurate diagnosis of fetal RhD type in 394/410 (96.1%) and 2293/2377 (96.5%), respectively. There were 719/783 (91.8%) alloimmunized patients that were correctly diagnosed. There were 16 studies that reported 100% diagnostic accuracy in their fetal RhD genotyping. CONCLUSION: The diagnostic accuracy of noninvasive fetal Rh determination using maternal peripheral blood is 94.8%. Its use can be applicable to Rh prophylaxis and to the management of Rh alloimmunized pregnancies. Improvements of the technique and further study of structure and rearrangements of the RhD gene may improve accuracy of testing and enable large-scale, risk-free fetal RhD genotyping using maternal blood.
Journal Subset:
Biomedical; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Obstetric Care; Women's Health
ISSN:
0002-9378
MEDLINE Info:
PMID: 17000250 NLM UID: 0370476
Entry Date:
20070112
Revision Date:
20091218
Accession Number:
2009301402
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2009301402&site=ehost-live">Diagnostic accuracy of noninvasive fetal Rh genotyping from maternal blood--a meta-analysis.</A>
Database:
CINAHL Plus
Record: 29
Title:
Discordance in Hormone Receptor Status Among Primary, Metastatic, and Second Primary Breast Cancers: Biological Difference or Misclassification?
Authors:
Sighoko, Dominique; Juxin Liu; Ningqi Hou; Gustafson, Paul; Dezheng Huo
Affiliation:
Center for Clinical Cancer Genetics and Global Health, Department of Medicine, University of Chicago, Chicago, Illinois, USA
Department of Mathematics and Statistics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Department of Health Studies, University of Chicago, Chicago, Illinois, USA
Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
Source:
Oncologist (ONCOLOGIST), 2014; 19 (6): 592-601.
Publication Type:
journal article - equations & formulas, meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Breast Neoplasms -- Classification
Breast Neoplasms -- Pathology
Receptors, Cell Surface
Sex Hormones
Minor Subjects:
Human; Education, Continuing (Credit); Systematic Review; Meta Analysis; Biological Assay; Estrogens; Progesterone; Female; PubMed; Descriptive Statistics; Data Analysis Software; Confidence Intervals; Regression; Odds Ratio; Sensitivity and Specificity; Funding Source
Abstract:
Introduction. Discordance in hormone receptor status has been observed between two breast tumors of the same patients; however, the degree of heterogeneity is debatable with regard to whether it reflects true biological difference or the limited accuracy of receptor assays. Methods. A Bayesian misclassification correction method was applied to data on hormone receptor status of two primary breast cancers from the Surveillance, Epidemiology, and End Results database between 1990 and 2010 and to data on primary breast cancer and paired recurrent/metastatic disease assembled from a meta-analysis of the literature published between 1979 and 2014. Results. The sensitivity and specificity of the estrogen receptor (ER) assay were estimated to be 0.971 and 0.920, respectively. After correcting for misclassification, the discordance in ER between two primary breast cancers was estimated to be 1.2% for synchronous ipsilateral pairs, 5.0% for synchronous contralateral pairs, 14.6% for metachronous ipsilateral pairs, and 25.0% for metachronous contralateral pairs. Technical misclassification accounted for 53%-83% of the ER discordance between synchronous primary cancers and 11%-25% of the ER discordance between metachronous cancers. The corrected discordance in ER between primary tumors and recurrent or metastatic lesions was 12.4%, and there were more positive-to-negative changes (10.1%) than negative-topositive changes (2.3%). Similar patterns were observed for progesterone receptor (PR), although the overall discordance in PR was higher. Conclusion. A considerable proportion of discordance in hormone receptor status can be attributed to misclassification in receptor assessment, although the accuracy of receptor assays was excellent. Biopsy of recurrent tumors for receptor retesting should be conducted after considering feasibility, cost, and previous ER/PR status.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care; Women's Health
ISSN:
1083-7159
MEDLINE Info:
PMID: 24807915 NLM UID: 9607837
Grant Information:
This project is partially supported by the American Cancer Society (Grant MRSG-13-063-01).
Note:
For CE see website.
Entry Date:
20141107
Revision Date:
20150116
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1634/theoncologist.2013-0427
Accession Number:
2012775593
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012775593&site=ehost-live">Discordance in Hormone Receptor Status Among Primary, Metastatic, and Second Primary Breast Cancers: Biological Difference or Misclassification?</A>
Database:
CINAHL Plus
Record: 30
Title:
Early high-dose lipid-lowering therapy to avoid cardiac events: a systematic review and economic evaluation.
Authors:
Ara R; Pandor A; Stevens J; Rees A; Rafia R
Affiliation:
The University of Sheffield, School of Health and Related Research (ScHARR), UK
Source:
Health Technology Assessment (HEALTH TECHNOL ASSESS), 2009; 13 (34): 1-118.
Publication Type:
journal article - research, systematic review
Language:
English
Major Subjects:
Antilipemic Agents -- Administration and Dosage
Dose-Response Relationship, Drug
Heart Diseases -- Prevention and Control
Hyperlipidemia -- Drug Therapy
Minor Subjects:
Adult; Aged; Aged, 80 and Over; Antilipemic Agents -- Adverse Effects; Antilipemic Agents -- Economics; CINAHL Database; Cochrane Library; Cost Benefit Analysis; Embase; Female; Male; Medline; Meta Analysis; Middle Age; Human
Abstract:
OBJECTIVE: To evaluate the cost-effectiveness of high-dose statins (atorvastatin 80 mg/day, rosuvastatin 40 mg/day and simvastatin 80 mg/day) versus simvastatin 40 mg/day in individuals with acute coronary syndrome (ACS). DATA SOURCES: Eleven bibliographic databases, including MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, DARE and NHS EED, were searched from inception to 2008. REVIEW METHODS: Data relating to study design, baseline patient characteristics, clinical or surrogate outcome, and adverse events were abstracted, and methodological quality was assessed according to standard methods. A synthesis of the available evidence was performed using a Bayesian mixed treatment meta-analysis using both direct and indirect evidence. An existing Markov model was modified to explore the costs and benefits associated with a lifetime of the differing treatment regimens. RESULTS: A total of 3345 titles and abstracts were screened for inclusion in the review of clinical effectiveness and 125 full papers retrieved and assessed in detail. Of these, 30 papers met the inclusion criteria for the review, describing 28 trials. The Bayesian mixed treatment meta-analysis demonstrated a clear dose-response relationship in terms of reductions in low-density lipoprotein cholesterol (LDL-c), with rosuvastatin 40 mg/day achieving the greatest percentage reduction (56%) from baseline, followed by atorvastatin 80 mg/day (52%), simvastatin 80 mg/day (45%) and simvastatin 40 mg/day (37%). Although serious adverse events with statins are rare, their incidence is likely to be greater with higher doses. Several clinical scenarios were used to explore the effect of adherence on the cost-effectiveness of the treatment regimens. Using a threshold of 20,000 pounds per quality-adjusted life-year (QALY) and assuming that the benefits and adherence rates observed in the clinical trials are generalisable to a clinical setting and that individuals who do not tolerate the higher-dose statins are prescribed simvastatin 40 mg/day, then simvastatin 80 mg/day, atorvastatin 80 mg/day and rosuvastatin 40 mg/day would be considered cost-effective compared with simvastatin 40 mg/day in individuals with ACS. Simvastatin 80 mg/day is not well tolerated because of the high incidence rates of less severe adverse events such as myopathy (26-fold higher than rates in those receiving simvastatin 20 mg/day), which are likely to affect adherence levels in clinical practice. The reference case shows that rosuvastatin is the optimal treatment for individuals with a recent history of ACS using a threshold of 20,000 pounds per QALY. However, this is based on the assumption that the additional incremental reductions in LDL-c observed in patients treated with rosuvastatin 40 mg/day compared with atorvastatin will transfer into corresponding changes in relative risks of cardiovascular events. CONCLUSIONS: Simvastatin 80 mg/day cannot be recommended because of the high incidence rates of adverse events. If the cost of atorvastatin decreases in line with that observed for simvastatin when the patent ends in 2011, atorvastatin 80 mg/day will be the most cost-effective treatment for all thresholds; if the cost reduces to 25% of the current value, atorvastatin 80 mg/day will be the most cost-effective treatment for thresholds between 5000 pounds and 30,000 pounds per QALY. Large long-term RCTs reporting effects in terms of clinical events are required to determine the optimum statin use for subgroups.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1366-5278
MEDLINE Info:
PMID: 19604457 NLM UID: 9706284
Entry Date:
20091113
Revision Date:
20110520
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.3310/hta13340
Accession Number:
2010345905
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010345905&site=ehost-live">Early high-dose lipid-lowering therapy to avoid cardiac events: a systematic review and economic evaluation.</A>
Database:
CINAHL Plus
Record: 31
Title:
Effect of early and late GB virus C viraemia on survival of HIV-infected individuals: a meta-analysis.
Authors:
Zhang W; Chaloner K; Tillmann HL; Williams CF; Stapleton JT
Affiliation:
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA
Source:
HIV Medicine (HIV MED), 2006 Apr; 7 (3): 173-80. (39 ref)
Publication Type:
journal article - equations & formulas, research, systematic review, tables/charts
Language:
English
Major Subjects:
Hepatitis Viruses
HIV Infections -- Mortality
Minor Subjects:
Adult; Comorbidity; Confidence Intervals; Cox Proportional Hazards Model; Female; Male; Mantel-Haenszel Test; Medline; Meta Analysis; PubMed; Funding Source; Human
Abstract:
OBJECTIVES: To conduct a meta-analysis to synthesize the evidence regarding the effect of co-infection with GB virus C (GBV-C) on survival of HIV-infected individuals, and to estimate the effect. METHODS: A Bayesian meta-analysis was conducted to synthesize evidence from eligible studies. Prospective survival studies of HIV-1-infected individuals, with outcome defined as time from baseline to all-cause death, were included and classified by whether GBV-C status was determined in early or late HIV disease. The primary measure was the hazard ratio (HR) of death for HIV-infected individuals with GBV-C infection versus those without GBV-C infection. RESULTS: Eleven studies from eight publications met the inclusion criteria. For studies with GBV-C status measured 2 years or less after HIV seroconversion (912 subjects), the combined HR was 0.88 [95% credible interval (CI) 0.30, 1.50]. For studies with GBV-C status measured more than 2 years after HIV seroconversion (1294 subjects), the combined HR was 0.41 (95% CI 0.23, 0.69). CONCLUSIONS: No conclusive evidence was found of an association between survival and GBV-C infection early in HIV disease. However, when GBV-C infection was present later in HIV disease, a significant reduction in the hazard for mortality was observed for those with co-infection. Potential explanations for this difference include a non-proportional benefit of GBV-C over time, possibly related to clearance of GBV-C infection early in HIV disease. The timing of GBV-C infection appears to account for the contradictory results of studies on the effect of GBV-C coinfection on survival of HIV-infected people.
Journal Subset:
Biomedical; Europe; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1464-2662
MEDLINE Info:
PMID: 16494631 NLM UID: 100897392
Grant Information:
Funded in part, Merit Review Grant, Veterans Administration, NIH Grants AI 058740, NIAID (R01 058740, U01-AI31834, U01-34994, U01-AI34993, U01-AI42590), NICHD (U01-HD32632), NCCR (M01-RR00071, M01-RR00079, M01-RR00083); Supplemental Funding, NCI; NIDA; NIDCR; National Security Agency (H98230-04-1-0042); Paul Blümel Foundation, Hannover, Germany; Kompetenznetz Hepatitis, Federal Ministry for Education and Research of Germany; National Institute of Allergy and Infectious Disease; Supplemental Funding, National Cancer Institute; National Heart, Lung, and Blood Institute: UO1-AI-35042, 5-M01-RR-00052 (GCRC), UO1-AI-35043, UO1-AI-37984, UO1-AI-35039, UO1-AI-35040, UO1-AI-37613, UO1-AI-35041
Entry Date:
20060407
Revision Date:
20091218
Accession Number:
2009140402
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2009140402&site=ehost-live">Effect of early and late GB virus C viraemia on survival of HIV-infected individuals: a meta-analysis.</A>
Database:
CINAHL Plus
Record: 32
Title:
Effect of initial treatment strategy on survival of patients with advanced-stage Hodgkin's lymphoma: a systematic review and network meta-analysis.
Authors:
Skoetz, Nicole; Trelle, Sven; Rancea, Michaela; Haverkamp, Heinz; Diehl, Volker; Engert, Andreas; Borchmann, Peter
Affiliation:
Cochrane Haematological Malignancies Group, University Hospital of Cologne, Cologne, Germany
Source:
Lancet Oncology (LANCET ONCOL), 2013 Sep; 14 (10): 943-52.
Commentary:
André, Marc, Bosly, André. BEACOPPescalated versus ABVD in advanced Hodgkin's lymphoma. LANCET ONCOL 2013 Sep; 14(10): 911-2 (commentary) (2012245137)
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Antineoplastic Agents, Combined -- Therapeutic Use
Hodgkin's Disease -- Drug Therapy
Hodgkin's Disease -- Mortality
Minor Subjects:
Antineoplastic Agents, Alkylating -- Administration and Dosage; Antineoplastic Agents, Combined -- Administration and Dosage; Benzamides -- Administration and Dosage; Bleomycins -- Administration and Dosage; Cochrane Library; Cyclophosphamide -- Administration and Dosage; Doxorubicin -- Administration and Dosage; Etoposide -- Administration and Dosage; Human; Medline; Meta Analysis; Prednisone -- Administration and Dosage; Systematic Review; Vinblastine -- Administration and Dosage; Vincristine -- Administration and Dosage
Abstract:
BACKGROUND: Several treatment strategies are available for adults with advanced-stage Hodgkin's lymphoma, but studies assessing two alternative standards of care-increased dose bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPescalated), and doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD)-were not powered to test differences in overall survival. To guide treatment decisions in this population of patients, we did a systematic review and network meta-analysis to identify the best initial treatment strategy. METHODS: We searched the Cochrane Library, Medline, and conference proceedings for randomised controlled trials published between January, 1980, and June, 2013, that assessed overall survival in patients with advanced-stage Hodgkin's lymphoma given BEACOPPbaseline, BEACOPPescalated, BEACOPP variants, ABVD, cyclophosphamide (mechlorethamine), vincristine, procarbazine, and prednisone (C[M]OPP), hybrid or alternating chemotherapy regimens with ABVD as the backbone (eg, COPP/ABVD, MOPP/ABVD), or doxorubicin, vinblastine, mechlorethamine, vincristine, bleomycin, etoposide, and prednisone combined with radiation therapy (the Stanford V regimen). We assessed studies for eligibility, extracted data, and assessed their quality. We then pooled the data and used a Bayesian random-effects model to combine direct comparisons with indirect evidence. We also reconstructed individual patient survival data from published Kaplan-Meier curves and did standard random-effects Poisson regression. Results are reported relative to ABVD. The primary outcome was overall survival. FINDINGS: We screened 2055 records and identified 75 papers covering 14 eligible trials that assessed 11 different regimens in 9993 patients, providing 59651 patient-years of follow-up. 1189 patients died, and the median follow-up was 5·9 years (IQR 4·9-6·7). Included studies were of high methodological quality, and between-trial heterogeneity was negligible ((2)=0·01). Overall survival was highest in patients who received six cycles of BEACOPPescalated (HR 0·38, 95% credibility interval [CrI] 0·20-0·75). Compared with a 5 year survival of 88% for ABVD, the survival benefit for six cycles of BEACOPPescalated is 7% (95% CrI 3-10)-ie, a 5 year survival of 95%. Reconstructed individual survival data showed that, at 5 years, BEACOPPescalated has a 10% (95% CI 3-15) advantage over ABVD in overall survival. INTERPRETATION: Six cycles of BEACOPPescalated significantly improves overall survival compared with ABVD and other regimens, and thus we recommend this treatment strategy as standard of care for patients with access to the appropriate supportive care. FUNDING: None.
Journal Subset:
Biomedical; Europe; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
1470-2045
MEDLINE Info:
PMID: 23948348 NLM UID: 100957246
Entry Date:
20131115
Revision Date:
20150220
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/S1470-2045(13)70341-3
Accession Number:
2012245138
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012245138&site=ehost-live">Effect of initial treatment strategy on survival of patients with advanced-stage Hodgkin's lymphoma: a systematic review and network meta-analysis.</A>
Database:
CINAHL Plus
Record: 33
Title:
Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions.
Authors:
Graziani, Filippo; Gennai, Stefano; Roldán, Silvia; Discepoli, Nicola; Buti, Jacpop; Madianos, Phoebus; Herrera, David
Affiliation:
Unit of Dentistry and Oral Surgery, Department of Surgical & Medical Pathology, University of Pisa
Section of Graduate Periodontology, University Complutense
Unit of Dentistry and Oral Surgery, Department of Surgical & Medical Pathology, University of Pisa
School of Dentistry, The University of Manchester
School of Dentistry, University of Athens
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2014 Apr: Supplement: S63-76.
Publication Type:
journal article - meta analysis, proceedings, research, systematic review, tables/charts
Language:
English
Major Subjects:
Surgery, Plastic
Periodontium -- Surgery
Gingival Recession -- Surgery
Minor Subjects:
Human; Congresses and Conferences; Europe; Treatment Outcomes; Systematic Review; Meta Analysis; Medline -- Utilization; Embase -- Utilization; Databases -- Utilization
Abstract:
Objective To systematically review the efficacy of periodontal plastic procedures ( PPP) in the treatment of multiple gingival recessions ( MGR). Methods Randomized clinical trials ( RCT) on MGR treatment with at least 6 months duration were identified through electronic databases and hand-searched journals. Primary outcomes were complete root coverage ( CRC) and percentage of root coverage ( PRC). Weighted means and forest plots were calculated for all PPP. Subgroup analysis was performed according to the type of flap. A Bayesian network meta-analysis ( NM) on secondary outcomes was also performed. Results Nine trials including 208 subjects and 858 recessions were identified. CRC after PPP was 24-89%. Mean weighted PRC was 86.27% (95% CI 80.71-91.83; p < 0.01). Heterogeneity of the literature prevented inter-techniques comparison. Coronally advanced flap ( CAF) shows the higher variability in terms of CRC. Modified CAF and tunnel approaches show higher level of CRC. The NM suggests that CAF plus graft showed the higher probability of being the best treatment. Conclusions Limited evidence is available for MGR coverage. PPP are associated with high level of efficacy, in terms of PRC, and high variability of CRC. Indirect evidence indicates that CAF may benefit from newer variations of the technique and by the additional use of grafting.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
NLM UID: 0425123
Entry Date:
20140328
Revision Date:
20150410
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jcpe.12172
Accession Number:
2012510301
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012510301&site=ehost-live">Efficacy of periodontal plastic procedures in the treatment of multiple gingival recessions.</A>
Database:
CINAHL Plus
Record: 34
Title:
Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients: an indirect comparison using Bayesian network meta-analysis.
Authors:
Cure S; Diels J; Gavart S; Bianic F; Jones E
Source:
Current Medical Research & Opinion (CURR MED RES OPIN), 2012 Nov; 28 (11): 1841-56.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Antiviral Agents -- Therapeutic Use
Hepatitis C, Chronic -- Drug Therapy
Hepatitis Viruses
Oligopeptides -- Therapeutic Use
Probability
Proline
Minor Subjects:
Antiviral Agents -- Administration and Dosage; Clinical Trials; Drug Therapy, Combination; Genotype; Hepatitis C, Chronic; Human; Meta Analysis; Oligopeptides -- Administration and Dosage; Proline -- Administration and Dosage; Proline -- Therapeutic Use; Systematic Review
Abstract:
Abstract Background and aims: To indirectly compare the efficacy of telaprevir (TVR) and boceprevir (BOC) combined with peginterferon/ribavirin [alpha]-2a/2b (PR) in achieving sustained viral response (SVR) in treatment-naïve and treatment-experienced patients with genotype 1 chronic hepatitis C virus (HCV) infection. Methods: A systematic literature review was conducted to identify randomized controlled trials reporting the efficacy of PR-based treatment in genotype 1 chronic HCV patients. A Bayesian network meta-analysis was performed on the endpoint of SVR, assuming fixed study effects. For treatment-experienced patients, only previous relapsers and partial responders were included, as no results in prior null responders were available for boceprevir. Results: Eleven publications were included. In treatment-naïve patients, the odds ratios (OR) (posterior median [95% credible interval]) for telaprevir (12 weeks + response guided treatment [RGT] 24/48 weeks PR) and boceprevir (24 weeks + RGT 28/48 weeks PR) versus PR were respectively 3.80 (2.78-5.22) and 2.99 (2.23-4.01). The OR for telaprevir versus boceprevir was 1.42 (0.89-2.25), with a probability for telaprevir being more effective (P[OR > 1]) of 0.93. In treatment-experienced patients, the OR of telaprevir (12 weeks + 48 weeks PR) and boceprevir (32 weeks + RGT 36/48 weeks PR) versus PR were respectively 13.11 (7.30-24.43) and 5.36 (2.90-10.30). The OR for telaprevir versus boceprevir was 2.45 (1.02-5.80), with telaprevir having a probability of 0.98 of being more effective. Limitations: The main limitation of this study is the low number of trials included in the analysis, especially for the treatment-experienced patient population, which only allowed random-effect models to be explored. We tried to identify potential biases due to study heterogeneity. Conclusions: In the absence of direct comparative head-to-head studies between telaprevir and boceprevir for the treatment of chronic HCV genotype 1 patients, an indirect comparison based on Bayesian network meta-analysis suggests better efficacy for telaprevir than boceprevir in both treatment-naïve and treatment-experienced patients.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
0300-7995
MEDLINE Info:
PMID: 23016967 NLM UID: 0351014
Entry Date:
20130503
Revision Date:
20130503
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1185/03007995.2012.734798
Accession Number:
2011745827
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011745827&site=ehost-live">Efficacy of telaprevir and boceprevir in treatment-naïve and treatment-experienced genotype 1 chronic hepatitis C patients: an indirect comparison using Bayesian network meta-analysis.</A>
Database:
CINAHL Plus
Record: 35
Title:
Evidence based policy decisions through a Bayesian approach: the case of a statin appraisal in the Netherlands.
Authors:
Woertman, Willem; Vermeulen, Bram; Groenewoud, Hans; van der Wilt, Gert Jan
Affiliation:
Radboud University Nijmegen Medical Centre, Department for Health Evidence, The Netherlands. Electronic address: W.Woertman@ebh.umcn.nl
Source:
Health Policy (HEALTH POLICY), 2013 Oct; 112 (3): 234-40.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Antilipemic Agents -- Economics
Decision Making
Drug and Narcotic Control
Fatty Acids -- Economics
Heterocyclic Compounds -- Economics
Practice Patterns -- Statistics and Numerical Data
Simvastatin -- Economics
Minor Subjects:
Human; Insurance, Health, Reimbursement; Medical Practice, Evidence-Based; Meta Analysis; Netherlands; Probability; Systematic Review
Abstract:
It has often been suggested that Bayesian statistics is more congenial to the informational needs of policy makers than the standard frequentist methods. In order to illustrate this claim, we use both a Bayesian and a frequentist approach for revisiting a recommendation by the Dutch National Health Insurance Board that for all patients requiring lipid reduction, the cheapest alternative (Simvastatin) should be prescribed. We investigate whether Simvastatin and Atorvastatin, the most commonly used alternative, can be considered equivalent in terms of lipid control for patients with heterozygous familial hypercholesterolemia. Priors were elicited from GPs, cardiologists and internists. A systematic review for studies comparing Simvastatin and Atorvastatin was performed. The data from these studies were combined with the priors in a Bayesian meta-analysis. For comparability a frequentist meta-analysis was also performed. The two approaches lead to similar point estimates and 95% intervals. However, the Bayesian outcomes are easier to understand and interpret, and our Bayesian analysis leads to additional outcomes that would have more direct pertinence for policy makers, and which could help them to assess what the data have to say about the questions that are most relevant to the problems they face.
Journal Subset:
Continental Europe; Double Blind Peer Reviewed; Europe; Health Services Administration; Peer Reviewed
Special Interest:
Evidence-Based Practice
ISSN:
0168-8510
MEDLINE Info:
PMID: 23920344 NLM UID: 8409431
Entry Date:
20140905
Revision Date:
20140905
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1016/j.healthpol.2013.06.015
Accession Number:
2012363325
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012363325&site=ehost-live">Evidence based policy decisions through a Bayesian approach: the case of a statin appraisal in the Netherlands.</A>
Database:
CINAHL Plus
Record: 36
Title:
Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals.
Authors:
Holme Ø; Bretthauer M; Fretheim A; Odgaard-Jensen J; Hoff G
Source:
Cochrane Database of Systematic Reviews (COCHRANE DATABASE SYST REV), 2013 (9): N.PAG.
Publication Type:
journal article - research, systematic review
Language:
English
Major Subjects:
Cancer Screening
Colorectal Neoplasms
Occult Blood
Sigmoidoscopy
Minor Subjects:
Confidence Intervals; Human; Relative Risk
Abstract:
Colorectal cancer is the third most frequent cancer in the world. As the sojourn time for this cancer is several years and a good prognosis is associated with early stage diagnosis, screening has been implemented in a number of countries. Both screening with faecal occult blood test and flexible sigmoidoscopy have been shown to reduce mortality from colorectal cancer in randomised controlled trials. The comparative effectiveness of these tests on colorectal cancer mortality has, however, never been evaluated, and controversies exist over which test to choose. To compare the effectiveness of screening for colorectal cancer with flexible sigmoidoscopy to faecal occult blood testing. We searched MEDLINE and EMBASE (November 16, 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (2012, Issue 11) and reference lists for eligible studies. Randomised controlled trials comparing screening with flexible sigmoidoscopy or faecal occult blood testing to each other or to no screening. Only studies reporting mortality from colorectal cancer were included. Faecal occult blood testing had to be repeated (annually or biennially). Data retrieval and assessment of risk of bias were performed independently by two review authors. Standard meta-analyses using a random-effects model were conducted for flexible sigmoidoscopy and faecal occult blood testing (FOBT) separately and we calculated relative risks with 95% confidence intervals (CI). We used a Bayesian approach (a contrast-based network meta-analysis method) for indirect analyses and presented the results as posterior median relative risk with 95% credibility intervals. We assessed the quality of evidence using GRADE. We identified nine studies comprising 338,467 individuals randomised to screening and 405,919 individuals to the control groups. Five studies compared flexible sigmoidoscopy to no screening and four studies compared repetitive guaiac-based FOBT (annually and biennially) to no screening. We did not consider that study risk of bias reduced our confidence in our results. We did not identify any studies comparing the two screening methods directly. When compared with no screening, colorectal cancer mortality was lower with flexible sigmoidoscopy (relative risk 0.72; 95% CI 0.65 to 0.79, high quality evidence) and FOBT (relative risk 0.86; 95% CI 0.80 to 0.92, high quality evidence). In the analyses based on indirect comparison of the two screening methods, the relative risk of dying from colorectal cancer was 0.85 (95% credibility interval 0.72 to 1.01, low quality evidence) for flexible sigmoidoscopy screening compared to FOBT. No complications occurred after the FOBT test itself, but 0.03% of participants suffered a major complication after follow-up. Among more than 60,000 flexible sigmoidoscopy screening procedures and almost 6000 work-up colonoscopies, a major complication was recorded in 0.08% of participants. Adverse event data should be interpreted with caution as the reporting of adverse effects was incomplete. There is high quality evidence that both flexible sigmoidoscopy and faecal occult blood testing reduce colorectal cancer mortality when applied as screening tools. There is low quality indirect evidence that screening with either approach reduces colorectal cancer deaths more than the other. Major complications associated with screening require validation from studies with more complete reporting of harms.
[CINAHL Note: The Cochrane Collaboration systematic reviews contain interactive software that allows various calculations in the MetaView.]
Journal Subset:
Europe; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
1469-493X
MEDLINE Info:
PMID: 24085634 NLM UID: 100909747
Cochrane AN:
CD009259
Entry Date:
20131122
Revision Date:
20150619
Accession Number:
2012376556
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012376556&site=ehost-live">Flexible sigmoidoscopy versus faecal occult blood testing for colorectal cancer screening in asymptomatic individuals.</A>
Database:
CINAHL Plus
Record: 37
Title:
Health-related quality of life in systemic sclerosis: A systematic review.
Authors:
Hudson M; Thombs BD; Steele R; Panopalis P; Newton E; Baron M
Affiliation:
SMBD-Jewish General Hospital and McGill University, Montreal, Quebec, Canada
Corporate Authors:
Canadian Scleroderma Research GroupInvestigators of the Canadian Scleroderma Research Group are listed in Appendix A
Source:
Arthritis & Rheumatism: Arthritis Care & Research (ARTHRITIS RHEUM (ARTHRITIS CARE RES)), 2009 Aug 15; 61 (8): 1112-20.
Publication Type:
journal article - research, systematic review
Language:
English
Major Subjects:
Health Status
Quality of Life
Scleroderma, Systemic -- Physiopathology
Severity of Illness Indices
Minor Subjects:
Activities of Daily Living; CINAHL Database; Embase; Medline; Mental Health; Meta Analysis; Questionnaires; Reference Databases; Scleroderma, Systemic -- Psychosocial Factors; Short Form-36 Health Survey (SF-36); Human
Abstract:
OBJECTIVE: A number of studies (all n <200) have assessed health-related quality of life (HRQOL) in patients with systemic sclerosis (SSc), but no systematic review of the effect of SSc on HRQOL has been done. The objective of this study was to systematically review the literature on HRQOL in SSc measured using the Medical Outcomes Trust Short Form 36 (SF-36). METHODS: A comprehensive search was conducted in August 2007 using Medline, CINAHL, and EMBase to identify original research studies reporting SF-36 scores of SSc patients. Selected studies were reviewed and characteristics of the study samples and SF-36 data were extracted. Bayesian meta-analysis and meta-regression were performed to obtain pooled estimates of SF-36 physical component summary (PCS) and mental component summary (MCS) scores for all patients as well as by limited and diffuse disease status. RESULTS: Twelve data sets with a total of 1,127 SSc patients were included in the systematic review. HRQOL was impaired in patients with SSc, with pooled SF-36 PCS scores being more than 1 SD below the general population (38.3; 95% credible interval [95% CI] 35.2, 41.5) and pooled SF-36 MCS scores being approximately 0.5 SDs below the general population (46.6; 95% CI 44.2, 49.1). SF-36 PCS scores were 3.5 points (95% CI -1.0, 8.0) lower in patients with diffuse compared with limited disease. CONCLUSION: This study provides robust evidence of the presence and magnitude of impairment in HRQOL in patients with SSc. Although the impairment appears greater in physical health, mental health impairment is also reported.
Journal Subset:
Biomedical; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
Instrumentation:
Health-Related Quality of Life (HRQOL)
Short Form-36 Health Survey (SF-36)
Physical Component Summary (PCS)
Mental Component Summary (MCS)
ISSN:
0004-3591
MEDLINE Info:
PMID: 19644906 NLM UID: 0370605
Entry Date:
20090925
Revision Date:
20110520
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1002/art.24676
Accession Number:
2010367589
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010367589&site=ehost-live">Health-related quality of life in systemic sclerosis: A systematic review.</A>
Database:
CINAHL Plus
Record: 38
Title:
Immunomodulators and immunosuppressants for multiple sclerosis: a network meta-analysis.
Authors:
Filippini G; Del Giovane C; Vacchi L; D'Amico R; Di Pietrantonj C; Beecher D; Salanti G
Source:
Cochrane Database of Systematic Reviews (COCHRANE DATABASE SYST REV), 2013 (6): N.PAG.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Immunologic Factors -- Therapeutic Use
Immunosuppressive Agents -- Therapeutic Use
Multiple Sclerosis -- Drug Therapy
Treatment Outcomes
Minor Subjects:
Adrenal Cortex Hormones -- Therapeutic Use; Antibodies, Monoclonal -- Therapeutic Use; Cochrane Library; Confidence Intervals; Database Quality; Disease Progression -- Prevention and Control; Human; Interferons -- Therapeutic Use; Meta Analysis; Odds Ratio; Recurrence -- Prevention and Control; Time Factors
Abstract:
Different therapeutic strategies are available for treatment of multiple sclerosis (MS) including immunosuppressants, immunomodulators, and monoclonal antibodies. Their relative effectiveness in the prevention of relapse or disability progression is unclear due to the limited number of direct comparison trials. A summary of the results, including both direct and indirect comparisons of treatment effects, may help to clarify the above uncertainty. To estimate the relative efficacy and acceptability of interferon A-1b (IFNA-1b) (Betaseron), interferon A-1a (IFNA-1a) (Rebif and Avonex), glatiramer acetate, natalizumab, mitoxantrone, methotrexate, cyclophosphamide, azathioprine, intravenous immunoglobulins, and long-term corticosteroids versus placebo or another active agent in participants with MS and to provide a ranking of the treatments according to their effectiveness and risk-benefit balance. We searched the Cochrane Database of Systematic Reviews, the Cochrane MS Group Trials Register, and the Food and Drug Administration (FDA) reports. The most recent search was run in February 2012. Randomized controlled trials (RCTs) that studied one of the 11 treatments for use in adults with MS and that reported our pre-speciïed efficacy outcomes were considered for inclusion. Identifying search results and data extraction were performed independently by two authors. Data synthesis was performed by pairwise meta-analysis and network meta-analysis that was performed within a Bayesian framework. The body of evidence for outcomes within the pairwise meta-analysis was assessed according to GRADE, as very low, low, moderate, or high quality. Forty-four trials were included in this review, in which 17,401 participants had been randomised. Twenty-three trials included relapsing-remitting MS (RRMS) (9096 participants, 52%), 18 trials included progressive MS (7726, 44%), and three trials included both RRMS and progressive MS (579, 3%). The majority of the included trials were short-term studies, with the median duration being 24 months. The results originated mostly from 33 trials on IFNA, glatiramer acetate, and natalizumab that overall contributed outcome data for 9881 participants (66%).From the pairwise meta-analysis, there was high quality evidence that natalizumab and IFNA-1a (Rebif) were effective against recurrence of relapses in RRMS during the first 24 months of treatment compared to placebo (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.24 to 0.43; OR 0.45, 95% CI 0.28 to 0.71, respectively); they were more effective than IFNA-1a (Avonex) (OR 0.28, 95% CI 0.22 to 0.36; OR 0.19, 95% CI 0.06 to 0.60, respectively). IFNA-1b (Betaseron) and mitoxantrone probably decreased the odds of the participants with RRMS having clinical relapses compared to placebo (OR 0.55, 95% CI 0.31 to 0.99; OR 0.15, 95% CI 0.04 to 0.54, respectively) but the quality of evidence for these treatments was graded as moderate. From the network meta-analysis, the most effective drug appeared to be natalizumab (median OR versus placebo 0.29, 95% credible intervals (CrI) 0.17 to 0.51), followed by IFNA-1a (Rebif) (median OR versus placebo 0.44, 95% CrI 0.24 to 0.70), mitoxantrone (median OR versus placebo 0.43, 95% CrI 0.20 to 0.87), glatiramer acetate (median OR versus placebo 0.48, 95% CrI 0.38 to 0.75), IFNA-1b (Betaseron) (median OR versus placebo 0.48, 95% CrI 0.29 to 0.78). However, our confidence was moderate for direct comparison of mitoxantrone and IFNB-1b vs placebo and very low for direct comparison of glatiramer vs placebo. The relapse outcome for RRMS at three years' follow-up was not reported by any of the included trials.Disability progression was based on surrogate markers in the majority of included studies and was unavailable for RRMS beyond two to three years. The pairwise meta-analysis suggested, with moderate quality evidence, that natalizumab and IFNA-1a (Rebif) probably decreased the odds of the participants with RRMS having disability progression at two years' follow-up, with an absolute reduction of 14% and 10%, respectively, compared to placebo. Natalizumab and IFNA-1b (Betaseron) were significantly more effective (OR 0.62, 95% CI 0.49 to 0.78; OR 0.35, 95% CI 0.17 to 0.70, respectively) than IFNA-1a (Avonex) in reducing the number of the participants with RRMS who had progression at two years' follow-up, and confidence in this result was graded as moderate. From the network meta-analyses, mitoxantrone appeared to be the most effective agent in decreasing the odds of the participants with RRMS having progression at two years' follow-up, but our confidence was very low for direct comparison of mitoxantrone vs placebo. Both pairwise and network meta-analysis revealed that none of the individual agents included in this review were effective in preventing disability progression over two or three years in patients with progressive MS.There was not a dose-effect relationship for any of the included treatments with the exception of mitoxantrone. Our review should provide some guidance to clinicians and patients. On the basis of high quality evidence, natalizumab and IFNA-1a (Rebif) are superior to all other treatments for preventing clinical relapses in RRMS in the short-term (24 months) compared to placebo. Moderate quality evidence supports a protective effect of natalizumab and IFNA-1a (Rebif) against disability progression in RRMS in the short-term compared to placebo. These treatments are associated with long-term serious adverse events and their benefit-risk balance might be unfavourable. IFNA-1b (Betaseron) and mitoxantrone probably decreased the odds of the participants with RRMS having relapses, compared with placebo (moderate quality of evidence). The benefit-risk balance with azathioprine is uncertain, however this agent might be effective in decreasing the odds of the participants with RRMS having relapses and disability progression over 24 to 36 months, compared with placebo. The lack of convincing efficacy data shows that IFNA-1a (Avonex), intravenous immunoglobulins, cyclophosphamide and long-term steroids have an unfavourable benefit-risk balance in RRMS. None of the included treatments are effective in decreasing disability progression in patients with progressive MS. It is important to consider that the clinical effects of all these treatments beyond two years are uncertain, a relevant point for a disease of 30 to 40 years duration. Direct head-to-head comparison(s) between natalizumab and IFNA-1a (Rebif) or between azathioprine and IFNA-1a (Rebif) should be top priority on the research agenda and follow-up of the trial cohorts should be mandatory.
[CINAHL Note: The Cochrane Collaboration systematic reviews contain interactive software that allows various calculations in the MetaView.]
Journal Subset:
Europe; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1469-493X
MEDLINE Info:
PMID: 23744561 NLM UID: 100909747
Cochrane AN:
CD008933
Entry Date:
20130726
Revision Date:
20150619
Accession Number:
2012193115
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012193115&site=ehost-live">Immunomodulators and immunosuppressants for multiple sclerosis: a network meta-analysis.</A>
Database:
CINAHL Plus
Record: 39
Title:
Impact of intraoperative stimulation brain mapping on glioma surgery outcome: a meta-analysis.
Authors:
De Witt Hamer PC; Robles SG; Zwinderman AH; Duffau H; Berger MS
Affiliation:
Neurosurgical Center Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands, p.dewitthamer@vumc.nl
Source:
Journal of Clinical Oncology (J CLIN ONCOL), 2012 Jul 10; 30 (20): 2559-65.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Brain Mapping
Brain Neoplasms -- Surgery
Electric Stimulation
Glioma -- Surgery
Nervous System -- Physiopathology
Minor Subjects:
Adult; Behavior; Human; Intraoperative Period; Meta Analysis; Neurosurgery -- Adverse Effects; Neurosurgery -- Methods; Systematic Review; Treatment Outcomes
Abstract:
PURPOSE Surgery for infiltrative gliomas aims to balance tumor removal with preservation of functional integrity. The usefulness of intraoperative stimulation mapping (ISM) has not been addressed in randomized trials. This study addresses glioma surgery outcome on the basis of a meta-analysis of observational studies. METHODS A systematic search retrieved 90 reports published between 1990 and 2010 with 8,091 adult patients who had resective surgery for supratentorial infiltrative glioma, with or without ISM. Quality criteria consisted of postoperative neurologic examination details and follow-up timing. New postoperative neurologic deficits were categorized on the basis of timing and severity. Meta-analysis with a Bayesian random effects model determined summary event rates of deficits as well as gross total resection rate and eloquent locations. Meta-regression analysis explored heterogeneity among studies. Results Late severe neurologic deficits were observed in 3.4% (95% CI, 2.3% to 4.8%) of patients after resections with ISM, and in 8.2% (95% CI, 5.7% to 11.4%) of patients after resections without ISM (adjusted odds ratio, 0.39; 95% CI, 0.23 to 0.64). The percentages of radiologically confirmed gross total resections were 75% (95% CI, 66% to 82%) with ISM and 58% (95% CI, 48% to 69%) without ISM. Eloquent locations were involved in 99.9% (95% CI, 99.9% to 100%) of resections with ISM and in 95.8% (95% CI, 73.1% to 99.8%) of resections without ISM. Relevant sources of heterogeneity among studies were ISM, continent, and academic setting. CONCLUSION Glioma resections using ISM are associated with fewer late severe neurologic deficits and more extensive resection, and they involve eloquent locations more frequently. This indicates that ISM should be universally implemented as standard of care for glioma surgery.
Journal Subset:
Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
0732-183X
MEDLINE Info:
PMID: 22529254 NLM UID: 8309333
Entry Date:
20120928
Revision Date:
20120928
Accession Number:
2011605929
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011605929&site=ehost-live">Impact of intraoperative stimulation brain mapping on glioma surgery outcome: a meta-analysis.</A>
Database:
CINAHL Plus
Record: 40
Title:
In-office treatment for dentin hypersensitivity: a systematic review and network meta-analysis.
Authors:
Lin, Po-Yen; Cheng, Ya-Wen; Chu, Chia-Yi; Chien, Kuo-Liong; Lin, Chun-Pin; Tu, Yu-Kang
Affiliation:
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital
Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2013 Jan; 40 (1): 53-64.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Dentin
Hypersensitivity -- Therapy
Dentistry -- Methods
Minor Subjects:
Human; Meta Analysis; Randomized Controlled Trials; Confidence Intervals; Placebos; Medline; Cochrane Library; Databases; Visual Analog Scaling; Data Analysis Software; Regression
Abstract:
Aim Dentin hypersensitivity, caused by the exposure and patency of dentinal tubules, can affect patients' quality of life. The aim of this study was to undertake a systematic review and a network meta-analysis, comparing the effectiveness in resolving dentin hypersensitivity among different in-office desensitizing treatments. Materials and Methods A literature search was performed with electronic databases and by hand until December 2011. The included trials were divided into six treatment groups as placebo, physical occlusion, chemical occlusion, nerve desensitization, laser therapy and combined treatments. The treatment effects between groups were estimated with standardized mean differences by using a Bayesian network meta-analysis. Results Forty studies were included. The standardized mean difference between placebo and physical occlusion was −2.57 [95% credible interval ( CI): −4.24 to −0.94]; placebo versus chemical occlusion was −2.33 (95% CI: −3.65 to −1.04); placebo versus nerve desensitization was −1.72 (95% CI: −4.00 to 0.52); placebo versus laser therapy was −2.81 (95% CI: −4.41 to −1.24); placebo versus combined treatment was −3.47 (95% CI: −5.99 to −0.96). The comparisons of the five active treatments showed no significant differences. Conclusions The results from network meta-analysis showed that most active treatment options had significantly better treatment outcome than placebo.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
PMID: 23057701 NLM UID: 0425123
Entry Date:
20130104
Revision Date:
20141003
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jcpe.12011
Accession Number:
2011781261
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011781261&site=ehost-live">In-office treatment for dentin hypersensitivity: a systematic review and network meta-analysis.</A>
Database:
CINAHL Plus
Record: 41
Title:
Interventions for treating displaced midshaft clavicular fractures: a bayesian network meta-analysis of randomized controlled trials.
Authors:
Wang, Jia; Meng, Xiao-Hui; Guo, Zhi-Ming; Wu, Ying-Hua; Zhao, Jia-Guo
Affiliation:
From the Department of Orthopaedic Surgery (JW, Z-MG, Y-HW), Tianjin Hospital
Source:
Medicine (MEDICINE), 2015 Mar; 94 (11): e595.
Publication Type:
journal article - meta analysis, research, review
Language:
English
Major Subjects:
Clavicle -- Injuries
Fracture Fixation
Fractures -- Surgery
Minor Subjects:
Probability; Human; Clinical Trials; Surgical Wound Infection -- Epidemiology; Treatment Failure
Abstract:
Displaced midshaft clavicle fractures are frequent injuries. There are 3 treatment methods including conservative treatment, plate fixation, and intramedullary pin fixation. However, which is the best treatment remains a topic of debate.To establish the optimum treatment for displaced midshaft clavicular fractures, we did a network meta-analysis to compare 3 treatments in terms of postoperative nonunion and infection.We searched PubMed, the Cochrane Library, and Embase for relevant randomized controlled trials (RCTs) until the end of October 2014. Two investigators independently reviewed the abstract and full text of eligible studies and extracted information. We used WinBUGS 1.4 (Imperial College School of Medicine at St Mary's, London) to perform our Bayesian network meta-analysis. We used the graphical tools in STATA12 (StataCorp, Texas) to present the results of statistical analyses of WinBUGS14. Nonunion and infection were presented as odd ratios (ORs) with 95% confidence intervals (CIs). We also presented the results using surface under the cumulative ranking curve (SUCRA). A higher SUCRA value suggests better results for respective treatment method.Thirteen RCTs were included in our network meta-analysis, with a total of 894 patients randomized to receive 1 of 3 treatments. Nonunion rates were 0.9%, 2.4%, and 11.4% for intramedullary pin fixation, plate fixation, and conservative method, respectively. Nonunion occurred more commonly in patients treated with conservative method than in patients treated with either plate fixation (OR, 0.18; 95% CI, 0.05-0.46) or intramedullary pin fixation (OR, 0.12; 95% CI, 0.01-0.50). There was no significant difference between plate and intramedullary pin fixation in nonunion (OR, 3.64; 95% CI, 0.31-17.27). Furthermore, SUCRA probabilities were 87.8%, 62.0%, and 0.2% for intramedullary pin fixation, plate fixation, and conservative method, respectively. Infection rates were 3.6% and 3.9% for intramedullary pin fixation and plate fixation, respectively. There was no significant difference between plate and intramedullary pin fixation in infection (OR, 3.64; 95% CI, 0.31-17.27). SUCRA probabilities were 46.5% and 8.5% for intramedullary pin and plate fixation, respectively.Our network meta-analysis suggested that intramedullary pin fixation is the optimum treatment method for displaced midshaft clavicle fracture because of the low probabilities of nonunion and infection.
Journal Subset:
Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
ISSN:
0025-7974
MEDLINE Info:
PMID: 25789948 NLM UID: 2985248R
Entry Date:
20150605
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1097/MD.0000000000000595
Accession Number:
2012944502
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012944502&site=ehost-live">Interventions for treating displaced midshaft clavicular fractures: a bayesian network meta-analysis of randomized controlled trials.</A>
Database:
CINAHL Plus
Record: 42
Title:
Linear mixed model approach to network meta-analysis for continuous outcomes in periodontal research.
Authors:
Tu, Yu-Kang
Affiliation:
Institute of Epidemiology & Preventive Medicine College of Public Health National Taiwan University
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2015 Feb; 42 (2): 204-12.
Publication Type:
journal article - equations & formulas, meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Guided Tissue Regeneration
Periodontal Diseases
Clinical Research
Minor Subjects:
Human; Systematic Review; Meta Analysis; Randomized Controlled Trials; Funding Source; Data Analysis Software
Abstract:
Aim Analysing continuous outcomes for network meta-analysis by means of linear mixed models is a great challenge, as it requires statistical software packages to specify special patterns of model error variance and covariance structure. This article demonstrates a non-Bayesian approach to network meta-analysis for continuous outcomes in periodontal research with a special focus on the adjustment of data dependency. Data Seventeen studies on guided tissue regeneration were used to illustrate how the proposed linear mixed models for network meta-analysis of continuous outcomes. Methods & Results Arm-based network meta-analysis use treatment arms from each study as the unit of analysis; when patients are randomly assigned to each arm, data are deemed independent and therefore no adjustment is required for multi-arm trials. Trial-based network meta-analysis use treatment contrasts as the unit of analysis, and therefore treatment contrasts within a multi-arm trial are not independent. This data dependency occurs also in split-mouth studies, and adjustments for data dependency are therefore required. Conclusions Arm-based analysis is the preferred approach to network meta-analysis, when all included studies use the parallel group design and some compare more than two treatment arms. When included studies used designs that yield dependent data, the trial-based analysis is the preferred approach.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
PMID: 25581572 NLM UID: 0425123
Grant Information:
This project was funded by grants from the Ministry of Science & Technology in Taiwan (Grant No. NSC 101-2314-B-002-197-MY2 and MOST 103-2314-B-002-032-MY3).
Entry Date:
20150227
Revision Date:
20150306
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jcpe.12362
Accession Number:
2012901810
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012901810&site=ehost-live">Linear mixed model approach to network meta-analysis for continuous outcomes in periodontal research.</A>
Database:
CINAHL Plus
Record: 43
Title:
Maternal obesity and risk of gestational diabetes mellitus.
Authors:
Chu SY; Callaghan WM; Kim SY; Schmid CH; Lau J; England LJ; Dietz PM
Affiliation:
Centers for Disease Control and Prevention, Mailstop K-23, 1600 Clifton Rd., Atlanta, GA 30333, sycl@cdc.gov
Source:
Diabetes Care (DIABETES CARE), 2007 Aug; 30 (8): 2070-6. (59 ref)
Publication Type:
journal article - research, systematic review, tables/charts
Language:
English
Major Subjects:
Diabetes Mellitus, Gestational -- Risk Factors
Obesity -- Physiopathology
Minor Subjects:
Confidence Intervals; Diabetes Mellitus, Gestational -- Epidemiology; Female; Medical Practice, Evidence-Based; Meta Analysis; Odds Ratio; Pregnancy; PubMed; Human
Abstract:
OBJECTIVE: Numerous studies in the U.S. and elsewhere have reported an increased risk of gestational diabetes mellitus (GDM) among women who are overweight or obese compared with lean or normal-weight women. Despite the number and overall consistency of studies reporting a higher risk of GDM with increasing weight or BMI, the magnitude of the association remains uncertain. This meta-analysis was conducted to better estimate this risk and to explore differences across studies. RESEARCH DESIGN AND METHODS: We identified studies from three sources: 1) a PubMed search of relevant articles published between January 1980 and January 2006, 2) reference lists of publications selected from the PubMed search, and 3) reference lists of review articles on obesity and maternal outcomes published between January 2000 and January 2006. We used a Bayesian model to perform the meta-analysis and meta-regression. We included cohort-designed studies that reported obesity measures reflecting pregnancy body mass, that had a normal-weight comparison group, and that presented data allowing a quantitative measurement of risk. RESULTS: Twenty studies were included in the meta-analysis. The unadjusted ORs of developing GDM were 2.14 (95% CI 1.82-2.53), 3.56 (3.05-4.21), and 8.56 (5.07-16.04) among overweight, obese, and severely obese compared with normal-weight pregnant women, respectively. The meta-regression analysis found no evidence that these estimates were affected by selected study characteristics (publication date, study location, parity, type of data collection [retrospective vs. prospective], and prevalence of GDM among normal-weight women). CONCLUSIONS: Our findings indicate that high maternal weight is associated with a substantially higher risk of GDM.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Obstetric Care
ISSN:
0149-5992
MEDLINE Info:
PMID: 17416786 NLM UID: 7805975
Entry Date:
20071130
Revision Date:
20091218
Accession Number:
2009644128
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2009644128&site=ehost-live">Maternal obesity and risk of gestational diabetes mellitus.</A>
Database:
CINAHL Plus
Record: 44
Title:
Methods to decrease blood loss during liver resection: a network meta-analysis.
Authors:
Simillis C; Li T; Vaughan J; Becker LA; Davidson BR; Gurusamy KS
Source:
Cochrane Database of Systematic Reviews (COCHRANE DATABASE SYST REV), 2014 (4): N.PAG.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Blood Loss, Surgical -- Prevention and Control
Comparative Studies
Liver -- Surgery
Surgery, Operative -- Methods
Minor Subjects:
Cochrane Library; Computer Simulation; Confidence Intervals; Dissection -- Methods; Embase; Goodness of Fit Chi Square Test; Human; Medical Practice, Evidence-Based; Medline; Meta Analysis; Odds Ratio; Study Design; Surgical Equipment and Supplies; Vascular Patency -- Classification
Abstract:
Liver resection is a major surgery with significant mortality and morbidity. Various methods have been attempted to decrease blood loss and morbidity during elective liver resection. These methods include different methods of vascular occlusion, parenchymal transection, and management of the cut surface of the liver. A surgeon typically uses only one of the methods from each of these three categories. Together, one can consider this combination as a treatment strategy. The optimal treatment strategy for liver resection is unknown. To assess the comparative benefits and harms of different treatment strategies that aim to decrease blood loss during elective liver resection. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and Science Citation Index Expanded to July 2012 to identify randomised clinical trials. We also handsearched the references lists of identified trials. We included only randomised clinical trials (irrespective of language, blinding, or publication status) where the method of vascular occlusion, parenchymal transection, and management of the cut surface were clearly reported, and where people were randomly assigned to different treatment strategies based on different combinations of the three categories (vascular occlusion, parenchymal transection, cut surface). Two review authors identified trials and collected data independently. We assessed the risk of bias using The Cochrane Collaboration's methodology. We conducted a Bayesian network meta-analysis using the Markov chain Monte Carlo method in WinBUGS 1.4 following the guidelines of the National Institute for Health and Care Excellence Decision Support Unit guidance documents. We calculated the odds ratios (OR) with 95% credible intervals (CrI) (which are similar to confidence intervals in the frequentist approach for meta-analysis) for the binary outcomes and mean differences (MD) with 95% CrI for continuous outcomes using a fixed-effect model or random-effects model according to model-fit. We identified nine trials with 617 participants that met our inclusion criteria. Interventions in the trials included three different options for vascular occlusion, four for parenchymal transection, and two for management of the cut liver surface. These interventions were combined in different ways in the trials giving 11 different treatment strategies. However, we were only able to include 496 participants randomised to seven different treatment strategies from seven trials in our network meta-analysis, because the treatment strategies from the trials that used fibrin sealant for management of the raw liver surface could not be connected to the network for any outcomes. Thus, the trials included in the network meta-analysis varied only in their approaches to vascular exclusion and parenchymal transection and none used fibrin sealant. All the trials were of high risk of bias and the quality of evidence was very low for all the outcomes. The differences in mortality between the different strategies was imprecise (seven trials; seven treatment strategies; 496 participants). Five trials (six strategies; 406 participants) reported serious adverse events. There was an increase in the proportion of people with serious adverse events when surgery was performed using radiofrequency dissecting sealer compared with the standard clamp-crush method in the absence of vascular occlusion and fibrin sealant. The OR for the difference in proportion was 7.13 (95% CrI 1.77 to 28.65; 15/49 (adjusted proportion 24.9%) in radiofrequency dissecting sealer group compared with 6/89 (6.7%) in the clamp-crush method). The differences in serious adverse events between the other groups were imprecise. There was a high probability that 'no vascular occlusion with clamp-crush method and no fibrin' and 'intermittent vascular occlusion with Cavitron ultrasonic surgical aspirator and no fibrin' are better than other treatments with regards to serious adverse events. Quality of life was not reported in any of the trials.The differences in the proportion of people requiring blood transfusion was imprecise (six trials; seven treatments; 446 participants). Two trials (three treatments; 155 participants) provided data for quantity of blood transfused. People undergoing liver resection by intermittent vascular occlusion had higher amounts of blood transfused than people with continuous vascular occlusion when the parenchymal transection was carried out with the clamp-crush method and no fibrin sealant was used for the cut surface (MD 1.2 units; 95% CrI 0.08 to 2.32). The differences in the other comparisons were imprecise (very low quality evidence). Three trials (four treatments; 281 participants) provided data for operative blood loss. People undergoing liver resection using continuous vascular occlusion had lower blood loss than people with no vascular occlusion when the parenchymal transection was carried out with clamp-crush method and no fibrin sealant was used for the cut surface (MD -130.9 mL; 95% CrI -255.9 to -5.9). None of the trials reported the proportion of people with major blood loss.The differences in the length of hospital stay (six trials; seven treatments; 446 participants) and intensive therapy unit stay (four trials; six treatments; 261 participants) were imprecise. Four trials (four treatments; 245 participants) provided data for operating time. Liver resection by intermittent vascular occlusion took longer than liver resection performed with no vascular occlusion when the parenchymal transection was carried out with Cavitron ultrasonic surgical aspirator and no fibrin sealant was used for the cut surface (MD 49.6 minutes; 95% CrI 29.8 to 69.4). The differences in the operating time between the other comparisons were imprecise. None of the trials reported the time needed to return to work. Very low quality evidence suggested that liver resection using a radiofrequency dissecting sealer without vascular occlusion or fibrin sealant may increase serious adverse events and this should be evaluated in further randomised clinical trials. The risk of serious adverse events with liver resection using no special equipment compared with more complex methods requiring special equipment was uncertain due to the very low quality of the evidence. The credible intervals were wide and considerable benefit or harm with a specific method of liver resection cannot be ruled out.
[CINAHL Note: The Cochrane Collaboration systematic reviews contain interactive software that allows various calculations in the MetaView.]
Journal Subset:
Europe; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Perioperative Care
ISSN:
1469-493X
MEDLINE Info:
PMID: 24696014 NLM UID: 100909747
Cochrane AN:
CD010683
Entry Date:
20140613
Revision Date:
20150619
Accession Number:
2012608725
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012608725&site=ehost-live">Methods to decrease blood loss during liver resection: a network meta-analysis.</A>
Database:
CINAHL Plus
Record: 45
Title:
Spontaneous regression of hepatocellular carcinoma: a systematic review.
Authors:
Oquiñena S; Guillen-Grima F; Iñarrairaegui M; Zozaya JM; Sangro B
Affiliation:
Department of Gastroenterology, Hospital Virgen del Camino, Pamplona, Spain
Source:
European Journal of Gastroenterology & Hepatology (EUR J GASTROENTEROL HEPATOL), 2009 Mar; 21 (3): 254-7. (20 ref)
Publication Type:
journal article - research, systematic review, tables/charts
Language:
English
Major Subjects:
Liver Neoplasms
Liver Neoplasms -- Epidemiology
Neoplasm Regression, Spontaneous
Minor Subjects:
American Society of Clinical Oncology; Cochrane Library; Embase; Funding Source; Medline; Meta Analysis; PubMed; Human
Abstract:
OBJECTIVE: To estimate the actual frequency of spontaneous regression of hepatocellular carcinoma. METHODS: A systematic review of the literature published during 1978-2007 has been carried out to identify randomized clinical trials of hepatocellular carcinoma that included a control arm receiving either placebo or best supportive care, and in which patients were followed prospectively for tumor response using predefined criteria. Data extraction was conducted independently by two investigators. A meta-analysis to provide a global estimation of regressions in the control arms was performed using an empiric Bayesian random-effects model. RESULTS: We identified 16 cases of regression (including minor and partial responses) in 10 phase III clinical trials. The rate of spontaneous objective partial regression among patients with hepatocellular carcinoma was 0.406% [95% confidence interval: 0.067-1.043%]. CONCLUSION: Although very infrequent, spontaneous regression is not an extraordinary event among patients with hepatocellular carcinoma. Therefore, individual responses to any given therapy should be assessed with caution and this fact may be considered at the time of calculating sample size of pilot clinical trials of new agents.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
0954-691X
MEDLINE Info:
PMID: 19279469 NLM UID: 9000874
Grant Information:
Funded in part by Instituto de Salud Carlos III, Spain
Entry Date:
20090501
Revision Date:
20110513
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1097/MEG.0b013e328324b6a2
Accession Number:
2010221323
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010221323&site=ehost-live">Spontaneous regression of hepatocellular carcinoma: a systematic review.</A>
Database:
CINAHL Plus
Record: 46
Title:
Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis.
Authors:
Dennis LK; Vanbeek MJ; Freeman LEB; Smith BJ; Dawson DV; Coughlin JA
Affiliation:
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA. leslie-dennis@uiowa.edu
Source:
Annals of Epidemiology (ANN EPIDEMIOL), 2008 Aug; 18 (8): 614-27. (93 ref)
Publication Type:
journal article - research, systematic review, tables/charts
Language:
English
Major Subjects:
Age Factors
Melanoma -- Risk Factors
Sunburn -- Complications
Ultraviolet Rays -- Adverse Effects
Minor Subjects:
Adolescence; Adult; Child; Confidence Intervals; Dose-Response Relationship; Funding Source; Meta Analysis; Odds Ratio; Human
Abstract:
PURPOSE: Sunburns are an important risk factor for melanoma and those occurring in childhood are often cited as posing the greatest risk. We conducted a meta-analysis to quantify the magnitude of association for melanoma and sunburns during childhood, adolescence, adulthood and over a lifetime. METHODS: After reviewing over 1300 article titles and evaluating 270 articles in detail, we pooled odds ratios from 51 independent study populations for "ever" sunburned and risk of cutaneous melanoma. Among these, 26 studies reported results from dose-response analyses. Dose-response analyses were examined using both fixed-effects models and Bayesian random-effects models. RESULTS: An increased risk of melanoma was seen with increasing number of sunburns for all time-periods (childhood, adolescence, adulthood, and lifetime). In an attempt to understand how risk between life-periods compares, we also report these same linear models on a scale of five sunburns per decade for each life-period. The magnitude of risk for five sunburns per decade is highest for adult and lifetime sunburns. CONCLUSIONS: Overall, these results show an increased risk of melanoma with increasing number of sunburns during all life-periods, not just childhood. Prevention efforts should focus on reducing sunburns during all life-periods.
Journal Subset:
Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; Public Health; USA
Special Interest:
Evidence-Based Practice; Public Health
ISSN:
1047-2797
MEDLINE Info:
PMID: 18652979 NLM UID: 9100013
Grant Information:
Supported in part by the National Cancer Institute and the American Cancer Society
Entry Date:
20090213
Revision Date:
20091218
Accession Number:
2010003330
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2010003330&site=ehost-live">Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis.</A>
Database:
CINAHL Plus
Record: 47
Title:
Systematic Literature Review and Network Meta-Analysis Comparing Bone-Targeted Agents for the Prevention of Skeletal-Related Events in Cancer Patients With Bone Metastasis.
Authors:
Zhiyu Wang; Qiao, Dan; Yaohong Lu; Curtis, Dana; Xiaoting Wen; Yang Yao; Hui Zhao
Affiliation:
Department of Internal Oncology, Shanghai JiaoTong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Department of Internal Oncology, Shanghai JiaoTong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
Source:
Oncologist (ONCOLOGIST), 2015 Apr; 20 (4): 440-9.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Bone Metastases -- Complications
Cancer Patients
Diphosphonates -- Therapeutic Use
Antibodies, Monoclonal -- Therapeutic Use
Bone Diseases -- Etiology
Bone Diseases -- Prevention and Control
Minor Subjects:
Human; Systematic Review; Meta Analysis; Medline; Embase; Cochrane Library; Descriptive Statistics; Confidence Intervals; Odds Ratio; Data Analysis Software; Male; Female; Adult; Middle Age; Aged; Aged, 80 and Over; Funding Source
Abstract:
Background. Complications from skeletal-related events (SREs) constitute a challenge in the care of cancer patients with bone metastasis (BM). Objectives. This study evaluated the comparative effectiveness of pamidronate, ibandronate, zoledronate, and denosumab in reducing the morbidity of SREs in cancer patients with BM. Methods. Medline (1948 to January 2014), Embase (1980 to January 2014), the Cochrane Library (2014 issue 1), and Web of Science with Conference Proceedings (1970 to January 2014) were searched. Only randomized controlled trials assessing denosumab, bisphosphonates, or placebo in cancer patients with BM were included. The primary outcomes were SREs and SREs by type. The network meta-analysis (NMA) was performed with a random-effects Bayesian model. Results. The NMA included 14 trials with 10,192 patients. Denosumab was superior to placebo in reducing the risk of SREs (odds ratio [OR]: 0.49; 95% confidence interval [CI]: 0.31-0.75), followed by zoledronate (OR: 0.57; 95% CI: 0.41-0.77) and pamidronate (OR: 0.55; 95% CI: 0.41-0.72). Ibandronate compared with placebo could not reduce the risk of SREs. Denosumab was superior to placebo in reducing the risk of pathologic fractures (OR: 0.50; 95% CI: 0.32-0.79), followed by zoledronate (OR: 0.61; 95% CI: 0.43-0.86). Denosumab was superior to placebo in reducing the risk of radiation (OR: 0.51; 95% CI: 0.35-0.75), followed by pamidronate (OR: 0.67; 95% CI: 0.52-0.86) and zoledronate (OR: 0.70; 95% CI: 0.52-0.96). Conclusion. This NMA showed that denosumab, zoledronate, and pamidronate were generally effective in preventing SREs in cancer patients with BM. Denosumab and zoledronate were also associated with reductions in the risk of pathologic fractures and radiation compared with placebo. Denosumab was shown to be the most effective of the bone-targeted agents.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
1083-7159
MEDLINE Info:
PMID: 25732263 NLM UID: 9607837
Grant Information:
This study was funded by Natural Science Foundation of China Grant No. 81201628.
Entry Date:
20150515
Revision Date:
20150522
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1634/theoncologist.2014-0328
Accession Number:
2012991495
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012991495&site=ehost-live">Systematic Literature Review and Network Meta-Analysis Comparing Bone-Targeted Agents for the Prevention of Skeletal-Related Events in Cancer Patients With Bone Metastasis.</A>
Database:
CINAHL Plus
Record: 48
Title:
Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer.
Authors:
Ramsay, C; Pickard, R; Robertson, C; Close, A; Vale, L; Armstrong, N; Barocas, D A; Eden, C G; Fraser, C; Gurung, T; Jenkinson, D; Jia, X; Lam, T B; Mowatt, G; Neal, D E; Robinson, M C; Royle, J; Rushton, S P; Sharma, P; Shirley, M D F; Soomro, N
Affiliation:
Health Services Research Unit, University of Aberdeen, Aberdeen, UK
Source:
Health Technology Assessment (HEALTH TECHNOL ASSESS), 2012; 16 (41): 1-313.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Laparoscopy -- Economics
Models, Statistical
Prostatectomy -- Economics
Prostatic Neoplasms -- Surgery
Robotics -- Economics
Robotics -- Methods
Minor Subjects:
Cochrane Library; Cost Benefit Analysis; Embase; Human; Laparoscopy -- Methods; Male; Medline; Meta Analysis; Prostatectomy; Prostatectomy -- Methods; Prostatic Neoplasms -- Economics; Systematic Review; Treatment Outcomes
Abstract:
BACKGROUND: Complete surgical removal of the prostate, radical prostatectomy, is the most frequently used treatment option for men with localised prostate cancer. The use of laparoscopic (keyhole) and robot-assisted surgery has improved operative safety but the comparative effectiveness and cost-effectiveness of these options remains uncertain. OBJECTIVE: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of robotic radical prostatectomy compared with laparoscopic radical prostatectomy in the treatment of localised prostate cancer within the UK NHS. DATA SOURCES: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, BIOSIS, Science Citation Index and Cochrane Central Register of Controlled Trials were searched from January 1995 until October 2010 for primary studies. Conference abstracts from meetings of the European, American and British Urological Associations were also searched. Costs were obtained from NHS sources and the manufacturer of the robotic system. Economic model parameters and distributions not obtained in the systematic review were derived from other literature sources and an advisory expert panel. REVIEW METHODS: Evidence was considered from randomised controlled trials (RCTs) and non-randomised comparative studies of men with clinically localised prostate cancer (cT1 or cT2); outcome measures included adverse events, cancer related, functional, patient driven and descriptors of care. Two reviewers abstracted data and assessed the risk of bias of the included studies. For meta-analyses, a Bayesian indirect mixed-treatment comparison was used. Cost-effectiveness was assessed using a discrete-event simulation model. RESULTS: The searches identified 2722 potentially relevant titles and abstracts, from which 914 reports were selected for full-text eligibility screening. Of these, data were included from 19,064 patients across one RCT and 57 non-randomised comparative studies, with very few studies considered at low risk of bias. The results of this study, although associated with some uncertainty, demonstrated that the outcomes were generally better for robotic than for laparoscopic surgery for major adverse events such as blood transfusion and organ injury rates and for rate of failure to remove the cancer (positive margin) (odds ratio 0.69; 95% credible interval 0.51 to 0.96; probability outcome favours robotic prostatectomy = 0.987). The predicted probability of a positive margin was 17.6% following robotic prostatectomy compared with 23.6% for laparoscopic prostatectomy. Restriction of the meta-analysis to studies at low risk of bias did not change the direction of effect but did decrease the precision of the effect size. There was no evidence of differences in cancer-related, patient-driven or dysfunction outcomes. The results of the economic evaluation suggested that when the difference in positive margins is equivalent to the estimates in the meta-analysis of all included studies, robotic radical prostatectomy was on average associated with an incremental cost per quality-adjusted life-year that is less than threshold values typically adopted by the NHS (£30,000) and becomes further reduced when the surgical capacity is high. LIMITATIONS: The main limitations were the quantity and quality of the data available on cancer-related outcomes and dysfunction. CONCLUSIONS: This study demonstrated that robotic prostatectomy had lower perioperative morbidity and a reduced risk of a positive surgical margin compared with laparoscopic prostatectomy although there was considerable uncertainty. Robotic prostatectomy will always be more costly to the NHS because of the fixed capital and maintenance charges for the robotic system. Our modelling showed that this excess cost can be reduced if capital costs of equipment are minimised and by maintaining a high case volume for each robotic system of at least 100-150 procedures per year. This finding was primarily driven by a difference in positive margin rate. There is a need for further research to establish how positive margin rates impact on long-term outcomes. FUNDING: The National Institute for Health Research Health Technology Assessment programme.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1366-5278
MEDLINE Info:
PMID: 23127367 NLM UID: 9706284
Entry Date:
20130426
Revision Date:
20130503
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.3310/hta16410
Accession Number:
2011922899
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011922899&site=ehost-live">Systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer.</A>
Database:
CINAHL Plus
Record: 49
Title:
Systematic Review and Network Meta-Analysis of Overall Survival Comparing 3 mg/kg Ipilimumab With Alternative Therapies in the Management of Pretreated Patients With Unresectable Stage III or IV Melanoma.
Authors:
Dequen, Pascale; Lorigan, Paul; Jansen, Jeroen P.; Van Baardewijk, Marc; Ouwens, Mario J. N. M.; Kotapati, Srividya
Affiliation:
MAPI Group, Houten, The Netherlands
Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
MAPI Group, Boston, Massachusetts, USA
Bristol-Myers Squibb, Braine-lÂ¿Alleud, Belgium
Bristol-Myers Squibb, Wallingford, Connecticut, USA
Source:
Oncologist (ONCOLOGIST), 2012 Nov; 17 (11): 1376-85.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Ipilimumab -- Administration and Dosage
Melanoma -- Drug Therapy
Chemotherapy, Cancer
Melanoma -- Therapy
Survival
Immunotherapy
Minor Subjects:
Human; Systematic Review; Meta Analysis; Kaplan-Meier Estimator; Confidence Intervals; Medline; Embase; Cochrane Library; Data Analysis Software; Descriptive Statistics; Adult; Middle Age; Male; Female
Abstract:
Objective. To compare the overall survival (OS) of patients treated with 3 mg/kg ipilimumab versus alternative systemic therapies in pretreated unresectable stage III or IV melanoma patients. Methods. A systematic literature search was performed to identify relevant randomized clinical trials. From these trials, Kaplan-Meier survival curves for each intervention were digitized and combined by means of a Bayesian network meta-analysis (NMA) to compare different drug classes. Results. Of 38 trials identified, 15 formed one interlinked network by drug class to allow for an NMA. Ipilimumab, at a dose of 3 mg/kg, was associated with a greater mean OS time (18.8 months; 95% credible interval [CrI], 15.5-23.0 months) than single-agent chemotherapy (12.3 months; 95% CrI, 6.3-28.0 months), chemotherapy combinations (12.2 months; 95% CrI, 7.1-23.3 months), biochemotherapies (11.9 months; 95% CrI, 7.0 -22.0 months), single-agent immunotherapy (11.1 months; 95% CrI, 8.5-16.2 months), and immunotherapy combinations (14.1 months; 95% CrI, 9.0 -23.8 months). Conclusion. Results of this NMA were in line with previous findings and suggest that OS with ipilimumab is expected to be greater than with alternative systemic therapies, alone or in combination, for the management of pretreated patients with unresectable stage III or IV melanoma.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice; Oncologic Care
ISSN:
1083-7159
MEDLINE Info:
PMID: 23024154 NLM UID: 9607837
Entry Date:
20130104
Revision Date:
20150605
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1634/theoncologist.2011-0427
Accession Number:
2011787036
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2011787036&site=ehost-live">Systematic Review and Network Meta-Analysis of Overall Survival Comparing 3 mg/kg Ipilimumab With Alternative Therapies in the Management of Pretreated Patients With Unresectable Stage III or IV Melanoma.</A>
Database:
CINAHL Plus
Record: 50
Title:
Systematic review, meta-analysis and economic modelling of diagnostic strategies for suspected acute coronary syndrome.
Authors:
Goodacre S; Thokala P; Carroll C; Stevens J; Leaviss J; Al Khalaf M; Collinson P; Morris F; Evans P; Wang J
Affiliation:
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
Source:
Health Technology Assessment (HEALTH TECHNOL ASSESS), 2013 Jan; 17 (1): 1-188.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Acute Coronary Syndrome -- Blood
Acute Coronary Syndrome -- Diagnosis
Models, Statistical
Myocardial Infarction -- Blood
Myocardial Infarction -- Diagnosis
Minor Subjects:
Biological Markers -- Blood; Carrier Proteins -- Blood; CINAHL Database; Cochrane Library; Cost Benefit Analysis; Decision Support Techniques; Electrocardiography; Embase; Exercise Test; Human; Medline; Meta Analysis; Myoglobin -- Blood; Probability; Prognosis; Quality-Adjusted Life Years; Sensitivity and Specificity; Serum Albumin; Systematic Review; Troponin -- Blood
Abstract:
BACKGROUND: Current practice for suspected acute coronary syndrome (ACS) involves troponin testing 10-12 hours after symptom onset to diagnose myocardial infarction (MI). Patients with a negative troponin can be investigated further with computed tomographic coronary angiography (CTCA) or exercise electrocardiography (ECG). OBJECTIVES: We aimed to estimate the diagnostic accuracy of early biomarkers for MI, the prognostic accuracy of biomarkers for major adverse cardiac adverse events (MACEs) in troponin-negative patients, the diagnostic accuracy of CTCA and exercise ECG for coronary artery disease (CAD) and the prognostic accuracy of CTCA and exercise ECG for MACEs in patients with suspected ACS. We then aimed to estimate the cost-effectiveness of using alternative biomarker strategies to diagnose MI, and using biomarkers, CTCA and exercise ECG to risk-stratify troponin-negative patients. DATA SOURCES: We searched MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations; Cumulative Index of Nursing and Allied Health Literature (CINAHL), EMBASE, Web of Science, Cochrane Central Database of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), NHS Database of Abstracts of Reviews of Effects (DARE) and the Health Technology Assessment database from 1985 (CTCA review) or 1995 (biomarkers review) to November 2010, reviewed citation lists and contacted experts to identify relevant studies. REVIEW METHODS: Diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and prognostic studies using a framework adapted for the project. Meta-analysis was conducted using Bayesian Markov chain Monte Carlo simulation. We developed a decision-analysis model to evaluate the cost-effectiveness of alternative biomarker strategies to diagnose MI, and the cost-effectiveness of biomarkers, CTCA or exercise ECG to risk-stratify patients with a negative troponin. Strategies were applied to a theoretical cohort of patients with suspected ACS. Cost-effectiveness was estimated as the incremental cost per quality-adjusted life-year (QALY) of each strategy compared with the next most effective, taking a health-service perspective and a lifetime horizon. RESULTS: Sensitivity and specificity (95% predictive interval) were 77% (29-96%) and 93% (46-100%) for troponin I, 80% (33-97%) and 91% (53-99%) for troponin T (99th percentile threshold), 81% (50-95%) and 80% (26-98%) for quantitative heart-type fatty acid-binding protein (H-FABP), 68% (11-97%) and 92% (20-100%) for qualitative H-FABP, 77% (19-98%) and 39% (2-95%) for ischaemia-modified albumin and 62% (35-83%) and 83% (35-98%) for myoglobin. CTCA had 94% (61-99%) sensitivity and 87% (16-100%) specificity for CAD. Positive CTCA and positive-exercise ECG had relative risks of 5.8 (0.6-24.5) and 8.0 (2.3-22.7) for MACEs. In most scenarios in the economic analysis presentation, high-sensitivity troponin measurement was the most effective strategy with an incremental cost-effectiveness ratio (ICER) of less than the £20,000-30,000/QALY threshold (ICER £7487-17,191/QALY). CTCA appeared to be the most cost-effective strategy for patients with a negative troponin, with an ICER of £11,041/QALY. However, when a lower MACE rate was assumed, CTCA had a high ICER (£262,061/QALY) and the no-testing strategy was optimal. LIMITATIONS: There was substantial variation between the primary studies and heterogeneity in their results. Findings of the economic model were dependent on assumptions regarding the value of detecting and treating positive cases. CONCLUSIONS: Although presentation troponin has suboptimal sensitivity, measurement of a 10-hour troponin level is unlikely to be cost-effective in most scenarios compared with a high-sensitivity presentation troponin. CTCA may be a cost-effective strategy for troponin-negative patients, but further research is required to estimate the effect of CTCA on event rates and health-care costs. FUNDING: The National Institute for Health Research Health Technology Assessment programme.
Journal Subset:
Biomedical; Blind Peer Reviewed; Editorial Board Reviewed; Europe; Expert Peer Reviewed; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice
ISSN:
1366-5278
MEDLINE Info:
PMID: 23331845 NLM UID: 9706284
Entry Date:
20130719
Revision Date:
20130719
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.3310/hta17010
Accession Number:
2011900648
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Database:
CINAHL Plus



Record: 1
Title:
Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis.
Authors:
Rabelo, Cleverton Correa; Feres, Magda; Gonçalves, Cristiane; Figueiredo, Luciene C.; Faveri, Marcelo; Tu, Yu-Kang; Chambrone, Leandro
Affiliation:
Division of Periodontics, Federal University of Juiz de Fora (UFJF)
Dental Research Division, Department of Periodontology, Guarulhos University
Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University
Department of Periodontics, College of Dentistry, The University of Iowa
Source:
Journal of Clinical Periodontology (J CLIN PERIODONTOL), 2015 Jul; 42 (7): 647-57.
Publication Type:
journal article - meta analysis, research, systematic review, tables/charts
Language:
English
Major Subjects:
Aggressive Periodontitis -- Drug Therapy
Antibiotics -- Therapeutic Use
Minor Subjects:
Human; Systematic Review; Meta Analysis; Medline; Embase; Databases; Funding Source; Root Planing
Abstract:
Aim The aim of this study was to assess the effect of systemic antibiotic therapy on the treatment of aggressive periodontitis (AgP). Methods This study was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 2014 for randomized clinical trials comparing the treatment of subjects with AgP with either scaling and root planing ( SRP) alone or associated with systemic antibiotics. Bayesian network meta-analysis was prepared using the Bayesian random-effects hierarchical models and the outcomes reported at 6-month post-treatment. Results Out of 350 papers identified, 14 studies were eligible. Greater gain in clinical attachment ( CA) (mean difference [ MD]: 1.08 mm; p < 0.0001) and reduction in probing depth ( PD) ( MD: 1.05 mm; p < 0.00001) were observed for SRP + metronidazole (Mtz), and for SRP + Mtz + amoxicillin (Amx) ( MD: 0.45 mm, MD: 0.53 mm, respectively; p < 0.00001) than SRP alone/placebo. Bayesian network meta-analysis showed additional benefits in CA gain and PD reduction when SRP was associated with systemic antibiotics. Conclusions SRP plus systemic antibiotics led to an additional clinical effect compared with SRP alone in the treatment of AgP. Of the antibiotic protocols available for inclusion into the Bayesian network meta-analysis, Mtz and Mtz/Amx provided to the most beneficial outcomes.
Journal Subset:
Biomedical; Continental Europe; Europe; Expert Peer Reviewed; Peer Reviewed
Special Interest:
Dental Care; Evidence-Based Practice
ISSN:
0303-6979
MEDLINE Info:
NLM UID: 0425123
Grant Information:
The study was supported by the research grants 2012/09645-1 from Sao Paulo Research Foundation ~ (FAPESP, Brazil) and NSC101-2314- B-002-197-MY2 from the National Science Council in Taiwan.
Entry Date:
20150807
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1111/jcpe.12427
Accession Number:
2013097915
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2013097915&site=ehost-live">Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis.</A>
Database:
CINAHL Plus
Record: 2
Title:
Treatments for Shoulder Impingement Syndrome: A PRISMA Systematic Review and Network Meta-Analysis.
Authors:
Dong, Wei; Goost, Hans; Lin, Xiang-Bo; Burger, Christof; Paul, Christian; Wang, Zeng-Li; Zhang, Tian-Yi; Jiang, Zhi-Chao; Welle, Kristian; Kabir, Koroush
Affiliation:
From the Department of Orthopedic and Trauma Surgery (WD, Z-LW, T-YZ), Central Hospital of PetroChina, Langfang, Hebei, China
Source:
Medicine (MEDICINE), 2015 Mar; 94 (10): e510.
Publication Type:
journal article - meta analysis, research, systematic review
Language:
English
Major Subjects:
Arthroscopy
Shoulder Impingement Syndrome -- Therapy
Therapeutic Exercise
Minor Subjects:
Acupuncture; Adrenal Cortex Hormones -- Administration and Dosage; Combined Modality Therapy; Decompression, Surgical -- Methods; Human; Meta Analysis; Pain Measurement; Professional Practice, Evidence-Based; Shoulder Impingement Syndrome -- Surgery; Systematic Review; Treatment Outcomes; Ultrasonic Therapy
Abstract:
Many treatments for shoulder impingement syndrome (SIS) are available in clinical practice; some of which have already been compared with other treatments by various investigators. However, a comprehensive treatment comparison is lacking.Several widely used electronic databases were searched for eligible studies. The outcome measurements were the pain score and the Constant-Murley score (CMS). Direct comparisons were performed using the conventional pair-wise meta-analysis method, while a network meta-analysis based on the Bayesian model was used to calculate the results of all potentially possible comparisons and rank probabilities.Included in the meta-analysis procedure were 33 randomized controlled trials involving 2300 patients. Good agreement was demonstrated between the results of the pair-wise meta-analyses and the network meta-analyses. Regarding nonoperative treatments, with respect to the pain score, combined treatments composed of exercise and other therapies tended to yield better effects than single-intervention therapies. Localized drug injections that were combined with exercise showed better treatment effects than any other treatments, whereas worse effects were observed when such injections were used alone. Regarding the CMS, most combined treatments based on exercise also demonstrated better effects than exercise alone. Regarding surgical treatments, according to the pain score and the CMS, arthroscopic subacromial decompression (ASD) together with treatments derived from it, such as ASD combined with radiofrequency and arthroscopic bursectomy, showed better effects than open subacromial decompression (OSD) and OSD combined with the injection of platelet-leukocyte gel. Exercise therapy also demonstrated good performance. Results for inconsistency, sensitivity analysis, and meta-regression all supported the robustness and reliability of these network meta-analyses.Exercise and other exercise-based therapies, such as kinesio taping, specific exercises, and acupuncture, are ideal treatments for patients at an early stage of SIS. However, low-level laser therapy and the localized injection of nonsteroidal anti-inflammatory drugs are not recommended. For patients who have a long-term disease course, operative treatments may be considered, with standard ASD surgery preferred over arthroscopic bursectomy and the open surgical technique for subacromial decompression. Notwithstanding, the choice of surgery should be made cautiously because similar outcomes may also be achieved by the implementation of exercise therapy.
Journal Subset:
Biomedical; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA
Special Interest:
Evidence-Based Practice
ISSN:
0025-7974
MEDLINE Info:
PMID: 25761173 NLM UID: 2985248R
Entry Date:
20150522
Revision Date:
20150717
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1097/MD.0000000000000510
Accession Number:
2012935463
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<A href="http://search.ebscohost.com.ezproxy.kingston.ac.uk/login.aspx?direct=true&db=jlh&AN=2012935463&site=ehost-live">Treatments for Shoulder Impingement Syndrome: A PRISMA Systematic Review and Network Meta-Analysis.</A>
Database:
CINAHL Plus
Record: 3
Title:
Where errors occur in the preparation and administration of intravenous medicines: a systematic review and Bayesian analysis.
Authors:
McDowell SE; Mt-Isa S; Ashby D; Ferner RE
Affiliation:
West Midlands Centre for Adverse Drug Reactions, City Hospital, Birmingham B18 7QH, UK
Source:
Quality & Safety in Health Care (QUAL SAF HEALTH CARE), 2010 Aug; 19 (4): 341-5. (43 ref)
Publication Type:
journal article - research, systematic review, tables/charts
Language:
English
Major Subjects:
Intravenous Therapy
Medication Errors
Professional Practice, Evidence-Based
Minor Subjects:
Confidence Intervals; Drug Compounding -- Methods; Embase; Funding Source; Human; Medline; Models, Statistical -- Utilization; Odds Ratio; Probability; Sensitivity and Specificity
Abstract:
OBJECTIVE: To investigate the overall probability of error in preparing and administering intravenous medicines; to identify at which stage of the process an error is most likely to occur; and to determine the impact of error correction on the error probability. DESIGN: Systematic review and random-effects Bayesian conditional independence modelling. METHODS: Medline and EMBASE were searched for studies on intravenous medicines. The error rates of each stage were extracted. These, expert estimates, and error rates from generic tasks, were used in a Bayesian conditional independence model to find error 'hot-spots.' The main outcome measure was the probability of at least one error occurring during intravenous therapy. RESULTS: Nine published studies were identified for inclusion in the systematic review and meta-analysis. The overall probability of making at least one error in intravenous therapy was 0.73 (95% credible interval (CrI) 0.54 to 0.90). If error-checking was introduced at each stage of the process, the overall rate fell to 0.22 (95% CrI 0.14 to 0.31). Errors were most likely in the reconstitution step. Removing the reconstitution step by providing preprepared injections would reduce the overall error rate to 0.17 (95% CrI 0.09 to 0.27). CONCLUSIONS: Intravenous therapy is complex and error-prone. Error-checking at each stage could reduce the error probability. The use of preprepared injections may help by eliminating errors in the reconstitution of drug and diluent. However, it will be important to ensure that benefits are not outweighed by practical disadvantages such as an increase in selection errors.
Journal Subset:
Blind Peer Reviewed; Europe; Expert Peer Reviewed; Health Services Administration; Peer Reviewed; UK & Ireland
Special Interest:
Evidence-Based Practice; Patient Safety; Quality Assurance
ISSN:
1475-3898
MEDLINE Info:
PMID: 20065297 NLM UID: 101136980
Grant Information:
Antidote Trust Fund of Sandwell and West Birmingham Hospitals NHS Trust
Entry Date:
20101022
Revision Date:
20110916
DOI:
http://dx.doi.org.ezproxy.kingston.ac.uk/10.1136/qshc.2008.029785
Accession Number:
2010765106
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Database:
CINAHL Plus

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