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Sample records for imaging systematic review

  1. Personality and body image: A systematic review.

    PubMed

    Allen, Mark S; Walter, Emma E

    2016-12-01

    This study systematically reviewed the evidence for personality as a correlate of body image. Electronic databases and reference lists were searched in May 2016 for studies reporting an association between at least one dimension of personality and at least one component of negative body image. Twenty-six studies (33 discrete samples) met inclusion criteria. Sixteen samples were coded as medium-high quality. The results indicated that negative body image was associated with higher levels of Neuroticism and lower levels of Extraversion. Agreeableness was not related to body image, and findings for Conscientiousness and Openness were indeterminate. After taking study quality into account, negative body image was also associated with lower levels of Conscientiousness. Neuroticism was associated with negative body image in both women and men. Sex moderation effects for Extraversion, Openness, and Conscientiousness were indeterminate. Large-sample, prospective studies of personality and body image are recommended.

  2. Imaging biomarkers in acute ischemic stroke trials: a systematic review.

    PubMed

    Harston, G W J; Rane, N; Shaya, G; Thandeswaran, S; Cellerini, M; Sheerin, F; Kennedy, J

    2015-05-01

    Imaging biomarkers are increasingly used to provide a better understanding of the pathophysiology of acute ischemic stroke. However, this approach of routinely using imaging biomarkers to inform treatment decisions has yet to be translated into successful randomized trials. The aim of this study was to systematically review the use of imaging biomarkers in randomized controlled trials in patients with acute ischemic stroke, exploring the purposes for which the imaging biomarkers were used. We performed a systematic review of imaging biomarkers used in randomized controlled trials of acute ischemic stroke, in which a therapeutic intervention was trialed within 48 hours of symptom onset. Data bases searched included MEDLINE, EMBASE, strokecenter.org, and the Virtual International Stroke Trials Archive (1995-2014). Eighty-four studies met the criteria, of which 49 used imaging to select patients; 31, for subgroup analysis; and 49, as an outcome measure. Imaging biomarkers were broadly used for 8 purposes. There was marked heterogeneity in the definitions and uses of imaging biomarkers and significant publication bias among post hoc analyses. Imaging biomarkers offer the opportunity to refine the trial cohort by minimizing participant variation, to decrease sample size, and to personalize treatment approaches for those who stand to benefit most. However, within imaging modalities, there has been little consistency between stroke trials. Greater effort to prospectively use consistent imaging biomarkers should help improve the development of novel treatment strategies in acute stroke and improve comparison between studies. © 2015 by American Journal of Neuroradiology.

  3. Vibration response imaging: protocol for a systematic review

    PubMed Central

    2013-01-01

    Background The concept of lung sounds conveying information regarding lung physiology has been used extensively in clinical practice, particularly with physical auscultation using a stethoscope. Advances in computer technology have facilitated the construction of dynamic visual images derived from recorded lung sounds. Arguably, the most significant progress in this field was the development of the commercially available vibration response imaging (VRI) (Deep Breeze Ltd, Or-Akiva, Israel). This device provides a non-invasive, dynamic image of both lungs constructed from sounds detected from the lungs using surface sensors. In the literature, VRI has been utilized in a multitude of clinical and research settings. This systematic review aims to address three study questions relating to whether VRI can be used as an evaluative device, whether the images generated can be characterized, and which tools and measures have been used to assess these images. Methods/Design This systematic review will involve implementing search strategies in five online journal databases in order to extract articles relating to the application of VRI. Appropriate articles will be identified against a set of pre-determined eligibility criteria and assessed for methodological quality using a standardized scale. Included articles will have data extracted by the reviewers using a standardized evidence table. A narrative synthesis based on a standardized framework will be conducted, clustering evidence into three main groups; one for each of the study questions. A meta-analysis will be conducted if two or more research articles meet pre-determined criteria that allow quantitative synthesis to take place. Discussion This systematic review aims to provide a complete overview of the scope of VRI in the clinical and research settings, as well as to discuss methods to interpret the data obtained from VRI. The systematic review intends to help clinicians to make informed decisions on the clinical

  4. Quality assurance in digital dental imaging: a systematic review.

    PubMed

    Metsälä, Eija; Henner, Anja; Ekholm, Marja

    2014-07-01

    Doses induced by individual dental examinations are low. However, dental radiography accounts for nearly one third of the total number of radiological examinations in the European Union. Therefore, special attention is needed with regard to radiation protection. In order to lower patient doses, the staff performing dental examinations must have competence in imaging as well as in radiation protection issues. This paper presents a systematic review about the core competencies needed by the healthcare staff in performing digital dental radiological imaging quality assurance. The following databases were searched: Pubmed, Cinahl, Pro Quest and IEEXplore digital library. Also volumes of some dental imaging journals and doctoral theses of the Finnish universities educating dentists were searched. The search was performed using both MeSH terms and keywords using the option 'search all text'. The original keywords were: dental imaging, digital, x-ray, panoramic, quality, assurance, competence, competency, skills, knowledge, radiographer, radiologist technician, dentist, oral hygienist, radiation protection and their Finnish synonyms. Core competencies needed by the healthcare staff performing digital dental radiological imaging quality assurance described in the selected studies were: management of dental imaging equipment, competence in image quality and factors associated with it, dose optimization and quality assurance. In the future there will be higher doses in dental imaging due to increasing use of CBCT and digital imaging. The staff performing dental imaging must have competence in dental imaging quality assurance issues found in this review. They also have to practice ethical radiation safety culture in clinical practice.

  5. PET imaging in ectopic Cushing syndrome: a systematic review.

    PubMed

    Santhanam, Prasanna; Taieb, David; Giovanella, Luca; Treglia, Giorgio

    2015-11-01

    Cushing syndrome due to endogenous hypercortisolism may cause significant morbidity and mortality. The source of excess cortisol may be adrenal, pituitary, or ectopic. Ectopic Cushing syndrome is sometimes difficult to localize on conventional imaging like CT and MRI. After performing a multilevel thoracoabdominal imaging with CT, the evidence regarding the use of radiotracers for PET imaging is unclear due to significant molecular and etiological heterogeneity of potential causes of ectopic Cushing's syndrome. In our systematic review of literature, it appears that GalLium-based (Ga68) somatostatin receptor analogs have better sensitivity in diagnosis of bronchial carcinoids causing Cushing syndrome and FDG PET appears superior for small-cell lung cancers and other aggressive tumors. Further large-scale studies are needed to identify the best PET tracer for this condition.

  6. Laparoscopic Imaging Techniques in Endometriosis Therapy: A Systematic Review.

    PubMed

    Vlek, Stijn L; Lier, M C I; Ankersmit, M; Ket, Johannes C F; Dekker, J J M L; Mijatovic, V; Tuynman, J B

    2016-01-01

    Endometriosis is a common disease associated with pelvic pain and subfertility. Laparoscopic surgical treatment has proven effective in endometriosis, but is hampered by a high rate of recurrence. The aim of this systematic review was to evaluate the intraoperative identification of endometriosis by enhanced laparoscopic imaging techniques, focusing on sensitivity and specificity. A systematic review was conducted according to PRISMA guidelines in PubMed, Embase, Cochrane Library, and Web of Science. Published prospective studies reporting on enhanced laparoscopic imaging techniques during endometriosis surgery were included. General study characteristics and reported outcomes, including sensitivity and specificity, were extracted. Nine studies were eligible for inclusion. Three techniques were described: 5-ALA fluorescence (5-ALA), autofluorescence (AFI), and narrow-band imaging (NBI). The reported sensitivity of 5-ALA and AFI for identifying endometriosis ranged from 91% to 100%, compared with 48% to 69% for conventional white light laparoscopy (WL). A randomized controlled trial comparing NBI + WL with WL alone reported better sensitivity of NBI (100% vs 79%; p < .001). All 9 studies reported an enhanced detection rate of endometriotic lesions with enhanced imaging techniques. Enhanced imaging techniques are a promising additive for laparoscopic detection and treatment of endometriosis. The 5-ALA, AFI, and NBI intraoperative imaging techniques had a better detection rate for peritoneal endometriosis compared with conventional WL laparoscopy. None of the studies reported clinical data regarding outcomes. Future studies should address long-term results, such as quality of life, recurrence, and need for reoperation. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  7. Systematic reviews.

    PubMed

    Milner, Kerry A

    2015-01-01

    Systematic reviews are a type of literature review in which authors systematically search for, critically appraise, and synthesize evidence from several studies on the same topic (Grant & Booth, 2009). The precise and systematic method differentiates systematic reviews from traditional reviews (Khan, Kunz, Kleijnen, & Antes, 2003). In all types of systematic reviews, a quality assessment is done of the individual studies that meet inclusion criteria. These individual assessments are synthesized, and aggregated results are reported. Systematic reviews are considered the highest level of evidence in evidence-based health care because the reviewers strive to use transparent, rigorous methods that minimize bias.

  8. Diffusion tensor tractography imaging in pediatric epilepsy - A systematic review.

    PubMed

    Szmuda, Marta; Szmuda, Tomasz; Springer, Janusz; Rogowska, Marianna; Sabisz, Agnieszka; Dubaniewicz, Mirosława; Mazurkiewicz-Bełdzińska, Maria

    2016-01-01

    Recent years brought several experimental and clinical reports applying diffusion tensor tractography imaging (DTI) of the brain in epilepsy. This study was aimed to evaluate current evidence for adding the DTI sequence to the standard diagnostic magnetic resonance imaging (MRI) protocol in pediatric epilepsy. Rapid and qualitative systematic review (RAE, Rapid Evidence Assessment), aggregating relevant studies from the recent 7 years. The PubMed database was hand searched for records containing terms "tractography AND epilepsy." Only studies referring to children were included; studies were rated using "final quality of evidence." Out of 144 screened records, relevant 101 were aggregated and reviewed. The synthesis was based on 73 studies. Case-control clinical studies were the majority of the material and comprised 43.8% of the material. Low 'confirmability' and low 'applicability' referred to 18 and 17 articles (29.5% and 27.9%), respectively. The sufficient quality of evidence supported performing DTI in temporal lobe epilepsy, malformations of cortical development and prior to a neurosurgery of epilepsy. The qualitative RAE provides an interim estimate of the clinical relevance of quickly developing diagnostic methods. Based on the critical appraisal of current knowledge, adding the DTI sequence to the standard MRI protocol may be clinically beneficial in selected patient groups with childhood temporal lobe epilepsy or as a part of planning for an epilepsy surgery. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  9. Cognitive behavioural therapy for depression: systematic review of imaging studies.

    PubMed

    Franklin, George; Carson, Alan J; Welch, Killian A

    2016-04-01

    Although cognitive behavioural therapy (CBT) has been shown to be an effective treatment for depression, the biological mechanisms underpinning it are less clear. This review examines if it is associated with changes identifiable with current brain imaging technologies. To better understand the mechanisms by which CBT exerts its effects, we undertook a systematic review of studies examining brain imaging changes associated with CBT treatment of depression. Ten studies were identified, five applying functional magnetic resonance imaging, three positron emission tomography, one single photon emission computer tomography, and one magnetic resonance spectroscopy. No studies used structural MRI. Eight studies included a comparator group; in only one of these studies was there randomised allocation to another treatment. CBT-associated changes were most commonly observed in the anterior cingulate cortex (ACC), posterior cingulate, ventromedial prefrontal cortex/orbitofrontal cortex (VMPFC/OFC) and amygdala/hippocampus. The evidence, such as it is, suggests resting state activity in the dorsal ACC is decreased by CBT. It has previously been suggested that treatment with CBT may result in increased efficiency of a putative 'dorsal cognitive circuit', important in cognitive control and effortful regulation of emotion. It is speculated this results in an increased capacity for 'top-down' emotion regulation, which is employed when skills taught in CBT are engaged. Though changes in activity of the dorsal ACC could be seen as in-keeping with this model, the data are currently insufficient to make definitive statements about how CBT exerts its effects. Data do support the contention that CBT is associated with biological brain changes detectable with current imaging technologies.

  10. Diagnostic value of imaging in infective endocarditis: a systematic review.

    PubMed

    Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

    2017-01-01

    Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of infective endocarditis; however, their diagnostic value is unclear. We did a systematic literature review to critically appraise the evidence for the diagnostic performance of these imaging modalities, according to PRISMA and GRADE criteria. We searched PubMed, Embase, and Cochrane databases. 31 studies were included that presented original data on the performance of electrocardiogram (ECG)-gated multidetector CT angiography (MDCTA), ECG-gated MRI, (18)F-fluorodeoxyglucose ((18)F-FDG) PET/CT, and leucocyte scintigraphy in diagnosis of native valve endocarditis, intracardiac prosthetic material-related infection, and extracardiac foci in adults. We consistently found positive albeit weak evidence for the diagnostic benefit of (18)F-FDG PET/CT and MDCTA. We conclude that additional imaging techniques should be considered if infective endocarditis is suspected. We propose an evidence-based diagnostic work-up for infective endocarditis including these non-invasive techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Incidental findings in imaging diagnostic tests: a systematic review

    PubMed Central

    Lumbreras, B; Donat, L; Hernández-Aguado, I

    2010-01-01

    The objective of this review is to summarise the available evidence on the frequency and management of incidental findings in imaging diagnostic tests. Original articles were identified by a systematic search of the MEDLINE, EMBASE and Cochrane Library Plus databases using appropriate medical headings. Extracted variables were study design; sample size; type of imaging test; initial diagnosis; frequency and location of incidental findings; whether clinical follow-up was performed; and whether a definitive diagnosis was made. Study characteristics were assessed by one reviewer and checked by a second reviewer. Any disagreement was solved by consensus. The relationship between the frequency of incidental findings and the study characteristics was assessed using a one-way ANOVA test, as was the frequency of follow-up of incidental findings and the frequency of confirmation. 251 potentially relevant abstracts were identified and 44 articles were finally included in the review. Overall, the mean frequency of incidental findings was 23.6% (95% confidence interval (CI) 15.8–31.3%). The frequency of incidental findings was higher in studies involving CT technology (mean 31.1%, 95% CI 20.1–41.9%), in patients with an unspecific initial diagnosis (mean 30.5, 95% CI 0–81.6) and when the location of the incidental findings was unspecified (mean 33.9%, 95% CI 18.1–49.7). The mean frequency of clinical follow-up was 64.5% (95% CI 52.9–76.1%) and mean frequency of clinical confirmation was 45.6% (95% CI 32.1–59.2%). Although the optimal strategy for the management of these abnormalities is still unclear, it is essential to be aware of the low clinical confirmation in findings of moderate and major importance. PMID:20335439

  12. Brain imaging in myotonic dystrophy type 1: A systematic review.

    PubMed

    Okkersen, Kees; Monckton, Darren G; Le, Nhu; Tuladhar, Anil M; Raaphorst, Joost; van Engelen, Baziel G M

    2017-08-29

    To systematically review brain imaging studies in myotonic dystrophy type 1 (DM1). We searched Embase (index period 1974-2016) and MEDLINE (index period 1946-2016) for studies in patients with DM1 using MRI, magnetic resonance spectroscopy (MRS), functional MRI (fMRI), CT, ultrasound, PET, or SPECT. From 81 studies, we extracted clinical characteristics, primary outcomes, clinical-genetic correlations, and information on potential risk of bias. Results were summarized and pooled prevalence of imaging abnormalities was calculated, where possible. In DM1, various imaging changes are widely dispersed throughout the brain, with apparently little anatomical specificity. We found general atrophy and widespread gray matter volume reductions in all 4 cortical lobes, the basal ganglia, and cerebellum. The pooled prevalence of white matter hyperintensities is 70% (95% CI 64-77), compared with 6% (95% CI 3-12) in unaffected controls. DTI shows increased mean diffusivity in all 4 lobes and reduced fractional anisotropy in virtually all major association, projection, and commissural white matter tracts. Functional studies demonstrate reduced glucose uptake and cerebral perfusion in frontal, parietal, and temporal lobes, and abnormal fMRI connectivity patterns that correlate with personality traits. There is significant between-study heterogeneity in terms of imaging methods, which together with the established clinical variability of DM1 may explain divergent results. Longitudinal studies are remarkably scarce. DM1 brains show widespread white and gray matter involvement throughout the brain, which is supported by abnormal resting-state network, PET/SPECT, and MRS parameters. Longitudinal studies evaluating spatiotemporal imaging changes are essential. © 2017 American Academy of Neurology.

  13. Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis.

    PubMed

    Vest, Joshua R; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B

    2015-12-01

    Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004-2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = -0.17; 95% confidence interval [CI] = [-0.25, -0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis

    PubMed Central

    Vest, Joshua R.; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B.

    2016-01-01

    Introduction Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Methods Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004–2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. Results A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = −0.17; 95% confidence interval [CI] = [−0.25, −0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Conclusions Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. PMID:26614882

  15. Body Image in Younger Breast Cancer Survivors: A Systematic Review

    PubMed Central

    Paterson, Carly; Lengacher, Cecile A.; Donovan, Kristine A.; Kip, Kevin E.; Tofthagen, Cindy S.

    2015-01-01

    Background Body image is a complex issue with the potential to impact many aspects of cancer survivorship, particularly for the younger breast cancer survivor. Objective The purpose of this review is to synthesize the current state of the science for body image in younger women with breast cancer. Intervention/Methods Combinations of the terms “body image,” “sexuality intervention,” “women,” “younger women,” and “breast cancer” were searched in the PubMed, PsycInfo, CINAHL, Web of Knowledge and Science Direct databases through January 2014. Inclusion criteria for this review were: 1) original research; 2) published in English from the year 2000 forward; 3) measuring body image as an outcome variable; and 4) results included reporting of age-related outcomes. Results Thirty-six articles met the inclusion criteria. The majority of studies were cross-sectional, with extensive variation in body image assessment tools. Age and treatment type had a significant impact on body image, and poorer body image was related to physical and psychological distress, sex and intimacy, and the partnered relationship among younger women. Only one intervention study found a significant improvement in body image post-intervention. Conclusions Findings suggest body image is a complex post-treatment concern for breast cancer survivors, particularly younger women. The findings of this review are limited by the high level of variation in the methods for assessing body image. Implications for Practice Further research of interventions to address body image concerns following treatment for breast cancer is warranted. Improvement of body image may improve the quality of life of younger breast cancer survivors. PMID:25881807

  16. Computational microscopic imaging for malaria parasite detection: a systematic review.

    PubMed

    Das, D K; Mukherjee, R; Chakraborty, C

    2015-10-01

    Malaria, being an epidemic disease, demands its rapid and accurate diagnosis for proper intervention. Microscopic image-based characterization of erythrocytes plays an integral role in screening of malaria parasites. In practice, microscopic evaluation of blood smear image is the gold standard for malaria diagnosis; where the pathologist visually examines the stained slide under the light microscope. This visual inspection is subjective, error-prone and time consuming. In order to address such issues, computational microscopic imaging methods have been given importance in recent times in the field of digital pathology. Recently, such quantitative microscopic techniques have rapidly evolved for abnormal erythrocyte detection, segmentation and semi/fully automated classification by minimizing such diagnostic errors for computerized malaria detection. The aim of this paper is to present a review on enhancement, segmentation, microscopic feature extraction and computer-aided classification for malaria parasite detection. © 2015 The Authors Journal of Microscopy © 2015 Royal Microscopical Society.

  17. MR Imaging in Spinocerebellar Ataxias: A Systematic Review.

    PubMed

    Klaes, A; Reckziegel, E; Franca, M C; Rezende, T J R; Vedolin, L M; Jardim, L B; Saute, J A

    2016-08-01

    Polyglutamine expansion spinocerebellar ataxias are autosomal dominant slowly progressive neurodegenerative diseases with no current treatment. MR imaging is the best-studied surrogate biomarker candidate for polyglutamine expansion spinocerebellar ataxias, though with conflicting results. We aimed to review quantitative central nervous system MR imaging technique findings in patients with polyglutamine expansion spinocerebellar ataxias and correlations with well-established clinical and molecular disease markers. We searched MEDLINE, LILACS, and Cochrane data bases of clinical trials between January 1995 and January 2016, for quantitative MR imaging volumetric approaches, MR spectroscopy, diffusion tensor imaging, or other quantitative techniques, comparing patients with polyglutamine expansion spinocerebellar ataxias (SCAs) with controls. Pertinent details for each study regarding participants, imaging methods, and results were extracted. After reviewing the 706 results, 18 studies were suitable for inclusion: 2 studies in SCA1, 1 in SCA2, 15 in SCA3, 1 in SCA7, 1 in SCA1 and SCA6 presymptomatic carriers, and none in SCA17 and dentatorubropallidoluysian atrophy. Cerebellar hemispheres and vermis, whole brain stem, midbrain, pons, medulla oblongata, cervical spine, striatum, and thalamus presented significant atrophy in SCA3. The caudate, putamen and whole brain stem presented similar sensitivity to change compared with ataxia scales after 2 years of follow-up in a single prospective study in SCA3. MR spectroscopy and DTI showed abnormalities only in cross-sectional studies in SCA3. Results from single studies in other polyglutamine expansion spinocerebellar ataxias should be replicated in different cohorts. Additional cross-sectional and prospective volumetric analysis, MR spectroscopy, and DTI studies are necessary in polyglutamine expansion spinocerebellar ataxias. The properties of preclinical disease biomarkers (presymptomatic) of MR imaging should be

  18. A systematic review of visual image theory, assessment, and use in skin cancer and tanning research.

    PubMed

    McWhirter, Jennifer E; Hoffman-Goetz, Laurie

    2014-01-01

    Visual images increase attention, comprehension, and recall of health information and influence health behaviors. Health communication campaigns on skin cancer and tanning often use visual images, but little is known about how such images are selected or evaluated. A systematic review of peer-reviewed, published literature on skin cancer and tanning was conducted to determine (a) what visual communication theories were used, (b) how visual images were evaluated, and (c) how visual images were used in the research studies. Seven databases were searched (PubMed/MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, Social Sciences Full Text, ERIC, and ABI/INFORM) resulting in 5,330 citations. Of those, 47 met the inclusion criteria. Only one study specifically identified a visual communication theory guiding the research. No standard instruments for assessing visual images were reported. Most studies lacked, to varying degrees, comprehensive image description, image pretesting, full reporting of image source details, adequate explanation of image selection or development, and example images. The results highlight the need for greater theoretical and methodological attention to visual images in health communication research in the future. To this end, the authors propose a working definition of visual health communication.

  19. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations.

    PubMed

    Brinjikji, W; Luetmer, P H; Comstock, B; Bresnahan, B W; Chen, L E; Deyo, R A; Halabi, S; Turner, J A; Avins, A L; James, K; Wald, J T; Kallmes, D F; Jarvik, J G

    2015-04-01

    Degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. We sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals. We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014. Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates. For each imaging finding, we fit a generalized linear mixed-effects model for the age-specific prevalence estimate clustering in the study, adjusting for the midpoint of the reported age interval. Thirty-three articles reporting imaging findings for 3110 asymptomatic individuals met our study inclusion criteria. The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age. Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient's clinical condition. © 2015 by American Journal of Neuroradiology.

  20. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations

    PubMed Central

    Brinjikji, W.; Luetmer, P.H.; Comstock, B.; Bresnahan, B.W.; Chen, L.E.; Deyo, R.A.; Halabi, S.; Turner, J.A.; Avins, A.L.; James, K.; Wald, J.T.; Kallmes, D.F.; Jarvik, J.G.

    2015-01-01

    BACKGROUND AND PURPOSE Degenerative changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. We sought to estimate the prevalence, by age, of common degenerative spine conditions by performing a systematic review studying the prevalence of spine degeneration on imaging in asymptomatic individuals. MATERIALS AND METHODS We performed a systematic review of articles reporting the prevalence of imaging findings (CT or MR imaging) in asymptomatic individuals from published English literature through April 2014. Two reviewers evaluated each manuscript. We selected age groupings by decade (20, 30, 40, 50, 60, 70, 80 years), determining age-specific prevalence estimates. For each imaging finding, we fit a generalized linear mixed-effects model for the age-specific prevalence estimate clustering in the study, adjusting for the midpoint of the reported age interval. RESULTS Thirty-three articles reporting imaging findings for 3110 asymptomatic individuals met our study inclusion criteria. The prevalence of disk degeneration in asymptomatic individuals increased from 37% of 20-year-old individuals to 96% of 80-year-old individuals. Disk bulge prevalence increased from 30% of those 20 years of age to 84% of those 80 years of age. Disk protrusion prevalence increased from 29% of those 20 years of age to 43% of those 80 years of age. The prevalence of annular fissure increased from 19% of those 20 years of age to 29% of those 80 years of age. CONCLUSIONS Imaging findings of spine degeneration are present in high proportions of asymptomatic individuals, increasing with age. Many imaging-based degenerative features are likely part of normal aging and unassociated with pain. These imaging findings must be interpreted in the context of the patient’s clinical condition. PMID:25430861

  1. Technology and Technique Standards for Camera-Acquired Digital Dermatologic Images: A Systematic Review.

    PubMed

    Quigley, Elizabeth A; Tokay, Barbara A; Jewell, Sarah T; Marchetti, Michael A; Halpern, Allan C

    2015-08-01

    Photographs are invaluable dermatologic diagnostic, management, research, teaching, and documentation tools. Digital Imaging and Communications in Medicine (DICOM) standards exist for many types of digital medical images, but there are no DICOM standards for camera-acquired dermatologic images to date. To identify and describe existing or proposed technology and technique standards for camera-acquired dermatologic images in the scientific literature. Systematic searches of the PubMed, EMBASE, and Cochrane databases were performed in January 2013 using photography and digital imaging, standardization, and medical specialty and medical illustration search terms and augmented by a gray literature search of 14 websites using Google. Two reviewers independently screened titles of 7371 unique publications, followed by 3 sequential full-text reviews, leading to the selection of 49 publications with the most recent (1985-2013) or detailed description of technology or technique standards related to the acquisition or use of images of skin disease (or related conditions). No universally accepted existing technology or technique standards for camera-based digital images in dermatology were identified. Recommendations are summarized for technology imaging standards, including spatial resolution, color resolution, reproduction (magnification) ratios, postacquisition image processing, color calibration, compression, output, archiving and storage, and security during storage and transmission. Recommendations are also summarized for technique imaging standards, including environmental conditions (lighting, background, and camera position), patient pose and standard view sets, and patient consent, privacy, and confidentiality. Proposed standards for specific-use cases in total body photography, teledermatology, and dermoscopy are described. The literature is replete with descriptions of obtaining photographs of skin disease, but universal imaging standards have not been developed

  2. Religiosity, spirituality in relation to disordered eating and body image concerns: A systematic review.

    PubMed

    Akrawi, Daniel; Bartrop, Roger; Potter, Ursula; Touyz, Stephen

    2015-01-01

    This systematic review aims to critically examine the existing literature that has reported on the links between aspects of religiosity, spirituality and disordered eating, psychopathology and body image concerns. A systematic search of online databases (PsycINFO, Medline, Embase and Web of Science) was conducted in December 2014. A search protocol was designed to identify relevant articles that quantitatively explored the relationship between various aspects of religiosity and/or spirituality and disordered eating, psychopathology and/or body image concerns in non-clinical samples of women and men. Twenty-two studies were identified to have matched the inclusion criteria. Overall, the main findings to emerge were that strong and internalised religious beliefs coupled with having a secure and satisfying relationship with God were associated with lower levels of disordered eating, psychopathology and body image concern. Conversely, a superficial faith coupled with a doubtful and anxious relationship with God were associated with greater levels of disordered eating, psychopathology and body image concern. While the studies reviewed have a number of evident limitations in design and methodology, there is sufficient evidence to make this avenue of enquiry worth pursuing. It is hoped that the direction provided by this review will lead to further investigation into the protective benefits of religiosity and spirituality in the development of a clinical eating disorder. Thus a stronger evidence base can then be utilised in developing community awareness and programs which reduce the risk.

  3. Post-mortem imaging compared with autopsy in trauma victims--A systematic review.

    PubMed

    Jalalzadeh, Hamid; Giannakopoulos, Georgios F; Berger, Ferco H; Fronczek, Judith; van de Goot, Frank R W; Reijnders, Udo J; Zuidema, Wietse P

    2015-12-01

    Post-mortem imaging or virtual autopsy is a rapidly advancing field of post-mortem investigations of trauma victims. In this review we evaluate the feasibility of complementation or replacement of conventional autopsy by post-mortem imaging in trauma victims. A systematic review was performed in compliance with the PRISMA guidelines. MEDLINE, Embase and Cochrane databases were systematically searched for studies published between January 2008 and January 2014, in which post-mortem imaging was compared to conventional autopsy in trauma victims. Studies were included when two or more trauma victims were investigated. Twenty-six studies were included, with a total number of 563 trauma victims. Post-mortem computer tomography (PMCT) was performed in 22 studies, post-mortem magnetic resonance imaging (PMMRI) in five studies and conventional radiography in two studies. PMCT and PMMRI both demonstrate moderate to high-grade injuries and cause of death accurately. PMCT is more sensitive than conventional autopsy or PMMRI in detecting skeletal injuries. For detecting minor organ and soft tissue injuries, autopsy remains superior to imaging. Aortic injuries are missed frequently by PMCT and PMMRI and form their main limitation. PMCT should be considered as an essential supplement to conventional autopsy in trauma victims since it detects many additional injuries. Despite some major limitations, PMCT could be used as an alternative for conventional autopsy in situations where conventional autopsy is rejected or unavailable. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. Impact of hybrid molecular imaging in retroperitoneal fibrosis: a systematic review.

    PubMed

    Grozdic Milojevic, Isidora T; Milojevic, Bogomir; Sobic-Saranovic, Dragana P; Artiko, Vera M

    2017-08-24

    The aim of this article was to critically assess the usefulness of hybrid molecular imaging (FDG PET/CT and FDG PET/MR) procedures in the evaluation of inflammatory activity in retroperitoneal fibrosis (RPF). A systematic review of the literature was performed using PubMed without timeline restriction and using the following keywords: retroperitoneal fibrosis, disease activity, diagnostic techniques, PET/CT, PET/MR. We evaluated full text articles written in the English language. Case reports, review articles or editorials and articles not in the field of interest of this review were excluded. Nine articles comprising a total of 186 patients met the inclusion criteria and were included and described in this systematic review. The new hybrid molecular imaging methods give promising results in the evaluation of the activity of the disease, quantification and prediction of therapeutic response and in tailoring medical therapy in RPF. FDG PET/CT can be a valuable tool in detecting disease activity, particularly in asymptomatic patients with RPF with acute phase reactant increase. Hybrid imaging can predict therapy response outcome and the best time for stent removal. Although PET/MR has potential advantage in small lesions and has reduced radiation exposure in comparison to PET/CT, PET quantification parameters have potentially higher diagnostic value over MR parameters in the evaluation of RPF. Acute phase reactants alone may not be reliable for the management and follow-up assessment of the disease. Hybrid imaging in RFP could be more comfortable, more accurate, with less radiation burden than different separate imaging studies acquired at different points in time.

  5. Follow-up of occult bone lesions detected at MR imaging: systematic review.

    PubMed

    Boks, Simone S; Vroegindeweij, Dammis; Koes, Bart W; Hunink, M G Myriam; Bierma-Zeinstra, Sita M A

    2006-03-01

    To perform a systematic review of the literature regarding the natural course of posttraumatic occult bone lesions (often referred to as bone bruises) detected at magnetic resonance (MR) imaging. A systematic review of the literature was performed by searching the MEDLINE database (from January 1966 to February 2003) with the keywords bone bruise, trauma, follow-up, and MRI. Keywords were linked by using the Boolean operator AND. Studies were included if all of the following criteria were fulfilled: patients sustained trauma, MR imaging was used as a diagnostic method, results of clinical or MR imaging follow-up were available, and study was written in English, Dutch, German, French, Spanish, Italian, Swedish, Danish, or Norwegian. The quality of each study was assessed by using a standardized criteria set, and kappa statistics were estimated to rate the level of agreement between the two reviewers. Results were compared with regard to study design and quality scores. The MEDLINE search identified 266 articles, 13 of which met the inclusion criteria. The quality of the included studies was moderate. The two reviewers initially agreed on 179 quality items (kappa = 0.84). The study population was generally small, and follow-up periods ranged from 1 to 73 months. Four different classification systems were used, and in two studies bone bruise was not specified. Study results suggest a generally good clinical prognosis of bone bruises. Normalization of MR imaging appearance is possible and is most often encountered after the occurrence of reticular lesions. Cartilage loss at follow-up is often found in cases of initial cartilage damage (impaction or osteochondral fracture). In general, a healing response was often encountered after sustained posttraumatic occult bone lesions. The initial MR imaging appearance appears to have prognostic value. Copyright RSNA, 2006.

  6. A systematic review of diffusion tensor imaging findings in sports-related concussion.

    PubMed

    Gardner, Andrew; Kay-Lambkin, Frances; Stanwell, Peter; Donnelly, James; Williams, W Huw; Hiles, Alexandra; Schofield, Peter; Levi, Christopher; Jones, Derek K

    2012-11-01

    Sports-related concussion (SRC) is typically associated with functional, as opposed to structural, injury. The results of traditional structural neuroimaging techniques used to assess SRC tend to be normal in many athletes, and are only clinically helpful in ruling out a more serious injury. Diffusion tensor imaging (DTI) has increasingly been touted as a method offering greater clinical potential in mild traumatic brain injury (mTBI). Despite this, the utility of DTI as a clinical tool for diagnosing and managing SRC has received considerably less attention than it has in the general TBI research literature. The aim of this article is to conduct a systematic review of DTI in SRC, and to provide a focus and overview of research findings using this MRI technique in SRC. A systematic review of articles published in the English language, up to February 2012, was retrieved via PsycINFO(®), MEDLINE(®), EMBASE, SPORTDiscus(™), Scopus, Web of Science, and Informit; using the key search terms: diffusion tensor imaging, diffusion magnetic resonance imaging, diffusion weighted MRI, diffusion MRI, fractional anisotropy, tractography, apparent diffusion coefficient, magnetic resonance imaging, mild traumatic brain injury, mTBI, traumatic brain injury, concussion, sport, athletic and athlete. Observational, cohort, correlation, cross-sectional and longitudinal studies were all included in the current review. Results of the review found eight articles that met inclusion criteria, which included data on 214 athletes and 96 controls. Seven of eight studies reported some type of DTI abnormality, although the neuroanatomical sites involved varied. Although considerable methodological variations exist across studies, the current review suggests that DTI may possess adequate diagnostic sensitivity to detect SRC in affected athletes. Further longitudinal studies are required to demonstrate its discriminate validity and prognostic capacity within this field.

  7. Systematic reviews. Some examples.

    PubMed Central

    Knipschild, P.

    1994-01-01

    Reviewing the literature is a scientific inquiry that needs a clear design to preclude bias. It is a real enterprise if one aims at completeness of the literature on a certain subject. Going through refereed English language journals is not enough. On line databases are helpful, but mainly as a starting point. This article gives examples of systematic reviews on vitamin C and the common cold, pyridoxine against the premenstrual syndrome, homeopathy, and physiotherapy. Images p720-a PMID:7950526

  8. The impact of computerized provider order entry systems on medical-imaging services: a systematic review

    PubMed Central

    Prgomet, Mirela; Markewycz, Andrew; Adams, Edwina; Westbrook, Johanna I

    2011-01-01

    Background Computerized provider order entry (CPOE) systems have been strongly promoted as a means to improve the quality and efficiency of healthcare. Methods This systematic review aimed to assess the evidence of the impact of CPOE on medical-imaging services and patient outcomes. Results Fourteen studies met the inclusion criteria, most of which (10/14) used a pre-/postintervention comparison design. Eight studies demonstrated benefits, such as decreased test utilization, associated with decision-support systems promoting adherence to test ordering guidelines. Three studies evaluating medical-imaging ordering and reporting times showed statistically significant decreases in turnaround times. Conclusions The findings reveal the potential for CPOE to contribute to significant efficiency and effectiveness gains in imaging services. The diversity and scope of the research evidence can be strengthened through increased attention to the circumstances and mechanisms that contribute to the success (or otherwise) of CPOE and its contribution to the enhancement of patient care delivery. PMID:21385821

  9. The impact of computerized provider order entry systems on medical-imaging services: a systematic review.

    PubMed

    Georgiou, Andrew; Prgomet, Mirela; Markewycz, Andrew; Adams, Edwina; Westbrook, Johanna I

    2011-05-01

    Computerized provider order entry (CPOE) systems have been strongly promoted as a means to improve the quality and efficiency of healthcare. This systematic review aimed to assess the evidence of the impact of CPOE on medical-imaging services and patient outcomes. Fourteen studies met the inclusion criteria, most of which (10/14) used a pre-/postintervention comparison design. Eight studies demonstrated benefits, such as decreased test utilization, associated with decision-support systems promoting adherence to test ordering guidelines. Three studies evaluating medical-imaging ordering and reporting times showed statistically significant decreases in turnaround times. The findings reveal the potential for CPOE to contribute to significant efficiency and effectiveness gains in imaging services. The diversity and scope of the research evidence can be strengthened through increased attention to the circumstances and mechanisms that contribute to the success (or otherwise) of CPOE and its contribution to the enhancement of patient care delivery.

  10. Biomechanical Imaging Markers as Predictors of Abdominal Aortic Aneurysm Growth or Rupture: A Systematic Review.

    PubMed

    Indrakusuma, R; Jalalzadeh, H; Planken, R N; Marquering, H A; Legemate, D A; Koelemay, M J W; Balm, R

    2016-10-01

    Biomechanical characteristics, such as wall stress, are important in the pathogenesis of abdominal aortic aneurysms (AAA) and can be visualised and quantified using imaging techniques. This systematic review aims to present an overview of all biomechanical imaging markers that have been studied in relation to AAA growth and rupture. This systematic review followed the PRISMA guidelines. A search in Medline, Embase, and the Cochrane Library identified 1503 potentially relevant articles. Studies were included if they assessed biomechanical imaging markers and their potential association with growth or rupture. Twenty-seven articles comprising 1730 patients met the inclusion criteria. Eighteen studies performed wall stress analysis using finite element analysis (FEA), 13 of which used peak wall stress (PWS) to quantify wall stress. Ten of 13 case control FEA studies reported a significantly higher PWS for symptomatic or ruptured AAAs than for intact AAAs. However, in some studies there was confounding bias because of baseline differences in aneurysm diameter between groups. Clinical heterogeneity in methodology obstructed a meaningful meta-analysis of PWS. Three of five FEA studies reported a significant positive association between several wall stress markers, such as PWS and 99th percentile stress, and growth. One study reported a significant negative association and one other study reported no significant association. Studies assessing wall compliance, the augmentation index and wall stress analysis using Laplace's law, computational fluid dynamics and fluid structure interaction were also included in this systematic review. Although PWS is significantly higher in symptomatic or ruptured AAAs in most FEA studies, confounding bias, clinical heterogeneity, and lack of standardisation limit the interpretation and generalisability of the results. Also, there is conflicting evidence on whether increased wall stress is associated with growth. Copyright © 2016 European

  11. Fundus autofluorescence imaging: systematic review of test accuracy for the diagnosis and monitoring of retinal conditions.

    PubMed

    Frampton, G K; Kalita, N; Payne, L; Colquitt, J L; Loveman, E; Downes, S M; Lotery, A J

    2017-03-10

    We conducted a systematic review of the accuracy of fundus autofluorescence (FAF) imaging for diagnosing and monitoring retinal conditions. Searches in November 2014 identified English language references. Sources included MEDLINE, EMBASE, the Cochrane Library, Web of Science, and MEDION databases; reference lists of retrieved studies; and internet pages of relevant organisations, meetings, and trial registries. For inclusion, studies had to report FAF imaging accuracy quantitatively. Studies were critically appraised using QUADAS risk of bias criteria. Two reviewers conducted all review steps. From 2240 unique references identified, eight primary research studies met the inclusion criteria. These investigated diagnostic accuracy of FAF imaging for choroidal neovascularisation (one study), reticular pseudodrusen (three studies), cystoid macular oedema (two studies), and diabetic macular oedema (two studies). Diagnostic sensitivity of FAF imaging ranged from 32 to 100% and specificity from 34 to 100%. However, owing to methodological limitations, including high and/or unclear risks of bias, none of these studies provides conclusive evidence of the diagnostic accuracy of FAF imaging. Study heterogeneity precluded meta-analysis. In most studies, the patient spectrum was not reflective of those who would present in clinical practice and no studies adequately reported whether FAF images were interpreted consistently. No studies of monitoring accuracy were identified. An update in October 2016, based on MEDLINE and internet searches, identified four new studies but did not alter our conclusions. Robust quantitative evidence on the accuracy of FAF imaging and how FAF images are interpreted is lacking. We provide recommendations to address this.Eye advance online publication, 10 March 2017; doi:10.1038/eye.2017.19.

  12. Preoperative physical examination and imaging of femoroacetabular impingement prior to hip arthroscopy—a systematic review

    PubMed Central

    Haldane, Chloe E.; Ekhtiari, Seper; de SA, Darren; Simunovic, Nicole

    2017-01-01

    Abstract The purpose of this systematic review is to report current preoperative assessment for femoroacetabular impingement (FAI) including physical examination and imaging modalities prior to hip arthroscopy, and report current imaging measures used in the diagnosis of FAI. The electronic databases MEDLINE, EMBASE and PubMed were searched and screened in duplicate for relevant studies. Data regarding patient demographics, non-operative treatment, preoperative assessment including physical examination and imaging prior to hip arthroscopy were abstracted. Study quality was assessed in duplicate using the Methodological Index for Non-Randomized Studies criteria. Sixty-eight studies of fair quality evidence that involved a total of 5125 patients (5400 hips) were included. In total, 56% of all patients were male and mean age was 36 years (SD ± 10.0). Within physical examination, FADIR impingement testing was reported in 57% of patients. All included studies reported plain radiographic imaging as a component of preoperative assessment with anterior–posterior pelvis view being the most commonly reported view, followed by the cross-table lateral and Dunn views. Magnetic resonance imaging was obtained for 52% of included patients and computed tomography for 26% of patients. The most commonly reported measure within imaging for the diagnosis of cam type impingement was alpha angle (66%), whereas for pincer type impingement, the cross-over sign (48%) was most reported. Preoperative assessment is underreported in the FAI literature. Improved reporting is warranted to develop a more consistent and validated diagnostic algorithm for FAI to enhance patient selection. Level of evidence: Level IV, Systematic Review of Level I–IV Studies. PMID:28948032

  13. Fractal analysis in radiological and nuclear medicine perfusion imaging: a systematic review.

    PubMed

    Michallek, Florian; Dewey, Marc

    2014-01-01

    To provide an overview of recent research in fractal analysis of tissue perfusion imaging, using standard radiological and nuclear medicine imaging techniques including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and to discuss implications for different fields of application. A systematic review of fractal analysis for tissue perfusion imaging was performed by searching the databases MEDLINE (via PubMed), EMBASE (via Ovid) and ISI Web of Science. Thirty-seven eligible studies were identified. Fractal analysis was performed on perfusion imaging of tumours, lung, myocardium, kidney, skeletal muscle and cerebral diseases. Clinically, different aspects of tumour perfusion and cerebral diseases were successfully evaluated including detection and classification. In physiological settings, it was shown that perfusion under different conditions and in various organs can be properly described using fractal analysis. Fractal analysis is a suitable method for quantifying heterogeneity from radiological and nuclear medicine perfusion images under a variety of conditions and in different organs. Further research is required to exploit physiologically proven fractal behaviour in the clinical setting. • Fractal analysis of perfusion images can be successfully performed. • Tumour, pulmonary, myocardial, renal, skeletal muscle and cerebral perfusion have already been examined. • Clinical applications of fractal analysis include tumour and brain perfusion assessment. • Fractal analysis is a suitable method for quantifying perfusion heterogeneity. • Fractal analysis requires further research concerning the development of clinical applications.

  14. Visual images for skin cancer prevention: a systematic review of qualitative studies.

    PubMed

    McWhirter, Jennifer E; Hoffman-Goetz, Laurie

    2012-06-01

    Visual images play an important role in educating the public about skin cancer prevention. The objectives of this systematic review were to: 1) determine how visual images are evaluated in skin cancer and tanning qualitative research studies (including theoretical and methodological approaches) and 2) summarize and discuss the image-related findings of the studies with respect to cancer education and public health. Seven databases were searched (PubMed-MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, Social Sciences Full Text, ERIC, and ABI/INFORM) using multiple search terms, including MeSH terms, resulting in 5330 citations. Studies were included if they were in English, peer-reviewed, qualitative in design or methodology, dealt with skin cancer or UV exposure, used visual images, and had a focus on the public or patients (i.e., not medical professionals). Eight studies met the inclusion criteria: seven content analyses and one focus group study. Content analysis studies in this review suggest the mass media portray Caucasian men and women as unprotected from the sun and with tanned skin, and thus, may inform behaviors related to skin cancer risk. The focus group study suggests visible minorities may benefit from the incorporation of images of melanoma on ethnic skin in cancer education materials. None of the studies used visual communication theory to explicitly guide the research, nor were standardized tools used for image assessment. The lack of guiding theory and standardized assessment instruments can introduce bias in how images are selected and used in research on skin cancer education.

  15. Imaging as a potential outcome measure in gout studies: A systematic literature review.

    PubMed

    Durcan, Laura; Grainger, Rebecca; Keen, Helen I; Taylor, William J; Dalbeth, Nicola

    2016-04-01

    Despite major progress in the imaging of gout, it is unclear which domains these techniques can evaluate and whether imaging modalities have the potential to provide valid outcome measures. The aim of this study was to assess the use of imaging instruments in gout according to the Outcomes in Rheumatology Clinical Trials (OMERACT) filter to inform the development of imaging as an outcome measure. A systematic literature search of imaging modalities for gout was undertaken. Articles were assessed by two reviewers to identify imaging domains and summarize information according to the OMERACT filter. The search identified 78 articles (one abstract). Modalities included were conventional radiography (CR) (16 articles), ultrasound (US) (29), conventional computed tomography (CT) (11), dual energy computed tomography (DECT) (20), and magnetic resonance imaging (MRI) (16). Three domains were identified as follows: urate deposition, joint damage, and inflammation. Although sufficient data were available to assess feasibility, validity, and reliability, comprehensive assessment of discrimination was not possible due to the paucity of prospective imaging studies. CR is widely accessible, inexpensive with a validated damage scoring system. US and MRI offer radiation-free methods of evaluating urate deposition, damage and inflammation, but may be limited by accessibility. DECT provides excellent definition of urate deposition and bone damage, but has restricted availability and requires radiation. Imaging methods can detect urate deposition, damage, and inflammation in gout. More than one modality may be required depending on the domains and therapeutic agent of interest. No single imaging method currently fulfils all aspects of the OMERACT filter for any domain. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A systematic review of lessons learned from PET molecular imaging research in atypical parkinsonism.

    PubMed

    Niccolini, Flavia; Politis, Marios

    2016-11-01

    To systematically review the previous studies and current status of positron emission tomography (PET) molecular imaging research in atypical parkinsonism. MEDLINE, ISI Web of Science, Cochrane Library, and Scopus electronic databases were searched for articles published until 29th March 2016 and included brain PET studies in progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and corticobasal syndrome (CBS). Only articles published in English and in peer-reviewed journals were included in this review. Case-reports, reviews, and non-human studies were excluded. Seventy-seven PET studies investigating the dopaminergic system, glucose metabolism, microglial activation, hyperphosphorilated tau, opioid receptors, the cholinergic system, and GABAA receptors in PSP, MSA, and CBS patients were included in this review. Disease-specific patterns of reduced glucose metabolism have shown higher accuracy than dopaminergic imaging techniques to distinguish between parkinsonian syndromes. Microglial activation has been found in all forms of atypical parkinsonism and reflects the known distribution of neuropathologic changes in these disorders. Opioid receptors are decreased in the striatum of PSP and MSA patients. Subcortical cholinergic dysfunction was more severe in MSA and PSP than Parkinson's disease patients although no significant changes in cortical cholinergic receptors were seen in PSP with cognitive impairment. GABAA receptors were decreased in metabolically affected cortical and subcortical regions in PSP patients. PET molecular imaging has provided valuable insight for understanding the mechanisms underlying atypical parkinsonism. Changes at a molecular level occur early in the course of these neurodegenerative diseases and PET imaging provides the means to aid differential diagnosis, monitor disease progression, identify of novel targets for pharmacotherapy, and monitor response to new treatments.

  17. Magnetic resonance imaging acquisition techniques intended to decrease movement artefact in paediatric brain imaging: a systematic review.

    PubMed

    Woodfield, Julie; Kealey, Susan

    2015-08-01

    Attaining paediatric brain images of diagnostic quality can be difficult because of young age or neurological impairment. The use of anaesthesia to reduce movement in MRI increases clinical risk and cost, while CT, though faster, exposes children to potentially harmful ionising radiation. MRI acquisition techniques that aim to decrease movement artefact may allow diagnostic paediatric brain imaging without sedation or anaesthesia. We conducted a systematic review to establish the evidence base for ultra-fast sequences and sequences using oversampling of k-space in paediatric brain MR imaging. Techniques were assessed for imaging time, occurrence of movement artefact, the need for sedation, and either image quality or diagnostic accuracy. We identified 24 relevant studies. We found that ultra-fast techniques had shorter imaging acquisition times compared to standard MRI. Techniques using oversampling of k-space required equal or longer imaging times than standard MRI. Both ultra-fast sequences and those using oversampling of k-space reduced movement artefact compared with standard MRI in unsedated children. Assessment of overall diagnostic accuracy was difficult because of the heterogeneous patient populations, imaging indications, and reporting methods of the studies. In children with shunt-treated hydrocephalus there is evidence that ultra-fast MRI is sufficient for the assessment of ventricular size.

  18. White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies

    PubMed Central

    Martin Monzon, Beatriz; Hay, Phillipa; Foroughi, Nasim; Touyz, Stephen

    2016-01-01

    AIM: To identify findings concerning white matter (WM) fibre microstructural alterations in anorexia nervosa (AN). METHODS: A systematic electronic search was undertaken in several databases up to April 2015. The search strategy aimed to locate all studies published in English or Spanish that included participants with AN and which investigated WM using diffusion tensor imaging (DTI). Trials were assessed for quality assessment according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and a published quality index guideline. RESULTS: A total of 6 studies met the inclusion criteria, four of people in the acute state of the illness, one included both recovered and unwell participants, and one included people who had recovered. Participants were female with ages ranging from 14 to 29 years. All studies but one measured a range of psychopathological features. Fractional anisotropy and mean diffusivity were the main DTI correlates reported. Alterations were reported in a range of WM structures of the limbic system, most often of the fornix and cingulum as well as the fronto-occipital fibre tracts, i.e., regions associated with anxiety, body image and cognitive function. Subtle abnormalities also appeared to persist after recovery. CONCLUSION: This diversity likely reflects the symptom complexity of AN. However, there were few studies, they applied different methodologies, and all were cross-sectional. PMID:27014606

  19. Identification of mineral deposits in the brain on radiological images: a systematic review.

    PubMed

    Valdés Hernández, Maria del C; Maconick, Lucy C; Tan, Elizabeth M J; Wardlaw, Joanna M

    2012-11-01

    MRI has allowed the study of mineral deposition in the brain throughout life and in disease. However, studies differ in their reporting of minerals on MRI for reasons that are unclear. We conducted a systematic review from 1985 to July 2011 to determine the appearance of iron, calcium, copper and manganese on MRI and CT and their reliability. We assessed which imaging investigations provided the most consistent results compared with histology. Of 325 papers on minerals imaging, we included 46 studies that confirmed findings either directly or indirectly using a non-imaging method such as histology. Within this group, there was inconsistency in the identification of iron probably because of changes in its paramagnetic properties during its degradation. Iron appeared consistently hypointense only on T2*-weighted MRI, and along with calcified areas, hyperattenuated on CT. Appearance of copper, calcium and manganese, although consistently reported as hyperintense on T1-weighted MRI, was confirmed histologically in few studies. On T2-weighted imaging, calcified areas were always reported as hypointense, while the appearance of iron depended on the concentration, location and degradation stage. More work is required to improve the reliability of imaging methods to detect and differentiate brain mineral deposition accurately. There is inconsistency in reporting the appearance of minerals on radiological images. • Only 46 studies confirmed mineral appearance using a non-imaging method. • Iron is the mineral more widely studied, consistently hypointense on T2*-weighted MRI. • T1-weighted MRI consistently reported copper, calcium and manganese hyperintense. • Calcium is consistently reported hypointense on T2-weighted MRI and hyperattenuating on CT.

  20. Evidence and Recommendations for Imaging Liver Fat in Children, Based upon Systematic Review

    PubMed Central

    Awai, Hannah I.; Newton, Kimberly P.; Sirlin, Claude B.; Behling, Cynthia; Schwimmer, Jeffrey B.

    2013-01-01

    Background & Aims Fatty liver is a common problem in children, and increases their risk for cirrhosis, diabetes, and cardiovascular disease. Liver biopsy is the clinical standard for diagnosing and grading fatty liver. However, non-invasive imaging modalities are needed to assess liver fat in children. We performed a systematic review of studies that evaluated imaging of liver fat in children. Methods We searched PubMed for original research articles in peer-reviewed journals from January 1, 1982 through December 31, 2012 using the key words “imaging liver fat.” Studies included those in English, and those performed in children from birth to 18 y of age. To be eligible for inclusion, studies were required to measure hepatic steatosis via an imaging modality and a quantitative comparator as the reference standard. Results We analyzed 9 studies comprising 610 children; 4 studies assessed ultrasonography and 5 assessed magnetic resonance imaging (MRI). Ultrasonography was used in the diagnosis of fatty liver with positive predictive values of 47–62%. There was not a consistent relationship between ultrasound steatosis score and the reference measurement of hepatic steatosis. Liver fat as measurements by MRI or by spectroscopy varied with the methodologies used. Liver fat measurements by MRI correlated with results from histologic analyses, but sample size did not allow for assessment of diagnostic accuracy. Conclusions Available evidence does not support the use of ultrasonography for the diagnosis or grading of fatty liver in children. Although MRI is a promising approach, the data are insufficient to make evidence-based recommendations regarding its use in children for assessment of hepatic steatosis. PMID:24090729

  1. Practical planning to maintain premature infants' safety during magnetic resonance imaging: a systematic review.

    PubMed

    Knudsen, Lina Merete M; Moen, Anne

    2015-02-01

    Magnetic resonance imaging (MRI) makes a significant contribution to diagnose brain injury in premature infants and is a diagnostic procedure that requires the infant to be taken out of the controlled environment established for growth and development. To ensure safe procedures for these vulnerable patients, practical planning and surveillance are paramount. This systematic review summarizes and evaluates the literature reporting on practical planning to maintain required safety for premature infants undergoing MRI. Literature identified through various search strategies was screened, abstracted, appraised, and synthesized through a descriptive analysis. Thirteen research studies, 2 quality improvement projects, and 10 other documents, including practice guidelines, general reviews and articles, a book chapter, and an editorial article, were retained for in-depth review. Various procedures and equipment to ensure the safety of premature infants during MRI have been developed and tested. Although the results are promising and increasingly consistent, our review suggests that more research is needed before conclusive recommendations for the use of magnetic resonance-compatible incubators, the "feed-and-sleep" approach to avoid sedation, or the specific noise-cancelling ear protection for the premature infants' safety during MRI can be established.

  2. Recent development of feature extraction and classification multispectral/hyperspectral images: a systematic literature review

    NASA Astrophysics Data System (ADS)

    Setiyoko, A.; Dharma, I. G. W. S.; Haryanto, T.

    2017-01-01

    Multispectral data and hyperspectral data acquired from satellite sensor have the ability in detecting various objects on the earth ranging from low scale to high scale modeling. These data are increasingly being used to produce geospatial information for rapid analysis by running feature extraction or classification process. Applying the most suited model for this data mining is still challenging because there are issues regarding accuracy and computational cost. This research aim is to develop a better understanding regarding object feature extraction and classification applied for satellite image by systematically reviewing related recent research projects. A method used in this research is based on PRISMA statement. After deriving important points from trusted sources, pixel based and texture-based feature extraction techniques are promising technique to be analyzed more in recent development of feature extraction and classification.

  3. Contribution of brain imaging to the understanding of gait disorders in Alzheimer's disease: a systematic review.

    PubMed

    Annweiler, Cédric; Beauchet, Olivier; Celle, Sébastien; Roche, Frédéric; Annweiler, Thierry; Allali, Gilles; Bartha, Robert; Montero-Odasso, Manuel

    2012-09-01

    Although gait disorders are common in Alzheimer's disease (AD), determining which brain structures and related lesions are specifically involved is a goal yet to be reached. Our objective was to systematically review all published data that examined associations between gait disorders and brain imaging in AD. Of 486 selected studies, 4 observational studies met the selection criteria. The number of participants ranged from 2 to 61 community dwellers (29%-100% female) with prodromal or dementia-stage AD. Quantitative gait disorders (ie, slower gait velocity explained by shorter stride length) were associated with white matter lesions, mainly in the medial frontal lobes and basal ganglia. The nigrostriatal dopamine system was unaffected. Qualitative gait disorders (ie, higher stride length variability) correlated with lower hippocampal volume and function. Gait disorders in AD could be explained by a high burden of age-related subcortical hyperintensities on the frontal-subcortical circuits (nonspecific) together with hippocampal atrophy and hypometabolism (specific).

  4. A systematic review of interventions on body image and disordered eating outcomes among women in midlife.

    PubMed

    Lewis-Smith, Helena; Diedrichs, Phillippa C; Rumsey, Nichola; Harcourt, Diana

    2016-01-01

    Body dissatisfaction and disordered eating are widely recognized as issues that warrant attention among women in midlife, particularly the development and delivery of effective interventions. This article systematically reviews existing research on interventions among midlife women on body image and disordered eating outcomes, in order to inform intervention delivery and provide strategic directions for future research. Fourteen electronic databases were searched for articles published between 1992 and 2015 that evaluated interventions with nonclinical samples of women (M age 35-55 years) in controlled trials with at least one body image measure. Data were extracted and evaluated, and the methodological quality of studies was assessed using the Cochrane Collaboration tool for assessing risk of bias. From 7,475 records identified, nine articles evaluating 11 interventions met the inclusion criteria. Seven interventions significantly improved body image at post-test (d's = 0.19-2.22), with significant improvements on disordered eating achieved by two of these interventions (d's = 0.90-1.72). Sustained improvements were achieved by three interventions that employed a multisession, therapeutically based, group intervention format; two with sustained body image and disordered eating improvements, and one with sustained body image improvements only (d's = 0.55-1.21; 2 weeks to 6 months). Methodological quality varied between studies. To date, three interventions have demonstrated sustained improvements and are indicated for practitioners aiming to improve body image and disordered eating among women in midlife. Replication and more rigorous randomised controlled trials are required to enhance the methodological quality of intervention studies in this field. © 2015 Wiley Periodicals, Inc.

  5. Diagnostic imaging for chronic plantar heel pain: a systematic review and meta-analysis

    PubMed Central

    2009-01-01

    Background Chronic plantar heel pain (CPHP) is a generalised term used to describe a range of undifferentiated conditions affecting the plantar heel. Plantar fasciitis is reported as the most common cause and the terms are frequently used interchangeably in the literature. Diagnostic imaging has been used by many researchers and practitioners to investigate the involvement of specific anatomical structures in CPHP. These observations help to explain the underlying pathology of the disorder, and are of benefit in forming an accurate diagnosis and targeted treatment plan. The purpose of this systematic review was to investigate the diagnostic imaging features associated with CPHP, and evaluate study findings by meta-analysis where appropriate. Methods Bibliographic databases including Medline, Embase, CINAHL, SportDiscus and The Cochrane Library were searched electronically on March 25, 2009. Eligible articles were required to report imaging findings in participants with CPHP unrelated to inflammatory arthritis, and to compare these findings with a control group. Methodological quality was evaluated by use of the Quality Index as described by Downs and Black. Meta-analysis of study data was conducted where appropriate. Results Plantar fascia thickness as measured by ultrasonography was the most widely reported imaging feature. Meta-analysis revealed that the plantar fascia of CPHP participants was 2.16 mm thicker than control participants (95% CI = 1.60 to 2.71 mm, P < 0.001) and that CPHP participants were more likely to have plantar fascia thickness values greater than 4.0 mm (OR = 105.11, 95% CI = 3.09 to 3577.28, P = 0.01). CPHP participants were also more likely to show radiographic evidence of subcalcaneal spur than control participants (OR = 8.52, 95% CI = 4.08 to 17.77, P < 0.001). Conclusion This systematic review has identified 23 studies investigating the diagnostic imaging appearance of the plantar fascia and inferior calcaneum in people with CPHP

  6. Radiological interpretation of images displayed on tablet computers: a systematic review.

    PubMed

    Caffery, L J; Armfield, N R; Smith, A C

    2015-06-01

    To review the published evidence and to determine if radiological diagnostic accuracy is compromised when images are displayed on a tablet computer and thereby inform practice on using tablet computers for radiological interpretation by on-call radiologists. We searched the PubMed and EMBASE databases for studies on the diagnostic accuracy or diagnostic reliability of images interpreted on tablet computers. Studies were screened for inclusion based on pre-determined inclusion and exclusion criteria. Studies were assessed for quality and risk of bias using Quality Appraisal of Diagnostic Reliability Studies or the revised Quality Assessment of Diagnostic Accuracy Studies tool. Treatment of studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). 11 studies met the inclusion criteria. 10 of these studies tested the Apple iPad(®) (Apple, Cupertino, CA). The included studies reported high sensitivity (84-98%), specificity (74-100%) and accuracy rates (98-100%) for radiological diagnosis. There was no statistically significant difference in accuracy between a tablet computer and a digital imaging and communication in medicine-calibrated control display. There was a near complete consensus from authors on the non-inferiority of diagnostic accuracy of images displayed on a tablet computer. All of the included studies were judged to be at risk of bias. Our findings suggest that the diagnostic accuracy of radiological interpretation is not compromised by using a tablet computer. This result is only relevant to the Apple iPad and to the modalities of CT, MRI and plain radiography. The iPad may be appropriate for an on-call radiologist to use for radiological interpretation.

  7. Radiological interpretation of images displayed on tablet computers: a systematic review

    PubMed Central

    Armfield, N R; Smith, A C

    2015-01-01

    Objective: To review the published evidence and to determine if radiological diagnostic accuracy is compromised when images are displayed on a tablet computer and thereby inform practice on using tablet computers for radiological interpretation by on-call radiologists. Methods: We searched the PubMed and EMBASE databases for studies on the diagnostic accuracy or diagnostic reliability of images interpreted on tablet computers. Studies were screened for inclusion based on pre-determined inclusion and exclusion criteria. Studies were assessed for quality and risk of bias using Quality Appraisal of Diagnostic Reliability Studies or the revised Quality Assessment of Diagnostic Accuracy Studies tool. Treatment of studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: 11 studies met the inclusion criteria. 10 of these studies tested the Apple iPad® (Apple, Cupertino, CA). The included studies reported high sensitivity (84–98%), specificity (74–100%) and accuracy rates (98–100%) for radiological diagnosis. There was no statistically significant difference in accuracy between a tablet computer and a digital imaging and communication in medicine-calibrated control display. There was a near complete consensus from authors on the non-inferiority of diagnostic accuracy of images displayed on a tablet computer. All of the included studies were judged to be at risk of bias. Conclusion: Our findings suggest that the diagnostic accuracy of radiological interpretation is not compromised by using a tablet computer. This result is only relevant to the Apple iPad and to the modalities of CT, MRI and plain radiography. Advances in knowledge: The iPad may be appropriate for an on-call radiologist to use for radiological interpretation. PMID:25882691

  8. Imaging modalities for the classification of gout: systematic literature review and meta-analysis.

    PubMed

    Ogdie, Alexis; Taylor, William J; Weatherall, Mark; Fransen, Jaap; Jansen, Tim L; Neogi, Tuhina; Schumacher, H Ralph; Dalbeth, Nicola

    2015-10-01

    Although there has been major progress in gout imaging, no gout classification criteria currently include advanced imaging techniques. To examine the usefulness of imaging modalities in the classification of gout when compared to monosodium urate (MSU) crystal confirmation as the gold standard, in order to inform development of new gout classification criteria. We systematically reviewed the published literature concerning the diagnostic performance of plain film radiography, MRI, ultrasound (US), conventional CT and dual energy CT (DECT). Only studies with MSU crystal confirmation as the gold standard were included. When more than one study examined the same imaging feature, the data were pooled and summary test characteristics were calculated. 11 studies (9 manuscripts and 2 meeting abstracts) satisfied the inclusion criteria. All were set in secondary care, with mean gout disease duration of at least 7 years. Three features were examined in more than one study: the double contour sign (DCS) on US, tophus on US, and MSU crystal deposition on DECT. The pooled (95% CI) sensitivity and specificity of US DCS were 0.83 (0.72 to 0.91) and 0.76 (0.68 to 0.83), respectively; of US tophus, were 0.65 (0.34 to 0.87) and 0.80 (0.38 to 0.96), respectively; and of DECT, were 0.87 (0.79 to 0.93) and 0.84 (0.75 to 0.90), respectively. US and DECT show promise for gout classification but the few studies to date have mostly been in patients with longstanding, established disease. The contribution of imaging over clinical features for gout classification criteria requires further examination. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Diagnostic accuracy of postmortem imaging vs autopsy-A systematic review.

    PubMed

    Eriksson, Anders; Gustafsson, Torfinn; Höistad, Malin; Hultcrantz, Monica; Jacobson, Stella; Mejare, Ingegerd; Persson, Anders

    2017-04-01

    Background Postmortem imaging has been used for more than a century as a complement to medico-legal autopsies. The technique has also emerged as a possible alternative to compensate for the continuous decline in the number of clinical autopsies. To evaluate the diagnostic accuracy of postmortem imaging for various types of findings, we performed this systematic literature review. Data sources The literature search was performed in the databases PubMed, Embase and Cochrane Library through January 7, 2015. Relevant publications were assessed for risk of bias using the QUADAS tool and were classified as low, moderate or high risk of bias according to pre-defined criteria. Autopsy and/or histopathology were used as reference standard. Findings The search generated 2600 abstracts, of which 340 were assessed as possibly relevant and read in full-text. After further evaluation 71 studies were finally included, of which 49 were assessed as having high risk of bias and 22 as moderate risk of bias. Due to considerable heterogeneity - in populations, techniques, analyses and reporting - of included studies it was impossible to combine data to get a summary estimate of the diagnostic accuracy of the various findings. Individual studies indicate, however, that imaging techniques might be useful for determining organ weights, and that the techniques seem superior to autopsy for detecting gas Conclusions and Implications In general, based on the current scientific literature, it was not possible to determine the diagnostic accuracy of postmortem imaging and its usefulness in conjunction with, or as an alternative to autopsy. To correctly determine the usefulness of postmortem imaging, future studies need improved planning, improved methodological quality and larger materials, preferentially obtained from multi-center studies. Copyright © 2016. Published by Elsevier B.V.

  10. EOS 2D/3D X-ray imaging system: a systematic review and economic evaluation.

    PubMed

    McKenna, C; Wade, R; Faria, R; Yang, H; Stirk, L; Gummerson, N; Sculpher, M; Woolacott, N

    2012-01-01

    EOS is a biplane X-ray imaging system manufactured by EOS Imaging (formerly Biospace Med, Paris, France). It uses slot-scanning technology to produce a high-quality image with less irradiation than standard imaging techniques. To determine the clinical effectiveness and cost-effectiveness of EOS two-dimensional (2D)/three-dimensional (3D) X-ray imaging system for the evaluation and monitoring of scoliosis and other relevant orthopaedic conditions. For the systematic review of EOS, electronic databases (MEDLINE, Allied and Complementary Medicine Database, BIOSIS Previews, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, EMBASE, Health Management Information Consortium, Inspec, ISI Science Citation Index and PASCAL), clinical trials registries and the manufacturer's website were searched from 1993 to November 2010. A systematic review of studies comparing EOS with standard X-ray [film, computed radiography (CR) or digital radiography] in any orthopaedic condition was performed. A narrative synthesis was undertaken. A decision-analytic model was developed to assess the cost-effectiveness of EOS in the relevant indications compared with standard X-ray and incorporated the clinical effectiveness of EOS and the adverse effects of radiation. The model incorporated a lifetime horizon to estimate outcomes in terms of quality-adjusted life-years (QALYs) and costs from the perspective of the NHS. Three studies met the inclusion criteria for the review. Two studies compared EOS with film X-ray and one study compared EOS with CR. The three included studies were small and of limited quality. One study used an earlier version of the technology, the Charpak system. Both studies comparing EOS with film X-ray found image quality to be comparable or better with EOS overall. Radiation dose was considerably lower with EOS: ratio of means for posteroanterior spine was 5.2 (13.1 for the study using the Charpak system); ratio of means for the lateral spine

  11. Systematic review automation technologies.

    PubMed

    Tsafnat, Guy; Glasziou, Paul; Choong, Miew Keen; Dunn, Adam; Galgani, Filippo; Coiera, Enrico

    2014-07-09

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

  12. Systematic review automation technologies

    PubMed Central

    2014-01-01

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

  13. Autism Spectrum Disorder: Does Neuroimaging Support the DSM-5 Proposal for a Symptom Dyad? A Systematic Review of Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Studies

    ERIC Educational Resources Information Center

    Pina-Camacho, Laura; Villero, Sonia; Fraguas, David; Boada, Leticia; Janssen, Joost; Navas-Sanchez, Francisco J.; Mayoral, Maria; Llorente, Cloe; Arango, Celso; Parellada, Mara

    2012-01-01

    A systematic review of 208 studies comprising functional magnetic resonance imaging and diffusion tensor imaging data in patients with "autism spectrum disorder" (ASD) was conducted, in order to determine whether these data support the forthcoming DSM-5 proposal of a social communication and behavioral symptom dyad. Studies consistently reported…

  14. Autism Spectrum Disorder: Does Neuroimaging Support the DSM-5 Proposal for a Symptom Dyad? A Systematic Review of Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging Studies

    ERIC Educational Resources Information Center

    Pina-Camacho, Laura; Villero, Sonia; Fraguas, David; Boada, Leticia; Janssen, Joost; Navas-Sanchez, Francisco J.; Mayoral, Maria; Llorente, Cloe; Arango, Celso; Parellada, Mara

    2012-01-01

    A systematic review of 208 studies comprising functional magnetic resonance imaging and diffusion tensor imaging data in patients with "autism spectrum disorder" (ASD) was conducted, in order to determine whether these data support the forthcoming DSM-5 proposal of a social communication and behavioral symptom dyad. Studies consistently reported…

  15. Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis.

    PubMed

    Shin, Jin Yong; Yi, Hyung Suk

    2016-11-01

    Accurate assessment of burn depth is important for determination of treatment modality. Laser Doppler imaging (LDI) is known to be an objective and effective measurement tool in burn depth assessment. Our study evaluated the diagnostic accuracy of LDI across enrolled studies and subgroups. A systematic literature review and meta-analysis were performed using MEDLINE, EMBASE, and Cochrane databases. Data from LDI cases were extracted from all primary studies and categorized into four cell values (true positives, false positives, true negatives, and false negatives). Subgroup analyses were performed according to perfusion units of LDI, clinical criteria of superficial and deep burns during the treatment period, and publication date of enrolled studies. The search strategy identified 321 publications. After screening, 10 articles were selected for review. The pooled sensitivity and specificity of LDI in all enrolled studies and subgroups were found to be similarly high. However, the sensitivity of LDI in our meta-analysis was not as high as that identified in previous studies. Although LDI in burn depth assessment was identified as an accurate measurement tool in this meta-analysis, careful clinical assessment should be performed along with LDI in patients with deep burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  16. A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease

    PubMed Central

    Meghji, Jamilah; Simpson, Hope; Squire, S. Bertel; Mortimer, Kevin

    2016-01-01

    Background Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our ability to phenotype post-TB lung disease in to meaningful categories for clinical management, prognostication, and ongoing research. The relationship between post-TB lung damage and patient-centred outcomes including functional impairment, respiratory symptoms, and health related quality of life also remains unclear. Methods We performed a systematic literature review to determine the prevalence and pattern of imaging-defined lung pathology in adults after medical treatment for pleural, miliary, or pulmonary TB disease. Data were collected on study characteristics, and the modality, timing, and findings of thoracic imaging. The proportion of studies relating imaging findings to spirometry results and patient morbidity was recorded. Study quality was assessed using a modified Newcastle-Ottowa score. (Prospero Registration number CRD42015027958) Results We identified 37 eligible studies. The principle features seen on CXR were cavitation (8.3–83.7%), bronchiectasis (4.3–11.2%), and fibrosis (25.0–70.4%), but prevalence was highly variable. CT imaging identified a wider range of residual abnormalities than CXR, including nodules (25.0–55.8%), consolidation (3.7–19.2%), and emphysema (15.0–45.0%). The prevalence of cavitation was generally lower (7.4–34.6%) and bronchiectasis higher (35.0–86.0%) on CT vs. CXR imaging. A paucity of prospective data, and data from HIV-infected adults and sub-Saharan Africa (sSA) was noted. Few studies related structural damage to physiological impairment, respiratory symptoms, or patient morbidity. Conclusions Post-TB structural lung pathology is common. Prospective data are required to determine the evolution of this lung damage and

  17. Conventional and Nuclear Medicine Imaging in Ectopic Cushing's Syndrome: A Systematic Review

    PubMed Central

    Isidori, Andrea M.; Sbardella, Emilia; Zatelli, Maria Chiara; Boschetti, Mara; Vitale, Giovanni; Colao, Annamaria

    2015-01-01

    Context: Ectopic Cushing's Syndrome (ECS) can be a diagnostic challenge with the hormonal source difficult to find. This study analyzes the accuracy of imaging studies in ECS localization. Evidence Acquisition: Systematic review of medical literature for ECS case series providing individual patient data on at least one conventional imaging technique (computed tomography [CT]/magnetic resonance imaging) and one of the following: 111In-pentetreotide (OCT), 131I/123I-metaiodobenzylguanidine, 18F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET), 18F-fluorodopa-PET (F-DOPA-PET), 68Ga-DOTATATE-PET/CT or 68Ga-DOTATOC-PET/CT scan (68Gallium-SSTR-PET/CT). Evidence Summary: The analysis comprised 231 patients (females, 50.2%; age, 42.6 ± 17 y). Overall, 52.4% (121/231) had “overt” ECS, 18.6% had “occult” ECS, and 29% had “covert” ECS. Tumors were located in the lung (55.3%), mediastinum-thymus (7.9%), pancreas (8.5%), adrenal glands (6.4%), gastrointestinal tract (5.4%), thyroid (3.7%), and other sites (12.8%), and primary tumors were mostly bronchial neuroendocrine tumors (NETs) (54.8%), pancreatic NETs (8%), mediastinum-thymus NETs (6.9%), gastrointestinal NETs (5.3%), pheochromocytoma (6.4%), neuroblastoma (3.2%), and medullary thyroid carcinoma (3.2%). Tumors were localized by CT in 66.2% (137/207), magnetic resonance imaging in 51.5% (53/103), OCT in 48.9% (84/172), FDG-PET in 51.7% (46/89), F-DOPA-PET in 57.1% (12/21), 131/123I-metaiodobenzylguanidine in 30.8% (4/13), and 68Gallium-SSTR-PET/CT in 81.8% (18/22) of cases. Molecular imaging discovered 79.1% (53/67) of tumors unidentified by conventional radiology, with OCT the most commonly used, revealing the tumor in 64%, followed by FDG-PET in 59.4%. F-DOPA-PET was used in only seven covert cases (sensitivity, 85.7%). Notably, 68Gallium-SSTR-PET/CT had 100% sensitivity among covert cases. Conclusions: Nuclear medicine improves the sensitivity of conventional radiology when tumor site

  18. Conventional and Nuclear Medicine Imaging in Ectopic Cushing's Syndrome: A Systematic Review.

    PubMed

    Isidori, Andrea M; Sbardella, Emilia; Zatelli, Maria Chiara; Boschetti, Mara; Vitale, Giovanni; Colao, Annamaria; Pivonello, Rosario

    2015-09-01

    Ectopic Cushing's Syndrome (ECS) can be a diagnostic challenge with the hormonal source difficult to find. This study analyzes the accuracy of imaging studies in ECS localization. Systematic review of medical literature for ECS case series providing individual patient data on at least one conventional imaging technique (computed tomography [CT]/magnetic resonance imaging) and one of the following: 111In-pentetreotide (OCT), 131I/123I-metaiodobenzylguanidine, 18Ffluoro-2-deoxyglucose-positron emission tomography (FDG-PET), 18F-fluorodopa-PET (F-DOPA-PET), 68Ga- DOTATATE-PET/CT or 68Ga-DOTATOC-PET/CT scan (68Gallium-SSTR-PET/CT). The analysis comprised 231 patients (females, 50.2%; age, 42.617 y). Overall, 52.4%(121/231) had "overt" ECS,18.6% had "occult" ECS, and 29% had "covert" ECS. Tumors were located in the lung (55.3%), mediastinum-thymus (7.9%), pancreas (8.5%), adrenal glands (6.4%), gastrointestinal tract (5.4%), thyroid (3.7%), and other sites (12.8%), and primary tumors were mostly bronchial neuroendocrine tumors (NETs) (54.8%), pancreatic NETs (8%), mediastinum-thymus NETs (6.9%), gastrointestinal NETs (5.3%), pheochromocytoma (6.4%), neuroblastoma (3.2%), and medullary thyroid carcinoma (3.2%). Tumors were localized byCTin66.2%(137/207), magnetic resonance imaging in 51.5% (53/103), OCT in 48.9% (84/172), FDG-PET in 51.7% (46/89), F-DOPAPET in 57.1% (12/21), 131/123I-metaiodobenzylguanidine in 30.8% (4/13), and 68Gallium-SSTRPET/CT in 81.8% (18/22) of cases. Molecular imaging discovered 79.1% (53/67) of tumors unidentified by conventional radiology, with OCT the most commonly used, revealing the tumor in 64%, followed by FDG-PET in 59.4%. F-DOPA-PET was used in only seven covert cases (sensitivity, 85.7%). Notably, 68Gallium-SSTR-PET/CT had 100% sensitivity among covert cases. Nuclear medicine improves the sensitivity of conventional radiology when tumor site identification is problematic. OCT offers a good availability/reliability ratio, and FDG-PET was

  19. Emerging clinical imaging techniques for cerebral cavernous malformations: a systematic review

    PubMed Central

    Campbell, Peter G.; Jabbour, Pascal; Yadla, Sanjay; Awad, Issam A.

    2013-01-01

    Cerebral cavernous malformations (CCM) are divided into sporadic and familial forms. For clinical imaging, T2-weighted gradient-echo sequences have been shown to be more sensitive than conventional sequences. Recently more advanced imaging techniques such as high-field and susceptibility-weighted magnetic resonance imaging has been employed for the evaluation of CCMs. Furthermore, diffusion tensor imaging and functional magnetic resonance imaging have been applied to the preoperative and intraoperative management of these lesions. In this paper, the authors attempt to provide a concise review of the emerging imaging methods utilized in the clinical diagnosis and treatment of CCMs. PMID:20809764

  20. Whole Brain Magnetic Resonance Image Atlases: A Systematic Review of Existing Atlases and Caveats for Use in Population Imaging

    PubMed Central

    Dickie, David Alexander; Shenkin, Susan D.; Anblagan, Devasuda; Lee, Juyoung; Blesa Cabez, Manuel; Rodriguez, David; Boardman, James P.; Waldman, Adam; Job, Dominic E.; Wardlaw, Joanna M.

    2017-01-01

    Brain MRI atlases may be used to characterize brain structural changes across the life course. Atlases have important applications in research, e.g., as registration and segmentation targets to underpin image analysis in population imaging studies, and potentially in future in clinical practice, e.g., as templates for identifying brain structural changes out with normal limits, and increasingly for use in surgical planning. However, there are several caveats and limitations which must be considered before successfully applying brain MRI atlases to research and clinical problems. For example, the influential Talairach and Tournoux atlas was derived from a single fixed cadaveric brain from an elderly female with limited clinical information, yet is the basis of many modern atlases and is often used to report locations of functional activation. We systematically review currently available whole brain structural MRI atlases with particular reference to the implications for population imaging through to emerging clinical practice. We found 66 whole brain structural MRI atlases world-wide. The vast majority were based on T1, T2, and/or proton density (PD) structural sequences, had been derived using parametric statistics (inappropriate for brain volume distributions), had limited supporting clinical or cognitive data, and included few younger (>5 and <18 years) or older (>60 years) subjects. To successfully characterize brain structural features and their changes across different stages of life, we conclude that whole brain structural MRI atlases should include: more subjects at the upper and lower extremes of age; additional structural sequences, including fluid attenuation inversion recovery (FLAIR) and T2* sequences; a range of appropriate statistics, e.g., rank-based or non-parametric; and detailed cognitive and clinical profiles of the included subjects in order to increase the relevance and utility of these atlases. PMID:28154532

  1. Effect of heroin use on changes of brain functions as measured by functional magnetic resonance imaging, a systematic review.

    PubMed

    Fareed, Ayman; Kim, Jungjin; Ketchen, Bethany; Kwak, Woo Jin; Wang, Danzhao; Shongo-Hiango, Hilaire; Drexler, Karen

    2017-01-01

    In this study the authors focus on reviewing imaging studies that used resting state functional magnetic resonance imaging for individuals with a history of heroin use. This review study compiled existing research addressing the effect of heroin use on decision making by reviewing available functional neuroimaging data. Systematic review of the literatures using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Eligible articles were retrieved through a computer-based MEDLINE and PsycINFO search from 1960 to December 2015 using the major medical subject headings "heroin, fMRI" (all fields). Only English language was included. Thirty-seven articles were initially included in the review. Sixteen were excluded because they did not meet the inclusion criteria. The results of 21 articles that met all the inclusion criteria were presented. Based on the 21 studies included in the current review, there is evidence that heroin use may have a direct and damaging effect on certain brain functions and that these changes may be associated with impulsive and unhealthy decision making. From the review of these studies, the authors understand that a longer duration of heroin use may be associated with more damaging effects on brain functions. The authors also understand that these brain changes could last long after abstinence, which may increase the risk of relapse to heroin use. More research is needed to create a biomarker map for patients with heroin use disorder that can be used to guide and assess response to treatment.

  2. Malpractice Liability Risk and Use of Diagnostic Imaging Services: A Systematic Review of the Literature.

    PubMed

    Li, Suhui; Brantley, Erin

    2015-12-01

    A widespread concern among physicians is that fear of medical malpractice liability may affect their decisions for diagnostic imaging orders. The purpose of this article is to synthesize evidence regarding the defensive use of imaging services. A literature search was conducted using a number of databases. The review included peer-reviewed publications that studied the link between physician orders of imaging tests and malpractice liability pressure. We identified 13 peer-reviewed studies conducted in the United States. Five of the studies reported physician assessments of the role of defensive medicine in imaging-order decisions; five assessed the association between physicians' liability risk and imaging ordering, and three assessed the impact of liability risk on imaging ordering at the state level. Although the belief that medical liability risk could influence decisions is highly prevalent among physicians, findings are mixed regarding the impact of liability risk on imaging orders at both the state and physician level. Inconclusive evidence suggests that physician ordering of imaging tests is affected by malpractice liability risk. Further research is needed to disentangle defensive medicine from other reasons for inefficient use of imaging. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Imaging for Polyps and Leiomyomas in Women With Abnormal Uterine Bleeding: A Systematic Review.

    PubMed

    Maheux-Lacroix, Sarah; Li, Fiona; Laberge, Philippe Y; Abbott, Jason

    2016-12-01

    permits concomitant visualization of the ovaries and myometrium. Cost, convenience, and tolerability of different imaging techniques require further evaluation. PROSPERO International prospective register of systematic reviews, http://www.crd.york.ac.uk/PROSPERO, CRD42016034005.

  4. A systematic review of brain frontal lobe parcellation techniques in magnetic resonance imaging.

    PubMed

    Cox, Simon R; Ferguson, Karen J; Royle, Natalie A; Shenkin, Susan D; MacPherson, Sarah E; MacLullich, Alasdair M J; Deary, Ian J; Wardlaw, Joanna M

    2014-01-01

    Manual volumetric measurement of the brain's frontal lobe and its subregions from magnetic resonance images (MRIs) is an established method for researching neural correlates of clinical disorders or cognitive functions. However, there is no consensus between methods used to identify relevant boundaries of a given region of interest (ROI) on MRIs, and those used may bear little relation to each other or the underlying structural, functional and connective architecture. This presents challenges for the analysis and synthesis of such results. We therefore performed a systematic literature review to highlight variations in the anatomical boundaries used to measure frontal regions, contextualised by up-to-date evidence from histology, hodology and neuropsychology. We searched EMBASE and MEDLINE for studies in English reporting three-dimensional boundaries for manually delineating the brain's frontal lobe or sub-regional ROIs from MRIs. Exclusion criteria were: exclusive use of co-ordinate grid systems; insufficient detail to allow method replication; publication in grey literature only. Papers were assessed on quality criteria relating to bias, reproducibility and protocol rationale. There was a large degree of variability in the three-dimensional boundaries of all regions used by the 208 eligible papers. Half of the reports did not justify their rationale for boundary selection, and each paper met on average only three quarters of quality criteria. For the frontal lobe and each subregion (frontal pole, anterior cingulate, dorsolateral, inferior-lateral, and orbitofrontal) we identified reproducible methods for a biologically plausible target ROI. It is hoped that this synthesis will guide the design of future volumetric studies of cerebral structure.

  5. Appropriate Use of Cardiac Stress Testing with Imaging: A Systematic Review and Meta-Analysis.

    PubMed

    Ladapo, Joseph A; Blecker, Saul; O'Donnell, Michael; Jumkhawala, Saahil A; Douglas, Pamela S

    2016-01-01

    Appropriate use criteria (AUC) for cardiac stress tests address concerns about utilization growth and patient safety. We systematically reviewed studies of appropriateness, including within physician specialties; evaluated trends over time and in response to AUC updates; and characterized leading indications for inappropriate/rarely appropriate testing. We searched PubMed (2005-2015) for English-language articles reporting stress echocardiography or myocardial perfusion imaging (MPI) appropriateness. Data were pooled using random-effects meta-analysis and meta-regression. Thirty-four publications of 41,578 patients were included, primarily from academic centers. Stress echocardiography appropriate testing rates were 53.0% (95% CI, 45.3%-60.7%) and 50.9% (42.6%-59.2%) and inappropriate/rarely appropriate rates were 19.1% (11.4%-26.8%) and 28.4% (23.9%-32.8%) using 2008 and 2011 AUC, respectively. Stress MPI appropriate testing rates were 71.1% (64.5%-77.7%) and 72.0% (67.6%-76.3%) and inappropriate/rarely appropriate rates were 10.7% (7.2%-14.2%) and 15.7% (12.4%-19.1%) using 2005 and 2009 AUC, respectively. There was no significant temporal trend toward rising rates of appropriateness for stress echocardiography or MPI. Unclassified stress echocardiograms fell by 79% (p = 0.04) with updated AUC. There were no differences between cardiac specialists and internists. Rates of appropriate use tend to be lower for stress echocardiography compared to MPI, and updated AUC reduced unclassified stress echocardiograms. There is no conclusive evidence that AUC improved appropriate use over time. Further research is needed to determine if integration of appropriateness guidelines in academic and community settings is an effective approach to optimizing inappropriate/rarely appropriate use of stress testing and its associated costs and patient harms.

  6. Reviewing the literature, how systematic is systematic?

    PubMed

    MacLure, Katie; Paudyal, Vibhu; Stewart, Derek

    2016-06-01

    Introduction Professor Archibald Cochrane, after whom the Cochrane Collaboration is named, was influential in promoting evidence-based clinical practice. He called for "relevant, valid research" to underpin all aspects of healthcare. Systematic reviews of the literature are regarded as a high quality source of cumulative evidence but it is unclear how truly systematic they, or other review articles, are or 'how systematic is systematic?' Today's evidence-based review industry is a burgeoning mix of specialist terminology, collaborations and foundations, databases, portals, handbooks, tools, criteria and training courses. Aim of the review This study aims to identify uses and types of reviews, key issues in planning, conducting, reporting and critiquing reviews, and factors which limit claims to be systematic. Method A rapid review of review articles published in IJCP. Results This rapid review identified 17 review articles published in IJCP between 2010 and 2015 inclusive. It explored the use of different types of review article, the variation and widely available range of guidelines, checklists and criteria which, through systematic application, aim to promote best practice. It also identified common pitfalls in endeavouring to conduct reviews of the literature systematically. Discussion Although a limited set of IJCP reviews were identified, there is clear evidence of the variation in adoption and application of systematic methods. The burgeoning evidence industry offers the tools and guidelines required to conduct systematic reviews, and other types of review, systematically. This rapid review was limited to the database of one journal over a period of 6 years. Although this review was conducted systematically, it is not presented as a systematic review. Conclusion As a research community we have yet to fully engage with readily available guidelines and tools which would help to avoid the common pitfalls. Therefore the question remains, of not just IJCP but

  7. Exploring CBCT-based DICOM files. A systematic review on the properties of images used to evaluate maxillofacial bone grafts.

    PubMed

    Spin-Neto, Rubens; Marcantonio, Elcio; Gotfredsen, Erik; Wenzel, Ann

    2011-12-01

    Previous studies suggests that cone beam computerized tomography (CBCT) images could provide reliable information regarding the fate of bone grafts in the maxillofacial region, but no systematic information regarding the standardization of CBCT settings and properties is available, i.e., there is a lack of information on how the images were generated, exported, and analyzed when bone grafts were evaluated. The aim of this study was to (1) do a systematic review on which type of CBCT-based DICOM images have been used for the evaluation of the fate of bone grafts in humans and (2) use a software suggested in the literature to test DICOM-based data sets, exemplifying the effect of variation in selected parameters (windowing/contrast control, plane definition, slice thickness, and number of measured slices) on the final image characteristics. The results from review identified three publications that used CBCT to evaluate maxillofacial bone grafts in humans, and in which the methodology/results comprised at least one of the expected outcomes (image acquisition protocol, image reconstruction, and image generation information). The experimental shows how the influence of information that was missing in the retrieved papers, can influence the reproducibility and the validity of image measurements. Although the use of CBCT-based images for the evaluation of bone grafts in humans has become more common, this does not reflect on a better standardization of the developed studies. Parameters regarding image acquisition and reconstruction, while important, are not addressed in the proper way in the literature, compromising the reproducibility and scientific impact of the studies.

  8. Ethics in systematic reviews.

    PubMed

    Vergnes, Jean-Noel; Marchal-Sixou, Christine; Nabet, Cathy; Maret, Delphine; Hamel, Olivier

    2010-12-01

    Since its introduction by the Nuremberg Code and the Declaration of Helsinki, the place held by ethics in biomedical research has been continuously increasing in importance. The past 30 years have also seen exponential growth in the number of biomedical articles published. A systematic review of the literature is the scientific way of synthesising a plethora of information, by exhaustively searching out and objectively analysing the studies dealing with a given issue. However, the question of ethics in systematic reviews is rarely touched upon. This could lead to some drawbacks, as systematic reviews may contain studies with ethical insufficiencies, may be a possible way to publish unethical research and may also be prone to conflict of interest. Finally, informed consent given for an original study is not necessarily still valid at the systematic review level. There is no doubt that routine ethical assessment in systematic reviews would help to improve the ethical and methodological quality of studies in general. However, ethical issues change so much with time and location, and are so broad in scope and in context that it appears illusory to search for a universal, internationally accepted standard for ethical assessment in systematic reviews. Some simple suggestions could nevertheless be drawn from the present reflection and are discussed in the paper.

  9. Appropriate Use of Cardiac Stress Testing with Imaging: A Systematic Review and Meta-Analysis

    PubMed Central

    Ladapo, Joseph A.; Blecker, Saul; O'Donnell, Michael; Jumkhawala, Saahil A.; Douglas, Pamela S.

    2016-01-01

    Background Appropriate use criteria (AUC) for cardiac stress tests address concerns about utilization growth and patient safety. We systematically reviewed studies of appropriateness, including within physician specialties; evaluated trends over time and in response to AUC updates; and characterized leading indications for inappropriate/rarely appropriate testing. Methods We searched PubMed (2005–2015) for English-language articles reporting stress echocardiography or myocardial perfusion imaging (MPI) appropriateness. Data were pooled using random-effects meta-analysis and meta-regression. Results Thirty-four publications of 41,578 patients were included, primarily from academic centers. Stress echocardiography appropriate testing rates were 53.0% (95% CI, 45.3%–60.7%) and 50.9% (42.6%–59.2%) and inappropriate/rarely appropriate rates were 19.1% (11.4%–26.8%) and 28.4% (23.9%–32.8%) using 2008 and 2011 AUC, respectively. Stress MPI appropriate testing rates were 71.1% (64.5%–77.7%) and 72.0% (67.6%–76.3%) and inappropriate/rarely appropriate rates were 10.7% (7.2%–14.2%) and 15.7% (12.4%–19.1%) using 2005 and 2009 AUC, respectively. There was no significant temporal trend toward rising rates of appropriateness for stress echocardiography or MPI. Unclassified stress echocardiograms fell by 79% (p = 0.04) with updated AUC. There were no differences between cardiac specialists and internists. Conclusions Rates of appropriate use tend to be lower for stress echocardiography compared to MPI, and updated AUC reduced unclassified stress echocardiograms. There is no conclusive evidence that AUC improved appropriate use over time. Further research is needed to determine if integration of appropriateness guidelines in academic and community settings is an effective approach to optimizing inappropriate/rarely appropriate use of stress testing and its associated costs and patient harms. PMID:27536775

  10. A systematic review of automated melanoma detection in dermatoscopic images and its ground truth data

    NASA Astrophysics Data System (ADS)

    Ali, Abder-Rahman A.; Deserno, Thomas M.

    2012-02-01

    Malignant melanoma is the third most frequent type of skin cancer and one of the most malignant tumors, accounting for 79% of skin cancer deaths. Melanoma is highly curable if diagnosed early and treated properly as survival rate varies between 15% and 65% from early to terminal stages, respectively. So far, melanoma diagnosis is depending subjectively on the dermatologist's expertise. Computer-aided diagnosis (CAD) systems based on epiluminescense light microscopy can provide an objective second opinion on pigmented skin lesions (PSL). This work systematically analyzes the evidence of the effectiveness of automated melanoma detection in images from a dermatoscopic device. Automated CAD applications were analyzed to estimate their diagnostic outcome. Searching online databases for publication dates between 1985 and 2011, a total of 182 studies on dermatoscopic CAD were found. With respect to the systematic selection criterions, 9 studies were included, published between 2002 and 2011. Those studies formed databases of 14,421 dermatoscopic images including both malignant "melanoma" and benign "nevus", with 8,110 images being available ranging in resolution from 150 x 150 to 1568 x 1045 pixels. Maximum and minimum of sensitivity and specificity are 100.0% and 80.0% as well as 98.14% and 61.6%, respectively. Area under the receiver operator characteristics (AUC) and pooled sensitivity, specificity and diagnostics odds ratio are respectively 0.87, 0.90, 0.81, and 15.89. So, although that automated melanoma detection showed good accuracy in terms of sensitivity, specificity, and AUC, but diagnostic performance in terms of DOR was found to be poor. This might be due to the lack of dermatoscopic image resources (ground truth) that are needed for comprehensive assessment of diagnostic performance. In future work, we aim at testing this hypothesis by joining dermatoscopic images into a unified database that serves as a standard reference for dermatology related research in

  11. Autism spectrum disorder: does neuroimaging support the DSM-5 proposal for a symptom dyad? A systematic review of functional magnetic resonance imaging and diffusion tensor imaging studies.

    PubMed

    Pina-Camacho, Laura; Villero, Sonia; Fraguas, David; Boada, Leticia; Janssen, Joost; Navas-Sánchez, Francisco J; Mayoral, Maria; Llorente, Cloe; Arango, Celso; Parellada, Mara

    2012-07-01

    A systematic review of 208 studies comprising functional magnetic resonance imaging and diffusion tensor imaging data in patients with 'autism spectrum disorder' (ASD) was conducted, in order to determine whether these data support the forthcoming DSM-5 proposal of a social communication and behavioral symptom dyad. Studies consistently reported abnormal function and structure of fronto-temporal and limbic networks with social and pragmatic language deficits, of temporo-parieto-occipital networks with syntactic-semantic language deficits, and of fronto-striato-cerebellar networks with repetitive behaviors and restricted interests in ASD patients. Therefore, this review partially supports the DSM-5 proposal for the ASD dyad.

  12. Quantitation of mitral regurgitation with cardiac magnetic resonance imaging: a systematic review.

    PubMed

    Krieger, Eric V; Lee, James; Branch, Kelley R; Hamilton-Craig, Christian

    2016-12-01

    In this review discuss the application of cardiac magnetic resonance (CMR) to the evaluation and quantification of mitral regurgitation and provide a systematic literature review for comparisons with echocardiography. Using the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, we searched Medline and PubMed for original research articles published since 2000 that provided data on the quantification of mitral regurgitation by CMR. We identified 220 articles of which 33 were included. Four main techniques of mitral regurgitation quantification were identified. Reproducibility varied substantially between papers but was high overall for all techniques. However, quantification differed between the techniques studied. When compared with two-dimensional echocardiography, mitral regurgitation fraction and regurgitant volume measured by CMR were comparable but typically lower. CMR has high reproducibility for the quantification of mitral regurgitation in experienced centres, but further technological refinement is needed. An integrated and standardised approach that combines multiple techniques is recommended for optimal reproducibility and precise mitral regurgitation quantification. Definitive outcome studies using CMR as a basis for treatment are lacking but needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Biliary tract visualization using near-infrared imaging with indocyanine green during laparoscopic cholecystectomy: results of a systematic review.

    PubMed

    Vlek, S L; van Dam, D A; Rubinstein, S M; de Lange-de Klerk, E S M; Schoonmade, L J; Tuynman, J B; Meijerink, W J H J; Ankersmit, M

    2017-07-01

    Near-infrared imaging with indocyanine green (ICG) has been extensively investigated during laparoscopic cholecystectomy (LC). However, methods vary between studies, especially regarding patient selection, dosage and timing. The aim of this systematic review was to evaluate the potential of the near-infrared imaging technique with ICG to identify biliary structures during LC. A comprehensive systematic literature search was performed. Prospective trials examining the use of ICG during LC were included. Primary outcome was biliary tract visualization. Risk of bias was assessed using ROBINS-I. Secondly, a meta-analysis was performed comparing ICG to intraoperative cholangiography (IOC) for identification of biliary structures. GRADE was used to assess the quality of the evidence. Nineteen studies were included. Based upon the pooled data from 13 studies, cystic duct (Lusch et al. in J Endourol 28:261-266, 2014) visualization was 86.5% (95% CI 71.2-96.6%) prior to dissection of Calot's triangle with a 2.5-mg dosage of ICG and 96.5% (95% CI 93.9-98.4%) after dissection. The results were not appreciably different when the dosage was based upon bodyweight. There is moderate quality evidence that the CD is more frequently visualized using ICG than IOC (RR 1.16; 95% CI 1.00-1.35); however, this difference was not statistically significant. This systematic review provides equal results for biliary tract visualization with near-infrared imaging with ICG during LC compared to IOC. Near-infrared imaging with ICG has the potential to replace IOC for biliary mapping. However, methods of near-infrared imaging with ICG vary. Future research is necessary for optimization and standardization of the near-infrared ICG technique.

  14. What tendon pathology is seen on imaging in people who have taken fluoroquinolones? A systematic review.

    PubMed

    Lang, Tina R; Cook, Jill; Rio, Ebonie; Gaida, James E

    2017-02-01

    Fluoroquinolones (FQs) are highly effective broad-spectrum antibiotics. Clinical data reveal an increased incidence of tendon pain and rupture in those taking FQs, yet little is known about tendon structural changes. This review synthesises published data on tendon structural changes in people who have taken FQs. Eight databases were searched for potentially relevant articles (Medline, CINAHL, Biological Abstracts, AMED, Web of Knowledge, SCOPUS, SportDiscus and EMBASE) using MeSH and free-text searches. Inclusion and exclusion criteria determined which articles were used for this review. Twenty-six papers met the eligibility criteria. The Achilles tendon was most commonly affected, and ciprofloxacin and levofloxacin were the most commonly implicated FQs. Mean time to onset of symptoms was 16 days following first FQ dose. Imaging modalities used included magnetic resonance imaging (MRI), B-mode ultrasound (US) and computed tomography (CT). Tendon measurements were rarely reported, and intratendinous imaging findings were not reported in a consistent manner. Few studies imaged tendons bilaterally, and only two studies were longitudinal in design. Future studies should report imaging measures such as thickness and cross-sectional area and use consistent descriptions of intratendinous changes during and post-FQ treatment. © 2016 Société Française de Pharmacologie et de Thérapeutique.

  15. Computer-aided diagnosis of breast cancer using cytological images: A systematic review.

    PubMed

    Saha, Monjoy; Mukherjee, Rashmi; Chakraborty, Chandan

    2016-10-01

    Cytological evaluation by microscopic image-based characterization [imprint cytology (IC) and fine needle aspiration cytology (FNAC)] plays an integral role in primary screening/detection of breast cancer. The sensitivity of IC and FNAC as a screening tool is dependent on the image quality and the pathologist's level of expertise. Computer-aided diagnosis (CAD) is used to assists the pathologists by developing various machine learning and image processing algorithms. This study reviews the various manual and computer-aided techniques used so far in breast cytology. Diagnostic applications were studied to estimate the role of CAD in breast cancer diagnosis. This paper presents an overview of image processing and pattern recognition techniques that have been used to address several issues in breast cytology-based CAD including slide preparation, staining, microscopic imaging, pre-processing, segmentation, feature extraction and diagnostic classification. This review provides better insights to readers regarding the state of the art the knowledge on CAD-based breast cancer diagnosis to date. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature.

    PubMed

    De Vos, W; Casselman, J; Swennen, G R J

    2009-06-01

    This study reviewed the literature on cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial (OMF) region. A PUBMED search (National Library of Medicine, NCBI; revised 1 December 2007) from 1998 to December 2007 was conducted. This search revealed 375 papers, which were screened in detail. 176 papers were clinically relevant and were analyzed in detail. CBCT is used in OMF surgery and orthodontics for numerous clinical applications, particularly for its low cost, easy accessibility and low radiation compared with multi-slice computerized tomography. The results of this systematic review show that there is a lack of evidence-based data on the radiation dose for CBCT imaging. Terminology and technical device properties and settings were not consistent in the literature. An attempt was made to provide a minimal set of CBCT device-related parameters for dedicated OMF scanners as a guideline for future studies.

  17. MRI in Dentistry- A Future Towards Radiation Free ImagingSystematic Review

    PubMed Central

    Patthi, Basavaraj; Singla, Ashish; Gupta, Ritu; Ali, Irfan; Dhama, Kuldeep; Kumar, Jishnu Krishna; Prasad, Monika

    2016-01-01

    Introduction Magnetic Resonance Imaging (MRI), being a technique with huge potential, has become the primary diagnostic investigation for many clinical problems. Its application now has been successfully used in dentistry to maximize the diagnostic certainty. Aim The present review aims to analyze the applicability, feasibility and efficacy of MRI in the field of dentistry. Materials and Methods A literature search was performed in main databases like Pub Med Central, Cochrane Library, Embase and Google Scholar from 1970 up to December 2015. The 2672 titles that appeared, 25 fulfilled the criteria and were included in the review. Two articles were hand searched and three articles through e-mail were also included. Results The review highlights the increasing role of MRI in dentistry. In the available literature, it was found that T1 and T2 weighted images were the acceptable diagnostic images for detection of dental related diseases. Conclusion MRI can be used in diagnosis and treatment planning of implants, jaw lesions, diseases of Temporomandibular Joints (TMJ), orthodontic treatment, endodontic treatment etc., to achieve better prognosis. PMID:27891491

  18. MRI in Dentistry- A Future Towards Radiation Free Imaging - Systematic Review.

    PubMed

    Niraj, Lav Kumar; Patthi, Basavaraj; Singla, Ashish; Gupta, Ritu; Ali, Irfan; Dhama, Kuldeep; Kumar, Jishnu Krishna; Prasad, Monika

    2016-10-01

    Magnetic Resonance Imaging (MRI), being a technique with huge potential, has become the primary diagnostic investigation for many clinical problems. Its application now has been successfully used in dentistry to maximize the diagnostic certainty. The present review aims to analyze the applicability, feasibility and efficacy of MRI in the field of dentistry. A literature search was performed in main databases like Pub Med Central, Cochrane Library, Embase and Google Scholar from 1970 up to December 2015. The 2672 titles that appeared, 25 fulfilled the criteria and were included in the review. Two articles were hand searched and three articles through e-mail were also included. The review highlights the increasing role of MRI in dentistry. In the available literature, it was found that T1 and T2 weighted images were the acceptable diagnostic images for detection of dental related diseases. MRI can be used in diagnosis and treatment planning of implants, jaw lesions, diseases of Temporomandibular Joints (TMJ), orthodontic treatment, endodontic treatment etc., to achieve better prognosis.

  19. The use of thermal imaging to monitoring skin temperature during cryotherapy: A systematic review

    NASA Astrophysics Data System (ADS)

    Matos, Filipe; Neves, Eduardo Borba; Norte, Marco; Rosa, Claudio; Reis, Victor Machado; Vilaça-Alves, José

    2015-11-01

    Cryotherapy has been applied on clinical injuries and as a method for exercise recovery. It is aimed to reduce edema, nervous conduction velocity, and tissue metabolism, as well as to accelerate the recovery process of the muscle injury induced by exercise. Objective: This review aim to investigate the applicability of thermal imaging as a method for monitoring skin temperature during cryotherapy. Method: Search the Web of Science database using the terms "Cryotherapy", "Thermography", "Thermal Image" and "Cooling". Results: Nineteen studies met the inclusion criteria and pass the PEDro scale quality evaluation. Evidence support the use of thermal imaging as a method for monitoring the skin temperature during cryotherapy, and it is superior to other contact methods and subjective methods of assessing skin temperature. Conclusion: Thermography seems to be an efficient, trustworthy and secure method in order to monitoring skin temperature during cryotherapy application. Evidence supports the use of thermography in detriment of contact methods as well as other subjective ones.

  20. Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders.

    PubMed

    Gold, Judith E; Hallman, David M; Hellström, Fredrik; Björklund, Martin; Crenshaw, Albert G; Mathiassen, Svend Erik; Barbe, Mary F; Ali, Sayed

    2017-09-12

    This study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs? PubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies. Most of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity. Although research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.

  1. Can ultrasound imaging predict the development of Achilles and patellar tendinopathy? A systematic review and meta-analysis.

    PubMed

    McAuliffe, Seán; McCreesh, Karen; Culloty, Fiona; Purtill, Helen; O'Sullivan, Kieran

    2016-12-01

    Ultrasound (US) imaging is commonly used to visualise tendon structure. It is not clear whether the presence of structural abnormalities in asymptomatic tendons predicts the development of future tendon symptoms in the Achilles or patellar tendon. To perform a systematic review and meta-analysis investigating the ability of US imaging to predict future symptoms of patellar or Achilles tendinopathy. Prospective studies that performed US imaging of Achilles OR patellar tendon structure among asymptomatic patients at baseline and a clinical measure of pain and/or function at follow-up were included. Study quality was assessed using the Critical Appraisal Skills Programme tool by two independent reviewers, and predictive ability of US was assessed using meta-analyses. The majority of participants in the review were from sporting populations. Meta-analysis revealed that tendon abnormalities on US are associated with future symptoms of both patellar and Achilles tendinopathy (RR=4.97, 95% CI 3.20 to 7.73). Subgroup analysis indicated that tendon abnormalities at baseline were associated with an increased risk of both Achilles (RR=7.33, 95% CI 2.95 to 18.24) and patellar (RR=4.35, 95% CI 2.62 to 7.23) tendinopathy. This systematic review and meta-analysis indicates that tendon abnormalities visualised using US in asymptomatic tendons are predictive of future tendinopathy and are associated with at least a fourfold increased risk. Identification of at-risk athletes using screening tools such as US may allow preventative programmes to be implemented. However, it is clear that other factors beyond tissue structure are involved in the development of lower limb tendinopathy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. The meaning of body image experiences during the perinatal period: A systematic review of the qualitative literature.

    PubMed

    Watson, Brittany; Fuller-Tyszkiewicz, Matthew; Broadbent, Jaclyn; Skouteris, Helen

    2015-06-01

    Literature reporting body image disturbances across the perinatal period has produced inconsistent findings, owing to the complexity of body image experiences during pregnancy and the first year postpartum. Existing qualitative data might provide potential avenues to advance understanding of pregnancy-related body image experiences and guide future quantitative research. The present systematic review synthesised the findings of 10 qualitative studies exploring the body image experiences of women through the perinatal period, albeit the majority focused only on pregnancy. Themes emerging included malleability of body image ideals across pregnancy (including the shift from aesthetic to functional concerns about one's appearance), the salience of stomach and breasts for self-rated body satisfaction, and perceived pressure to limit weight gain across pregnancy in order to return quickly to pre-pregnancy figure following birth. These qualitative findings suggest greater complexity of body image experiences during perinatal period than can be captured by typically used self-report measures. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  3. Volumetric structural magnetic resonance imaging findings in pediatric posttraumatic stress disorder and obsessive compulsive disorder: a systematic review.

    PubMed

    Ahmed, Fatima; Ras, Johan; Seedat, Soraya

    2012-01-01

    Structural magnetic resonance imaging (sMRI) studies of anxiety disorders in children and adolescents are limited. Posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) have been best studied in this regard. We systematically reviewed structural neuroimaging findings in pediatric PTSD and OCD. The literature was reviewed for all sMRI studies examining volumetric parameters using PubMed, ScienceDirect, and PsychInfo databases, with no limit on the time frame of publication. Nine studies in pediatric PTSD and six in OCD were suitable for inclusion. Volumetric findings were inconsistent in both disorders. In PTSD, findings suggest increased as well as decreased volumes of the prefrontal cortex (PFC) and corpus callosum; whilst in OCD studies indicate volumetric increase of the putamen, with inconsistent findings for the anterior cingulate cortex (ACC) and frontal regions. Methodological differences may account for some of this inconsistency and additional volume-based studies in pediatric anxiety disorders using more uniform approaches are needed.

  4. Comparison of modern and conventional imaging techniques in establishing multiple myeloma-related bone disease: a systematic review.

    PubMed

    Regelink, Josien C; Minnema, Monique C; Terpos, Evangelos; Kamphuis, Marjolein H; Raijmakers, Pieter G; Pieters-van den Bos, Indra C; Heggelman, Ben G F; Nievelstein, Rutger-Jan; Otten, Rene H J; van Lammeren-Venema, Danielle; Zijlstra, Josee M; Arens, Anne I J; de Rooy, Jacky W; Hoekstra, Otto S; Raymakers, Reinier; Sonneveld, Pieter; Ostelo, Raymond W; Zweegman, Sonja

    2013-07-01

    This systematic review of studies compared magnetic resonance imaging (MRI), (18) F-fluorodeoxyglucose positron emission tomography (FDG-PET), FDG-PET with computerized tomography (PET-CT) and CT with whole body X-Ray (WBXR) or (whole body) CT in order to provide evidence-based diagnostic guidelines in multiple myeloma bone disease. A comprehensive search of 3 bibliographic databases was performed; methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria (score 1-14). Data from 32 directly comparative studies were extracted. The mean QUADAS score was 7·1 (3-11), with quality hampered mainly by a poor description of selection and execution criteria. All index tests had a higher detection rate when compared to WBXR, with up to 80% more lesions detected by the newer imaging techniques; MRI (1·12-1·82) CT (1·04-1·33), PET (1·00-1·58) and PET-CT (1·27-1·45). However, the modern imaging techniques detected fewer lesions in the skull and ribs. In a direct comparison CT and MRI performed equally with respect to detection rate and sensitivity. This systematic review supports the International Myeloma Working Group guidelines, which recommend that WBCT can replace WBXR. In our opinion, the equal performance of MRI also indicates that it is a valuable alternative. As lesions of the skull and ribs are underdiagnosed by modern imaging techniques we advise additional X-rays of these regions. The consequences of this approach are discussed. © 2013 John Wiley & Sons Ltd.

  5. Imaging for the Diagnosis of Hepatocellular Carcinoma: a Systematic Review and Meta-analysis.

    PubMed

    Roberts, Lewis R; Sirlin, Claude B; Zaiem, Feras; Almasri, Jehad; Prokop, Larry J; Heimbach, Julie; Murad, M Hassan; Mohammed, Khaled

    2017-08-31

    Multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) are both used for non-invasive diagnosis of hepatocellular carcinoma (HCC) in patients with cirrhosis. To determine if there is a relative diagnostic benefit of one over the other, we synthesized evidence regarding the relative performances of CT, extracellular-contrast-enhanced-MRI, and gadoxetate-enhanced-MRI for diagnosis of HCC in patients with cirrhosis. We also assessed whether liver biopsy versus follow-up with the same versus alternative imaging is best for CT- or MRI-indeterminate liver nodules in patients with cirrhosis. We searched multiple databases from inception to April 27, 2016 for studies comparing CT with extracellular-contrast-enhanced-MRI or gadoxetate-enhanced-MRI in adults with cirrhosis and suspected HCC. Two reviewers independently selected studies and extracted data. Of 33 included studies, 19 were comprehensive, while 14 reported sensitivity only. For all tumor sizes, the 19 comprehensive comparisons showed significantly higher sensitivity (0.82 vs. 0.66) and lower negative likelihood ratio (0.20 vs. 0.37) for MRI over CT. The specificities of MRI vs. CT (0.91 vs. 0.92) and the positive likelihood ratios (8.8 vs. 8.1) were not different. All three modalities performed better for HCCs ≥2 cm. Performance was poor for HCCs <1 cm. No studies examined whether adults with cirrhosis and an indeterminate nodule are best evaluated using biopsy, repeated imaging or alternative imaging. Concerns about publication bias, inconsistent study results, low study quality, and clinical factors precluded support for exclusive use of either gadoxetate-enhanced or extracellular-contrast-enhanced MRI over CT. CT, extracellular-contrast-enhanced-MRI or gadoxetate-enhanced-MRI could not be definitively preferred for HCC diagnosis in patients with cirrhosis. In patients with cirrhosis and an indeterminate mass, there was insufficient data comparing biopsy to repeat cross-sectional imaging

  6. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes.

    PubMed

    Holland, Grace; Tiggemann, Marika

    2016-06-01

    A large body of literature has demonstrated mass media effects on body image and disordered eating. More recently, research in this area has turned to 'new' forms of media, such as the Internet, and particularly Social Networking Sites (SNSs). A systematic search for peer-reviewed articles on SNS use and body image and eating disorders resulted in 20 studies meeting specific inclusion criteria. As a whole, these articles demonstrated that use of SNSs is associated with body image and disordered eating. Specific SNS activities, such as viewing and uploading photos and seeking negative feedback via status updates, were identified as particularly problematic. A small number of studies also addressed underlying processes and found that appearance-based social comparison mediated the relationship between SNS use and body image and eating concerns. Gender was not found to be a moderating factor. It was concluded that, although there is a good deal of correlational research supporting the maladaptive effect of SNS use on body image and disordered eating, more longitudinal and experimental studies are needed.

  7. Magnetic Resonance Imaging of Myocardial Strain After Acute ST-Segment-Elevation Myocardial Infarction: A Systematic Review.

    PubMed

    Mangion, Kenneth; McComb, Christie; Auger, Daniel A; Epstein, Frederick H; Berry, Colin

    2017-08-01

    The purpose of this systematic review is to provide a clinically relevant, disease-based perspective on myocardial strain imaging in patients with acute myocardial infarction or stable ischemic heart disease. Cardiac magnetic resonance imaging uniquely integrates myocardial function with pathology. Therefore, this review focuses on strain imaging with cardiac magnetic resonance. We have specifically considered the relationships between left ventricular (LV) strain, infarct pathologies, and their associations with prognosis. A comprehensive literature review was conducted in accordance with the PRISMA guidelines. Publications were identified that (1) described the relationship between strain and infarct pathologies, (2) assessed the relationship between strain and subsequent LV outcomes, and (3) assessed the relationship between strain and health outcomes. In patients with acute myocardial infarction, circumferential strain predicts the recovery of LV systolic function in the longer term. The prognostic value of longitudinal strain is less certain. Strain differentiates between infarcted versus noninfarcted myocardium, even in patients with stable ischemic heart disease with preserved LV ejection fraction. Strain recovery is impaired in infarcted segments with intramyocardial hemorrhage or microvascular obstruction. There are practical limitations to measuring strain with cardiac magnetic resonance in the acute setting, and knowledge gaps, including the lack of data showing incremental value in clinical practice. Critically, studies of cardiac magnetic resonance strain imaging in patients with ischemic heart disease have been limited by sample size and design. Strain imaging has potential as a tool to assess for early or subclinical changes in LV function, and strain is now being included as a surrogate measure of outcome in therapeutic trials. © 2017 American Heart Association, Inc.

  8. Identification of topics for comparative effectiveness systematic reviews in the field of cancer imaging.

    PubMed

    Rao, Madhu; Concannon, Thomas W; Iovin, Ramon; Yu, Winifred W; Chan, Jeffrey A; Lypas, Georgios; Terasawa, Teruhiko; Gaylor, James M; Kong, Lina; Rausch, Andrew C; Lau, Joseph; Kitsios, Georgios D

    2013-09-01

    With rapid innovations in diagnostic and therapeutic interventions in cancer care, comparative effectiveness reviews (CERs) are essential to inform clinical practice and guide future research. However, the optimal means to identify priority CER topics are uninvestigated. We aimed to devise a transparent and reproducible process to identify ten to 12 CER topics in the area of cancer imaging relevant to a wide range of stakeholders. Environmental scans and explicit prioritization criteria supported interactions (email communications, web-based discussions and live teleconferences) with experts and stakeholders culminating in a three-phase deductive exercise for prioritization of CER topics. We prioritized 12 CER topics in breast, lung and gastrointestinal cancers that addressed screening, diagnosis, staging, monitoring and evaluating response to treatment. Our project developed and implemented a transparent and reproducible process for research prioritization and topic nomination that can be further refined to improve the relevance of future CERs.

  9. Predicting muscle mass from anthropometry using magnetic resonance imaging as reference: a systematic review.

    PubMed

    Al-Gindan, Yasmin Y; Hankey, Catherine R; Leslie, Wilma; Govan, Lindsay; Lean, Michael E J

    2014-02-01

    Identification and management of sarcopenia are limited by lack of reliable simple approaches to assess muscle mass. The aim of this review is to identify and evaluate simple methods to quantify muscle mass/volume of adults. Using Cochrane Review methodology, Medline (1946-2012), Embase (1974-2012), Web of Science (1898-2012), PubMed, and the Cochrane Library (to 08/2012) were searched for publications that included prediction equations (from anthropometric measurements) to estimate muscle mass by magnetic resonance imaging (MRI) in adults. Of 257 papers identified from primary search terms, 12 studies met the inclusion criteria. Most studies (n = 10) assessed only regional/limb muscle mass/volume. Many studies (n = 9) assessed limb circumference adjusted for skinfold thickness, which limits their practical applications. Only two included validation in separate subject-samples, and two reported relationships between whole-body MRI-measured muscle mass and anthropometry beyond linear correlations. In conclusion, one simple prediction equation shows promise, but it has not been validated in a separate population with different investigators. Furthermore, it did not incorporate widely available trunk/limb girths, which have offered valuable prediction of body composition in other studies.

  10. (68)Ga-DOTATOC Imaging of Neuroendocrine Tumors: A Systematic Review and Meta-Analysis.

    PubMed

    Graham, Michael M; Gu, Xiaomei; Ginader, Timothy; Breheny, Patrick; Sunderland, John

    2017-03-09

    (68)Ga-DOTATOC, a somatostatin receptor targeted ligand, has been used clinically in Europe over the past decade for imaging neuroendocrine tumors (NETs). It appears to be quite sensitive and effective for clinical management decision-making. This meta-analysis summarizes the efficacy of (68)Ga-DOTATOC for several distinct indications and is intended to support approval of this agent by the U.S. Food and Drug Administration. Methods: The major electronic medical databases were searched for relevant papers over the period from January 2001 until November 2015. Papers were selected for review in 3 categories: clinical trials that reported sensitivity and specificity, comparison studies with (111)In-octreotide, and change of management studies. All the eligible papers underwent Quality Assessment of Diagnostic Accuracy Studies (QUADAS) assessment, which was useful in the final selection of papers for review. Results: The initial search yielded 468 papers. After detailed evaluation, 17 papers were finally selected. Five types of studies emerged: workup of patients with symptoms and biomarker findings suggestive of NET, but with negative conventional imaging (3 papers, yield was only 13%); sensitivity (12 papers, sensitivity 92%,) and specificity (7 papers, specificity 82%); identification of site of unknown primary in patients with metastatic NET (4 papers, yield was 44%); impact on subsequent NET patient management (4 papers - change in management in 51%); and comparison with (111)In-octreotide (2 papers, sensitivity of DOTATOC on a per lesion basis was 100%,for (111)In-octreotide was 78.2%; specificity was not available). Safety was not explicitly addressed in any study, but there were no reports of adverse events. Conclusion:(68)Ga-DOTATOC is useful for evaluating the presence and extent in disease for staging, restaging, and to assist in treatment decision making for patients with NET. It is also effective in locating the site of an unknown primary in NET patients

  11. Accuracy of musculoskeletal imaging for the diagnosis of polymyalgia rheumatica: systematic review

    PubMed Central

    Mackie, Sarah Louise; Koduri, Gouri; Hill, Catherine L; Wakefield, Richard J; Hutchings, Andrew; Loy, Clement; Dasgupta, Bhaskar; Wyatt, Jeremy C

    2015-01-01

    Objectives To review the evidence for accuracy of imaging for diagnosis of polymyalgia rheumatica (PMR). Methods Searches included MEDLINE, EMBASE and PubMed. Evaluations of diagnostic accuracy of imaging tests for PMR were eligible, excluding reports with <10 PMR cases. Two authors independently extracted study data and three authors assessed methodological quality using modified QUADAS-2 criteria. Results 26 studies of 2370 patients were evaluated: 10 ultrasound scanning studies; 6 MRI studies; 1 USS and MRI study; 7 18-fluorodeoxyglucose-positron emission tomography (PET) studies; 1 plain radiography and 1 technetium scintigraphy study. In four ultrasound studies, subacromial-subdeltoid bursitis had sensitivity 80% (95% CI 55% to 93%) and specificity 68% (95% CI 60% to 75%), whereas bilateral subacromial-subdeltoid bursitis had sensitivity 66% (95% CI 43% to 87%) and specificity 89% (95% CI 66% to 97%). Sensitivity for ultrasound detection of trochanteric bursitis ranged from 21% to 100%. In four ultrasound studies reporting both subacromial-subdeltoid bursitis and glenohumeral synovitis, detection of subacromial-subdeltoid bursitis was more accurate than that of glenohumeral synovitis (p=0.004). MRI and PET/CT revealed additional areas of inflammation in the spine and pelvis, including focal areas between the vertebrae and anterior to the hip joint, but the number of controls with inflammatory disease was inadequate for precise specificity estimates. Conclusions Subacromial-subdeltoid bursitis appears to be the most helpful ultrasound feature for PMR diagnosis, but interpretation is limited by study heterogeneity and methodological issues, including variability in blinding and potential bias due to case–control study designs. Recent MRI and PET/CT case–control studies, with blinded readers, yielded promising data requiring validation within a diagnostic cohort study. PMID:26535139

  12. The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review.

    PubMed

    Brennan, Rebekah; Wells, John S G; Van Hout, Marie Claire

    2016-01-25

    Injecting use of image and performance-enhancing drugs (IPED) in the general population is a public health concern. A wide and varied range of IPED are now easily accessible to all through the online market. A comprehensive literature review was undertaken according to Critical Appraisal Skills Programme (CASP) guidelines for systematic review, to identify the relevant literature. No date restrictions were placed on the database search in the case of human growth hormone melanotan I and II, and oil and cosmetic injectables. In the case of anabolic androgenic steroids search dates were restricted to January 2014-2015. Publications not in English and with a lack of specificity to the topic were excluded. The review yielded 133 relevant quantitative and qualitative papers, clinical trials, clinical case presentations and editorials/reports. Findings were examined/reviewed under emergent themes which identified/measured extent of use, user profiling, sourcing, product endorsement, risk behaviours and health outcomes in users. Motivation for IPED use may be grounded in appearance, pursuit of health and youth, and body image disturbance. IPED users can practice moderated use, with pathological use linked to high-risk behaviours, which may be normalised within IPED communities. Many IPED trajectories and pathways of use are not scientifically documented. Much of this information may be available online in IPED specific discussion forums, an underutilised setting for research, where uncensored discourse takes place among users. This review underscores the need for future internet and clinical research to investigate prevalence and patterns of injecting use, and to map health outcomes in IPED users. This paper provides community-based clinical practice and health promotion services with a detailed examination and analysis of the injecting use of IPED, highlighting the patterns of this public health issue. It serves to disseminate updated publication information to health

  13. Imaging and neuropsychological correlates of white matter lesions in different subtypes of Mild Cognitive Impairment: A systematic review.

    PubMed

    Lam, Charlene L M; Yiend, Jenny; Lee, Tatia M C

    2017-01-01

    White matter lesions (WML) are prevalent in older adults. The association between WML and cognition in different subtypes of Mild Cognitive Impairment (MCI) is inconsistent in the literature. We aim to provide a systematic review on the impact of WML in different subtypes of MCI, and discuss the recent findings on white matter plasticity. We reviewed peer-reviewed articles from January 2011 to August 2016 and identified 12 studies investigating the association between WML and subtypes of MCI with both neuroimaging and cognitive measures. Our review shows that 1) WM abnormality was identified between different subtypes of MCI and healthy controls on diffusion imaging; 2) neither visual ratings of WML nor its volumetry differentiate different subtypes of MCI or its prognosis to dementia; and 3) cognitive correlates of WML were evident in the Amnestic-type MCI in the domains of memory, language, psychomotor speed, attention and executive functions. Cognitive reserve and the plasticity of white matter may modulate the impact of WML on the manifestation of the neurodegenerative disease. Further research is needed to study the plasticity of white matter in the MCI population to evaluate its potential clinical application.

  14. Neural Correlates of Depressive Symptoms in Smokers - A Systematic Review of Imaging Studies.

    PubMed

    Gonzalez, Michele de Oliveira; Goudriaan, Anna E; Périco, Cíntia de Azevedo-Marques; Waisman Campos, Marcela; de Andrade, Arthur Guerra; Bhugra, Dinesh; Castaldelli-Maia, João Mauricio

    2017-07-25

    This review aims to summarize neuroimaging studies in order to better understand the neural correlates of depressive symptoms in tobacco smokers. Using the keywords "depressive OR depression" AND "tobacco OR nicotine OR smok(*) OR cigarette" AND "neuroimage OR magnetic resonance OR smri OR structural magnetic resonance OR fmri OR functional magnetic resonance OR pet OR positron emission tomography", literature search was conducted in PubMed, Web of Science and PsycINFO databases. The first and the last author read the abstracts of all the studies found in the search (n = 179). The inclusion and exclusion criteria were applied and 150 articles were excluded. Then, both authors assessed the remaining 29 studies for eligibility and 16 studies were included in the present review. In the phase of active/chronic smoking, depressive symptoms are characterized as comorbidity related to an enhancement of dopamine release, and smokers have decreased Monoamine oxidase A (MAO-A). Stimuli-related functional magnetic resonance imaging (Stimuli-fMRI) studies also show that there is a positive correlation between the level of depressive symptoms and a greater response to general negative stimuli in active/chronic smokers. In the withdrawal phase, depressive symptoms are related to the withdrawal syndrome and increased MAO-A. Stimuli-fMRI studies show that there is a negative correlation between level of depressive symptoms and reactivity to negative stimuli in recent abstinent smokers. Major areas of the reward system such as the striatum and areas related to impulse control are activated to a greater extent in depressive smokers compared to non-depressed smokers.

  15. Diagnosis of sessile serrated adenomas/polyps with image-enhanced endoscopy: a systematic review and meta-analysis.

    PubMed

    Parikh, Neil D; Chaptini, Louis; Njei, Basile; Laine, Loren

    2016-08-01

    Distinguishing sessile serrated adenomas/polyps (SSA/Ps) from non-neoplastic tissue may be challenging when white-light endoscopy (WLE) is used. Image-enhanced endoscopy (IEE) has shown accuracy in differentiating adenomas from hyperplastic polyps. The aim of this systematic review and meta-analysis was to evaluate the utility of IEE in diagnosis of SSA/Ps. Studies were eligible if: they included patients undergoing colonoscopy with an endoscopy-based image-enhancement modality; endoscopic diagnoses, including SSA/P, were based on the appearance of polyps at IEE; and the corresponding histologic diagnoses of polyps were provided. The primary outcome was sensitivity of IEE for SSA/Ps differentiated from non-neoplastic lesions (primary convention) and differentiated from all non-SSA/P lesions, including adenomas (secondary convention). 13 studies met inclusion criteria. Sensitivity ranged from 38 % to 100 % but sensitivity ≥ 90 % was seen in 4 of 10 narrow band imaging (NBI) or magnification-NBI studies. Pooled sensitivities for discriminating SSA/Ps from non-neoplastic lesions were 80 % for magnification-NBI, 60 % for NBI, 49 % for autofluorescence, and 47 % for flexible spectral imaging color enhancement. In head-to-head comparisons with WLE, NBI (89 % vs. 75 %) and magnification-NBI (78 % vs. 63 %) demonstrated significantly greater sensitivity, while autofluorescence imaging (56 % vs. 66 %), flexible spectral imaging color enhancement (100 % vs. 100 %), and high-resolution endomicroscopy (88 % vs. 100 %) did not. IEE currently cannot be recommended as a diagnostic tool for SSA/P. While NBI studies showed promise, more IEE studies employing validated SSA/P criteria in well-defined polyp populations are needed. IEE studies assessing SSA/P detection rates at colonoscopy are also needed. © Georg Thieme Verlag KG Stuttgart · New York.

  16. An overview of systematic review.

    PubMed

    Baker, Kathy A; Weeks, Susan Mace

    2014-12-01

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

  17. Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis

    PubMed Central

    Rigolli, Marzia; Anandabaskaran, Sulakchanan; Christiansen, Jonathan P

    2016-01-01

    Purpose Cardiac MR (CMR) is the gold standard for left ventricular (LV) quantification. However, two-dimensional echocardiography (2DE) is the most common approach, and both three-dimensional echocardiography (3DE) and multidetector CT (MDCT) are increasingly available. The clinical significance and interchangeability of these modalities remains under-investigated. Therefore, we undertook a systemic review to evaluate the accuracy and absolute bias in LV quantification of all the commonly available non-invasive imaging modalities (2DE, CE-2DE, 3DE, MDCT) compared to cardiac MR (CMR). Methods Studies were included that reported LV echocardiographic (2DE, CE-2DE, 3DE) and/or MDCT measurements compared to CMR. Only modern CMR (SSFP sequences) was considered. Studies involving small sample size (<10 patients) and unusual cardiac geometry (ie, congenital heart diseases) were excluded. We evaluated LV end-diastolic volume (LVEDV), end-systolic volume (LVESV) and ejection fraction (LVEF). Results 1604 articles were initially considered: 65 studies were included (total of 4032 scans (echo, CT, MRI) performed in 2888 patients). Compared to CMR, significant biased underestimation of LV volumes with 2DE was seen (LVEDV—33.30 mL, LVESV −16.20 mL, p<0.0001). This difference was reduced but remained significant with CE-2DE (LVEDV −18.05, p<0.0001) and 3DE (LVEDV −14.41, p<0.001), while MDCT values were similar to CMR (LVEDV −1.20, p=0.43; LVESV −0.13, p=0.91). However, excellent agreement for echocardiographic LVEF evaluation (2DE LVEF 0.78–1.01%, p=0.37) was observed, especially with 3DE (LVEF 0.14%, p=0.88). Conclusions Comparing imaging modalities to CMR as reference standard, 3DE had the highest accuracy in LVEF estimation: 2DE and 3DE-derived LV volumes were significantly underestimated. Newer generation CT showed excellent accuracy for LV volumes. PMID:27158524

  18. A systematic review of studies comparing body image concerns among female college athletes and non-athletes, 1997-2012.

    PubMed

    Varnes, Julia R; Stellefson, Michael L; Janelle, Christopher M; Dorman, Steven M; Dodd, Virginia; Miller, M David

    2013-09-01

    Research prior to 2001 indicated that athletes experienced better body image than non-athletes, with no differences among sport types. Since then, female athletes have become increasingly sexually objectified in the media, and the sociocultural beauty ideal has shifted to emphasize appearing both athletic and thin. Part I of this paper explores the literature describing these changes. Part II presents a systematic and comprehensive literature review of 10 recent studies comparing body image concerns (BIC) among collegiate female athletes and non-athletes to identify the current status of BIC in female athletes. Findings indicate that involvement in collegiate athletics provides some protection from BIC; however, this protection appears attenuated for athletes in more feminine sports (e.g., gymnastics), and higher level athletes (Division I). Researchers should examine how sociocultural pressures unrelated to competition predict female athletes' BIC using measures that focus on objectification, positive body image, body functionality, and thin- and athletic-ideal internalization. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Effectiveness of Policies on Reducing Exposure to Ionizing Radiation From Medical Imaging: A Systematic Review.

    PubMed

    Thaker, Ashesh; Navadeh, Soodabeh; Gonzales, Hugo; Malekinejad, Mohsen

    2015-12-01

    The use of medical imaging has expanded greatly in the past three decades, raising concern about potential unwanted carcinogenic harms associated with exposure to ionizing radiation among patients. This study summarizes evidence of efficacy of interventions that have prompted policies, and structural-level interventions aimed at reducing radiation dose and risk of cancer, especially among women. Using standard terms, we conducted searches in MEDLINE, Scopus, and Web of Science, and de-duplicated retrieved citations. We hand-searched the reference section of eligible studies and contacted radiology experts to identify studies missed from electronic searches. Two reviewers screened retrieved citations based on predefined eligibility criteria, to identify relevant studies, extract key information from each, rate the quality of evidence, and summarize data in tabular and graphical format. From a total of 1,543 unique citations identified from all sources, 16 were included for data extraction. Half of the studies focused on reduction of ionizing exposure from CT, and half on x-ray or fluoroscopy. Identified interventions were broadly categorized as: policy or structural intervention (two; 13%); multipronged (four; 25%); dose-feedback system (five; 31%); provision of training (four; 25%); and quality-control audit (one; 6%). In general, multipronged programs had a higher range for dose reduction (22%-74%), followed by policy/structural interventions (37%-50%). Existing evidence on the effectiveness of policies aimed at reducing patient radiation dose is disperse and low in quality. Compared with other approaches, multipronged efforts may offer more patient protection. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Achieving Adequate Margins in Ameloblastoma Resection: The Role for Intra-Operative Specimen Imaging. Clinical Report and Systematic Review

    PubMed Central

    Ramakrishnan, Anand; Mirkazemi, Mansoor; Baillieu, Charles; Ptasznik, Ronnie; Leong, James

    2012-01-01

    Background Ameloblastoma is a locally aggressive odontogenic neoplasm. With local recurrence rates reaching 90%, only completeness of excision can facilitate cure. Surgical clearance has widely been based on pre-operative imaging to guide operative excision margins, however use of intra-operative specimen x-ray or frozen-section has been sought to improve clearance rates, and advanced imaging technologies in this role have been proposed. This manuscript aims to quantify the evidence for evaluating intra-operative resection margins and present the current standard in this role. Method The current study comprises the first reported comparison of imaging modalities for assessing ameloblastoma margins. A case is presented in which margins are assessed with each of clinical assessment based on preoperative imaging, intra-operative specimen x-ray, intra-operative specimen computed tomography (CT) and definitive histology. Each modality is compared quantitatively. These results are compared to the literature through means of systematic review of current evidence. Results A comparative study highlights the role for CT imaging over plain radiography. With no other comparative studies and a paucity of high level evidence establishing a role for intra-operative margin assessment in ameloblastoma in the literature, only level 4 evidence supporting the use of frozen section and specimen x-ray, and only one level 4 study assesses intra-operative CT. Conclusion The current study suggests that intra-operative specimen CT offers an improvement over existing techniques in this role. While establishing a gold-standard will require higher level comparative studies, the use of intra-operative CT can facilitate accurate single-stage resection. PMID:23094099

  1. A systematic review of the clinical effectiveness of EOS 2D/3D X-ray imaging system.

    PubMed

    Wade, Ros; Yang, Huiqin; McKenna, Claire; Faria, Rita; Gummerson, Nigel; Woolacott, Nerys

    2013-02-01

    To evaluate the available evidence for the clinical effectiveness of the EOS(®) 2D/3D X-ray imaging system for the evaluation and monitoring of scoliosis and other relevant orthopaedic conditions. A systematic review of studies of EOS(®), compared with standard X-ray film, computed radiography or digital radiography, of patients with orthopaedic conditions was undertaken. Ten electronic databases were searched. The quality of the included studies was assessed and a narrative synthesis undertaken. Three small, limited quality studies, primarily of children with scoliosis, were identified. No patient health outcomes were reported. Spinal image quality was comparable or better overall with EOS(®). Radiation dose was considerably lower with EOS(®) than X-ray film or computed radiography; the mean entrance surface dose was over five times lower with EOS(®) for the posteroanterior spine radiograph and over six times lower for the lateral spine radiograph. The available clinical evidence for EOS(®) is limited to establishing its basic technical ability. The technical advancements associated with EOS(®) (the ability to generate a full body scan and to construct a three-dimensional model from synchronously acquired lateral and posteroanterior images) have not been evaluated in terms of their ability to improve patient outcomes. Whilst radiation dose is a concern for orthopaedic patients who require repeated imaging, it is difficult to quantify the reductions in radiation dose seen with EOS(®) in terms of patient health benefits. Clinical studies that investigate the impact of EOS(®) on patient management are required.

  2. Magnetic Resonance Imaging of the Small Bowel in Crohn's Disease: A Systematic Review and Meta-Analysis

    PubMed Central

    Ahmed, Osman; Rodrigues, David Mario

    2016-01-01

    Introduction. Crohn's disease is most commonly found in the terminal ileum and colonic region. Magnetic resonance has become a useful modality for assessing small bowel activity. In this study, we performed a systematic review and meta-analysis on the use of MR in detecting small bowel activity as well as extramural complications in Crohn's patients. Methods. Two independent reviewers sorted through articles until October 2, 2014. We included both studies providing raw data for pooling and studies without raw data. Sensitivity, specificity, likelihood ratios, and 95% confidence intervals were calculated for each study. Results. There were 27 included studies, of which 19 were included in the pooled analysis. Pooled analysis of the 19 studies (1020 patients) with raw data revealed a sensitivity of 0.88 (95% CI 0.86 to 0.91) and specificity was 0.88 (95% CI 0.84 to 0.91). In regard to detecting stenosis, pooled sensitivity was 0.65 (95% CI 0.53 to 0.76) and specificity was 0.93 (95% CI 0.89 to 0.96). Conclusion. MR imaging provides a reliable alternative in detecting small bowel activity in patients with Crohn's disease. Its advantages include high diagnostic accuracy and no radiation exposure while its disadvantages include high cost and limited availability. PMID:27446869

  3. Volumetric Structural Magnetic Resonance Imaging Findings in Pediatric Posttraumatic Stress Disorder and Obsessive Compulsive Disorder: A Systematic Review

    PubMed Central

    Ahmed, Fatima; Ras, Johan; Seedat, Soraya

    2012-01-01

    Objectives: Structural magnetic resonance imaging (sMRI) studies of anxiety disorders in children and adolescents are limited. Posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) have been best studied in this regard. We systematically reviewed structural neuroimaging findings in pediatric PTSD and OCD. Methods: The literature was reviewed for all sMRI studies examining volumetric parameters using PubMed, ScienceDirect, and PsychInfo databases, with no limit on the time frame of publication. Nine studies in pediatric PTSD and six in OCD were suitable for inclusion. Results: Volumetric findings were inconsistent in both disorders. In PTSD, findings suggest increased as well as decreased volumes of the prefrontal cortex (PFC) and corpus callosum; whilst in OCD studies indicate volumetric increase of the putamen, with inconsistent findings for the anterior cingulate cortex (ACC) and frontal regions. Conclusions: Methodological differences may account for some of this inconsistency and additional volume-based studies in pediatric anxiety disorders using more uniform approaches are needed. PMID:23272001

  4. Optical Coherence Tomography Imaging of Normal, Chronologically Aged, Photoaged and Photodamaged Skin: A Systematic Review

    PubMed Central

    Mamalis, Andrew; Ho, Derek; Jagdeo, Jared

    2016-01-01

    BACKGROUND Optical coherence tomography (OCT) is capable of providing a non-invasive real-time cross-sectional image of the skin through the use of light-based interferometry– a method sometimes described as a “light-based ultrasound.” One key application of OCT in dermatology is the visualization of dermal collagen during processes such as chronological aging, photoaging, or photodamage. These skin conditions are typically managed by the practitioner’s subjective assessment of severity and response to therapy. METHODS & MATERIALS We searched Medline, PubMed, EMBASE, Web of Science, Google Scholar, and Cochrane databases for published literature on the imaging of skin collagen by OCT using the following search terms: “optical coherence tomography,” “OCT,” “skin,” “collagen,” “photoaging,” “wrinkles,” and “photodamage.” RESULTS Our search resulted in 23 articles investigating OCT skin collagen imaging meeting our search criteria. CONCLUSION We anticipate tremendous growth in the field of OCT skin imaging that will parallel the development ultrasound technology has experienced over the past 30 years. We foresee that OCT imaging to evaluate skin aging will not only help identify pathological changes earlier, but will also assist evaluation of response-to-therapy longitudinally without biopsy. PMID:26322560

  5. Magnetic resonance imaging in experimental stroke and comparison with histology: systematic review and meta-analysis.

    PubMed

    Milidonis, Xenios; Marshall, Ian; Macleod, Malcolm R; Sena, Emily S

    2015-03-01

    Because the new era of preclinical stroke research demands improvements in validity and generalizability of findings, moving from single site to multicenter studies could be pivotal. However, the conduct of magnetic resonance imaging (MRI) in stroke remains ill-defined. We sought to assess the variability in the use of MRI for evaluating lesions post stroke and to examine the possibility as an alternative to gold standard histology for measuring the infarct size. We identified animal studies of ischemic stroke reporting lesion sizes using MRI. We assessed the degree of heterogeneity and reporting of scanning protocols, postprocessing methods, study design characteristics, and study quality. Studies performing histological evaluation of infarct size were further selected to compare with corresponding MRI using meta-regression. Fifty-four articles undertaking a total of 78 different MRI scanning protocols met the inclusion criteria. T2-weighted imaging was most frequently used (83% of the studies), followed by diffusion-weighted imaging (43%). Reporting of the imaging parameters was adequate, but heterogeneity between studies was high. Twelve studies assessed the infarct size using both MRI and histology at corresponding time points, with T2-weighted imaging-based treatment effect having a significant positive correlation with histology (; P<0.001). Guidelines for standardized use and reporting of MRI in preclinical stroke are urgently needed. T2-weighted imaging could be used as an effective in vivo alternative to histology for estimating treatment effects based on the extent of infarction; however, additional studies are needed to explore the effect of individual parameters. © 2015 American Heart Association, Inc.

  6. Gynecomastia: A systematic review.

    PubMed

    Fagerlund, Anders; Lewin, Richard; Rufolo, Guglielmo; Elander, Anna; Santanelli di Pompeo, Fabio; Selvaggi, Gennaro

    2015-01-01

    Gynecomastia is a common medical problem presenting in nearly a third of the male population. Treatment for gynecomastia can be either pharmacological or surgical. Patients with gynecomastia often experience affected quality-of-life. The aim of this systematic review was to analyze the quality of evidence of the current literature in relation to different treatment modalities and Quality-of-Life in patients with gynecomastia. A systematic search of the literature was performed in PubMed, Medline, Scopus, The Cochrane Library, and SveMed+ in accordance with the PRISMA statement. All searches were undertaken between September-November 2014. The PICOS (patients, intervention, comparator, outcomes, and study design) approach was used to specify inclusion criteria. Methodological quality was graded according to MINORS. Quality of evidence was rated according to GRADE. Data from the included studies were extracted based on study characteristics, participants specifics, type of intervention/treatment, and type of outcome measures into data extraction forms. A total of 134 abstracts were identified in the literature search. Seventeen studies met inclusion criteria, 14 concerning treatment and three concerning Quality-of-Life. All studies were non-randomised with a high risk of bias and very low quality of evidence according to GRADE. Several different surgical methods have been described with good results, minimal scars, and various levels of complications. Traditional surgical excision of glandular tissue combined with liposuction provides most consistent results and a low rate of complications. Pubertal gynecomastia may safely be managed by pharmacological anti-oestrogen treatment.

  7. A Systematic Review.

    PubMed

    Drejet, Sarah; Halum, Stacey; Brigger, Matthew; Skopelja, Elaine; Parker, Noah P

    2017-03-01

    Objectives (1) To systematically identify studies evaluating the use of intralesional cidofovir or bevacizumab as an adjunct in adult recurrent respiratory papillomatosis, determine disease severity and functional outcomes, and assess study quality. (2) To compare outcomes between the 2 adjuncts. Data Sources Ovid Medline, EMBASE, Scopus, and Clinical-Trials.gov . Review Methods Data sources were systematically searched. A priori inclusion and exclusion criteria were instituted. Quality was evaluated with the Newcastle-Ottawa Quality Assessment Scale. A priori criteria were instituted to select studies suitable for comparison. Results A total of 254 identified studies led to 16 for full-text review, including 14 for cidofovir and 2 for bevacizumab. Disease severity outcomes were reported in all studies, including remission rate, Derkay scores, time interval between operations, and/or lesion volume reduction. Remission rate was the most commonly reported (14 studies). Functional outcomes were reported in 5 studies (36%), including quality-of-life questionnaires, acoustic/aerodynamic analysis, and perceptual voice analysis. Voice-related quality of life was the most commonly reported (2 studies). Of 16 studies, 12 (75%) were rated poor quality. Reports almost invariably showed improved disease severity and functional outcomes following treatment; however, variable outcome measures and inadequate follow-up disallowed direct comparison of adjuncts. Conclusion Remission rate was the most commonly reported disease severity outcome, and voice-related quality of life was the most commonly reported functional outcome. Most studies were of poor quality. No studies met criteria for comparative analysis between adjuncts. Future research would be improved by reporting consistent and comparable disease severity and functional outcomes, treatment protocols, and follow-up.

  8. Pancreatic size and fat content in diabetes: A systematic review and meta-analysis of imaging studies.

    PubMed

    Garcia, Tiago Severo; Rech, Tatiana Helena; Leitão, Cristiane Bauermann

    2017-01-01

    Imaging studies are expected to produce reliable information regarding the size and fat content of the pancreas. However, the available studies have produced inconclusive results. The aim of this study was to perform a systematic review and meta-analysis of imaging studies assessing pancreas size and fat content in patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM). Medline and Embase databases were performed. Studies evaluating pancreatic size (diameter, area or volume) and/or fat content by ultrasound, computed tomography, or magnetic resonance imaging in patients with T1DM and/or T2DM as compared to healthy controls were selected. Seventeen studies including 3,403 subjects (284 T1DM patients, 1,139 T2DM patients, and 1,980 control subjects) were selected for meta-analyses. Pancreas diameter, area, volume, density, and fat percentage were evaluated. Pancreatic volume was reduced in T1DM and T2DM vs. controls (T1DM vs. controls: -38.72 cm3, 95%CI: -52.25 to -25.19, I2 = 70.2%, p for heterogeneity = 0.018; and T2DM vs. controls: -12.18 cm3, 95%CI: -19.1 to -5.25, I2 = 79.3%, p for heterogeneity = 0.001). Fat content was higher in T2DM vs. controls (+2.73%, 95%CI 0.55 to 4.91, I2 = 82.0%, p for heterogeneity<0.001). Individuals with T1DM and T2DM have reduced pancreas size in comparison with control subjects. Patients with T2DM have increased pancreatic fat content.

  9. Imaging features of intracerebral hemorrhage with cerebral amyloid angiopathy: Systematic review and meta-analysis.

    PubMed

    Samarasekera, Neshika; Rodrigues, Mark Alexander; Toh, Pheng Shiew; Salman, Rustam Al-Shahi

    2017-01-01

    We sought to summarize Computed Tomography (CT)/Magnetic Resonance Imaging (MRI) features of intracerebral hemorrhage (ICH) associated with cerebral amyloid angiopathy (CAA) in published observational radio-pathological studies. In November 2016, two authors searched OVID Medline (1946-), Embase (1974-) and relevant bibliographies for studies of imaging features of lobar or cerebellar ICH with pathologically proven CAA ("CAA-associated ICH"). Two authors assessed studies' diagnostic test accuracy methodology and independently extracted data. We identified 22 studies (21 cases series and one cross-sectional study with controls) of CT features in 297 adults, two cross-sectional studies of MRI features in 81 adults and one study which reported both CT and MRI features in 22 adults. Methods of CAA assessment varied, and rating of imaging features was not masked to pathology. The most frequently reported CT features of CAA-associated ICH in 21 case series were: subarachnoid extension (pooled proportion 82%, 95% CI 69-93%, I2 = 51%, 12 studies) and an irregular ICH border (64%, 95% CI 32-91%, I2 = 85%, five studies). CAA-associated ICH was more likely to be multiple on CT than non-CAA ICH in one cross-sectional study (CAA-associated ICH 7/41 vs. non-CAA ICH 0/42; χ2 = 7.8, p = 0.005). Superficial siderosis on MRI was present in 52% of CAA-associated ICH (95% CI 39-65%, I2 = 35%, 3 studies). Subarachnoid extension and an irregular ICH border are common imaging features of CAA-associated ICH, but methodologically rigorous diagnostic test accuracy studies are required to determine the sensitivity and specificity of these features.

  10. White matter changes in early phase schizophrenia and cannabis use: an update and systematic review of diffusion tensor imaging studies.

    PubMed

    Cookey, Jacob; Bernier, Denise; Tibbo, Philip G

    2014-07-01

    The impact of cannabis use on the brain tissue is still unclear, both in the healthy developing brain and in people with schizophrenia. The focus of this review is on white matter, the primary connective infrastructure of the brain. We systematically reviewed diffusion tensor imaging (DTI) studies of early phase schizophrenia (illness effect), of cannabis use in otherwise healthy brains (drug effect), and of early phase schizophrenia with cannabis use (combined effects). Studies had to include a healthy, non-cannabis using, control group as well as report on fractional anisotropy as it is the most commonly used DTI index. We excluded cohorts with heavy alcohol or illicit drug use and studies with a sample size of less than 20 in the clinical group. We retained 17 studies of early phase schizophrenia, which together indicate deficits in white matter integrity observed in all fiber tract families, but most frequently in association, callosal and projection fibers. In otherwise healthy cannabis users (2 studies), deficits in white matter tracts were reported mainly in callosal fibers, but also in projection and limbic fibers. In cannabis users with early phase schizophrenia (1 study), deficits in white matter integrity were also observed in all fiber tract families, except for limbic fibers. The current literature points to several families of white matter tracts being differentially affected in early phase schizophrenia. Further work is required to reveal the impact of cannabis use in otherwise healthy people as well as those with schizophrenia. Paucity of available studies as well as restricting analysis to FA values represent the main limitations of this review. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Neurophysiological effects of acute oxytocin administration: systematic review and meta-analysis of placebo-controlled imaging studies

    PubMed Central

    Wigton, Rebekah; Radua, Jocham; Allen, Paul; Averbeck, Bruno; Meyer-Lindenberg, Andreas; McGuire, Philip; Shergill, Sukhi S.; Fusar-Poli, Paolo

    2015-01-01

    Background Oxytocin (OXT) plays a prominent role in social cognition and may have clinical applications for disorders such as autism, schizophrenia and social anxiety. The neural basis of its mechanism of action remains unclear. Methods We conducted a systematic literature review of placebo-controlled imaging studies using OXT as a pharmacological manipulator of brain activity. Results We identified a total of 21 studies for inclusion in our review, and after applying additional selection criteria, 11 of them were included in our fMRI voxel-based meta-analysis. The results demonstrate consistent alterations in activation of brain regions, including the temporal lobes and insula, during the processing of social stimuli, with some variation dependent on sex and task. The meta-analysis revealed significant left insular hyperactivation after OXT administration, suggesting a potential modulation of neural circuits underlying emotional processing. Limitations This quantitative review included only a limited number of studies, thus the conclusions of our analysis should be interpreted cautiously. This limited sample size precluded a more detailed exploration of potential confounding factors, such as sex or other demographic factors, that may have affected our meta-analysis. Conclusion Oxytocin has a wide range of effects over neural activity in response to social and emotional processing, which is further modulated by sex and task specificity. The magnitude of this neural activation is largest in the temporal lobes, and a meta-analysis across all tasks and both sexes showed that the left insula demonstrated the most robust activation to OXT administration. PMID:25520163

  12. Frankincense: systematic review

    PubMed Central

    2008-01-01

    Objective To assess evidence from randomised clinical trials about the effectiveness of extracts of Boswellia serrata (frankincense). Design Systematic review. Data sources Electronic searches on Medline, Embase, Cinahl, Amed, and Cochrane Library. Hand searches of conference proceedings, bibliographies, and departmental files. Review methods All randomised clinical trials of B serrata extract as a treatment for any human medical condition were included and studies of B serrata preparations combined with other ingredients were excluded. Titles and abstracts of all retrieved articles were read and hard copies of all relevant articles were obtained. Selection of studies, data extraction and validation were done by the author. The Jadad score was used to evaluate the methodological quality of all included trials. Results Of 47 potentially relevant studies, seven met all inclusion criteria (five placebo controlled, two with active controls). The included trials related to asthma, rheumatoid arthritis, Crohn’s disease, osteoarthritis, and collagenous colitis. Results of all trials indicated that B serrata extracts were clinically effective. Three studies were of good methodological quality. No serious safety issues were noted. Conclusions The evidence for the effectiveness of B serrata extracts is encouraging but not compelling. PMID:19091760

  13. Accreta placentation: a systematic review of prenatal ultrasound imaging and grading of villous invasiveness.

    PubMed

    Jauniaux, Eric; Collins, Sally L; Jurkovic, Davor; Burton, Graham J

    2016-12-01

    placentation. The wide heterogeneity in terminology used to describe the grades of accreta placentation and differences in study design limits the evaluation of the accuracy of ultrasound imaging in the screening and diagnosis of placenta accreta. This review emphasizes the need for further prospective studies using a standardized evidence-based approach including a systematic correlation between ultrasound signs of placenta accreta and detailed clinical and pathologic examinations at delivery. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Elastic Versus Rigid Image Registration in Magnetic Resonance Imaging-transrectal Ultrasound Fusion Prostate Biopsy: A Systematic Review and Meta-analysis.

    PubMed

    Venderink, Wulphert; de Rooij, Maarten; Sedelaar, J P Michiel; Huisman, Henkjan J; Fütterer, Jurgen J

    2016-07-29

    The main difference between the available magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion platforms for prostate biopsy is the method of image registration being either rigid or elastic. As elastic registration compensates for possible deformation caused by the introduction of an ultrasound probe for example, it is expected that it would perform better than rigid registration. The aim of this meta-analysis is to compare rigid with elastic registration by calculating the detection odds ratio (OR) for both subgroups. The detection OR is defined as the ratio of the odds of detecting clinically significant prostate cancer (csPCa) by MRI-TRUS fusion biopsy compared with systematic TRUS biopsy. Secondary objectives were the OR for any PCa and the OR after pooling both registration techniques. The electronic databases PubMed, Embase, and Cochrane were systematically searched for relevant studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis Statement. Studies comparing MRI-TRUS fusion and systematic TRUS-guided biopsies in the same patient were included. The quality assessment of included studies was performed using the Quality Assessment of Diagnostic Accuracy Studies version 2. Eleven papers describing elastic and 10 describing rigid registration were included. Meta-analysis showed an OR of csPCa for elastic and rigid registration of 1.45 (95% confidence interval [CI]: 1.21-1.73, p<0.0001) and 1.40 (95% CI: 1.13-1.75, p=0.002), respectively. No significant difference was seen between the subgroups (p=0.83). Pooling subgroups resulted in an OR of 1.43 (95% CI: 1.25-1.63, p<0.00001). No significant difference was identified between rigid and elastic registration for MRI-TRUS fusion-guided biopsy in the detection of csPCa; however, both techniques detected more csPCa than TRUS-guided biopsy alone. We did not identify any significant differences in prostate cancer detection between two distinct magnetic resonance

  15. White-matter tract abnormalities and antisocial behavior: A systematic review of diffusion tensor imaging studies across development.

    PubMed

    Waller, Rebecca; Dotterer, Hailey L; Murray, Laura; Maxwell, Andrea M; Hyde, Luke W

    2017-01-01

    Antisocial behavior (AB), including aggression, violence, and theft, is thought be underpinned by abnormal functioning in networks of the brain critical to emotion processing, behavioral control, and reward-related learning. To better understand the abnormal functioning of these networks, research has begun to investigate the structural connections between brain regions implicated in AB using diffusion tensor imaging (DTI), which assesses white-matter tract microstructure. This systematic review integrates findings from 22 studies that examined the relationship between white-matter microstructure and AB across development. In contrast to a prior hypothesis that AB is associated with greater diffusivity specifically in the uncinate fasciculus, findings suggest that adult AB is associated with greater diffusivity across a range of white-matter tracts, including the uncinate fasciculus, inferior fronto-occipital fasciculus, cingulum, corticospinal tract, thalamic radiations, and corpus callosum. The pattern of findings among youth studies was inconclusive with both higher and lower diffusivity found across association, commissural, and projection and thalamic tracts.

  16. Relationship between brain structure on magnetic resonance imaging and motor outcomes in children with cerebral palsy: a systematic review.

    PubMed

    Arnfield, Evyn; Guzzetta, Andrea; Boyd, Roslyn

    2013-07-01

    Magnetic resonance imaging (MRI) is recommended in all children with cerebral palsy (CP) where the aetiology has not been established, and the major presenting problem in CP is reduced motor capacity. A systematic review of the literature was performed to investigate the relationship between brain structure on MRI and motor outcomes in children with CP. A total of 37 studies met inclusion criteria, and were analysed in terms of (a) population characteristics, (b) MRI data, (c) motor outcome data, and (d) the relationship between MRI data and motor outcomes. All studies used a qualitative system to classify brain lesions; however, few reported information about the location and extent of lesions. Valid and reliable classifications of motor abilities were not always used, and three studies did not link motor findings to MRI features. There was, however, a relationship between the type of brain lesion on MRI and two specific motor outcomes, namely gross motor functional classification (using GMFCS) and motor type. This relationship could aid in the prediction and optimisation of early interventions for children with CP. There is also need for a quantitative MRI classification measure which includes detailed information about the location and severity of lesions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Quantification of Heterogeneity as a Biomarker in Tumor Imaging: A Systematic Review

    PubMed Central

    Alic, Lejla; Niessen, Wiro J.; Veenland, Jifke F.

    2014-01-01

    Background Many techniques are proposed for the quantification of tumor heterogeneity as an imaging biomarker for differentiation between tumor types, tumor grading, response monitoring and outcome prediction. However, in clinical practice these methods are barely used. This study evaluates the reported performance of the described methods and identifies barriers to their implementation in clinical practice. Methodology The Ovid, Embase, and Cochrane Central databases were searched up to 20 September 2013. Heterogeneity analysis methods were classified into four categories, i.e., non-spatial methods (NSM), spatial grey level methods (SGLM), fractal analysis (FA) methods, and filters and transforms (F&T). The performance of the different methods was compared. Principal Findings Of the 7351 potentially relevant publications, 209 were included. Of these studies, 58% reported the use of NSM, 49% SGLM, 10% FA, and 28% F&T. Differentiation between tumor types, tumor grading and/or outcome prediction was the goal in 87% of the studies. Overall, the reported area under the curve (AUC) ranged from 0.5 to 1 (median 0.87). No relation was found between the performance and the quantification methods used, or between the performance and the imaging modality. A negative correlation was found between the tumor-feature ratio and the AUC, which is presumably caused by overfitting in small datasets. Cross-validation was reported in 63% of the classification studies. Retrospective analyses were conducted in 57% of the studies without a clear description. Conclusions In a research setting, heterogeneity quantification methods can differentiate between tumor types, grade tumors, and predict outcome and monitor treatment effects. To translate these methods to clinical practice, more prospective studies are required that use external datasets for validation: these datasets should be made available to the community to facilitate the development of new and improved methods. PMID:25330171

  18. Antenatal magnetic resonance imaging versus ultrasound for predicting neonatal macrosomia: a systematic review and meta-analysis.

    PubMed

    Malin, G L; Bugg, G J; Takwoingi, Y; Thornton, J G; Jones, N W

    2016-01-01

    Fetal macrosomia is associated with an increased risk of adverse maternal and neonatal outcomes. To compare the accuracy of antenatal two-dimensional (2D) ultrasound, three-dimensional (3D) ultrasound, and magnetic resonance imaging (MRI) in predicting fetal macrosomia at birth. Medline (1966-2013), Embase, the Cochrane Library and Web of Knowledge. Cohort or diagnostic accuracy studies of women with a singleton pregnancy, who had third-trimester imaging to predict macrosomia (>4000 g, >4500 g or >90th or >95th centile). Two reviewers screened studies, performed data extraction and assessed methodological quality. The bivariate model was used to obtain summary sensitivities, specificities and likelihood ratios. Fifty-eight studies (34 367 pregnant women) were included. Most were poorly reported. Only one study assessed 3D ultrasound volumetry. For predicting birthweight >4000 g or >90th centile, the summary sensitivity for 2D ultrasound (Hadlock) estimated fetal weight (EFW) >90th centile or >4000 g (29 studies) was 0.56 (95% CI 0.49-0.61), 2D ultrasound abdominal circumference (AC) >35 cm (four studies) was 0.80 (95% confidence interval [95% CI] 0.69-0.87) and MRI EFW (three studies) was 0.93 (95% CI 0.76-0.98). The summary specificities were 0.92 (95% CI 0.90-0.94), 0.86 (95% CI 0.74-0.93) and 0.95 (95% CI 0.92-0.97), respectively. There is insufficient evidence to conclude that MRI EFW is more sensitive than 2D ultrasound AC (which is more sensitive than 2D EFW); although it was more specific. Further primary research is required before recommending MRI EFW for use in clinical practice. Systematic review of antenatal imaging to predict macrosomia. MRI EFW is more sensitive than ultrasound EFW. © 2015 The Authors BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

  19. Urinothorax: a systematic review

    PubMed Central

    Toubes, María E.; Lama, Adriana; Golpe, Antonio; Álvarez-Dobaño, José M.; González-Barcala, Francisco J.; San José, Esther; Rodríguez-Núñez, Nuria; Rábade, Carlos; Lourido, Tamara; Valdés, Luis

    2017-01-01

    Background The characteristics of patients with urinothorax (UT) are poorly defined. Methods A systematic review was performed searching for studies reporting clinical findings, pleural fluid (PF) characteristics, and the most effective treatment of UT. Case descriptions and retrospective studies were included. Results The review included 78 studies with a total of 88 patients. Median age was 45 years, male/female ratio was 1.6:1 and in 76% of cases the etiology was trauma. Pleural effusion (PE) was predominantly unilateral (87%) and occupied over 2/3 of the hemithorax in most cases (64.4%). PF was straw-colored (72.7%) or hematic (27.3%) with urine-like odor in all cases. PF was transudate in 56.2% of cases (18/32) and among 14 exudates (43.8%), 3 were concordant exudates, 1 protein-discordant and 10 LDH-discordant, with lymphocyte (44.4%) and neutrophil (38.5%) predominance. The PF/serum (PF/S) creatinine ratio was >1 in all cases except one (97.9%). The diagnosis was established on the basis of PF/S creatinine ratio >1 (56.6%), urinary tract contrast extravasation (12%), abnormal computed tomography (8.4%), laparotomy findings (6%), and association of obstructive uropathy with PE (6%). The outcome was favorable (74/77; 96.1%) when treatment was direct towards the uropathy (alone or associated with thoracentesis/thoracic drainage). Outcome was unfavorable in the 15 patients who were only treated with thoracentesis/thoracic drainage. Conclusions UT is usually traumatic, unilateral, and PF does not have a specific pattern or cellularity predominance, with a PF/S creatinine ratio almost always >1. Treatment should include the uropathy, with or without PF evacuation. PMID:28616270

  20. Aromatherapy: a systematic review.

    PubMed Central

    Cooke, B; Ernst, E

    2000-01-01

    Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials. PMID:10962794

  1. Automating data extraction in systematic reviews: a systematic review.

    PubMed

    Jonnalagadda, Siddhartha R; Goyal, Pawan; Huffman, Mark D

    2015-06-15

    Automation of the parts of systematic review process, specifically the data extraction step, may be an important strategy to reduce the time necessary to complete a systematic review. However, the state of the science of automatically extracting data elements from full texts has not been well described. This paper performs a systematic review of published and unpublished methods to automate data extraction for systematic reviews. We systematically searched PubMed, IEEEXplore, and ACM Digital Library to identify potentially relevant articles. We included reports that met the following criteria: 1) methods or results section described what entities were or need to be extracted, and 2) at least one entity was automatically extracted with evaluation results that were presented for that entity. We also reviewed the citations from included reports. Out of a total of 1190 unique citations that met our search criteria, we found 26 published reports describing automatic extraction of at least one of more than 52 potential data elements used in systematic reviews. For 25 (48 %) of the data elements used in systematic reviews, there were attempts from various researchers to extract information automatically from the publication text. Out of these, 14 (27 %) data elements were completely extracted, but the highest number of data elements extracted automatically by a single study was 7. Most of the data elements were extracted with F-scores (a mean of sensitivity and positive predictive value) of over 70 %. We found no unified information extraction framework tailored to the systematic review process, and published reports focused on a limited (1-7) number of data elements. Biomedical natural language processing techniques have not been fully utilized to fully or even partially automate the data extraction step of systematic reviews.

  2. Systematic Reviews in Sports Medicine.

    PubMed

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

    2016-02-01

    The number of systematic reviews published in the orthopaedic literature has increased, and these reviews can help guide clinical decision making. However, the quality of these reviews can affect the reader's ability to use the data to arrive at accurate conclusions and make clinical decisions. To evaluate the methodological and reporting quality of systematic reviews and meta-analyses in the sports medicine literature to determine whether such reviews should be used to guide treatment decisions. The hypothesis was that many systematic reviews in the orthopaedic sports medicine literature may not follow the appropriate reporting guidelines or methodological criteria recommended for systematic reviews. Systematic review. All clinical sports medicine systematic reviews and meta-analyses from 2009 to 2013 published in The American Journal of Sports Medicine (AJSM), The Journal of Bone and Joint Surgery (JBJS), Arthroscopy, Sports Health, and Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) were reviewed and evaluated for level of evidence according to the guidelines from the Oxford Centre for Evidence-Based Medicine, for reporting quality according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and for methodological quality according to the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Analysis was performed by year and journal of publication, and the levels of evidence included in the systematic reviews were also analyzed. A total of 200 systematic reviews and meta-analyses were identified over the study period. Of these, 53% included evidence levels 4 and 5 in their analyses, with just 32% including evidence levels 1 and 2 only. There were significant differences in the proportion of articles with high levels of evidence (P < .001) and low levels of evidence (P = .005) by journal. The average PRISMA score was 87% and the average AMSTAR score was 73% among all journals. The average AMSTAR and PRISMA

  3. Global myocardial strain assessment by different imaging modalities to predict outcomes after ST-elevation myocardial infarction: A systematic review

    PubMed Central

    Shetye, Abhishek; Nazir, Sheraz A; Squire, Iain B; McCann, Gerald P

    2015-01-01

    AIM: To conduct a systematic review relating myocardial strain assessed by different imaging modalities for prognostication following ST-elevation myocardial infarction (STEMI). METHODS: An online literature search was performed in PubMed and OVID® electronic databases to identify any studies that assessed global myocardial strain parameters using speckle-tracking echocardiography (STE) and/or cardiac magnetic resonance imaging (CMR) techniques [either myocardial tagging or feature tracking (FT) software] in an acute STEMI cohort (days 0-14 post-event) to predict prognosis [either development of major adverse cardiac events (MACE)] or adverse left ventricular (LV) remodelling at follow-up (≥ 6 mo for MACE, ≥ 3 mo for remodelling). Search was restricted to studies within the last 20 years. All studies that matched the pre-defined search criteria were reviewed and their results interpreted. Due to considerable heterogeneity between studies, meta-analysis was not performed. RESULTS: A total of seven studies (n = 7) were identified that matched the search criteria. All studies used STE to evaluate strain parameters - five (n = 5) assessed global longitudinal strain (GLS) (n = 5), one assessed GLS rate (GLS-R) (n = 1) and one assessed both (n = 1). Three studies showed that GLS independently predicted the development of adverse LV remodelling by multivariate analysis - odds ratio between 1.19 (CI: 1.04-1.37, P < 0.05) and 10 (CI: 6.7-14, P < 0.001) depending on the study. Four studies showed that GLS predicted the development of MACE - hazard ratio (HR) between 1.1 (CI: 1-1.1, P = 0.006) and 2.34 (1.10-4.97, P < 0.05). One paper found that GLS-R could significantly predict MACE - HR 18 (10-35, P < 0.001) - whilst another showed it did not. GLS < -10.85% had sensitivity/specificity of 89.7%/91% respectively for predicting the development of remodelling whilst GLS < -13% could predict the development of MACE with sensitivity/specificity of 100%/89% respectively. No

  4. The Effects of Bariatric Surgery on Cardiac Structure and Function: a Systematic Review of Cardiac Imaging Outcomes.

    PubMed

    Aggarwal, Ravi; Harling, Leanne; Efthimiou, Evangelos; Darzi, Ara; Athanasiou, Thanos; Ashrafian, Hutan

    2016-05-01

    Obesity is associated with cardiac dysfunction, atherosclerosis, and increased cardiovascular risk. It can be lead to obesity cardiomyopathy and severe heart failure, which in turn raise morbidity and mortality while carrying a negative impact on quality of life. There is increasing clinical and mechanistic evidence on the metabolic and weight loss effects of bariatric surgery on improving cardiac structure and function in obese patients. The objective of this study was to quantify the effects of bariatric surgery on cardiac structure and function by appraising cardiac imaging changes before and after metabolic operations. This is a comprehensive systematic review of studies reporting pre-operative and post-operative echocardiographic or magnetic resonance cardiac indices in obese patients undergoing bariatric surgery. Studies were quality scored, and data were meta-analyzed using random effects modeling. Bariatric surgery is associated with significant improvements in the weighted incidence of a number of cardiac indices including a decrease in left ventricular mass index (11.2%, 95% confidence intervals (CI) 8.2-14.1%), left ventricular end-diastolic volume (13.28 ml, 95% CI 5.22-21.34 ml), and left atrium diameter (1.967 mm, 95% CI 0.980-2.954). There were beneficial increases in left ventricular ejection fraction (1.198%, 95%CI -0.050-2.347) and E/A ratio (0.189%, 95%CI -0.113-0.265). Bariatric surgery offers beneficial cardiac effects on diastolic function, systolic function, and myocardial structure in obese patients. These may derive from surgical modulation of an enterocardiac axis. Future studies must focus on higher evidence levels to better identify the most successful bariatric approaches in preventing and treating the broad spectrum of obesity-associated heart disease while also enhancing treatment strategies in the management of obesity cardiomyopathy.

  5. Body image change in obese and overweight persons enrolled in weight loss intervention programs: a systematic review and meta-analysis.

    PubMed

    Chao, Hai-Lun

    2015-01-01

    To report the results of a systematic review and meta-analysis examining whether weight loss interventions improve body image in obese/overweight individuals. Medline, Current Contents, and the Cochrane database were searched to identify studies involving obese/overweight adults who were enrolled in weight loss interventions in which body image was quantitatively assessed. Outcomes assessed were changes in body shape concern, body size dissatisfaction, and body satisfaction (intervention vs comparator/control group). Seven studies were included in the systematic review (4 in the meta-analysis). All but 1 study involved female participants only. The type of weight loss intervention varied between studies as did the type of control/comparator group. In 3 studies, there was no significant difference in body image outcomes, whereas in 4 studies, improvement in body image was significantly more pronounced in the intervention vs the control/comparator group. Meta-analysis revealed that improvements in body shape concern (standardized difference: -0.52; 95% confidence interval [CI]: -1.04 to 0.00), body size dissatisfaction (standardized difference: -0.66; 95% CI: -0.88 to -0.45), and body satisfaction (standardized difference: 0.74; 95% CI: 0.09 to 1.38) significantly favored the intervention over the comparator/control group (P<0.05). The results of this systematic review/meta-analysis lend support to the notion that weight loss interventions may improve body image. This is a noteworthy finding that has clear clinical applicability because body image affects psychological well-being and the ability of an individual to maintain weight loss. Future research should determine which weigh loss interventions are associated with optimal improvements in body image and maintenance of weight loss.

  6. Systematic Review Workshop (August 2013)

    EPA Pesticide Factsheets

    The goal for this workshop is to receive scientific input regarding approaches for different steps within a systematic review, such as evaluating individual studies, synthesizing evidence within a particular discipline, etc.

  7. Guidelines on radiographic imaging as part of root canal treatment: a systematic review with a focus on review imaging after treatment.

    PubMed

    Mahasneh, S A; Horner, K; Cunliffe, J; Al-Salehi, S; Sengupta, A; AlHadidi, A

    2017-09-07

    To identify guidelines on endodontics which make recommendations relating to post-root canal treatment radiological review imaging, to make an objective assessment of their quality using the AGREE tool and to examine the evidence cited in support of their recommendations. The primary sources to identify published guidelines were MEDLINE (Ovid(®) ) and EMBASE. The search aim was to identify guidelines pertaining to the post-root canal treatment follow-up recommendations published from 1946 with the final search date being 26 June 2016. The primary search was supplemented by searching internet search engines and several websites that might have guidelines. The guidelines obtained from the search end-result were assessed for quality and scientific evidence using the AGREE II instrument. Similarities and differences in the recommendations were identified. Thirty guidelines were identified, seven of which met the inclusion criteria. Two guidelines used and clearly described the methods for obtaining scientific evidence from which the recommendations were set. The recommendations varied, particularly as regards the timing of the first review radiograph. Some guidelines lacked supporting evidence. The recommendations for post-endodontic treatment radiographic follow-up varied among the identified guidelines. However, the methodology for obtaining the scientific evidence was poorly described in most of the guidelines. Guideline development groups should use the AGREE II instrument as a guide to produce higher quality guidelines. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  8. Salutogenically focused outcomes in systematic reviews of intrapartum interventions: a systematic review of systematic reviews.

    PubMed

    Smith, Valerie; Daly, Deirdre; Lundgren, Ingela; Eri, Tine; Benstoem, Carina; Devane, Declan

    2014-04-01

    research on intrapartum interventions in maternity care has focused traditionally on the identification of risk factors' and on the reduction of adverse outcomes with less attention given to the measurement of factors that contribute to well-being and positive health outcomes. We conducted a systematic review of reviews to determine the type and number of salutogenically-focused reported outcomes in current maternity care intrapartum intervention-based research. For the conduct of this review, we interpreted salutogenic outcomes as those relating to optimum and/or positive maternal and neonatal health and well-being. to identify salutogenically-focused outcomes reported in systematic reviews of randomised trials of intrapartum interventions. we searched Issue 9 (September) 2011 of the Cochrane Database of Systematic Reviews for all reviews of intrapartum interventions published by the Cochrane Pregnancy and Childbirth Group using the group filter "hm-preg". Systematic reviews of randomised trials of intrapartum interventions were eligible for inclusion. We excluded protocols for systematic reviews and systematic reviews that had been withdrawn. Outcome data were extracted independently from each included review by at least two review authors. Unique lists of salutogenically and non-salutogenically focused outcomes were established. 16 salutogenically-focused outcome categories were identified in 102 included reviews. Maternal satisfaction and breast feeding were reported most frequently. 49 non-salutogenically-focused outcome categories were identified in the 102 included reviews. Measures of neonatal morbidity were reported most frequently. there is an absence of salutogenically-focused outcomes reported in intrapartum intervention-based research. We recommend the development of a core outcome data set of salutogenically-focused outcomes for intrapartum research. © 2013 Published by Elsevier Ltd.

  9. The difficulties of systematic reviews.

    PubMed

    Westgate, Martin J; Lindenmayer, David B

    2017-01-02

    The need for robust evidence to support conservation actions has driven the adoption of systematic approaches to research synthesis in ecology. However, applying systematic review to complex or open questions remains challenging, and this task is becoming more difficult as the quantity of scientific literature increases. Here, we draw on the science of linguistics for guidance as to why the process of identifying and sorting information during systematic review remains so labor-intensive, and to provide potential solutions. Several linguistic properties of peer-reviewed corpora - including non-random selection of review topics, 'small world' properties of semantic networks, and spatiotemporal variation in word meaning - greatly increase the effort needed to complete the systematic review process. Conversely, the resolution of these semantic complexities is a common motivation for so-called 'narrative' reviews, but this process is rarely enacted with the rigor applied during linguistic analysis. Therefore, linguistics provides a unifying framework for understanding some key challenges of systematic review. Where semantic complexity generates barriers to synthesis, ecologists should consider drawing on existing methods from linguistics and information management that provide models for mapping and resolving that complexity. This article is protected by copyright. All rights reserved.

  10. Three-dimensional Imaging Methods for Quantitative Analysis of Facial Soft Tissues and Skeletal Morphology in Patients with Orofacial Clefts: A Systematic Review

    PubMed Central

    Kuijpers, Mette A. R.; Chiu, Yu-Ting; Nada, Rania M.; Carels, Carine E. L.; Fudalej, Piotr S.

    2014-01-01

    Background Current guidelines for evaluating cleft palate treatments are mostly based on two-dimensional (2D) evaluation, but three-dimensional (3D) imaging methods to assess treatment outcome are steadily rising. Objective To identify 3D imaging methods for quantitative assessment of soft tissue and skeletal morphology in patients with cleft lip and palate. Data sources Literature was searched using PubMed (1948–2012), EMBASE (1980–2012), Scopus (2004–2012), Web of Science (1945–2012), and the Cochrane Library. The last search was performed September 30, 2012. Reference lists were hand searched for potentially eligible studies. There was no language restriction. Study selection We included publications using 3D imaging techniques to assess facial soft tissue or skeletal morphology in patients older than 5 years with a cleft lip with/or without cleft palate. We reviewed studies involving the facial region when at least 10 subjects in the sample size had at least one cleft type. Only primary publications were included. Data extraction Independent extraction of data and quality assessments were performed by two observers. Results Five hundred full text publications were retrieved, 144 met the inclusion criteria, with 63 high quality studies. There were differences in study designs, topics studied, patient characteristics, and success measurements; therefore, only a systematic review could be conducted. Main 3D-techniques that are used in cleft lip and palate patients are CT, CBCT, MRI, stereophotogrammetry, and laser surface scanning. These techniques are mainly used for soft tissue analysis, evaluation of bone grafting, and changes in the craniofacial skeleton. Digital dental casts are used to evaluate treatment and changes over time. Conclusion Available evidence implies that 3D imaging methods can be used for documentation of CLP patients. No data are available yet showing that 3D methods are more informative than conventional 2D methods. Further research

  11. A systematic review of systematic reviews of homeopathy.

    PubMed

    Ernst, E

    2002-12-01

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

  12. Image-Based Medical Expert Teleconsultation in Acute Care of Injuries. A Systematic Review of Effects on Information Accuracy, Diagnostic Validity, Clinical Outcome, and User Satisfaction

    PubMed Central

    Hasselberg, Marie; Beer, Netta; Blom, Lisa; Wallis, Lee A.; Laflamme, Lucie

    2014-01-01

    Objective To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects. Design Systematic review of peer-reviewed journal articles. Data sources Searches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals. Eligibility criteria Studies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded. Method The procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently. Results Out of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management. Conclusions Image-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological shortcomings. As in the case

  13. Diagnostic accuracy of CT perfusion imaging for detecting acute ischemic stroke: a systematic review and meta-analysis.

    PubMed

    Biesbroek, J M; Niesten, J M; Dankbaar, J W; Biessels, G J; Velthuis, B K; Reitsma, J B; van der Schaaf, I C

    2013-01-01

    The aim of the current study was to determine the sensitivity and specificity of CT perfusion (CTP) for the detection of ischemic stroke by performing a systematic review and meta-analysis of published reports. We searched PubMed, Embase and the Cochrane library using the terms 'perfusion computed tomography', 'ischemic stroke' and synonyms. We included studies that: (1) reported original data, (2) studied the diagnostic value of CTP for detecting ischemic stroke, (3) used MRI-DWI, follow-up MRI or follow-up CT as the reference standard, (4) included at least 10 patients who were suspected of ischemic stroke, and (5) reported the number of true positives, true negatives, false positives and false negatives for the diagnosis of ischemic stroke. Fifteen studies were finally included in the current review with a total of 1,107 patients. A pooled analysis resulted in a sensitivity of 80% (95% confidence interval, CI: 72-86%) and a specificity of 95% (95% CI: 86-98%). Almost two thirds of the false negatives were due to small lacunar infarcts; the remaining false negatives were mostly due to limited coverage. The current systematic review shows that CTP has a high sensitivity and a very high specificity for detecting infarcts. Copyright © 2013 S. Karger AG, Basel.

  14. F-18-fluoro-2-deoxyglucose positron emission tomography (PET) and PET/computed tomography imaging in primary staging of patients with malignant melanoma: a systematic review

    PubMed Central

    2012-01-01

    Purpose The aim of this systematic review was to systematically assess the potential patient-relevant benefit (primary aim) and diagnostic and prognostic accuracy (secondary aim) of positron emission tomography (PET) and PET/computed tomography (CT) in primary staging of malignant melanoma. This systematic review updates the previous evidence for PET(/CT) in malignant melanoma. Materials and methods For the first aim, randomized controlled trials (RCTs) investigating patient-relevant outcomes and comparing PET and PET(/CT) with each other or with conventional imaging were considered. For the secondary aim, a review of reviews was conducted, which was amended by an update search for primary studies. MEDLINE, EMBASE and four databases of the Cochrane Library were searched. The risk of bias was assessed using a modified QUADAS tool. Results No RCTs investigating the patient-relevant benefit of PET(/CT) and no prognostic accuracy studies were found. Seventeen diagnostic accuracy studies of varying quality were identified. For patients with American Joint Committee on Cancer (AJCC) stages I and II, sensitivity mostly ranged from 0 to 67%. Specificity ranged from 77 to 100%. For AJCC stages III and IV, sensitivity ranged from 68 to 87% and specificity from 92 to 98%. Conclusion There is currently no evidence of a patient-relevant benefit of PET(/CT) in the primary staging of malignant melanoma. RCTs investigating patient-relevant outcomes are therefore required. The diagnostic accuracy of PET(/CT) appears to increase with higher AJCC stages. PMID:23237499

  15. [Iridology: a systematic review].

    PubMed

    Salles, Léia Fortes; Silva, Maria Júlia Paes

    2008-09-01

    This study is a literature review about Iridology/Irisdiagnose in the period from 1970 to 2005. The objective was to identify the worldwide scientific publications (articles) in this field and the opinions about the method. Twenty-five articles were found, four of them from Brazilian authors. About the category, 1 was literature review, 12 research studies and 12 updates, historical reviews or editorials. The countries that have contributed more with the studies were Brazil and Russia. Fifteen of those are in favor of the method and 10 are against it. In conclusion, it is necessary to develop more studies inside the methodological rigor, once Iridology brings hope to preventive medicine.

  16. Synchrotron μCT imaging of bone, titanium implants and bone substitutes - a systematic review of the literature.

    PubMed

    Neldam, Camilla Albeck; Pinholt, Else Marie

    2014-09-01

    Today X-ray micro computer tomography (μCT) imaging is used to investigate bone microarchitecture. μCT imaging is obtained by polychromatic X-ray beams, resulting in images with beam hardening artifacts, resolution levels at 10 μm, geometrical blurring, and lack of contrasts. When μCT is coupled to synchrotron sources (SRμCT) a spatial resolution up to one tenth of a μm may be achieved. A review of the literature concerning SRμCT was performed to investigate its usability and its strength in visualizing fine bone structures, vessels, and microarchitecture of bone. Although mainly limited to in vitro examinations, SRμCT is considered as a gold standard to image trabecular bone microarchitecture since it is possible in a 3D manner to visualize fine structural elements within mineralized tissue such as osteon boundaries, rods and plates structures, cement lines, and differences in mineralization.

  17. Assessment of spinal cord compression by magnetic resonance imaging--can it predict surgical outcomes in degenerative compressive myelopathy? A systematic review.

    PubMed

    Karpova, Alina; Arun, Ranganathan; Cadotte, David W; Davis, Aileen M; Kulkarni, Abhaya V; O'Higgins, Madeleine; Fehlings, Michael G

    2013-07-15

    Systematic review. We sought to conduct a systematic review to examine the role of magnetic resonance imaging in predicting outcomes after surgery and to evaluate the evidence currently available critically. Degenerative compressive myelopathy is a common clinical problem associated with adverse health outcomes. Although a number of studies have investigated the association between preoperative magnetic resonance imaging characteristics and outcomes after surgery for degenerative compressive myelopathy, the conclusions of these studies have often yielded differing results. Articles examining the predictive value of magnetic resonance imaging were obtained from MEDLINE, EMBASE, and PubMed databases (1980-2011). Thirty publications that met the inclusion criteria were reviewed. Two reviewers independently assessed each study regarding the level of evidence (using the criteria proposed by Sackett) and methodological quality based on revised Cochrane quality assessment checklist. Three excellent, 1 good, and 10 poor quality studies assessed cord compression--transverse area (4), compression ratio (5), and anteroposterior diameter (1). Relationship between signal intensity (SI) changes and surgical outcomes were reviewed by 28 studies--8 excellent, 9 good, and 13 poor quality studies. SI changes within the spinal cord included the presence of SI on T2-weighted image (WI) (17), area of SI on T2WI (8), degree of SI on T2WI (5), presence of SI on both T1-/T2WI (2), SI ratio on T2WI (2), and the position of SI on T2WI (1). Based on a combination of excellent and good quality studies, transverse area correlates with recovery ratio but not with postoperative functional score assessed by Japanese Orthopaedic Association/modified Japanese Orthopaedic Association scores. SI changes defined by (1) its presence on T2WI, (2) its extent (focal or multisegmental), (3) its brightness, and (4) its presence on both T1-/T2WI can predict surgical outcomes in degenerative compressive

  18. Analysis of progress and challenges for various patterns of c-MET-targeted molecular imaging: a systematic review.

    PubMed

    Han, Zhaoguo; Wu, Yongyi; Wang, Kai; Xiao, Yadi; Cheng, Zhen; Sun, Xilin; Shen, Baozhong

    2017-12-01

    Mesenchymal-epithelial transition factor also named c-MET is a receptor tyrosine kinase for the hepatocyte growth factor that plays a pivotal role in tumorigenesis. c-MET-targeted therapies have been tested in preclinical models and patients, with significant benefits for cancer treatment. In recent years, many studies have shown that the expression level and activation status of c-MET are closely correlated to c-MET-targeted therapy response and clinical prognosis, thus highlighting the importance of evaluating the c-MET status during and prior to targeted therapy. Molecular imaging allows the monitoring of abnormal alterations of c-MET in real time and in vivo. In this review, we initially summarize the recent advances in c-MET-targeted molecular imaging, with a special focus on the development of imaging agents ranging in size from monoclonal antibody to small molecule. The aim of this review is to report the preclinical results and clinical application of all molecular imaging studies completed until now for in vivo detection of c-MET in cancer, in order to be beneficial to development of molecular probe and the combination of molecular imaging technologies for in vivo evaluation of c-MET. Various molecular probe targeted to c-MET possesses distinctive advantages and disadvantages. For example, antibody-based probes have high binding affinity but with long metabolic cycle as well as remarkable immunogenicity. Although studies for c-MET-targeted molecular imaging have made many important advances, most of imaging agents specifically target to extracellular area of c-MET receptor; however, it is difficult to reflect entirely activation of c-MET. Therefore, small molecule probes based on tyrosine kinase inhibitors, which could target to intracellular area of c-MET without any immunogenicity, should be paid more attention.

  19. Lateral cervical lymph node metastases in papillary thyroid cancer: a systematic review of imaging-guided and prophylactic removal of the lateral compartment.

    PubMed

    Mulla, Mubashir G; Knoefel, Wolfram Trudo; Gilbert, Jackie; McGregor, Alan; Schulte, Klaus-Martin

    2012-07-01

    Papillary thyroid cancer (PTC) is a common endocrine cancer and frequently presents with lymph node (LN) metastases. The frequency of LN metastases in the lateral compartment and their surgical removal are poorly defined. There are no prospective randomised controlled trials addressing an eventual outcome difference relating to the extent of the initial surgical approach. The aim of this study was to define the extent of lateral LN involvement and the role of imaging in identification of these metastatic LN. A systematic review of studies of patients with PTC undergoing either prophylactic or therapeutic lymphadenectomy of the lateral cervical compartment. Studies involving imaging modalities in the detection of lateral cervical LNs in PTC were also analysed. Systematic review on the frequency of lateral LN metastases and their detection using various imaging tools identified 19 studies containing data on 5587 patients undergoing prophylactic or imaging-guided removal of the lateral compartment. Imaging-guided surgery retrieved cancerous lateral LNs in 446/3178 or 14% of eligible patients, whilst prophylactic lateral neck dissection yielded histopathological proof of cancer in 1177/204 or 57·5% of patients. The frequency of lateral compartment metastases increased with T stage. The sensitivity of ultrasound and CT was poor as low as 27% when accurately calculated. Metastatic cervical LNs were found in more than half of patients when prophylactic lateral LN dissection was performed. Use of conventional imaging for the selection of the surgical approach to the lateral cervical compartment may commonly identify stage N1a instead of N1b and thus lead to false stage assignment as stage III rather than stage IV, concealing the severe prognostic implications of this stage progression in individual patients. © 2012 Blackwell Publishing Ltd.

  20. 68Ga-DOTATATE Compared with 111In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis.

    PubMed

    Deppen, Stephen A; Blume, Jeffrey; Bobbey, Adam J; Shah, Chirayu; Graham, Michael M; Lee, Patricia; Delbeke, Dominique; Walker, Ronald C

    2016-06-01

    Neuroendocrine tumors (NETs) are uncommon tumors with increasing incidence and prevalence. Current reports suggest that (68)Ga-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared with (111)In-DTPA-octreotide and conventional imaging. We performed a systematic review of (68)Ga-DOTATATE for safety and efficacy compared with octreotide and conventional imaging to determine whether available evidence supports U.S. Food and Drug Administration approval. Medline, EMBASE, Web of Science, and Cochrane Reviews electronic databases were searched from January 1999 to September 2015. Results were restricted to human studies comparing diagnostic accuracy of (68)Ga-DOTATATE with octreotide or conventional imaging for pulmonary or gastroenteropancreatic NET and for human studies reporting safety/toxicity for (68)Ga-DOTATATE with 10 subjects or more thought to have NETs. Direct communication with corresponding authors was attempted to obtain missing information. Abstracts meeting eligibility criteria were collected by a research librarian and assembled for reviewers; 2 reviewers independently determined whether or not to include each abstract. If either reviewer chose inclusion, the abstract was accepted for review. Database and bibliography searches yielded 2,479 articles, of which 42 were eligible. Three studies compared the 2 radiopharmaceuticals in the same patient, finding (68)Ga-DOTATATE to be more sensitive than octreotide. Nine studies compared (68)Ga-DOTATATE with conventional imaging. (68)Ga-DOTATATE estimated sensitivity, 90.9% (95% confidence interval, 81.4%-96.4%), and specificity, 90.6% (95% confidence interval, 77.8%-96.1%), were high. Five studies were retained for safety reporting only. Report of harm possibly related to (68)Ga-DOTATATE was rare (6 of 974), and no study reported major toxicity or safety issues. No direct comparison of octreotide and (68)Ga-DOTATATE imaging for diagnosis and staging in an unbiased population of NETs has been

  1. A systematic review of image segmentation methodology, used in the additive manufacture of patient-specific 3D printed models of the cardiovascular system.

    PubMed

    Byrne, N; Velasco Forte, M; Tandon, A; Valverde, I; Hussain, T

    2016-01-01

    Shortcomings in existing methods of image segmentation preclude the widespread adoption of patient-specific 3D printing as a routine decision-making tool in the care of those with congenital heart disease. We sought to determine the range of cardiovascular segmentation methods and how long each of these methods takes. A systematic review of literature was undertaken. Medical imaging modality, segmentation methods, segmentation time, segmentation descriptive quality (SDQ) and segmentation software were recorded. Totally 136 studies met the inclusion criteria (1 clinical trial; 80 journal articles; 55 conference, technical and case reports). The most frequently used image segmentation methods were brightness thresholding, region growing and manual editing, as supported by the most popular piece of proprietary software: Mimics (Materialise NV, Leuven, Belgium, 1992-2015). The use of bespoke software developed by individual authors was not uncommon. SDQ indicated that reporting of image segmentation methods was generally poor with only one in three accounts providing sufficient detail for their procedure to be reproduced. Predominantly anecdotal and case reporting precluded rigorous assessment of risk of bias and strength of evidence. This review finds a reliance on manual and semi-automated segmentation methods which demand a high level of expertise and a significant time commitment on the part of the operator. In light of the findings, we have made recommendations regarding reporting of 3D printing studies. We anticipate that these findings will encourage the development of advanced image segmentation methods.

  2. Conventional radiography and cross-sectional imaging when planning dental implants in the anterior edentulous mandible to support an overdenture: a systematic review.

    PubMed

    Shelley, A M; Glenny, A-M; Goodwin, M; Brunton, P; Horner, K

    2014-01-01

    The objectives for this systematic review were to determine if the pre-operative availability of cross-sectional imaging, such as cone beam CT, has a diagnostic impact, therapeutic impact or impact on patients' outcome when placing two dental implants in the anterior mandible to support an overdenture. The Cochrane Oral Health Group's Trials Register (CENTRAL), MEDLINE® and Embase were searched up to, and including, February 2013. Studies were considered eligible for inclusion if they compared the impact of conventional and cross-sectional imaging when placing dental implants in sites including the anterior mandible. An adapted quality assessment tool was used for the assessment of the risk of bias in included studies. Pooled quantitative analysis was not possible and, therefore, synthesis was qualitative. Of 2374 potentially eligible papers, 5 studies were included. Little can be determined from a synthesis of these studies because of their small number, clinical diversity and high risks of bias. Notwithstanding, it may be tentatively inferred that cross-sectional imaging has a therapeutic impact in the more challenging cases. In terms of impact, this review has found no evidence to support any specific imaging modality when planning dental implant placement in any region of the mouth. Therefore, those who argue that cross-sectional imaging should be used for the assessment of all dental implant sites are unsupported by evidence.

  3. Papillomaviruses: a systematic review.

    PubMed

    Araldi, Rodrigo Pinheiro; Assaf, Suely Muro Reis; Carvalho, Rodrigo Franco de; Carvalho, Márcio Augusto Caldas Rocha de; Souza, Jacqueline Mazzuchelli de; Magnelli, Roberta Fiusa; Módolo, Diego Grando; Roperto, Franco Peppino; Stocco, Rita de Cassia; Beçak, Willy

    2017-01-01

    In the last decades, a group of viruses has received great attention due to its relationship with cancer development and its wide distribution throughout the vertebrates: the papillomaviruses. In this article, we aim to review some of the most relevant reports concerning the use of bovines as an experimental model for studies related to papillomaviruses. Moreover, the obtained data contributes to the development of strategies against the clinical consequences of bovine papillomaviruses (BPV) that have led to drastic hazards to the herds. To overcome the problem, the vaccines that we have been developing involve recombinant DNA technology, aiming at prophylactic and therapeutic procedures. It is important to point out that these strategies can be used as models for innovative procedures against HPV, as this virus is the main causal agent of cervical cancer, the second most fatal cancer in women.

  4. Papillomaviruses: a systematic review

    PubMed Central

    Araldi, Rodrigo Pinheiro; Assaf, Suely Muro Reis; de Carvalho, Rodrigo Franco; de Carvalho, Márcio Augusto Caldas Rocha; de Souza, Jacqueline Mazzuchelli; Magnelli, Roberta Fiusa; Módolo, Diego Grando; Roperto, Franco Peppino; Stocco, Rita de Cassia; Beçak, Willy

    2017-01-01

    Abstract In the last decades, a group of viruses has received great attention due to its relationship with cancer development and its wide distribution throughout the vertebrates: the papillomaviruses. In this article, we aim to review some of the most relevant reports concerning the use of bovines as an experimental model for studies related to papillomaviruses. Moreover, the obtained data contributes to the development of strategies against the clinical consequences of bovine papillomaviruses (BPV) that have led to drastic hazards to the herds. To overcome the problem, the vaccines that we have been developing involve recombinant DNA technology, aiming at prophylactic and therapeutic procedures. It is important to point out that these strategies can be used as models for innovative procedures against HPV, as this virus is the main causal agent of cervical cancer, the second most fatal cancer in women. PMID:28212457

  5. Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors - A Systematic Review with Description of Type, Frequency, Risk Factors and Management.

    PubMed

    Vollherbst, Dominik; Bertheau, Robert; Kauczor, Hans-Ulrich; Radeleff, Boris Alexis; Pereira, Philippe L; Sommer, Christof-Matthias

    2017-03-01

    Background Radiofrequency ablation (RFA) is an established treatment for small renal tumors. The objective of this review is to systematically assess the type, frequency, risk factors and management of treatment failure after image-guided percutaneous RFA of renal tumors. Method 10 studies (967 patients, 1033 tumors) with a mean/median follow-up of ≥ 30 months were systematically identified and analyzed. Results and Conclusion Image-guided percutaneous RFA of localized renal tumors is very effective. The most common type of treatment failure is residual unablated tumor (5.9 %), followed by local tumor progression (4.7 %). De novo tumors in the kidneys occur in 1.3 % of cases and extra-renal metastases in 2.0 %. Local tumor progression, de novo tumors in the kidneys and extra-renal metastases occur predominantly later than 12 months after initial RFA. Tumor size > 3 cm and central tumor location are the major risk factors for treatment failure. In the case of treatment failure, repeated RFA shows high success rates (86.3 % for residual unablated tumors and 87.5 % for local tumor progression). Key Points: · Treatment failure can be subdivided into residual unablated tumor and local tumor progression.. · Residual unablated tumor occurs in 5.9 % of cases.. · Local tumor progression occurs in 4.7 % of cases.. · Tumor size and location are the major risk factors for treatment failure.. · Repeated RFA is effective and commonly used for management.. Citation Format · Vollherbst D, Bertheau R, Kauczor H et al. Treatment Failure After Image-Guided Percutaneous Radiofrequency Ablation (RFA) of Renal Tumors - A Systematic Review with Description of Type, Frequency, Risk Factors and Management. Fortschr Röntgenstr 2017; 189: 219 - 227.

  6. 68Ga-DOTATATE Compared with 111In-DTPA-Octreotide and Conventional Imaging for Pulmonary and Gastroenteropancreatic Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

    PubMed Central

    Deppen, Stephen A.; Blume, Jeffrey; Bobbey, Adam J.; Shah, Chirayu; Graham, Michael M.; Lee, Patricia; Delbeke, Dominique; Walker, Ronald C.

    2017-01-01

    Neuroendocrine tumors (NETs) are uncommon tumors with increasing incidence and prevalence. Current reports suggest that 68Ga-DOTATATE PET/CT imaging improves diagnosis and staging of NETs compared with 111In-DTPA-octreotide and conventional imaging. We performed a systematic review of 68Ga-DOTATATE for safety and efficacy compared with octreotide and conventional imaging to determine whether available evidence supports U.S. Food and Drug Administration approval. Methods Medline, EMBASE, Web of Science, and Cochrane Reviews electronic databases were searched from January 1999 to September 2015. Results were restricted to human studies comparing diagnostic accuracy of 68Ga-DOTATATE with octreotide or conventional imaging for pulmonary or gastroenteropancreatic NET and for human studies reporting safety/ toxicity for 68Ga-DOTATATE with 10 subjects or more thought to have NETs. Direct communication with corresponding authors was attempted to obtain missing information. Abstracts meeting eligibility criteria were collected by a research librarian and assembled for reviewers; 2 reviewers independently determined whether or not to include each abstract. If either reviewer chose inclusion, the abstract was accepted for review. Results Database and bibliography searches yielded 2,479 articles, of which 42 were eligible. Three studies compared the 2 radiopharmaceuticals in the same patient, finding 68Ga-DOTATATE to be more sensitive than octreotide. Nine studies compared 68Ga-DOTATATE with conventional imaging. 68Ga-DOTATATE estimated sensitivity, 90.9% (95% confidence interval, 81.4%–96.4%), and specificity, 90.6% (95% confidence interval, 77.8%–96.1%), were high. Five studies were retained for safety reporting only. Report of harm possibly related to 68Ga-DOTATATE was rare (6 of 974), and no study reported major toxicity or safety issues. Conclusion No direct comparison of octreotide and 68Ga-DOTATATE imaging for diagnosis and staging in an unbiased population of NETs

  7. A systematic review of systematic reviews of homeopathy

    PubMed Central

    Ernst, E

    2002-01-01

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

  8. Searching for non-genetic molecular and imaging PTSD risk and resilience markers: Systematic review of literature and design of the German Armed Forces PTSD biomarker study.

    PubMed

    Schmidt, Ulrike; Willmund, Gerd-Dieter; Holsboer, Florian; Wotjak, Carsten T; Gallinat, Jürgen; Kowalski, Jens T; Zimmermann, Peter

    2015-01-01

    Biomarkers allowing the identification of individuals with an above average vulnerability or resilience for posttraumatic stress disorder (PTSD) would especially serve populations at high risk for trauma exposure like firefighters, police officers and combat soldiers. Aiming to identify the most promising putative PTSD vulnerability markers, we conducted the first systematic review on potential imaging and non-genetic molecular markers for PTSD risk and resilience. Following the PRISMA guidelines, we systematically screened the PubMed database for prospective longitudinal clinical studies and twin studies reporting on pre-trauma and post-trauma PTSD risk and resilience biomarkers. Using 25 different combinations of search terms, we retrieved 8151 articles of which we finally included and evaluated 9 imaging and 27 molecular studies. In addition, we briefly illustrate the design of the ongoing prospective German Armed Forces (Bundeswehr) PTSD biomarker study (Bw-BioPTSD) which not only aims to validate these previous findings but also to identify novel and clinically applicable molecular, psychological and imaging risk, resilience and disease markers for deployment-related psychopathology in a cohort of German soldiers who served in Afghanistan.

  9. Neural Responses to Visual Food Cues According to Weight Status: A Systematic Review of Functional Magnetic Resonance Imaging Studies

    PubMed Central

    Pursey, Kirrilly M.; Stanwell, Peter; Callister, Robert J.; Brain, Katherine; Collins, Clare E.; Burrows, Tracy L.

    2014-01-01

    Emerging evidence from recent neuroimaging studies suggests that specific food-related behaviors contribute to the development of obesity. The aim of this review was to report the neural responses to visual food cues, as assessed by functional magnetic resonance imaging (fMRI), in humans of differing weight status. Published studies to 2014 were retrieved and included if they used visual food cues, studied humans >18 years old, reported weight status, and included fMRI outcomes. Sixty studies were identified that investigated the neural responses of healthy weight participants (n = 26), healthy weight compared to obese participants (n = 17), and weight-loss interventions (n = 12). High-calorie food images were used in the majority of studies (n = 36), however, image selection justification was only provided in 19 studies. Obese individuals had increased activation of reward-related brain areas including the insula and orbitofrontal cortex in response to visual food cues compared to healthy weight individuals, and this was particularly evident in response to energy dense cues. Additionally, obese individuals were more responsive to food images when satiated. Meta-analysis of changes in neural activation post-weight loss revealed small areas of convergence across studies in brain areas related to emotion, memory, and learning, including the cingulate gyrus, lentiform nucleus, and precuneus. Differential activation patterns to visual food cues were observed between obese, healthy weight, and weight-loss populations. Future studies require standardization of nutrition variables and fMRI outcomes to enable more direct comparisons between studies. PMID:25988110

  10. Neural responses to visual food cues according to weight status: a systematic review of functional magnetic resonance imaging studies.

    PubMed

    Pursey, Kirrilly M; Stanwell, Peter; Callister, Robert J; Brain, Katherine; Collins, Clare E; Burrows, Tracy L

    2014-01-01

    Emerging evidence from recent neuroimaging studies suggests that specific food-related behaviors contribute to the development of obesity. The aim of this review was to report the neural responses to visual food cues, as assessed by functional magnetic resonance imaging (fMRI), in humans of differing weight status. Published studies to 2014 were retrieved and included if they used visual food cues, studied humans >18 years old, reported weight status, and included fMRI outcomes. Sixty studies were identified that investigated the neural responses of healthy weight participants (n = 26), healthy weight compared to obese participants (n = 17), and weight-loss interventions (n = 12). High-calorie food images were used in the majority of studies (n = 36), however, image selection justification was only provided in 19 studies. Obese individuals had increased activation of reward-related brain areas including the insula and orbitofrontal cortex in response to visual food cues compared to healthy weight individuals, and this was particularly evident in response to energy dense cues. Additionally, obese individuals were more responsive to food images when satiated. Meta-analysis of changes in neural activation post-weight loss revealed small areas of convergence across studies in brain areas related to emotion, memory, and learning, including the cingulate gyrus, lentiform nucleus, and precuneus. Differential activation patterns to visual food cues were observed between obese, healthy weight, and weight-loss populations. Future studies require standardization of nutrition variables and fMRI outcomes to enable more direct comparisons between studies.

  11. Uterine transplantation: a systematic review

    PubMed Central

    Ejzenberg, Dani; Mendes, Luana Regina Baratelli Carelli; de Paiva Haddad, Luciana Bertocco; Baracat, Edmund Chada; D’Albuquerque, Luiz Augusto Carneiro; Andraus, Wellington

    2016-01-01

    Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women. PMID:27982170

  12. MANAGEMENT OF ENDOCRINE DISEASE: Imaging for the diagnosis of malignancy in incidentally discovered adrenal masses: a systematic review and meta-analysis

    PubMed Central

    Dinnes, Jacqueline; Bancos, Irina; Ferrante di Ruffano, Lavinia; Chortis, Vasileios; Davenport, Clare; Bayliss, Susan; Sahdev, Anju; Guest, Peter; Fassnacht, Martin; Deeks, Jonathan J

    2016-01-01

    Objective Adrenal masses are incidentally discovered in 5% of CT scans. In 2013/2014, 81 million CT examinations were undertaken in the USA and 5 million in the UK. However, uncertainty remains around the optimal imaging approach for diagnosing malignancy. We aimed to review the evidence on the accuracy of imaging tests for differentiating malignant from benign adrenal masses. Design A systematic review and meta-analysis was conducted. Methods We searched MEDLINE, EMBASE, Cochrane CENTRAL Register of Controlled Trials, Science Citation Index, Conference Proceedings Citation Index, and ZETOC (January 1990 to August 2015). We included studies evaluating the accuracy of CT, MRI, or 18F-fluoro-deoxyglucose (FDG)-PET compared with an adequate histological or imaging-based follow-up reference standard. Results We identified 37 studies suitable for inclusion, after screening 5469 references and 525 full-text articles. Studies evaluated the accuracy of CT (n=16), MRI (n=15), and FDG-PET (n=9) and were generally small and at high or unclear risk of bias. Only 19 studies were eligible for meta-analysis. Limited data suggest that CT density >10HU has high sensitivity for detection of adrenal malignancy in participants with no prior indication for adrenal imaging, that is, masses with ≤10HU are unlikely to be malignant. All other estimates of test performance are based on too small numbers. Conclusions Despite their widespread use in routine assessment, there is insufficient evidence for the diagnostic value of individual imaging tests in distinguishing benign from malignant adrenal masses. Future research is urgently needed and should include prospective test validation studies for imaging and novel diagnostic approaches alongside detailed health economics analysis. PMID:27257145

  13. MANAGEMENT OF ENDOCRINE DISEASE: Imaging for the diagnosis of malignancy in incidentally discovered adrenal masses: a systematic review and meta-analysis.

    PubMed

    Dinnes, Jacqueline; Bancos, Irina; Ferrante di Ruffano, Lavinia; Chortis, Vasileios; Davenport, Clare; Bayliss, Susan; Sahdev, Anju; Guest, Peter; Fassnacht, Martin; Deeks, Jonathan J; Arlt, Wiebke

    2016-08-01

    Adrenal masses are incidentally discovered in 5% of CT scans. In 2013/2014, 81 million CT examinations were undertaken in the USA and 5 million in the UK. However, uncertainty remains around the optimal imaging approach for diagnosing malignancy. We aimed to review the evidence on the accuracy of imaging tests for differentiating malignant from benign adrenal masses. A systematic review and meta-analysis was conducted. We searched MEDLINE, EMBASE, Cochrane CENTRAL Register of Controlled Trials, Science Citation Index, Conference Proceedings Citation Index, and ZETOC (January 1990 to August 2015). We included studies evaluating the accuracy of CT, MRI, or (18)F-fluoro-deoxyglucose (FDG)-PET compared with an adequate histological or imaging-based follow-up reference standard. We identified 37 studies suitable for inclusion, after screening 5469 references and 525 full-text articles. Studies evaluated the accuracy of CT (n=16), MRI (n=15), and FDG-PET (n=9) and were generally small and at high or unclear risk of bias. Only 19 studies were eligible for meta-analysis. Limited data suggest that CT density >10HU has high sensitivity for detection of adrenal malignancy in participants with no prior indication for adrenal imaging, that is, masses with ≤10HU are unlikely to be malignant. All other estimates of test performance are based on too small numbers. Despite their widespread use in routine assessment, there is insufficient evidence for the diagnostic value of individual imaging tests in distinguishing benign from malignant adrenal masses. Future research is urgently needed and should include prospective test validation studies for imaging and novel diagnostic approaches alongside detailed health economics analysis. © 2016 The authors.

  14. A Systematic Review of Cochrane Anticoagulation Reviews

    PubMed Central

    Cundiff, David Keith

    2009-01-01

    Context I coauthored a published review of anticoagulation for venous thromboembolism in the Cochrane Database of Systematic Reviews and published a review on the same topic in MedGenMed (now the Medscape Journal of Medicine). In contrast to the article in Medscape, the discussion and conclusions in the Cochrane review were altered appreciably during the review process. Consequently, I decided to critique all anticoagulation drug-related reviews and protocols in the Cochrane database with feedback letters concerning any issues of potential controversy. Evidence Acquisition Using key words in the search engine of the Cochrane Reviews, I located reviews and protocols involving anticoagulant drugs. I critiqued each anticoagulation review and protocol and sent a total of 57 feedback letters to Cochrane concerning each publication to elicit a response/rebuttal from the authors. Evidence Synthesis Cochrane anticoagulation review editors acknowledged receipt of all letters. As of 12 months after receipt of my last letter, the Cochrane authors have replied to 13 of the 57 and agreed with many of my points. Two protocols were withdrawn after my feedback letters were acknowledged. The 58 Cochrane anticoagulation drug reviews, including mine, contained 9 categories of methodological errors (207 total instances) and 4 types of biases (18 total instances). This review of those Cochrane reviews suggests that the effectiveness of anticoagulants for 30 medical indications is questionable. Conclusions The efficacy of anticoagulants for treatment and prophylaxis for 30 current medical indications should be reconsidered by the scientific community and medical regulatory agencies. At least 50,000 people per year worldwide have fatal bleeding due to anticoagulant treatment or prophylaxis for these indications. PMID:19295926

  15. Diagnostic Performance of Breast Magnetic Resonance Imaging in Non-Calcified Equivocal Breast Findings: Results from a Systematic Review and Meta-Analysis.

    PubMed

    Bennani-Baiti, Barbara; Bennani-Baiti, Nabila; Baltzer, Pascal A

    2016-01-01

    To evaluate the performance of MRI for diagnosis of breast cancer in non-calcified equivocal breast findings. We performed a systematic review and meta-analysis of peer-reviewed studies in PubMed from 01/01/1986 until 06/15/2015. Eligible were studies applying dynamic contrast-enhanced breast MRI as an adjunct to conventional imaging (mammography, ultrasound) to clarify equivocal findings without microcalcifications. Reference standard for MRI findings had to be established by histopathological sampling or imaging follow-up of at least 12 months. Number of true or false positives and negatives and other characteristics were extracted, and possible bias was determined using the QUADAS-2 applet. Statistical analyses included data pooling and heterogeneity testing. Fourteen out of 514 studies comprising 2,316 lesions met our inclusion criteria. Pooled diagnostic parameters were: sensitivity (99%, 95%-CI: 93-100%), specificity (89%, 95%-CI: 85-92%), PPV (56%, 95%-CI: 42-70%) and NPV (100%, 95%-CI: 99-100%). These estimates displayed significant heterogeneity (P<0.001). Breast MRI demonstrates an excellent diagnostic performance in case of non-calcified equivocal breast findings detected in conventional imaging. However, considering the substantial heterogeneity with regard to prevalence of malignancy, problem solving criteria need to be better defined.

  16. Diagnostic Performance of Breast Magnetic Resonance Imaging in Non-Calcified Equivocal Breast Findings: Results from a Systematic Review and Meta-Analysis

    PubMed Central

    Bennani-Baiti, Nabila

    2016-01-01

    Objectives To evaluate the performance of MRI for diagnosis of breast cancer in non-calcified equivocal breast findings. Materials and Methods We performed a systematic review and meta-analysis of peer-reviewed studies in PubMed from 01/01/1986 until 06/15/2015. Eligible were studies applying dynamic contrast-enhanced breast MRI as an adjunct to conventional imaging (mammography, ultrasound) to clarify equivocal findings without microcalcifications. Reference standard for MRI findings had to be established by histopathological sampling or imaging follow-up of at least 12 months. Number of true or false positives and negatives and other characteristics were extracted, and possible bias was determined using the QUADAS-2 applet. Statistical analyses included data pooling and heterogeneity testing. Results Fourteen out of 514 studies comprising 2,316 lesions met our inclusion criteria. Pooled diagnostic parameters were: sensitivity (99%, 95%-CI: 93–100%), specificity (89%, 95%-CI: 85–92%), PPV (56%, 95%-CI: 42–70%) and NPV (100%, 95%-CI: 99–100%). These estimates displayed significant heterogeneity (P<0.001). Conclusions Breast MRI demonstrates an excellent diagnostic performance in case of non-calcified equivocal breast findings detected in conventional imaging. However, considering the substantial heterogeneity with regard to prevalence of malignancy, problem solving criteria need to be better defined. PMID:27482715

  17. Diastolic Dysfunction of Hypertrophic Cardiomyopathy Genotype-Positive Subjects Without Hypertrophy Is Detected by Tissue Doppler Imaging: A Systematic Review and Meta-analysis.

    PubMed

    Liu, Wen; Sun, Dandan; Yang, Jun

    2017-10-01

    To evaluate whether diastolic dysfunction derived by tissue Doppler imaging (TDI) would be an earlier manifestation in genotype-positive hypertrophic cardiomyopathy (HCM) subjects without left ventricular hypertrophy (LVH). We systematically searched Pubmed, Medline, and Web of Science with an upper date limit of June 2016 for studies evaluating the diastolic function of HCM genotype-positive subjects without hypertrophy (G+/LVH-). Based on the inclusion criteria, eligible studies were selected. The quality of selected studies was assessed by the Newcastle-Ottawa Scale before being included in the meta-analysis. The statistic data such as weighted mean difference (WMD) and 95% confidence interval (CI) were calculated by Stata 12.0 software. Seventeen studies were included in the systematic review, and 12 were finally involved in the meta-analysis. The G+/LVH- subjects showed decreased Ea derived by TDI on both the interventricular septum (WMD [95% CI] = -1.822 [-3.104, -0.541]) and lateral wall (WMD [95% CI] = -2.269 [-3.820, -0.719]), and increased E/Ea on both interventricular septum (WMD [95% CI] = 1.363 [0.552, 2.174]) and lateral (WMD [95% CI] = 1.339 [0.386, 2.293]) wall. Tissue Doppler imaging-derived diastolic dysfunction can be found in HCM genotype-positive subjects without hypertrophy. © 2017 by the American Institute of Ultrasound in Medicine.

  18. Near-infrared fluorescence imaging for real-time intraoperative anatomical guidance in minimally invasive surgery: a systematic review of the literature.

    PubMed

    Schols, Rutger M; Connell, Niels J; Stassen, Laurents P S

    2015-05-01

    Near-infrared fluorescence (NIRF) imaging, using contrast agents with fluorescent characteristics in the near-infrared (NIR: 700-900 nm) window, is considered to possess great potential for clinical practice in the future of minimally invasive surgery (MIS), given its capacity for intraoperative, real-time anatomical navigation, and identification. The aim of this review is to provide an overview of the literature concerning the current and potential future applications of fluorescence imaging in supporting anatomical guidance during MIS, and thereby guiding future research. A systematic literature search was performed in the PubMed and Embase databases. All identified articles were screened and checked for eligibility by two authors. In addition, literature was sought by screening references of eligible articles. After administration of a fluorescent dye (e.g., indocyanine green), NIRF imaging can be helpful to improve the visualization of vital anatomical structures during MIS. Extra-hepatic bile ducts, arteries, ureters, sentinel lymph nodes, and lymph vessels have successfully been identified using NIRF imaging. A uniform approach regarding timing and route of dye administration has not yet been established. Optimization of both imaging systems and fluorescent dyes is needed to improve current shortcomings. New preclinical dyes are considered for optimization of NIRF imaging. Future implementation of new intraoperative optical methods, such as NIRF, could significantly contribute to intraoperative anatomy navigation and facilitate critical decision-making in MIS. Further research (i.e., large multi-center randomized controlled trials) is needed to establish the true value of this innovative optical imaging technique in standard clinical practice.

  19. Structural and Functional Imaging Studies in Chronic Cannabis Users: A Systematic Review of Adolescent and Adult Findings

    PubMed Central

    Batalla, Albert; Bhattacharyya, Sagnik; Yücel, Murat; Fusar-Poli, Paolo; Crippa, Jose Alexandre; Nogué, Santiago; Torrens, Marta; Pujol, Jesús; Farré, Magí; Martin-Santos, Rocio

    2013-01-01

    Background The growing concern about cannabis use, the most commonly used illicit drug worldwide, has led to a significant increase in the number of human studies using neuroimaging techniques to determine the effect of cannabis on brain structure and function. We conducted a systematic review to assess the evidence of the impact of chronic cannabis use on brain structure and function in adults and adolescents. Methods Papers published until August 2012 were included from EMBASE, Medline, PubMed and LILACS databases following a comprehensive search strategy and pre-determined set of criteria for article selection. Only neuroimaging studies involving chronic cannabis users with a matched control group were considered. Results One hundred and forty-two studies were identified, of which 43 met the established criteria. Eight studies were in adolescent population. Neuroimaging studies provide evidence of morphological brain alterations in both population groups, particularly in the medial temporal and frontal cortices, as well as the cerebellum. These effects may be related to the amount of cannabis exposure. Functional neuroimaging studies suggest different patterns of resting global and brain activity during the performance of several cognitive tasks both in adolescents and adults, which may indicate compensatory effects in response to chronic cannabis exposure. Limitations However, the results pointed out methodological limitations of the work conducted to date and considerable heterogeneity in the findings. Conclusion Chronic cannabis use may alter brain structure and function in adult and adolescent population. Further studies should consider the use of convergent methodology, prospective large samples involving adolescent to adulthood subjects, and data-sharing initiatives. PMID:23390554

  20. A systematic review and meta-analysis of magnetic resonance imaging measurement of structural volumes in posttraumatic stress disorder.

    PubMed

    O'Doherty, Daniel C M; Chitty, Kate M; Saddiqui, Sonia; Bennett, Maxwell R; Lagopoulos, Jim

    2015-04-30

    Posttraumatic stress disorder (PTSD) is a debilitating condition associated with mild to moderate cognitive impairment and with a prevalence rate of up to 22% in veterans. This systematic review and quantitative meta-analysis explore volumetric differences of three key structural brain regions (hippocampus, amygdala and anterior cingulate cortex (ACC)), all of which have been implicated in dysfunction of both salience network (SN) and default mode network (DMN) in PTSD sufferers. A literature search was conducted in Embase, Medline, PubMed and PsycINFO in May 2013. Fifty-nine volumetric analyses from 44 articles were examined and included (36 hippocampus, 14 amygdala and nine ACC) with n=846 PTSD participants, n=520 healthy controls (HCs) and n=624 traumatised controls (TCs). Nine statistical tests were performed for each of the three regions of interest (ROIs), measuring volume differences in PTSD subjects, healthy and traumatised controls. Hippocampal volume was reduced in subjects with PTSD, with a greater reduction in the left hippocampus. A medium effect size reduction was found in bilateral amygdala volume when compared with findings in healthy controls; however, no significant differences in amygdala volume between PTSD subjects and trauma-exposed controls were found. Significant volume reductions were found bilaterally in the ACC. While often well matched with their respective control groups, the samples of PTSD subjects composed from the source studies used in the meta-analyses are limited in their homogeneity. The current findings of reduced hippocampal volume in subjects with PTSD are consistent with the existing literature. Amygdala volumes did not show significant reductions in PTSD subjects when compared with volumes in trauma-exposed controls-congruous with reported symptoms of hypervigilance and increased propensity in acquisition of conditioned fear memories-but a significant reduction was found in the combined left and right hemisphere volume

  1. Correlations between renal function and the total kidney volume measured on imaging for autosomal dominant polycystic kidney disease: A systematic review and meta-analysis.

    PubMed

    Jo, Woo Ri; Kim, Seong Hee; Kim, Kyung Won; Suh, Chong Hyun; Kim, Jeong Kon; Kim, Hyosang; Lee, Jong Gu; Oh, Woo Yong; Choi, Seong Eun; Pyo, Junhee

    2017-10-01

    To provide a systematic summary of total kidney volume (TKV) as an imaging biomarker in clinical trials for autosomal dominant polycystic kidney disease (ADPKD), focusing on the correlation between TKV and renal function. A computerized literature search was performed using MEDLINE and EMBASE databases for studies that evaluated the correlation between TKV and the glomerular filtration rate (GFR) and between the TKV growth rate and GFR decline rate. A meta-analysis was performed to generate the summary correlation coefficient (r). A qualitative review was performed to evaluate the characteristics of TKV as an imaging biomarker. Eighteen articles including a total sample size of 2835 patients were retrieved. Meta-analysis revealed substantial correlations between TKV and GFR [r, -0.520; 95% confidence interval (CI), -0.60 to -0.43] and between the TKV growth rate and GFR decline rate [r, -0.320; 95% CI, -0.54 to -0.10]. The quantitative review revealed that baseline TKV can affect the TKV growth rate and GFR decline rate, such that patients with a higher baseline TKV showed faster TKV growth and GFR decline. There was significant variability in image acquisition and analysis methods. There were significant negative correlations between TKV and GFR as well as between TKV growth and GFR decline rates, suggesting that TKV imaging is a useful biomarker in clinical trials. However, standardization-or at least trial-specific standardization-of image acquisition and analysis techniques is required to use TKV as a reliable biomarker. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Central poststroke pain: A systematic review.

    PubMed

    Singer, Jonathan; Conigliaro, Alyssa; Spina, Elizabeth; Law, Susan W; Levine, Steven R

    2017-06-01

    Background Physical, psychological, and/or social impairment can result after a stroke and can be exacerbated by pain. One type of pain after stroke, central poststroke pain, is believed to be due to primary central nervous system mechanisms. Estimated prevalence of central poststroke pain ranges widely from 8% to 55% of stroke patients, suggesting a difficulty in reliably, accurately, and consistently identifying central poststroke pain. This may be due to the absence of a generally accepted definition. Aim We aimed to clarify the role of thalamic strokes and damage to the spinothalamic pathway in central poststroke pain patients. Also, we aimed to gain a current understanding of anatomic substrates, brain imaging, and treatment of central poststroke pain. Summary of review Two independent reviewers identified 10,144 publications. Based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we extracted data from 23 papers and categorized the articles' aims into four sections: somatosensory deficits, pathway stimulation, clinical trials, and brain imaging. Conclusions Our systematic review suggests that damage to the spinothalamic pathway is associated with central poststroke pain and this link could provide insights into mechanisms and treatment. Moreover, historical connection of strokes in the thalamic region of the brain and central poststroke pain should be reevaluated as many studies noted that strokes in other regions of the brain have high occurrence of central poststroke pain as well.

  3. The Emergence of Systematic Review in Toxicology

    PubMed Central

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

    2016-01-01

    The Evidence-based Toxicology Collaboration hosted a workshop on “The Emergence of Systematic Review and Related Evidence-based Approaches in Toxicology,” on November 21, 2014 in Baltimore, Maryland. The workshop featured speakers from agencies and organizations applying systematic review approaches to questions in toxicology, speakers with experience in conducting systematic reviews in medicine and healthcare, and stakeholders in industry, government, academia, and non-governmental organizations. Based on the workshop presentations and discussion, here we address the state of systematic review methods in toxicology, historical antecedents in both medicine and toxicology, challenges to the translation of systematic review from medicine to toxicology, and thoughts on the way forward. We conclude with a recommendation that as various agencies and organizations adapt systematic review methods, they continue to work together to ensure that there is a harmonized process for how the basic elements of systematic review methods are applied in toxicology. PMID:27208075

  4. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis

    PubMed Central

    Sun, J; Li, B; Li, CJ; Li, Y; Su, F; Gao, QH; Wu, FL; Yu, T; Wu, L; Li, LJ

    2015-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73–0.87]) than MRI (0.72 [95% CI 0.70–0.74]) when node was considered as unit of analysis (P<0.05); MRI had a higher SPE (0.81 [95% CI 0.80–0.82]) than CT (0.72 [95% CI 0.69–0.74]) when neck level was considered as unit of analysis (P<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (P<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively. PMID:26089682

  5. Computed tomography versus magnetic resonance imaging for diagnosing cervical lymph node metastasis of head and neck cancer: a systematic review and meta-analysis.

    PubMed

    Sun, J; Li, B; Li, C J; Li, Y; Su, F; Gao, Q H; Wu, F L; Yu, T; Wu, L; Li, L J

    2015-01-01

    Computed tomography (CT) and magnetic resonance imaging (MRI) are common imaging methods to detect cervical lymph node metastasis of head and neck cancer. We aimed to assess the diagnostic efficacy of CT and MRI in detecting cervical lymph node metastasis, and to establish unified diagnostic criteria via systematic review and meta-analysis. A systematic literature search in five databases until January 2014 was carried out. All retrieved studies were reviewed and eligible studies were qualitatively summarized. Besides pooling the sensitivity (SEN) and specificity (SPE) data of CT and MRI, summary receiver operating characteristic curves were generated. A total of 63 studies including 3,029 participants were involved. The pooled results of meta-analysis showed that CT had a higher SEN (0.77 [95% confidence interval {CI} 0.73-0.87]) than MRI (0.72 [95% CI 0.70-0.74]) when node was considered as unit of analysis (P<0.05); MRI had a higher SPE (0.81 [95% CI 0.80-0.82]) than CT (0.72 [95% CI 0.69-0.74]) when neck level was considered as unit of analysis (P<0.05) and MRI had a higher area under concentration-time curve than CT when the patient was considered as unit of analysis (P<0.05). With regards to diagnostic criteria, for MRI, the results showed that the minimal axial diameter of 10 mm could be considered as the best size criterion, compared to 12 mm for CT. Overall, MRI conferred significantly higher SPE while CT demonstrated higher SEN. The diagnostic criteria for MRI and CT on size of metastatic lymph nodes were suggested as 10 and 12 mm, respectively.

  6. Examining the validity of the rheumatoid arthritis magnetic resonance imaging score according to the OMERACT filter-a systematic literature review.

    PubMed

    Woodworth, Thasia G; Morgacheva, Olga; Pimienta, Olga L; Troum, Orrin M; Ranganath, Veena K; Furst, Daniel E

    2017-07-01

    To examine whether the RA MRI score (RAMRIS) for RA of the wrist/hand meets the OMERACT filter criteria-truth (validity), discrimination and feasibility. We conducted a systematic literature review in PubMed and Scopus, from 1970 through June 2014, focused on MRI measures of synovitis, osteitis/bone marrow oedema, erosions and/or joint space narrowing in RA randomized controlled trials and observational studies with cohort size ⩾10. Strength of evidence was assessed using the Cochrane Handbook criteria. Of 634 MRI titles/abstracts, 202 met the review criteria, with 92 providing at least 1 type of validity. Four articles provided criterion validity, and 26 articles utilized RAMRIS to assess 1.5 T MRI images. Histopathology data showed inflammation corresponding to MRI of synovitis and osteitis. MRI erosions corresponded to those identified with CT. Content and construct validity for RAMRIS synovitis, osteitis and erosions were documented by correlations with clinical, laboratory and/or radiographic data. Each measure was sensitive to change and responsive to therapy. RAMRIS synovitis and osteitis were able to discriminate between the efficacy of treatments vs placebo in 12-week studies, whereas RAMRIS erosions required studies of ⩾24 weeks. RAMRIS synovitis, osteitis and erosions imaged with 1.5 T MRI are valid and useful for evaluating joint inflammation and damage for RA of the wrist/hand, according to the OMERACT filter.

  7. Telemedicine security: a systematic review.

    PubMed

    Garg, Vaibhav; Brewer, Jeffrey

    2011-05-01

    Telemedicine is a technology-based alternative to traditional health care delivery. However, poor security measures in telemedicine services can have an adverse impact on the quality of care provided, regardless of the chronic condition being studied. We undertook a systematic review of 58 journal articles pertaining to telemedicine security. These articles were selected based on a keyword search on 14 relevant journals. The articles were coded to evaluate the methodology and to identify the key areas of research in security that are being reviewed. Seventy-six percent of the articles defined the security problem they were addressing, and only 47% formulated a research question pertaining to security. Sixty-one percent proposed a solution, and 20% of these tested the security solutions that they proposed. Prior research indicates inadequate reporting of methodology in telemedicine research. We found that to be true for security research as well. We also identified other issues such as using outdated security standards.

  8. Telemedicine Security: A Systematic Review

    PubMed Central

    Garg, Vaibhav; Brewer, Jeffrey

    2011-01-01

    Telemedicine is a technology-based alternative to traditional health care delivery. However, poor security measures in telemedicine services can have an adverse impact on the quality of care provided, regardless of the chronic condition being studied. We undertook a systematic review of 58 journal articles pertaining to telemedicine security. These articles were selected based on a keyword search on 14 relevant journals. The articles were coded to evaluate the methodology and to identify the key areas of research in security that are being reviewed. Seventy-six percent of the articles defined the security problem they were addressing, and only 47% formulated a research question pertaining to security. Sixty-one percent proposed a solution, and 20% of these tested the security solutions that they proposed. Prior research indicates inadequate reporting of methodology in telemedicine research. We found that to be true for security research as well. We also identified other issues such as using outdated security standards. PMID:21722592

  9. Accuracy of Pedicle Screw Insertion among Three Image-Guided Navigation Systems: A Systematic Review and Meta-Analysis.

    PubMed

    Du, Jin Peng; Fan, Yong; Wu, Qi Ning; Wang, Dai Hua; Zhang, Jing; Hao, Ding Jun

    2017-09-13

    Many retrospective studies of pedicle screw placement have revealed that intraoperative navigation systems provide higher accuracy rates and safety than do free-hand techniques. The accuracy of various image-guided navigation systems has been studied; however, differences have not been well defined due to the lack of adequate evidence-based comparative studies. A meta-analysis was conducted to focus on the variation in pedicle screw insertion among three navigation systems: a three-dimensional fluoroscopy-based navigation system (3D FluoroNav), a two-dimensional fluoroscopy-based navigation system (2D FluoroNav) and a conventional computed tomography navigation system (CT Nav). We screened for comparative studies on different pedicle screw insertion navigation systems published through January 2017 using the Cochrane Library, Ovid, Web of Science, PubMed, and EMBASE databases. From 125 papers that were identified, 10 articles were finally chosen. The present comparative study included 8 retrospective clinical studies, 1 prospective clinical trial and 1 randomized controlled cadaveric study. The prevalence rate of pedicle violation in the 3D FluoroNav group was significantly lower than the rates of the 2D FluoroNav group (RR 95% CI: 0.16-0.61, P<0.01) and the CT Nav group (RR 95% CI: 0.42-0.90, P=0.01), and the rate of the CT Nav group was significantly lower than that of the 2D FluoroNav group (RR 95% CI: 0.29-0.81, P<0.01). There are significant differences among CT Nav, 3D FluoroNav and 2D FluoroNav. Our review suggests that 3D FluoroNav may be superior to the other two methods in reducing pedicle violation and that clinicians should consider 3D FluoroNav as a better choice. Copyright © 2017. Published by Elsevier Inc.

  10. Systematic review of the value of ultrasound and magnetic resonance musculoskeletal imaging in the evaluation of response to treatment of gout.

    PubMed

    Villaverde, Virginia; Rosario, María Piedad; Loza, Estíbaliz; Pérez, Fernando

    2014-01-01

    Imaging may be useful for monitoring response to therapy. Within the OMERACT proposal for the core set domains for outcome measures in chronic gout, serum urate levels, recurrence of gouty flares, tophus regression, and joint damage imaging have been included, among other proposed issues. To perform a systematic literature review of the usefulness of magnetic resonance imaging (MRI) and ultrasound (US) on assessment of treatment response in patients with gout. MEDLINE, EMBASE, Cochrane Library (up to February 2012), and abstracts presented at the 2010 and 2011 meetings of the American College of Rheumatology and European League Against Rheumatism, were searched for treatment studies of any duration and therapeutic options, examining the ability of MRI/US to assess treatment response in gouty patients. Meta-analyses, systematic reviews, randomized clinical trials, cohort and case-control studies and validation studies were included. Quality was appraised using validated scales. There were only 3 US published studies in the literature that analysed US utility on assessment of response to treatment in patients with gout. All of them were prospective case studies with a small number of patients and they were reviewed in detailed. A total of 36 patients with gout were examined with US. All of them had a baseline serum urate >6mg/dL. US features of gout (double contour sign, hyperechoic spots in synovial fluid, hyperechoic cloudy areas, tophus diameter and volume) achieved significant reduction in patients who reached the objective of uricemia ≤6mg/dL in all the studies; however, patients in whom levels did not drop below 6mg/dL had no change of US features of gout. Other parameters evaluated in one study included ESR, CRP, number of tender joints (TRN), number of swollen joints, and pain score (SP). All of them decreased with uricemia reduction, but only TRN and SP were statistically significant. No data was found on the value of MRI on treatment response assessment

  11. Mountain Child: Systematic Literature Review.

    PubMed

    Audsley, Annie; Wallace, Rebecca M M; Price, Martin F

    2016-12-01

    Objectives This systematic review identifies and reviews both peer-reviewed and 'grey' literature, across a range of disciplines and from diverse sources, relating to the condition of children living in mountain communities in low- and middle-income countries. Findings The literature on poverty in these communities does not generally focus on the particular vulnerabilities of children or the impact of intersecting vulnerabilities on the most marginalised members of communities. However, this literature does contribute analyses of the broader context and variety of factors impacting on human development in mountainous areas. The literature on other areas of children's lives-health, nutrition, child mortality, education, and child labour-focuses more specifically on children's particular vulnerabilities or experiences. However, it sometimes lacks the broader analysis of the many interrelated characteristics of a mountainous environment which impact on children's situations. Themes Nevertheless, certain themes recur across many disciplines and types of literature, and point to some general conclusions: mountain poverty is influenced by the very local specificities of the physical environment; mountain communities are often politically and economically marginalised, particularly for the most vulnerable within these communities, including children; and mountain communities themselves are an important locus for challenging and interrupting cycles of increasing inequality and disadvantage. While this broad-scale review represents a modest first step, its findings provide the basis for further investigation.

  12. Childhood depression: a systematic review

    PubMed Central

    Lima, Nádia Nara Rolim; do Nascimento, Vânia Barbosa; de Carvalho, Sionara Melo Figueiredo; de Abreu, Luiz Carlos; Neto, Modesto Leite Rolim; Brasil, Aline Quental; Junior, Francisco Telésforo Celestino; de Oliveira, Gislene Farias; Reis, Alberto Olavo Advíncula

    2013-01-01

    As an important public health issue, childhood depression deserves special attention, considering the serious and lasting consequences of the disease to child development. Taking this into consideration, the present study was based on the following question: what practical contributions to clinicians and researchers does the current literature on childhood depression have to offer? The objective of the present study was to conduct a systematic review of articles regarding childhood depression. To accomplish this purpose, a systematic review of articles on childhood depression, published from January 1, 2010 to November 24, 2012, on MEDLINE and SciELO databases was carried out. Search terms were “depression” (medical subject headings [MeSH]), “child” (MeSH), and “childhood depression” (keyword). Of the 180 retrieved studies, 25 met the eligibility criteria. Retrieved studies covered a wide range of aspects regarding childhood depression, such as diagnosis, treatment, prevention and prognosis. Recent scientific literature regarding childhood depression converge to, directly or indirectly, highlight the negative impacts of depressive disorders to the children’s quality of life. Unfortunately, the retrieved studies show that childhood depression commonly grows in a background of vulnerability and poverty, where individual and familiar needs concerning childhood depression are not always taken into consideration. In this context, this review demonstrated that childhood-onset depression commonly leads to other psychiatric disorders and co-morbidities. Many of the retrieved studies also confirmed the hypothesis that human resources (eg, health care team in general) are not yet adequately trained to address childhood depression. Thus, further research on the development of programs to prepare health care professionals to deal with childhood depression is needed, as well as complementary studies, with larger and more homogeneous samples, centered on prevention

  13. Systematic Review Methodology in Higher Education

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  14. Systematic Review Methodology in Higher Education

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. Comparison of 18F-FDG-PET/CT and 18F-FDG-PET/MR imaging in oncology: a systematic review.

    PubMed

    Singnurkar, Amit; Poon, Raymond; Metser, Ur

    2017-06-01

    The aim of this study was to systematically review the literature to evaluate the clinical performance of integrated (18)F-FDG PET/MR as compared with (18)F-FDG PET/CT in oncologic imaging. The literature was searched using MEDLINE and EMBASE via OVID. Studies comparing the diagnostic accuracy of integrated (18)F-FDG PET/MR and (18)F-FDG PET/CT in the diagnosis, staging/restaging, assessment of treatment response, or evaluation of metastasis in patients with suspected or diagnosed cancers were deemed eligible for inclusion. Risk of bias and applicability concerns were assessed using the QUADAS-2 tool. Twenty studies met the inclusion criteria. The overall quality of the studies was rated favorably with bias or applicability concerns in a few studies. Our review suggests that (18)F-FDG PET/MR performs comparably to (18)F-FDG PET/CT in the detection of local lymph node and distant metastases and superiorly in determining the local extent of tumor. SUV obtained from (18)F-FDG PET/MR correlated highly with those obtained from (18)F-FDG PET/CT. Based on early evidence, (18)F-FDG PET/MR is comparable to (18)F-FDG PET/CT in the clinical scenarios examined in this review. The potential for interchangeability of (18)F-FDG PET/MR with (18)F-FDG PET/CT will vary by indication and the body site that is being imaged, with PET scanners integrated with MRI predicted to provide greater detail in the evaluation of local tumor extent, where (18)F-FDG PET/CT can be limited.

  16. Detection of Osteomyelitis in the Diabetic Foot by Imaging Techniques: A Systematic Review and Meta-analysis Comparing MRI, White Blood Cell Scintigraphy, and FDG-PET.

    PubMed

    Lauri, Chiara; Tamminga, Menno; Glaudemans, Andor W J M; Juárez Orozco, Luis Eduardo; Erba, Paola A; Jutte, Paul C; Lipsky, Benjamin A; IJzerman, Maarten J; Signore, Alberto; Slart, Riemer H J A

    2017-08-01

    Diagnosing bone infection in the diabetic foot is challenging and often requires several diagnostic procedures, including advanced imaging. We compared the diagnostic performances of MRI, radiolabeled white blood cell (WBC) scintigraphy (either with (99m)Tc-hexamethylpropyleneamineoxime [HMPAO] or (111)In-oxine), and [(18)F]fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET)/computed tomography. We searched Medline and Embase as of August 2016 for studies of diagnostic tests on patients known or suspected to have diabetes and a foot infection. We performed a systematic review using criteria recommended by the Cochrane Review of a database that included prospective and retrospective diagnostic studies performed on patients with diabetes in whom there was a clinical suspicion of osteomyelitis of the foot. The preferred reference standard was bone biopsy and subsequent pathological (or microbiological) examination. Our review found 6,649 articles; 3,894 in Medline and 2,755 in Embase. A total of 27 full articles and 2 posters was selected for inclusion in the analysis. The performance characteristics for the (18)F-FDG-PET were: sensitivity, 89%; specificity, 92%; diagnostic odds ratio (DOR), 95; positive likelihood ratio (LR), 11; and negative LR, 0.11. For WBC scan with (111)In-oxine, the values were: sensitivity, 92%; specificity, 75%; DOR, 34; positive LR, 3.6; and negative LR, 0.1. For WBC scan with (99m)Tc-HMPAO, the values were: sensitivity, 91%; specificity, 92%; DOR, 118; positive LR, 12; and negative LR, 0.1. Finally, for MRI, the values were: sensitivity, 93%; specificity, 75%; DOR, 37; positive LR, 3.66, and negative LR, 0.10. The various modalities have similar sensitivity, but (18)F-FDG-PET and (99m)Tc-HMPAO-labeled WBC scintigraphy offer the highest specificity. Larger prospective studies with a direct comparison among the different imaging techniques are required. © 2017 by the American Diabetes Association.

  17. How to Conduct a Systematic Review: A Narrative Literature Review

    PubMed Central

    Jahan, Nusrat; Zeshan, Muhammad; Tahir, Muhammad A

    2016-01-01

    Systematic reviews are ranked very high in research and are considered the most valid form of medical evidence. They provide a complete summary of the current literature relevant to a research question and can be of immense use to medical professionals. Our goal with this paper is to conduct a narrative review of the literature about systematic reviews and outline the essential elements of a systematic review along with the limitations of such a review. PMID:27924252

  18. Examining a supramodal network for conflict processing: a systematic review and novel functional magnetic resonance imaging data for related visual and auditory stroop tasks.

    PubMed

    Roberts, Katherine L; Hall, Deborah A

    2008-06-01

    Cognitive control over conflicting information has been studied extensively using tasks such as the color-word Stroop, flanker, and spatial conflict task. Neuroimaging studies typically identify a fronto-parietal network engaged in conflict processing, but numerous additional regions are also reported. Ascribing putative functional roles to these regions is problematic because some may have less to do with conflict processing per se, but could be engaged in specific processes related to the chosen stimulus modality, stimulus feature, or type of conflict task. In addition, some studies contrast activation on incongruent and congruent trials, even though a neutral baseline is needed to separate the effect of inhibition from that of facilitation. In the first part of this article, we report a systematic review of 34 neuroimaging publications, which reveals that conflict-related activity is reliably reported in the anterior cingulate cortex and bilaterally in the lateral prefrontal cortex, the anterior insula, and the parietal lobe. In the second part, we further explore these candidate "conflict" regions through a novel functional magnetic resonance imaging experiment, in which the same group of subjects perform related visual and auditory Stroop tasks. By carefully controlling for the same task (Stroop), the same to-be-ignored stimulus dimension (word meaning), and by separating out inhibitory processes from those of facilitation, we attempt to minimize the potential differences between the two tasks. The results provide converging evidence that the regions identified by the systematic review are reliably engaged in conflict processing. Despite carefully matching the Stroop tasks, some regions of differential activity remained, particularly in the parietal cortex. We discuss some of the task-specific processes which might account for this finding.

  19. A clinician's guide to systematic reviews.

    PubMed

    Crowther, David M

    2013-08-01

    The purpose of this article is to discuss systematic reviews, how they are performed, and their associated strengths and limitations. A systematic review is an assessment of evidence involving exact methods to systematically identify, select, and critically evaluate all available literature on a particular topic. Unlike most narrative reviews, systematic reviews have defined methods established a priori for searching, evaluating, extracting, synthesizing, and reporting available evidence. Key characteristics differentiating systematic reviews from most narrative reviews include: clearly stated objectives, pre-defined inclusion/exclusion criteria, an explicit reproducible methodology, systematic exhaustive searches to identify all sources of evidence, an assessment of the validity for each included study, and a systematic presentation of the study characteristics/results. Though there are significant advantages to systematic reviews, there are also clear limitations such as: the quality of included evidence; heterogeneity and homogeneity of included studies; and publication bias. Even with these limitations, systematic reviews are beneficial to front line clinicians when the quantity of evidence is so substantial that reviewing and synthesizing it is not feasible, available evidence is conflicting, or when the robustness of available evidence is unknown.

  20. Magnetic resonance imaging in the preoperative assessment of patients with primary breast cancer: systematic review of diagnostic accuracy and meta-analysis.

    PubMed

    Plana, María Nieves; Carreira, Carmen; Muriel, Alfonso; Chiva, Miguel; Abraira, Víctor; Emparanza, Jose Ignacio; Bonfill, Xavier; Zamora, Javier

    2012-01-01

    To estimate the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting additional lesions and contralateral cancer not identified using conventional imaging in primary breast cancer. We have conducted a systematic review and meta-analyses to estimate diagnostic accuracy indices and the impact of MRI on surgical management. Fifty articles were included (n = 10,811 women). MRI detected additional disease in 20% of women and in the contralateral breast in 5.5%. The summary PPV of ipsilateral additional disease was 67% (95% CI 59-74%). For contralateral breast, the PPV was 37% (95% CI 27-47%). For ipsilateral lesions, MRI devices ≥1.5 Tesla (T) had higher PPV (75%, 95% CI 64-83%) than MRI with <1.5 T (59%, 95% CI 53-71%). Similar results were found for contralateral cancer, PPV 40% (95% CI 29-53%) and 19% (95% CI 8-39%) for high- and low-field equipments, respectively. True positive MRI findings prompted conversion from wide local excision (WLE) to more extensive surgery in 12.8% of women while in 6.3% this conversion was inappropriate. MRI shows high diagnostic accuracy, but MRI findings should be pathologically verified because of the high FP rate. Future research on this emerging technology should focus on patient outcome as the primary end-point.

  1. Does pediatric post-traumatic stress disorder alter the brain? Systematic review and meta-analysis of structural and functional magnetic resonance imaging studies.

    PubMed

    Milani, Ana Carolina C; Hoffmann, Elis V; Fossaluza, Victor; Jackowski, Andrea P; Mello, Marcelo F

    2017-03-01

    Several studies have recently demonstrated that the volumes of specific brain regions are reduced in children and adolescents with post-traumatic stress disorder (PTSD) compared with those of healthy controls. Our study investigated the potential association between early traumatic experiences and altered brain regions and functions. We conducted a systematic review of the scientific literature regarding functional magnetic resonance imaging and a meta-analysis of structural magnetic resonance imaging studies that investigated cerebral region volumes in pediatric patients with PTSD. We searched for articles from 2000 to 2014 in the PsycINFO, PubMed, Medline, Lilacs, and ISI (Web of Knowledge) databases. All data regarding the amygdala, hippocampus, corpus callosum, brain, and intracranial volumes that fit the inclusion criteria were extracted and combined in a meta-analysis that assessed differences between groups. The meta-analysis found reduced total corpus callosum areas and reduced total cerebral and intracranial volumes in the patients with PTSD. The total hippocampus (left and right hippocampus) and gray matter volumes of the amygdala and frontal lobe were also reduced, but these differences were not significant. The functional studies revealed differences in brain region activation in response to stimuli in the post-traumatic stress symptoms/PTSD group. Our results confirmed that the pediatric patients with PTSD exhibited structural and functional brain abnormalities and that some of the abnormalities occurred in different brain regions than those observed in adults. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  2. Accuracy of Presurgical Functional MR Imaging for Language Mapping of Brain Tumors: A Systematic Review and Meta-Analysis.

    PubMed

    Weng, Hsu-Huei; Noll, Kyle R; Johnson, Jason M; Prabhu, Sujit S; Tsai, Yuan-Hsiung; Chang, Sheng-Wei; Huang, Yen-Chu; Lee, Jiann-Der; Yang, Jen-Tsung; Yang, Cheng-Ta; Tsai, Ying-Huang; Yang, Chun-Yuh; Hazle, John D; Schomer, Donald F; Liu, Ho-Ling

    2017-10-04

    Purpose To compare functional magnetic resonance (MR) imaging for language mapping (hereafter, language functional MR imaging) with direct cortical stimulation (DCS) in patients with brain tumors and to assess factors associated with its accuracy. Materials and Methods PubMed/MEDLINE and related databases were searched for research articles published between January 2000 and September 2016. Findings were pooled by using bivariate random-effects and hierarchic summary receiver operating characteristic curve models. Meta-regression and subgroup analyses were performed to evaluate whether publication year, functional MR imaging paradigm, magnetic field strength, statistical threshold, and analysis software affected classification accuracy. Results Ten articles with a total of 214 patients were included in the analysis. On a per-patient basis, the pooled sensitivity and specificity of functional MR imaging was 44% (95% confidence interval [CI]: 14%, 78%) and 80% (95% CI: 54%, 93%), respectively. On a per-tag basis (ie, each DCS stimulation site or "tag" was considered a separate data point across all patients), the pooled sensitivity and specificity were 67% (95% CI: 51%, 80%) and 55% (95% CI: 25%, 82%), respectively. The per-tag analysis showed significantly higher sensitivity for studies with shorter functional MR imaging session times (P = .03) and relaxed statistical threshold (P = .05). Significantly higher specificity was found when expressive language task (P = .02), longer functional MR imaging session times (P < .01), visual presentation of stimuli (P = .04), and stringent statistical threshold (P = .01) were used. Conclusion Results of this study showed moderate accuracy of language functional MR imaging when compared with intraoperative DCS, and the included studies displayed significant methodologic heterogeneity. (©) RSNA, 2017 Online supplemental material is available for this article.

  3. Excited Delirium: A Systematic Review.

    PubMed

    Gonin, Philippe; Beysard, Nicolas; Yersin, Bertrand; Carron, Pierre-Nicolas

    2017-10-09

    We aimed to clarify the definition, epidemiology, and pathophysiology of excited delirium syndrome (ExDS) and to summarize evidence-based treatment recommendations. We conducted a systematic literature search of MEDLINE, Ovid, Web of Knowledge, and Cochrane Library for articles published to March 18, 2017. We also searched the grey literature (Google Scholar) and official police or medical expert reports to complete specific epidemiological data. Search results and full-text articles were independently assessed by two investigators and agreements between reviewers assessed with K statistics. We classified articles by study type, setting, and evidence level. After reviewing the title and abstract of 3604 references, we fully reviewed 284 potentially relevant references, from which 66 were selected for final review. Six contributed to the definition of ExDS, 24 to its epidemiology, 38 to its pathophysiology, and 27 to its management. The incidence of ExDS varies widely with medical or medico-legal context. Mortality is estimated to be as much as 8.3 to 16.5%. Patients are predominantly male. Male gender, young age, African-American race, and being overweight are independent risk factors. Pathophysiology hypotheses mostly implicate dopaminergic pathways. Most cases occur with psychostimulant use or among psychiatric patients, or both. Proposed treatments are symptomatic, often with rapid sedation with benzodiazepines or antipsychotic agents. Ketamine is suggested as an alternative. The overall quality of studies was poor. A universally recognized definition is lacking, remaining mostly syndromic and based on clinical subjective criteria. High mortality rate may be due to definition inconsistency and reporting bias. Our results suggest that ExDS is a real clinical entity, that still kills people and that has probably specific mechanisms and risk factors. No comparative study has been done to conclude whether one treatment approach is preferable to another in the case

  4. How to write a systematic review.

    PubMed

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

    2014-11-01

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

  5. Systematic review of ceramic inlays.

    PubMed

    Hayashi, M; Wilson, N H F; Yeung, C A; Worthington, H V

    2003-03-01

    The purpose of the present study was to conduct a systematic review of ceramic inlays, assess the quality of published clinical studies, and determine the clinical effectiveness of ceramic inlays compared to other forms of posterior restorations. Prospective clinical trials of ceramic inlays published from 1990 to 2001 were retrieved by electronic and hand searching. The methodological quality of each study was assessed by two calibrated reviewers using a standardised checklist. The clinical effectiveness of ceramic inlays was evaluated in terms of failure rate, postoperative pain, and aesthetics. The results were compared to those of other forms of posterior restorations by means of an odds ratio. Among 46 articles selected for quality assessment, only five (10.6%) reported randomised controlled trials and 15 (32.6%) presented controlled clinical trials. The remaining 26 papers (56.5%) were longitudinal clinical trials lacking control groups. Only three papers fulfilled the requirement for statistical analysis to evaluate the clinical effectiveness of ceramic inlays. The results indicate no significant differences in longevity or postoperative sensitivity between ceramic and other posterior restorations over assessment periods of up to 1 year. It is concluded that no strong evidence is available to confirm the clinical effectiveness of ceramic inlays in comparison to other posterior restorations. Greater attention is required to the design and reporting of studies to improve the quality of clinical trials of ceramic inlays.

  6. Masked hypertension: a systematic review.

    PubMed

    Bobrie, Guillaume; Clerson, Pierre; Ménard, Joël; Postel-Vinay, Nicolas; Chatellier, Gilles; Plouin, Pierre-François

    2008-09-01

    The purpose of this research was to review the literature on masked hypertension. Studies, reviews and editorials on masked hypertension were identified by PubMed, Pascal BioMed and Cochrane literature systematic searches. Then, we carried out a meta-analysis of the six cohort studies reporting quantitative data for masked hypertension prognosis. There is still no clear consensus definition of masked hypertension and the reproducibility of the phenomenon is unknown. Nevertheless, the prevalence of masked hypertension seems to lie between 8 and 20%, and can be up to 50% in treated hypertensive patients. Subjects with masked hypertension have a higher risk of cardiovascular accidents [hazard ratios: 1.92 (1.51-2.44)] than normotensive subjects. This is due to a possible failure to recognize and appropriately manage this particular form of hypertension, the frequent association with other risk factors and coexisting target organ damage. The remaining unresolved questions are as follows: is masked hypertension a clinical entity that requires identification and characterization or a statistical phenomenon linked to the variability of blood pressure measurements?; because screening of the entire population is not feasible, how to identify individuals with masked hypertension?; and, in the absence of randomized trial, how to treat masked hypertension?

  7. Retinal implants: a systematic review.

    PubMed

    Chuang, Alice T; Margo, Curtis E; Greenberg, Paul B

    2014-07-01

    Retinal implants present an innovative way of restoring sight in degenerative retinal diseases. Previous reviews of research progress were written by groups developing their own devices. This systematic review objectively compares selected models by examining publications describing five representative retinal prostheses: Argus II, Boston Retinal Implant Project, Epi-Ret 3, Intelligent Medical Implants (IMI) and Alpha-IMS (Retina Implant AG). Publications were analysed using three criteria for interim success: clinical availability, vision restoration potential and long-term biocompatibility. Clinical availability: Argus II is the only device with FDA approval. Argus II and Alpha-IMS have both received the European CE Marking. All others are in clinical trials, except the Boston Retinal Implant, which is in animal studies. Vision restoration: resolution theoretically correlates with electrode number. Among devices with external cameras, the Boston Retinal Implant leads with 100 electrodes, followed by Argus II with 60 electrodes and visual acuity of 20/1262. Instead of an external camera, Alpha-IMS uses a photodiode system dependent on natural eye movements and can deliver visual acuity up to 20/546. Long-term compatibility: IMI offers iterative learning; Epi-Ret 3 is a fully intraocular device; Alpha-IMS uses intraocular photosensitive elements. Merging the results of these three criteria, Alpha-IMS is the most likely to achieve long-term success decades later, beyond current clinical availability.

  8. Keratocystic odontogenic tumour: systematic review

    PubMed Central

    MacDonald-Jankowski, D S

    2011-01-01

    Objectives The aim of this review is to evaluate the principal clinical and conventional radiographic features of non-syndromic keratocystic odontogenic tumour (KCOT) by systematic review (SR), and to compare the frequencies between four global groups. Methods The databases searched were the PubMed interface of Medline and LILACS. Only those reports of KCOTs that occurred in a series of consecutive cases, in the reporting authors' caseload, were considered. Results 51 reports, of 49 series of cases, were included in the SR. 11 SR-included series were in languages other than English. KCOTs affected males more frequently and were three times more prevalent in the mandible. Although the mean age at first presentation was 37 years, the largest proportion of cases first presented in the third decade. The main symptom was swelling. Over a third were found incidentally. Nearly two-thirds displayed buccolingual expansion. Over a quarter of cases recurred. Only a quarter of all SR-included reported series of cases included details of at least one radiological feature. The East Asian global group presented significantly as well-defined, even corticated, multilocular radiolucencies with buccolingual expansion. The KCOTs affecting the Western global group significantly displayed an association with unerupted teeth. Conclusions Long-term follow-up of large series that would have revealed detailed radiographic description and long-term outcomes of non-syndromic KCOT was lacking. PMID:21159911

  9. The potential of hypoxia markers as target for breast molecular imaging – a systematic review and meta-analysis of human marker expression

    PubMed Central

    2013-01-01

    Background Molecular imaging of breast cancer is a promising emerging technology, potentially able to improve clinical care. Valid imaging targets for molecular imaging tracer development are membrane-bound hypoxia-related proteins, expressed when tumor growth outpaces neo-angiogenesis. We performed a systematic literature review and meta-analysis of such hypoxia marker expression rates in human breast cancer to evaluate their potential as clinically relevant molecular imaging targets. Methods We searched MEDLINE and EMBASE for articles describing membrane-bound proteins that are related to hypoxia inducible factor 1α (HIF-1α), the key regulator of the hypoxia response. We extracted expression rates of carbonic anhydrase-IX (CAIX), glucose transporter-1 (GLUT1), C-X-C chemokine receptor type-4 (CXCR4), or insulin-like growth factor-1 receptor (IGF1R) in human breast disease, evaluated by immunohistochemistry. We pooled study results using random-effects models and applied meta-regression to identify associations with clinicopathological variables. Results Of 1,705 identified articles, 117 matched our selection criteria, totaling 30,216 immunohistochemistry results. We found substantial between-study variability in expression rates. Invasive cancer showed pooled expression rates of 35% for CAIX (95% confidence interval (CI): 26-46%), 51% for GLUT1 (CI: 40-61%), 46% for CXCR4 (CI: 33-59%), and 46% for IGF1R (CI: 35-70%). Expression rates increased with tumor grade for GLUT1, CAIX, and CXCR4 (all p < 0.001), but decreased for IGF1R (p < 0.001). GLUT1 showed the highest expression rate in grade III cancers with 58% (45-69%). CXCR4 showed the highest expression rate in small T1 tumors with 48% (CI: 28-69%), but associations with size were only significant for CAIX (p < 0.001; positive association) and IGF1R (p = 0.047; negative association). Although based on few studies, CAIX, GLUT1, and CXCR4 showed profound lower expression rates in normal breast tissue and benign

  10. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    PubMed

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  11. Characterizing Acupuncture Stimuli Using Brain Imaging with fMRI - A Systematic Review and Meta-Analysis of the Literature

    PubMed Central

    Huang, Wenjing; Pach, Daniel; Napadow, Vitaly; Park, Kyungmo; Long, Xiangyu; Neumann, Jane; Maeda, Yumi; Nierhaus, Till; Liang, Fanrong; Witt, Claudia M.

    2012-01-01

    Background The mechanisms of action underlying acupuncture, including acupuncture point specificity, are not well understood. In the previous decade, an increasing number of studies have applied fMRI to investigate brain response to acupuncture stimulation. Our aim was to provide a systematic overview of acupuncture fMRI research considering the following aspects: 1) differences between verum and sham acupuncture, 2) differences due to various methods of acupuncture manipulation, 3) differences between patients and healthy volunteers, 4) differences between different acupuncture points. Methodology/Principal Findings We systematically searched English, Chinese, Korean and Japanese databases for literature published from the earliest available up until September 2009, without any language restrictions. We included all studies using fMRI to investigate the effect of acupuncture on the human brain (at least one group that received needle-based acupuncture). 779 papers were identified, 149 met the inclusion criteria for the descriptive analysis, and 34 were eligible for the meta-analyses. From a descriptive perspective, multiple studies reported that acupuncture modulates activity within specific brain areas, including somatosensory cortices, limbic system, basal ganglia, brain stem, and cerebellum. Meta-analyses for verum acupuncture stimuli confirmed brain activity within many of the regions mentioned above. Differences between verum and sham acupuncture were noted in brain response in middle cingulate, while some heterogeneity was noted for other regions depending on how such meta-analyses were performed, such as sensorimotor cortices, limbic regions, and cerebellum. Conclusions Brain response to acupuncture stimuli encompasses a broad network of regions consistent with not just somatosensory, but also affective and cognitive processing. While the results were heterogeneous, from a descriptive perspective most studies suggest that acupuncture can modulate the

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

    PubMed

    Mueller, Katharina F; Briel, Matthias; Strech, Daniel; Meerpohl, Joerg J; Lang, Britta; Motschall, Edith; Gloy, Viktoria; Lamontagne, Francois; Bassler, Dirk

    2014-01-01

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

  13. The value of magnetic resonance imaging and ultrasonography (MRI/US)-fusion biopsy platforms in prostate cancer detection: a systematic review.

    PubMed

    Gayet, Maudy; van der Aa, Anouk; Beerlage, Harrie P; Schrier, Bart Ph; Mulders, Peter F A; Wijkstra, Hessel

    2016-03-01

    Despite limitations considering the presence, staging and aggressiveness of prostate cancer, ultrasonography (US)-guided systematic biopsies (SBs) are still the 'gold standard' for the diagnosis of prostate cancer. Recently, promising results have been published for targeted prostate biopsies (TBs) using magnetic resonance imaging (MRI) and ultrasonography (MRI/US)-fusion platforms. Different platforms are USA Food and Drug Administration registered and have, mostly subjective, strengths and weaknesses. To our knowledge, no systematic review exists that objectively compares prostate cancer detection rates between the different platforms available. To assess the value of the different MRI/US-fusion platforms in prostate cancer detection, we compared platform-guided TB with SB, and other ways of MRI TB (cognitive fusion or in-bore MR fusion). We performed a systematic review of well-designed prospective randomised and non-randomised trials in the English language published between 1 January 2004 and 17 February 2015, using PubMed, Embase and Cochrane Library databases. Search terms included: 'prostate cancer', 'MR/ultrasound(US) fusion' and 'targeted biopsies'. Extraction of articles was performed by two authors (M.G. and A.A.) and were evaluated by the other authors. Randomised and non-randomised prospective clinical trials comparing TB using MRI/US-fusion platforms and SB, or other ways of TB (cognitive fusion or MR in-bore fusion) were included. In all, 11 of 1865 studies met the inclusion criteria, involving seven different fusion platforms and 2626 patients: 1119 biopsy naïve, 1433 with prior negative biopsy, 50 not mentioned (either biopsy naïve or with prior negative biopsy) and 24 on active surveillance (who were disregarded). The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of included articles. No clear advantage of MRI/US fusion-guided TBs was seen for cancer detection rates (CDRs) of all prostate

  14. Parasitic leiomyomas: a systematic review.

    PubMed

    Lete, Iñaki; González, Janire; Ugarte, Lorea; Barbadillo, Nagore; Lapuente, Oihane; Álvarez-Sala, Javier

    2016-08-01

    Parasitic leiomyomas were first described as early as 1909 but are a rare condition. In recent years, due to the rise of laparoscopic surgery and power morcellation, several cases of parasitic leiomyomas associated with this surgical procedure have been reported. A literature search was performed using PubMed, Embase and Google Scholar with the following combination of keywords: leiomyoma OR uterine neoplasms OR uterine myomectomy OR laparoscopy OR hysterectomy OR peritoneal neoplasms AND parasitic. Papers describing parasitic leiomyomas were included. The results of these studies are summarized herein. We retrieved abstracts of 756 papers. Of these, 591 were excluded for not fulfilling the inclusion criteria and 54 were removed as duplicates; after full-text assessment, 8 were rejected for presenting cases of malignancy and finally 103 were included in our systematic review. From these, we present information about 274 patients with parasitic leiomyomas. The mean age of women was 40 years (range 18-79 years); and 154 (56%) had no history of uterine surgery, the others (120, 44%) having had a previous myomectomy or hysterectomy. Of the total, 106 (39%) women had a history of power morcellation. The most frequent clinical symptom was abdominal pain (49%) and the most frequent presentation was disseminated peritoneal leiomyomatosis. While parasitic leiomyoma was first described a century ago, the recent introduction of laparoscopic power morcellation has increased the number of reported cases. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Pyoderma gangrenosum: a systematic review.

    PubMed

    Cozzani, E; Gasparini, G; Parodi, A

    2014-10-01

    Pyoderma gangrenosum (PG) is a rare, chronic neutrophilic dermatosis of unknown etiology. The world wide incidence is estimated to be around 3-10 cases per million population per year. In 50-70% of cases inflammatory bowel diseases, hematological malignancies or rheumatologic disorders are associated to PG. Although the etiology is uncertain, the dysregulation of the immune system appears to be implied. Pathergy is the most important triggering factor of PG. Indeed, 20-30% of patients report the onset of PG following trivial trauma. Four main variants of PG have been described, namely classic, pustular, bullous, and vegetative forms. The classic form of PG is characterized by ulcers with a raised, undermined, inflammatory border. Intense pain is generally associated to PG. The diagnosis is mainly clinical and of exclusion. The differential diagnosis should take into account infections, vascular disorders and malignancies. The clinical course can be explosive and rapidly progressive or indolent and gradually progressive. Often patients develop only one episode and the overall prognosis is good but extremely influenced by the underlying disorders. Local therapy, mainly with topic steroids is used for mild to moderate lesions. For severe forms of PG a systemic therapy with glucocorticoids and/or other drugs such as tacrolimus, cyclosporine, etc. is needed. This paper is a systematic review of literature on PG.

  16. Geniculate neuralgia: a systematic review.

    PubMed

    Tang, I P; Freeman, S R; Kontorinis, G; Tang, M Y; Rutherford, S A; King, A T; Lloyd, S K W

    2014-05-01

    To systematically summarise the peer-reviewed literature relating to the aetiology, clinical presentation, investigation and treatment of geniculate neuralgia. Articles published in English between 1932 and 2012, identified using Medline, Embase and Cochrane databases. The search terms 'geniculate neuralgia', 'nervus intermedius neuralgia', 'facial pain', 'otalgia' and 'neuralgia' were used to identify relevant papers. Fewer than 150 reported cases were published in English between 1932 and 2012. The aetiology of the condition remains unknown, and clinical presentation varies. Non-neuralgic causes of otalgia should always be excluded by a thorough clinical examination, audiological assessment and radiological investigations before making a diagnosis of geniculate neuralgia. Conservative medical treatment is always the first-line therapy. Surgical treatment should be offered if medical treatment fails. The two commonest surgical options are transection of the nervus intermedius, and microvascular decompression of the nerve at the nerve root entry zone of the brainstem. However, extracranial intratemporal division of the cutaneous branches of the facial nerve may offer a safer and similarly effective treatment. The response to medical treatment for this condition varies between individuals. The long-term outcomes of surgery remain unknown because of limited data.

  17. Occupational skin cancer: Systematic review.

    PubMed

    Sena, Jéssica Suellen; Girão, Régio José Santiago; Carvalho, Sionara Melo Figueiredo de; Tavares, Rosielly Melo; Fonseca, Fernando Luiz Affonso; Silva, Patrícia Barros Aquino; Barbosa, Maria Clara Fortes Portela

    2016-01-01

    To analyze the epidemiological profile, risk factors in the workplace environment and prevention methods for professionals at risk of skin cancer. A systematic review of articles on occupational skin cancer, published in the Lilacs, Scielo, Medline and Cochrane Library from January 1st, 2008, to December 31st, 2013, was performed. The search included the following terms: "neoplasias cutâneas" (DeCS), "exposição ocupacional" (DeCS), "epidemiologia" (DeCS) as well as the keyword "prevenção", and their equivalents in English. After analyzing the titles and summaries of articles, the search strategy resulted in 83 references, of which 22 articles met the eligibility criteria. We found that sun exposure is the main occupational risk factor for skin cancer, causing outdoor workers to be the most vulnerable to developing occupational skin cancer. Professionals with low levels of education and European descent are at increased risk of developing this cancer. Outdoor workers are more vulnerable to developing occupational skin cancer, estimating that professionals with low level of education and European descent are at increased risk of developing this cancer. Therefore, companies need to invest more in the health of workers by providing protective equipment and thus preventing occupational skin cancer.

  18. Providing information to improve body image and care-seeking behavior of women and girls living with female genital mutilation: A systematic review and meta-analysis.

    PubMed

    Esu, Ekpereonne; Okoye, Ifeyinwa; Arikpo, Iwara; Ejemot-Nwadiaro, Regina; Meremikwu, Martin M

    2017-02-01

    Female genital mutilation (FGM) has become recognized worldwide as an extreme form of violation of the human rights of girls and women. Strategies have been employed to curb the practice. To conduct a systematic review of randomized and nonrandomized studies of the effects of providing educational interventions on the body image and care-seeking behavior of girls and women living with FGM with the view to ending the practice. CENTRAL, MEDLINE, and other databases were searched up to August 10, 2015 without any language restrictions. Studies that provided education to women and/or girls living with any type of FGM or residing in countries where FGM is predominantly practiced were included. Two authors independently screened and collected data. We summarized dichotomous outcomes using odds ratios and evidence was assessed using the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation). Educational interventions resulted in fewer women recommending FGM for their daughters and also reduced the incidence of FGM cases among daughters of women who received the educational interventions. These findings need to be validated with large randomized trials. 42015024637. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  19. Accuracy of imaging parameters in the prediction of lethal pulmonary hypoplasia secondary to mid-trimester prelabor rupture of fetal membranes: a systematic review and meta-analysis.

    PubMed

    van Teeffelen, A S P; Van Der Heijden, J; Oei, S G; Porath, M M; Willekes, C; Opmeer, B; Mol, B W J

    2012-05-01

    In women who have suffered mid-trimester prelabor rupture of membranes (PPROM), prediction of pulmonary hypoplasia is important for optimal management. We performed a systematic review to assess the capacity of imaging parameters to predict pulmonary hypoplasia. We searched for published articles that reported on biometric parameters and allowed the construction of a 2 × 2 table, comparing at least one of these parameters with the occurrence of pulmonary hypoplasia. The selected studies were scored on methodological quality and we calculated sensitivity and specificity of the tests in the prediction of pulmonary hypoplasia and lethal pulmonary hypoplasia. Overall performance was assessed by summary receiver-operating characteristics (sROC) analyses that were performed with bivariate meta-analysis. We detected 13 studies that reported on the prediction of lethal pulmonary hypoplasia. The quality of the included studies was poor to mediocre. The estimated sROC curves for the chest circumference/abdominal circumference ratio and other parameters showed limited accuracy in the prediction of pulmonary hypoplasia. In women with mid-trimester PPROM, the available evidence indicates limited accuracy of biometric parameters in the prediction of pulmonary hypoplasia.

  20. Diagnostic performance of computed tomography and magnetic resonance imaging for detecting peritoneal metastases: systematic review and meta-analysis.

    PubMed

    Laghi, Andrea; Bellini, Davide; Rengo, Marco; Accarpio, Fabio; Caruso, Damiano; Biacchi, Daniele; Di Giorgio, Angelo; Sammartino, Paolo

    2017-01-01

    Primary end point was to assess diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in detecting peritoneal metastases (PM). Secondary end points were determining the diagnostic sensitivity and specificity of CT in detecting PM according to the peritoneal cancer index (PCI), investigating correlations between radiological and surgical PCI, and comparing diagnostic yield of CT versus positron emission tomography (PET)/CT. We searched MEDLINE, Cochrane Library, Embase and Web of Science databases. Analytic methods were based on PRISMA. Pooled estimates for sensitivity, specificity, positive and negative likelihood ratios were calculated using fixed and random effect models. I (2) was used to evaluate heterogeneity. Of the 529 articles initially identified, 22 were selected for inclusion (934 patients). Cumulative data for per patient CT diagnostic accuracy were sensitivity 83 % (95 % CI 79-86 %), specificity 86 % (95 % CI 82-89 %), pooled positive LR 4.37 (2.58-7.41), and pooled negative LR 0.20 (0.11-0.35). On a per region basis CT performed best in epigastrium and pelvis. Correlation analysis showed a high correlation between CT-PCI and surgical-PCI scores, ranging from 0.49 to 0.96. MRI and PET/CT achieved similar per patient diagnostic accuracy. CT should be the preferred diagnostic imaging modality for detecting peritoneal metastases because of the robustness of the data. MRI and PET/CT should be considered second choices, until more consistent information on their diagnostic yield in detecting PM are obtained.

  1. Alterations of cerebral white matter structure in psychosis and their clinical correlations: a systematic review of Diffusion Tensor Imaging studies.

    PubMed

    Parnanzone, Serena; Serrone, Dario; Rossetti, Maria Cristina; D'Onofrio, Simona; Splendiani, Alessandra; Micelli, Valeria; Rossi, Alessandro; Pacitti, Francesca

    2017-01-01

    Schizophrenia is a common, severe and chronically disabling mental illness. Most of MRI studies in schizophrenia suggest the involvement of white matter (WM) pathology in multiple cerebral regions in the neurobiology of this condition. White matter fiber tracts connecting numerous cortical regions have been the focus of a number of studies using a magnetic resonance technique called “Diffusion Tensor Imaging” (DTI). A literature search of published DTI studies was conducted using the major database National Centre for Biotechnology information (NCBI) PubMed (MEDLINE). Our review covers 95 published papers. We summarise the main DTI findings involving the different brain regions in patients affected by or at high-risk for psychosis; we discuss clinical implications of these white matter disruptions and the limitations of current studies, listing the potential confounds and suggesting potential future research directions.

  2. Systematic reviews, systematic error and the acquisition of clinical knowledge.

    PubMed

    Mickenautsch, Steffen

    2010-06-10

    Since its inception, evidence-based medicine and its application through systematic reviews, has been widely accepted. However, it has also been strongly criticised and resisted by some academic groups and clinicians. One of the main criticisms of evidence-based medicine is that it appears to claim to have unique access to absolute scientific truth and thus devalues and replaces other types of knowledge sources. The various types of clinical knowledge sources are categorised on the basis of Kant's categories of knowledge acquisition, as being either 'analytic' or 'synthetic'. It is shown that these categories do not act in opposition but rather, depend upon each other. The unity of analysis and synthesis in knowledge acquisition is demonstrated during the process of systematic reviewing of clinical trials. Systematic reviews constitute comprehensive synthesis of clinical knowledge but depend upon plausible, analytical hypothesis development for the trials reviewed. The dangers of systematic error regarding the internal validity of acquired knowledge are highlighted on the basis of empirical evidence. It has been shown that the systematic review process reduces systematic error, thus ensuring high internal validity. It is argued that this process does not exclude other types of knowledge sources. Instead, amongst these other types it functions as an integrated element during the acquisition of clinical knowledge. The acquisition of clinical knowledge is based on interaction between analysis and synthesis. Systematic reviews provide the highest form of synthetic knowledge acquisition in terms of achieving internal validity of results. In that capacity it informs the analytic knowledge of the clinician but does not replace it.

  3. Systematic reviews, systematic error and the acquisition of clinical knowledge

    PubMed Central

    2010-01-01

    Background Since its inception, evidence-based medicine and its application through systematic reviews, has been widely accepted. However, it has also been strongly criticised and resisted by some academic groups and clinicians. One of the main criticisms of evidence-based medicine is that it appears to claim to have unique access to absolute scientific truth and thus devalues and replaces other types of knowledge sources. Discussion The various types of clinical knowledge sources are categorised on the basis of Kant's categories of knowledge acquisition, as being either 'analytic' or 'synthetic'. It is shown that these categories do not act in opposition but rather, depend upon each other. The unity of analysis and synthesis in knowledge acquisition is demonstrated during the process of systematic reviewing of clinical trials. Systematic reviews constitute comprehensive synthesis of clinical knowledge but depend upon plausible, analytical hypothesis development for the trials reviewed. The dangers of systematic error regarding the internal validity of acquired knowledge are highlighted on the basis of empirical evidence. It has been shown that the systematic review process reduces systematic error, thus ensuring high internal validity. It is argued that this process does not exclude other types of knowledge sources. Instead, amongst these other types it functions as an integrated element during the acquisition of clinical knowledge. Conclusions The acquisition of clinical knowledge is based on interaction between analysis and synthesis. Systematic reviews provide the highest form of synthetic knowledge acquisition in terms of achieving internal validity of results. In that capacity it informs the analytic knowledge of the clinician but does not replace it. PMID:20537172

  4. A systematic review of type 2 diabetes mellitus and hypertension in imaging studies of cognitive aging: time to establish new norms

    PubMed Central

    Meusel, Liesel-Ann C.; Kansal, Nisha; Tchistiakova, Ekaterina; Yuen, William; MacIntosh, Bradley J.; Greenwood, Carol E.; Anderson, Nicole D.

    2014-01-01

    The rising prevalence of type 2 diabetes (T2DM) and hypertension in older adults, and the deleterious effect of these conditions on cerebrovascular and brain health, is creating a growing discrepancy between the “typical” cognitive aging trajectory and a “healthy” cognitive aging trajectory. These changing health demographics make T2DM and hypertension important topics of study in their own right, and warrant attention from the perspective of cognitive aging neuroimaging research. Specifically, interpretation of individual or group differences in blood oxygenation level dependent magnetic resonance imaging (BOLD MRI) or positron emission tomography (PET H2O15) signals as reflective of differences in neural activation underlying a cognitive operation of interest requires assumptions of intact vascular health amongst the study participants. Without adequate screening, inclusion of individuals with T2DM or hypertension in “healthy” samples may introduce unwanted variability and bias to brain and/or cognitive measures, and increase potential for error. We conducted a systematic review of the cognitive aging neuroimaging literature to document the extent to which researchers account for these conditions. Of the 232 studies selected for review, few explicitly excluded individuals with T2DM (9%) or hypertension (13%). A large portion had exclusion criteria that made it difficult to determine whether T2DM or hypertension were excluded (44 and 37%), and many did not mention any selection criteria related to T2DM or hypertension (34 and 22%). Of all the surveyed studies, only 29% acknowledged or addressed the potential influence of intersubject vascular variability on the measured BOLD or PET signals. To reinforce the notion that individuals with T2DM and hypertension should not be overlooked as a potential source of bias, we also provide an overview of metabolic and vascular changes associated with T2DM and hypertension, as they relate to cerebrovascular and

  5. [Methods of evidence mapping. A systematic review].

    PubMed

    Schmucker, C; Motschall, E; Antes, G; Meerpohl, J J

    2013-10-01

    Evidence mapping is an increasingly popular approach to systematically evaluate published research. While there are methodological standards for systematic reviews, discrepancies exist between the terminology and methods used within evidence mapping. The aim of this systematic review is to describe the methodology and terminology used in evidence mapping and to demonstrate the continuum between evidence mapping and traditional systematic reviews. A systematic literature search was conducted in 10 databases in order to obtain a comprehensive picture of the state of the research standards for evidence mapping. In addition, websites of institutions which are already conducting evidence mapping were searched. The included study pool (n = 12) shows that the terms 'evidence map' and 'scoping review' are widely used within evidence mapping. Evidence maps are an approach to depict both the number and characteristics of studies in tabular form that exist as well as evidence gaps based on primary studies and systematic reviews of broad clinical questions. Scoping reviews also summarize the literature in a tabular form but also give a descriptive narrative summary of the results. A quality assessment of the studies is generally not included. Evidence mapping allows the identification of research gaps. This aspect is particularly important for interventions which are used without sufficient evidence. In contrast, systematic reviews are mainly used to estimate effects for interventions and evaluate whether the included studies are reliable.

  6. Glandular odontogenic cyst: systematic review

    PubMed Central

    MacDonald-Jankowski, D S

    2010-01-01

    Objectives The aim of this study was to evaluate the principal features of “glandular odontogenic cyst” (GOC), by systematic review (SR), and to compare their frequencies among four global groups. Methods The databases searched were the PubMed interface of MEDLINE and LILACS. Only those reports of GOCs that occurred in a series in the reporting authors' caseload were considered. All cases were confirmed histopathologically. Results 18 reports on 17 series of consecutive cases were included in the SR. GOC affected males twice as frequently and the mandible almost three times as frequently. The mean age at first presentation was 44 years, coincident with that of the Western global group, in which the largest proportion of reports and cases first presented in the second half of the fifth decade. However, age at presentation of GOCs in the East Asian and sub-Saharan African global groups was nearly a decade younger, this was significant. Six reports included details of at least one clinical presentation. Eight reports included at least one conventional radiological feature. There were some significant differences between global groups. The Western global group had a particular predilection for the anterior sextants of both jaws. The sub-Saharan African group displayed buccolingual expansion (as did the Latin American group) and tooth displacement in every case. 18% of GOCs recurred overall, except in the sub-Saharan African global group. Conclusions GOCs have a marked propensity to recur in most global groups. GOCs presented in older patients and with swellings, affected the anterior sextants of both jaws, and radiologically were more likely to present as a well-defined unilocular radiolucency with buccolingual expansion. Tooth displacement, root resorption and an association with unerupted teeth occurred in 50%, 30% and 11% of cases, respectively. PMID:20203274

  7. Magnetic Resonance Imaging for Diagnosis of Mandibular Involvement from Head and Neck Cancers: A Systematic Review and Meta-Analysis

    PubMed Central

    Li, Chunjie; Yang, Wenbin; Men, Yi; Wu, Fanglong; Pan, Jian; Li, Longjiang

    2014-01-01

    Background Diagnosis of mandibular involvement caused by head and neck cancers is critical for treatment. We performed a meta-analysis to determine the diagnostic efficacy of MR for distinguishing mandibular involvement caused by head and neck cancers. Methods Thirteen databases were searched electronically and hand-searching was also done. Two reviewers conducted study inclusion, data extractions, and quality assessment of the studies independently. Meta-disc 1.4 and STATA 11.0 were used to conduct the meta-analysis. Results 16 studies involving a total of 490 participants underwent MR examinations and were accounted for in this meta-analysis. Among the included studies, 2 had high risk of bias, while the rest had unclear risk of bias. Meta-regression showed that the slight clinical and methodological heterogeneities did not influence the outcome (P>0.05). Meta-analysis indicated that the MR for the diagnosis of mandibular involvement had a pooled sensitivity (SEN) of 78%, specificity (SPE) of 83%, positive likelihood ratio (+LR) of 3.80, negative likelihood ratio (-LR) of 0.28, diagnostic odds ratio (DOR) of 28.94, area under curve (AUC) of 0.9110, and Q* of 0.8432. Two studies detected the diagnostic efficacy of MR for the mandibular medullar invasion, and only one study reported the inferior alveolar canal invasion, which made it impossible to include it in our meta-analysis. In comparing to CT, MR had a higher SEN without statistical significance (P = 0.08), but a significantly lower SPE (P = 0.04). The synthesized diagnostic efficacy (AUC and Q*) on mandibular involvement was similar between the two modalities (P>0.05). Conclusions Present clinical evidence showed that MR had an acceptable diagnostic value in detecting mandibular involvement caused by head and neck cancers. MR exceeded CT in diagnosing patients with mandibular invasion (higher sensitivity than CT) but was less efficacious to exclude patients without the mandibular invasion (lower

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

    PubMed

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

    2014-06-01

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

  9. Clarifying the abstracts of systematic literature reviews*

    PubMed Central

    Hartley, James

    2000-01-01

    Background: There is a small body of research on improving the clarity of abstracts in general that is relevant to improving the clarity of abstracts of systematic reviews. Objectives: To summarize this earlier research and indicate its implications for writing the abstracts of systematic reviews. Method: Literature review with commentary on three main features affecting the clarity of abstracts: their language, structure, and typographical presentation. Conclusions: The abstracts of systematic reviews should be easier to read than the abstracts of medical research articles, as they are targeted at a wider audience. The aims, methods, results, and conclusions of systematic reviews need to be presented in a consistent way to help search and retrieval. The typographic detailing of the abstracts (type-sizes, spacing, and weights) should be planned to help, rather than confuse, the reader. PMID:11055300

  10. Search strategies for finding systematic reviews.

    PubMed

    Grindlay, D

    2017-03-13

    I have read with interest the 2017 article by F Gómez-García and colleagues called "Systematic reviews and meta-analyses on psoriasis: role of funding sources, conflict of interest, and bibliometric indices as predictors of methodological quality" published in the BJD. This study makes a very important point about the influence of funding sources and conflicts of interests on the methodological quality of systematic reviews. However, I have some concerns about the search strategy used to find systematic reviews for this analysis. This article is protected by copyright. All rights reserved.

  11. A systematic integrated literature review of systematic integrated literature reviews in nursing.

    PubMed

    Im, Eun-Ok; Chang, Sun Ju

    2012-11-01

    As faculty members, we frequently find that first-year doctoral students in nursing are confused about how to conduct a systematic integrated literature review. This could be due to its vague definition and a lack of recent literature that provides directions for conducting a systematic integrated literature review. This article aims to provide directions for conducting a systematic integrated literature review by identifying the essential components of published literature reviews in nursing. To achieve this goal, the literature was searched by using the keywords nursing, systematic, and review in multiple databases. A total of 267 articles were selected and are included in this systematic integrated literature review. The articles were then sorted by study design and analyzed in six areas of interests. Finally, a practical guideline for conducting systematic integrated literature reviews is proposed based on the analysis of the literature.

  12. Robotic bariatric surgery: a systematic review.

    PubMed

    Fourman, Matthew M; Saber, Alan A

    2012-01-01

    Obesity is a nationwide epidemic, and the only evidence-based, durable treatment of this disease is bariatric surgery. This field has evolved drastically during the past decade. One of the latest advances has been the increased use of robotics within this field. The goal of our study was to perform a systematic review of the recent data to determine the safety and efficacy of robotic bariatric surgery. The setting was the University Hospitals Case Medical Center (Cleveland, OH). A PubMed search was performed for robotic bariatric surgery from 2005 to 2011. The inclusion criteria were English language, original research, human, and bariatric surgical procedures. Perioperative data were then collected from each study and recorded. A total of 18 studies were included in our review. The results of our systematic review showed that bariatric surgery, when performed with the use of robotics, had similar or lower complication rates compared with traditional laparoscopy. Two studies showed shorter operative times using the robot for Roux-en-Y gastric bypass, but 4 studies showed longer operative times in the robotic arm. In addition, the learning curve appears to be shorter when robotic gastric bypass is compared with the traditional laparoscopic approach. Most investigators agreed that robotic laparoscopic surgery provides superior imaging and freedom of movement compared with traditional laparoscopy. The application of robotics appears to be a safe option within the realm of bariatric surgery. Prospective randomized trials comparing robotic and laparoscopic outcomes are needed to further define the role of robotics within the field of bariatric surgery. Longer follow-up times would also help elucidate any long-term outcomes differences with the use of robotics versus traditional laparoscopy. Copyright © 2012 American Society for Metabolic and Bariatric Surgery. All rights reserved.

  13. Advancing Systematic Review Workshop (December 2015)

    EPA Pesticide Factsheets

    EPA hosted an event to examine the systematic review process for development and applications of methods for different types of evidence (epidemiology, animal toxicology, and mechanistic). The presentations are also available.

  14. Systematic reviews in the field of nutrition

    USDA-ARS?s Scientific Manuscript database

    Systematic reviews are valuable tools for staying abreast of evolving nutrition and aging -related topics, formulating dietary guidelines, establishing nutrient reference intakes, formulating clinical practice guidance, evaluating health claims, and setting research agendas. Basic steps of conductin...

  15. A systematic review of the reporting of sample size calculations and corresponding data components in observational functional magnetic resonance imaging studies.

    PubMed

    Guo, Qing; Thabane, Lehana; Hall, Geoffrey; McKinnon, Margaret; Goeree, Ron; Pullenayegum, Eleanor

    2014-02-01

    Anecdotal evidence suggests that functional magnetic resonance imaging (fMRI) studies rarely consider statistical power when setting a sample size. This raises concerns since undersized studies may fail to detect effects of interest and encourage data dredging. Although sample size methodology in this field exists, implementation requires specifications of estimated effect size and variance components. We therefore systematically evaluated how often estimates of effect size and variance components were reported in observational fMRI studies involving clinical human participants published in six leading journals between January 2010 and December 2011. A random sample of 100 eligible articles was included in data extraction and analyses. Two independent reviewers assessed the reporting of sample size calculations and the data components required to perform the calculations in the fMRI literature. One article (1%) reported sample size calculations. The reporting of parameter estimates for effect size (8%), between-subject variance (4%), within-subject variance (1%) and temporal autocorrelation matrix (0%) was uncommon. Three articles (3%) reported Cohen's d or F effect sizes. The majority (83%) reported peak or average t, z or F statistics. The inter-rater agreement was very good, with a prevalence-adjusted bias-adjusted kappa (PABAK) value greater than 0.88. We concluded that sample size calculations were seldom reported in fMRI studies. Moreover, omission of parameter estimates for effect size, between- and within-subject variances, and temporal autocorrelation matrix could limit investigators' ability to perform power analyses for new studies. We suggest routine reporting of these quantities, and recommend strategies for reducing bias in their reported values.

  16. JBI's systematic reviews: data extraction and synthesis.

    PubMed

    Munn, Zachary; Tufanaru, Catalin; Aromataris, Edoardo

    2014-07-01

    This article is the fifth in a series on the systematic review from the Joanna Briggs Institute, an international collaborative supporting evidence-based practice in nursing, medicine, and allied health fields. The purpose of the series is to describe how to conduct a systematic review-one step at a time. This article details the data extraction and data synthesis stages, with an emphasis on conducting a meta-analysis of quantitative data.

  17. A Systematic Method for Search Term Selection in Systematic Reviews

    ERIC Educational Resources Information Center

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-01-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a…

  18. A Systematic Method for Search Term Selection in Systematic Reviews

    ERIC Educational Resources Information Center

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-01-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a…

  19. A Guideline for Applying Systematic Reviews to Child Language Intervention

    ERIC Educational Resources Information Center

    Hargrove, Patricia; Lund, Bonnie; Griffer, Mona

    2005-01-01

    This article focuses on applying systematic reviews to the Early Intervention (EI) literature. Systematic reviews are defined and differentiated from traditional, or narrative, reviews and from meta-analyses. In addition, the steps involved in critiquing systematic reviews and an illustration of a systematic review from the EI literature are…

  20. A Guideline for Applying Systematic Reviews to Child Language Intervention

    ERIC Educational Resources Information Center

    Hargrove, Patricia; Lund, Bonnie; Griffer, Mona

    2005-01-01

    This article focuses on applying systematic reviews to the Early Intervention (EI) literature. Systematic reviews are defined and differentiated from traditional, or narrative, reviews and from meta-analyses. In addition, the steps involved in critiquing systematic reviews and an illustration of a systematic review from the EI literature are…

  1. A systematic method for search term selection in systematic reviews.

    PubMed

    Thompson, Jenna; Davis, Jacqueline; Mazerolle, Lorraine

    2014-06-01

    The wide variety of readily available electronic media grants anyone the freedom to retrieve published references from almost any area of research around the world. Despite this privilege, keeping up with primary research evidence is almost impossible because of the increase in professional publishing across disciplines. Systematic reviews are a solution to this problem as they aim to synthesize all current information on a particular topic and present a balanced and unbiased summary of the findings. They are fast becoming an important method of research across a number of fields, yet only a small number of guidelines exist on how to define and select terms for a systematic search. This article presents a replicable method for selecting terms in a systematic search using the semantic concept recognition software called leximancer (Leximancer, University of Queensland, Brisbane, Australia). We use this software to construct a set of terms from a corpus of literature pertaining to transborder interventions for drug control and discuss the applicability of this method to systematic reviews in general. This method aims to contribute a more 'systematic' approach for selecting terms in a manner that is entirely replicable for any user.

  2. Sensitivity and specificity of indocyanine green near-infrared fluorescence imaging in detection of metastatic lymph nodes in colorectal cancer: Systematic review and meta-analysis.

    PubMed

    Emile, Sameh H; Elfeki, Hossam; Shalaby, Mostafa; Sakr, Ahmad; Sileri, Pierpaolo; Laurberg, Søren; Wexner, Steven D

    2017-06-01

    This review aimed to determine the overall sensitivity and specificity of indocyanine green (ICG) near-infrared (NIR) fluorescence in sentinel lymph node (SLN) detection in Colorectal cancer (CRC). A systematic search in electronic databases was conducted. Twelve studies including 248 patients were reviewed. The median sensitivity, specificity, and accuracy rates were 73.7, 100, and 75.7. The pooled sensitivity and specificity rates were 71% and 84.6%. In conclusion, ICG-NIR fluorescence is a promising technique for detecting SLNs in CRC. © 2017 Wiley Periodicals, Inc.

  3. Oral manifestations of lymphoma: a systematic review

    PubMed Central

    Silva, Taísa Domingues Bernardes; Ferreira, Camila Belo Tavares; Leite, Gustavo Boehmer; de Menezes Pontes, José Roberto; Antunes, Héliton S

    2016-01-01

    Lymphoma is a malignant disease with two forms: Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). Non-Hodgkin’s lymphoma is diagnosed in extranodal sites in 40% of cases, and the head and neck region is the second most affected, with an incidence of 11–33%, while HL has a very low incidence in extranodal sites (1–4%). The aim of this study was to identify the oral manifestations of lymphoma through a systematic literature review, which we conducted using the PubMed, Lilacs, Embase, and Cochrane Library databases. We found 1456 articles, from which we selected 73. Among the intraoral findings, the most frequent were ulcerations, pain, swelling, and tooth mobility, while the extraoral findings included facial asymmetry and cervical, submandibular, and submental lymphadenopathy. Among the few studies reporting imaging findings, the most cited lesions included hypodense lesions with diffuse boundaries, bone resorptions, and tooth displacements. The publications reviewed highlight gaps in the areas of early detection, diagnosis, and proper treatment. PMID:27594910

  4. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2013-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  5. A systematic review of antiproton radiotherapy

    NASA Astrophysics Data System (ADS)

    Bittner, Martin-Immanuel; Grosu, Anca-Ligia; Wiedenmann, Nicole; Wilkens, Jan

    2014-01-01

    Antiprotons have been proposed as possible particles for radiotherapy; over the past years, the renewed interest in the potential biomedical relevance led to an increased research activity. It is the aim of this review to deliver a comprehensive overview regarding the evidence accumulated so far, analysing the background and depicting the current status of antiprotons in radiotherapy. A literature search has been conducted, including major scientific and commercial databases. All articles and a number of relevant conference abstracts published in the respective field have been included in this systematic review. The physical basis of antiproton radiotherapy is complex; however, the characterisation of the energy deposition profile supports its potential use in radiotherapy. Also the dosimetry improved considerably over the past few years. Regarding the biological properties, data on the effects on cells are presented; however, definite conclusions regarding the relative biological effectiveness cannot be made at the moment and radiobiological evidence of enhanced effectiveness remains scarce. In addition, there is new evidence supporting the potential imaging properties, for example for online dose verification. Clinical settings which might profit from the use of antiprotons have been further tracked. Judging from the evidence available so far, clinical constellations requiring optimal sparing in the entrance region of the beam and re-irradiations might profit most from antiproton radiotherapy. While several open questions remain to be answered, first steps towards a thorough characterisation of this interesting modality have been made.

  6. Contribution of systematic reviews to management decisions.

    PubMed

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

    2013-10-01

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

  7. Borderline Intellectual Functioning: A Systematic Literature Review

    ERIC Educational Resources Information Center

    Peltopuro, Minna; Ahonen, Timo; Kaartinen, Jukka; Seppälä, Heikki; Närhi, Vesa

    2014-01-01

    The literature related to people with borderline intellectual functioning (BIF) was systematically reviewed in order to summarize the present knowledge. Database searches yielded 1,726 citations, and 49 studies were included in the review. People with BIF face a variety of hardships in life, including neurocognitive, social, and mental health…

  8. Help Options in CALL: A Systematic Review

    ERIC Educational Resources Information Center

    Cardenas-Claros, Monica S.; Gruba, Paul A.

    2009-01-01

    This paper is a systematic review of research investigating help options in the different language skills in computer-assisted language learning (CALL). In this review, emerging themes along with is-sues affecting help option research are identified and discussed. We argue that help options in CALL are application resources that do not only seem…

  9. Borderline Intellectual Functioning: A Systematic Literature Review

    ERIC Educational Resources Information Center

    Peltopuro, Minna; Ahonen, Timo; Kaartinen, Jukka; Seppälä, Heikki; Närhi, Vesa

    2014-01-01

    The literature related to people with borderline intellectual functioning (BIF) was systematically reviewed in order to summarize the present knowledge. Database searches yielded 1,726 citations, and 49 studies were included in the review. People with BIF face a variety of hardships in life, including neurocognitive, social, and mental health…

  10. The Need for Systematic Reviews of Reasons

    PubMed Central

    Sofaer, Neema; Strech, Daniel

    2012-01-01

    There are many ethical decisions in the practice of health research and care, and in the creation of policy and guidelines. We argue that those charged with making such decisions need a new genre of review. The new genre is an application of the systematic review, which was developed over decades to inform medical decision-makers about what the totality of studies that investigate links between smoking and cancer, for example, implies about whether smoking causes cancer. We argue that there is a need for similarly inclusive and rigorous reviews of reason-based bioethics, which uses reasoning to address ethical questions. After presenting a brief history of the systematic review, we reject the only existing model for writing a systematic review of reason-based bioethics, which holds that such a review should address an ethical question. We argue that such a systematic review may mislead decision-makers when a literature is incomplete, or when there are mutually incompatible but individually reasonable answers to the ethical question. Furthermore, such a review can be written without identifying all the reasons given when the ethical questions are discussed, their alleged implications for the ethical question, and the attitudes taken to the reasons. The reviews we propose address instead the empirical question of which reasons have been given when addressing a specified ethical question, and present such detailed information on the reasons. We argue that this information is likely to improve decision-making, both directly and indirectly, and also the academic literature. We explain the limitations of our alternative model for systematic reviews. PMID:21521251

  11. Methodologic Quality of Systematic Reviews Published in the Plastic and Reconstructive Surgery Literature: A Systematic Review.

    PubMed

    Samargandi, Osama A; Hasan, Haroon; Thoma, Achilleas

    2016-01-01

    Well-conducted systematic reviews have a critical role in informing evidence-based decision-making in plastic surgery. The authors' objective was to assess the methodologic quality of systematic reviews in the plastic surgery literature. The authors systematically assessed all systematic reviews in 10 high-impact plastic surgery journals using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from 2003 to 2013. These were evaluated for methodologic quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR), a validated 11-point instrument. After removal of duplicates and screening titles and abstracts, 190 systematic reviews met eligibility criteria. The majority of systematic reviews were published in Plastic and Reconstructive Surgery (n = 88). The most common domain covered was reconstruction (17.9 percent). Using AMSTAR, the median score was 4 (interquartile range, 2.25 to 6.00) on a scale of 1 to 11. No increase in AMSTAR score was observed with time (p = 0.18). Almost half of all systematic reviews (48.4 percent) included at least two independent data extractors, and less than one-third of them (15.3 percent) searched unpublished studies or provided a list of both included and excluded studies (14.8 percent). The methodologic quality of included primary studies was evaluated in 35.3 percent. Systematic reviews in plastic surgery demonstrated inadequate adherence to methodologic standards of quality, which raises concerns about validity. There has been an increase in the number of systematic reviews published in plastic surgery over the past decade, yet there has been no significant improvement observed in methodologic quality.

  12. Overview of systematic reviews in allergy epidemiology.

    PubMed

    Genuneit, J; Seibold, A M; Apfelbacher, C J; Konstantinou, G N; Koplin, J J; La Grutta, S; Logan, K; Perkin, M R; Flohr, C

    2017-06-01

    There is a substantial body of evidence on the epidemiology of allergic conditions, which has advanced the understanding of these conditions. We aimed to systematically identify systematic reviews and meta-analyses on the epidemiology of allergic diseases to assess what has been studied comprehensively and what areas might benefit from further research. We searched PubMed and EMBASE up to 12/2014 for systematic reviews on epidemiological research on allergic diseases. We indexed diseases and topics covered and extracted data on the search characteristics of each systematic review. The search resulted in 3991 entries after removing duplicates, plus 20 other items found via references and conference abstracts; 421 systematic reviews were relevant and included in this overview. The majority contained some evidence on asthma (72.9%). Allergic rhinitis, atopic eczema and food hypersensitivity were covered in 15.7%, 24.5% and 9.0%, respectively. Commonly studied risk factors for atopic eczema included dietary and microbial factors, while for asthma, pollution and genetic factors were often investigated in systematic reviews. There was some indication of differing search characteristics across topics. We present a comprehensive overview with an indexed database of published systematic reviews in allergy epidemiology. We believe that this clarifies where most research interest has focussed and which areas could benefit from further research. We propose that this effort is updated every few years to include the most recently published evidence and to extend the search to an even broader list of hypersensitivity/allergic disorders. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Expediting systematic reviews: methods and implications of rapid reviews

    PubMed Central

    2010-01-01

    Background Policy makers and others often require synthesis of knowledge in an area within six months or less. Traditional systematic reviews typically take at least 12 months to conduct. Rapid reviews streamline traditional systematic review methods in order to synthesize evidence within a shortened timeframe. There is great variation in the process of conducting rapid reviews. This review sought to examine methods used for rapid reviews, as well as implications of methodological streamlining in terms of rigour, bias, and results. Methods A comprehensive search strategy--including five electronic databases, grey literature, hand searching of relevant journals, and contacting key informants--was undertaken. All titles and abstracts (n = 1,989) were reviewed independently by two reviewers. Relevance criteria included articles published between 1995 and 2009 about conducting rapid reviews or addressing comparisons of rapid reviews versus traditional reviews. Full articles were retrieved for any titles deemed relevant by either reviewer (n = 70). Data were extracted from all relevant methodological articles (n = 45) and from exemplars of rapid review methods (n = 25). Results Rapid reviews varied from three weeks to six months; various methods for speeding up the process were employed. Some limited searching by years, databases, language, and sources beyond electronic searches. Several employed one reviewer for title and abstract reviewing, full text review, methodological quality assessment, and/or data extraction phases. Within rapid review studies, accelerating the data extraction process may lead to missing some relevant information. Biases may be introduced due to shortened timeframes for literature searching, article retrieval, and appraisal. Conclusions This review examined the continuum between diverse rapid review methods and traditional systematic reviews. It also examines potential implications of streamlined review methods. More of these rapid reviews need

  14. Conducting systematic reviews of economic evaluations.

    PubMed

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

    2015-09-01

    In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other

  15. Clinically Confirmed Stroke With Negative Diffusion-Weighted Imaging Magnetic Resonance Imaging: Longitudinal Study of Clinical Outcomes, Stroke Recurrence, and Systematic Review.

    PubMed

    Makin, Stephen D J; Doubal, Fergus N; Dennis, Martin S; Wardlaw, Joanna M

    2015-11-01

    We sought to establish whether the presence (versus absence) of a lesion on magnetic resonance imaging (MRI) with diffusion weighting (DWI-MRI) at presentation with acute stroke is associated with worse clinical outcomes at 1 year. We recruited consecutive patients with a nondisabling ischemic stroke and performed DWI-MRI. Patients were followed up at 1 year to establish stroke recurrence (clinical or on MRI), cognitive impairment (Addenbrooke Cognitive Assessment Revised,<88) and modified Rankin Scale. A median of 4 days post stroke, one third (76/264; 29%) of patients did not have a DWI lesion (95% confidence interval, 23%-35%). There was no statistically significant difference between those with and without a DWI lesion with respect to age or vascular risk factors. Patients without a lesion were more likely to be women or have previous stroke. At 1 year, 11 of 76 (14%) patients with a DWI-negative index stroke had a clinical diagnosis of recurrent stroke or transient ischemic attack, 33% had cognitive impairment (Addenbrooke Cognitive Assessment Revised<88), and 40% still had modified Rankin Scale>1, no different from DWI-positive patients; DWI-positive patients were more likely to have a new lesion on MRI (14%), symptomatic or asymptomatic, than DWI-negative patients (2%; P=0.02). Our data were consistent with 6 other studies (total n=976), pooled proportion of DWI-negative patients was 21% (95% confidence interval, 12%-32%). Nearly one third of patients with nondisabling stroke do not have a relevant lesion on acute DWI-MRI. Patients with negative DWI-MRI had no better prognosis than patients with a lesion. DWI-negative stroke patients should receive secondary prevention. © 2015 The Authors.

  16. Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis Describing the Diagnostic Accuracy of History, Physical Examination, Imaging, and Lumbar Puncture With an Exploration of Test Thresholds.

    PubMed

    Carpenter, Christopher R; Hussain, Adnan M; Ward, Michael J; Zipfel, Gregory J; Fowler, Susan; Pines, Jesse M; Sivilotti, Marco L A

    2016-09-01

    Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. The objective was to perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH. A secondary objective was to delineate probability of disease thresholds for imaging and lumbar puncture (LP). PubMed, Embase, Scopus, and research meeting abstracts were searched up to June 2015 for studies of emergency department patients with acute headache clinically concerning for spontaneous SAH. QUADAS-2 was used to assess study quality and, when appropriate, meta-analysis was conducted using random effects models. Outcomes were sensitivity, specificity, and positive (LR+) and negative (LR-) likelihood ratios. To identify test and treatment thresholds, we employed the Pauker-Kassirer method with Bernstein test indication curves using the summary estimates of diagnostic accuracy. A total of 5,022 publications were identified, of which 122 underwent full-text review; 22 studies were included (average SAH prevalence = 7.5%). Diagnostic studies differed in assessment of history and physical examination findings, CT technology, analytical techniques used to identify xanthochromia, and criterion standards for SAH. Study quality by QUADAS-2 was variable; however, most had a relatively low risk of biases. A history of neck pain (LR+ = 4.1; 95% confidence interval [CI] = 2.2 to 7.6) and neck stiffness on physical examination (LR+ = 6.6; 95% CI = 4.0 to 11.0) were the individual findings most strongly associated with SAH. Combinations of findings may rule out SAH, yet promising clinical decision rules await external validation. Noncontrast cranial CT within 6 hours of headache onset accurately ruled in (LR+ = 230; 95

  17. Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Describing the Diagnostic Accuracy of History, Physical Exam, Imaging, and Lumbar Puncture with an Exploration of Test Thresholds

    PubMed Central

    Carpenter, Christopher R.; Hussain, Adnan M.; Ward, Michael J.; Zipfel, Gregory J.; Fowler, Susan; Pines, Jesse M.; Sivilotti, Marco L.A.

    2016-01-01

    Background Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. Objectives To perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH. A secondary objective was to delineate probability of disease thresholds for imaging and lumbar puncture (LP). Methods PUBMED, EMBASE, SCOPUS, and research meeting abstracts were searched up to June 2015 for studies of emergency department (ED) patients with acute headache clinically concerning for spontaneous SAH. QUADAS-2 was used to assess study quality and, when appropriate, meta-analysis was conducted using random effects models. Outcomes were sensitivity, specificity, positive (LR+) and negative (LR−) likelihood ratios. To identify test- and treatment-thresholds, we employed the Pauker-Kassirer method with Bernstein test-indication curves using the summary estimates of diagnostic accuracy. Results A total of 5,022 publications were identified, of which 122 underwent full text-review; 22 studies were included (average SAH prevalence 7.5%). Diagnostic studies differed in assessment of history and physical exam findings, CT technology, analytical techniques used to identify xanthochromia, and criterion standards for SAH. Study quality by QUADAS-2 was variable; however, most had a relatively low-risk of biases. A history of neck pain (LR+ 4.1 [95% CI 2.2-7.6]) and neck stiffness on physical exam (LR+ 6.6 [4.0-11.0]) were the individual findings most strongly associated with SAH. Combinations of findings may rule out SAH, yet promising clinical decision rules await external validation. Non-contrast cranial CT within 6 hours of headache onset accurately ruled-in (LR+ 230 [6-8700]) and ruled-out SAH (LR− 0

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

    PubMed

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

    2016-06-07

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

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

    PubMed Central

    2011-01-01

    Background Hundreds of studies of maternity care interventions have been published, too many for most people involved in providing maternity care to identify and consider when making decisions. It became apparent that systematic reviews of individual studies were required to appraise, summarise and bring together existing studies in a single place. However, decision makers are increasingly faced by a plethora of such reviews and these are likely to be of variable quality and scope, with more than one review of important topics. Systematic reviews (or overviews) of reviews are a logical and appropriate next step, allowing the findings of separate reviews to be compared and contrasted, providing clinical decision makers with the evidence they need. Methods The methods used to identify and appraise published and unpublished reviews systematically, drawing on our experiences and good practice in the conduct and reporting of systematic reviews are described. The process of identifying and appraising all published reviews allows researchers to describe the quality of this evidence base, summarise and compare the review's conclusions and discuss the strength of these conclusions. Results Methodological challenges and possible solutions are described within the context of (i) sources, (ii) study selection, (iii) quality assessment (i.e. the extent of searching undertaken for the reviews, description of study selection and inclusion criteria, comparability of included studies, assessment of publication bias and assessment of heterogeneity), (iv) presentation of results, and (v) implications for practice and research. Conclusion Conducting a systematic review of reviews highlights the usefulness of bringing together a summary of reviews in one place, where there is more than one review on an important topic. The methods described here should help clinicians to review and appraise published reviews systematically, and aid evidence-based clinical decision-making. PMID:21291558

  20. Dental insurance: A systematic review

    PubMed Central

    Garla, Bharath Kumar; Satish, G.; Divya, K. T.

    2014-01-01

    To review uses of finance in dentistry. A search of 25 electronic databases and World Wide Web was conducted. Relevant journals were hand searched and further information was requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Insurance has come of ages and has become the mainstay of payment in many developed countries. So much so that all the alternative forms of payment which originated as an alternative to fee for service now depend on insurance at one point or the other. Fee for service is still the major form of payment in many developing countries including India. It is preferred in many instances since the payment is made immediately. PMID:25558454

  1. Systematic reviews and knowledge translation.

    PubMed

    Tugwell, Peter; Robinson, Vivian; Grimshaw, Jeremy; Santesso, Nancy

    2006-08-01

    Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings.

  2. Short implants: A systematic review

    PubMed Central

    Karthikeyan, I.; Desai, Shrikar R.; Singh, Rika

    2012-01-01

    Background: Short implants are manufactured for use in atrophic regions of the jaws. Although many studies report on short implants as ≤10 mm length with considerable success, the literature regarding survival rate of ≤7 mm is sparse. Purpose: The purpose of this study was to systematically evaluate the publications concerning short dental implants defined as an implant with a length of ≤7 mm placed in the maxilla or in the mandible. Materials and Methods: A Medline and manual search was conducted to identify studies concerning short dental implants of length ≤7 mm published between 1991 and 2011. The articles included in this study report data on implant length ≤7 mm, such as demographic variables, implant type, location in jaws, observation time, prostheses and complications. Results: The 28 included studies represent one randomized controlled trial, 12 prospective studies and 10 retrospective studies. The survival rate of short implant was found to be increased from 80% to 90% gradually, with recent articles showing 100%. Conclusion: When severe atrophy of jaws was encountered, short and wide implants can be placed successfully. PMID:23162320

  3. Systematic reviews and knowledge translation.

    PubMed Central

    Tugwell, Peter; Robinson, Vivian; Grimshaw, Jeremy; Santesso, Nancy

    2006-01-01

    Proven effective interventions exist that would enable all countries to meet the Millennium Development Goals. However, uptake and use of these interventions in the poorest populations is at least 50% less than in the richest populations within each country. Also, we have recently shown that community effectiveness of interventions is lower for the poorest populations due to a "staircase" effect of lower coverage/access, worse diagnostic accuracy, less provider compliance and less consumer adherence. We propose an evidence-based framework for equity-oriented knowledge translation to enhance community effectiveness and health equity. This framework is represented as a cascade of steps to assess and prioritize barriers and thus choose effective knowledge translation interventions that are tailored for relevant audiences (public, patient, practitioner, policy-maker, press and private sector), as well as the evaluation, monitoring and sharing of these strategies. We have used two examples of effective interventions (insecticide-treated bednets to prevent malaria and childhood immunization) to illustrate how this framework can provide a systematic method for decision-makers to ensure the application of evidence-based knowledge in disadvantaged populations. Future work to empirically validate and evaluate the usefulness of this framework is needed. We invite researchers and implementers to use the cascade for equity-oriented knowledge translation as a guide when planning implementation strategies for proven effective interventions. We also encourage policy-makers and health-care managers to use this framework when deciding how effective interventions can be implemented in their own settings. PMID:16917652

  4. VISCOSUPPLEMENTATION IN ANKLE OSTEOARTHRITIS: A SYSTEMATIC REVIEW

    PubMed Central

    Faleiro, Thiago Batista; Schulz, Renata da Silva; Jambeiro, Jorge Eduardo de Schoucair; Tavares, Antero; Delmonte, Fernando Moreira; Daltro, Gildásio de Cerqueira

    2016-01-01

    ABSTRACT To evaluate the efficacy of viscosupplementation in patients with osteoarthritis of the ankle. A systematic review to evaluate the evidence in the literature on the use of viscosupplementation for osteoarthritis of the ankle. For this review, we considered blind randomized prospective studies involving the use of viscosupplementation for osteoarthritis of the ankle. A total of 1,961 articles were identified in various databases. After examining each of the articles, five articles were included in this review. Treatment with intraarticular hyaluronic acid is a safe treatment modality that significantly improves functional scores of patients, with no evidence of superiority in relation to other conservative treatments. Further clinical trials with larger numbers of patients are needed so that we can recommend its use and address unanswered questions. Systematic Review of Randomized Clinical Trials. PMID:26997916

  5. Kawasaki disease and immunisation: A systematic review.

    PubMed

    Phuong, Linny Kimly; Bonetto, Caterina; Buttery, Jim; Pernus, Yolanda Brauchli; Chandler, Rebecca; Felicetti, Patrizia; Goldenthal, Karen L; Kucuku, Merita; Monaco, Giuseppe; Pahud, Barbara; Shulman, Stanford T; Top, Karina A; Trotta, Francesco; Ulloa-Gutierrez, Rolando; Varricchio, Frederick; de Ferranti, Sarah; Newburger, Jane W; Dahdah, Nagib; Singh, Surjit; Bonhoeffer, Jan; Burgner, David

    2017-03-27

    Kawasaki disease is a complex and potentially serious condition. It has been observed in temporal relation to immunisation. We conducted a systematic literature review using various reference sources to review the available evidence published in the literature. We identified twenty seven publications reporting a temporal association between immunisation and Kawasaki disease. We present a systematic review of data drawn from randomised controlled trials, observational studies, case series and reports, and reviews. Overall there was a lack of standardised case definitions, making data interpretation and comparability challenging. Although a temporal relationship between immunisation and Kawasaki disease is suggested, evidence for an increased risk or a causal association is lacking. Implementation of a standardised Kawasaki disease case definition would increase confidence in the findings and add value to future studies of pre- or post-licensure vaccine safety studies. Copyright © 2016. Published by Elsevier Ltd.

  6. Challenges of Systematic Reviewing Integrative Health Care

    PubMed Central

    Coulter, Ian D.; Khorsan, Raheleh; Crawford, Cindy; Hsiao, An-Fu

    2013-01-01

    This article is based on an extensive review of integrative medicine (IM) and integrative health care (IHC). Since there is no general agreement of what constitutes IM/IHC, several major problems were identified that make the review of work in this field problematic. In applying the systematic review methodology, we found that many of those captured articles that used the term integrative medicine were in actuality referring to adjunctive, complementary, or supplemental medicine. The objective of this study was to apply a sensitivity analysis to demonstrate how the results of a systematic review of IM and IHC will differ according to what inclusion criteria is used based on the definition of IM/IHC. By analyzing 4 different scenarios, the authors show that, due to unclear usage of these terms, results vary dramatically, exposing an inconsistent literature base for this field. PMID:23843689

  7. VISCOSUPPLEMENTATION IN ANKLE OSTEOARTHRITIS: A SYSTEMATIC REVIEW.

    PubMed

    Faleiro, Thiago Batista; Schulz, Renata da Silva; Jambeiro, Jorge Eduardo de Schoucair; Tavares, Antero; Delmonte, Fernando Moreira; Daltro, Gildásio de Cerqueira

    2016-01-01

    To evaluate the efficacy of viscosupplementation in patients with osteoarthritis of the ankle. A systematic review to evaluate the evidence in the literature on the use of viscosupplementation for osteoarthritis of the ankle. For this review, we considered blind randomized prospective studies involving the use of viscosupplementation for osteoarthritis of the ankle. A total of 1,961 articles were identified in various databases. After examining each of the articles, five articles were included in this review. Treatment with intraarticular hyaluronic acid is a safe treatment modality that significantly improves functional scores of patients, with no evidence of superiority in relation to other conservative treatments. Further clinical trials with larger numbers of patients are needed so that we can recommend its use and address unanswered questions . Systematic Review of Randomized Clinical Trials.

  8. Denture adhesives: a systematic review.

    PubMed

    Papadiochou, Sofia; Emmanouil, Ioannis; Papadiochos, Ioannis

    2015-05-01

    Denture adhesives have been the objective of scientific research for over half a century. Although they are used by denture wearers worldwide, investigations of their effectiveness and biocompatibility have led to controversial conclusions. The purpose of this study was to review the literature data with regard to the effectiveness and biocompatibility of denture adhesives as well as the attitudes of both patients and dental professionals toward these materials. An electronic search of English peer-reviewed dental literature in the Medline database was conducted to evaluate the effectiveness and biocompatibility of denture adhesives. There was no limitation in publication year, so the search included all the available scientific evidence included in that particular database until March 2014. Specific inclusion criteria were used for the selection of the appropriate articles. A manual search of the citations of the obtained articles followed to extend the electronic search. A full text review was carried out for only 32 articles. Of the 32 articles, 21 examined the efficacy of denture adhesives in terms of retention and stability and masticatory performance, 6 evaluated the issue of the biocompatibility of denture adhesives, and 5 presented the attitudes of either professionals or patients toward these materials. The majority of clinical studies supported the fact that denture adhesives enhance the retention, stability, and masticatory performance of a removable prosthesis. In terms of biocompatibility, long-term in vivo studies to investigate potential harmful effects were lacking. Patients are satisfied with denture adhesives that meet their needs. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  9. Composite inlays: a systematic review.

    PubMed

    Grivas, E; Roudsari, R V; Satterthwaite, J D

    2014-09-01

    The purpose of this study is to review the available literature related to composite inlays. Electronic databases published up to November 2013 were searched. Studies that evaluate composite resin inlays for the restoration of posterior teeth were selected. The studies should compare composite inlays against gold inlays, ceramic inlays and direct composite fillings regarding longevity, aesthetic quality and postoperative sensitivity or comparing the clinical effectiveness of them on premolars versus molars or on 1-2 surface preparations versus multi-surface preparations. Despite the heterogeneity of the available clinical trials composite inlays seem to be an effective method for the restoration of posterior teeth.

  10. Mobile Text Messaging for Health: A Systematic Review of Reviews

    PubMed Central

    Hall, Amanda K.; Cole-Lewis, Heather; Bernhardt, Jay M.

    2015-01-01

    The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness. PMID:25785892

  11. Mobile text messaging for health: a systematic review of reviews.

    PubMed

    Hall, Amanda K; Cole-Lewis, Heather; Bernhardt, Jay M

    2015-03-18

    The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness.

  12. Multimorbidity patterns: a systematic review.

    PubMed

    Prados-Torres, Alexandra; Calderón-Larrañaga, Amaia; Hancco-Saavedra, Jorge; Poblador-Plou, Beatriz; van den Akker, Marjan

    2014-03-01

    The aim of this review was to identify studies on patterns of associative multimorbidity, defined as the nonrandom association between diseases, focusing on the main methodological features of the studies and the similarities among the detected patterns. Studies were identified through MEDLINE and EMBASE electronic database searches from their inception to June 2012 and bibliographies. The final 14 articles exhibited methodological heterogeneity in terms of the sample size, age and recruitment of study participants, the data source, the number of baseline diseases considered, and the statistical procedure used. A total of 97 patterns composed of two or more diseases were identified. Among these, 63 patterns were composed of three or more diseases. Despite the methodological variability among studies, this review demonstrated relevant similarities for three groups of patterns. The first one comprised a combination of cardiovascular and metabolic diseases, the second one was related with mental health problems, and the third one with musculoskeletal disorders. The existence of associations beyond chance among the different diseases that comprise these patterns should be considered with the aim of directing future lines of research that measure their intensity, clarify their nature, and highlight the possible causal underlying mechanisms. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Aging techniques for deep vein thrombosis: a systematic review.

    PubMed

    Dharmarajah, B; Sounderajah, V; Rowland, S P; Leen, E L S; Davies, A H

    2015-03-01

    Deep vein thrombosis is common with an incidence of 1 in 1000. Acute thrombus removal for extensive proximal deep vein thrombosis using catheter-directed techniques highlights the need for accurate assessment of thrombus age. This systematic review summarises experimental and clinical evidence of imaging techniques for aging deep vein thrombosis. Ultrasound elastography and magnetic resonance imaging were highlighted as the most studied imaging modalities. Elastography was shown to distinguish between acute and chronic clots, despite demonstrating difficulty in accurate aging of clots older than 10 days in rat models. Elastography is noted as a feasible adjunct to current first-line imaging for deep vein thrombosis using duplex ultrasonography. Combinations of magnetic resonance imaging techniques can identify acute, sub-acute and chronic thrombi using endogenous contrast agents and provide objective standardisation of the diagnostic process, with reduced onus upon operator dependency. Further validation is required of these novel imaging techniques prior to clinical implementation for deep vein thrombosis aging.

  14. A Systematic Review of Assessment Literacy Measures

    ERIC Educational Resources Information Center

    Gotch, Chad M.; French, Brian F.

    2014-01-01

    This work systematically reviews teacher assessment literacy measures within the context of contemporary teacher evaluation policy. In this study, the researchers collected objective tests of assessment knowledge, teacher self-reports, and rubrics to evaluate teachers' work in assessment literacy studies from 1991 to 2012. Then they evaluated…

  15. Treatment of Childhood Obesity: A Systematic Review

    ERIC Educational Resources Information Center

    Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.

    2012-01-01

    Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…

  16. A Review of Dendroctonus frontalis Zimmermann Systematics

    Treesearch

    Anthony I. Cognato

    2011-01-01

    The systematic history of the southern pine beetle, Dendroctonus frontalis Zimmermann, is reviewed. Morphological, biological, karyological, and molecular data clearly define and diagnose the species limits of D. frontalis. More complete phylogenetic analysis and characterization of population genetic variation will further clarify the evolutionary history of the D....

  17. Treatment of Childhood Obesity: A Systematic Review

    ERIC Educational Resources Information Center

    Staniford, Leanne J.; Breckon, Jeff D.; Copeland, Robert J.

    2012-01-01

    Childhood obesity trends have increased dramatically over the past three decade's. The purpose of this quantitative systematic review is to provide an update of the evidence, illustrating the efficacy of childhood obesity treatment, considering whether treatment fidelity has been measured and/or reported and whether this related to the treatment…

  18. Evaluating clinical librarian services: a systematic review.

    PubMed

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

    2011-03-01

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

  19. A systematic review of busways

    SciTech Connect

    Martinelli, D.R.

    1996-05-01

    Busways are controlled-access facilities dedicated for bus service separated from general traffic. The concept of busways was first given serious consideration in the 1960s; however, only a few of them have been constructed in North America. This paper examines the potential of busway transit in providing urban environments with cost-effective mobility. The review makes the case that there are some misconceptions concerning the cost and level-of-service characteristics of busways. In the final section, a comparison is made between busways and their most prominent competitor, light rail. The comparison is done in the framework of the four most cited advantages of light rail, and concludes that busways, in most cases, are likely to be a superior mode of transit to light rail.

  20. Heart failure symptom relationships: a systematic review.

    PubMed

    Herr, Janet K; Salyer, Jeanne; Lyon, Debra E; Goodloe, Lauren; Schubert, Christine; Clement, Dolores G

    2014-01-01

    Heart failure is a prevalent chronic health condition in the United States. Individuals who have heart failure experience as many as 2 to 9 symptoms. The examination of relationships among heart failure symptoms may benefit patients and clinicians who are charged with managing heart failure symptoms. The purpose of this systematic review was to summarize what is known about relationships among heart failure symptoms, a precursor to the identification of heart failure symptom clusters, as well as to examine studies specifically addressing symptom clusters described in this population. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in the conduct of this systematic review. PubMed, PsychINFO, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Database were searched using the search term heart failure in combination with a pair of symptoms. Of a total of 1316 studies identified from database searches, 34 were included in this systematic review. More than 1 investigator found a moderate level of correlation between depression and fatigue, depression and anxiety, depression and sleep, depression and pain, anxiety and fatigue, and dyspnea and fatigue. The findings of this systematic review provide support for the presence of heart failure symptom clusters. Depression was related to several of the symptoms, providing an indication to clinicians that individuals with heart failure who experience depression may have other concurrent symptoms. Some symptom relationships such as the relationships between fatigue and anxiety or sleep or pain were dependent on the symptom characteristics studied. Symptom prevalence in the sample and restricted sampling may influence the robustness of the symptom relationships. These findings suggest that studies defining the phenotype of individual heart failure symptoms may be a beneficial step in the study of heart failure symptom clusters.

  1. Late prematurity: a systematic review.

    PubMed

    Machado Júnior, Luís Carlos; Passini Júnior, Renato; Rodrigues Machado Rosa, Izilda

    2014-01-01

    this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation) in its several aspects. the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  2. Cognitive insight: A systematic review.

    PubMed

    Van Camp, L S C; Sabbe, B G C; Oldenburg, J F E

    2017-07-01

    Cognitive insight is the ability to re-evaluate thoughts and beliefs in order to make thoughtful conclusions. It differs from clinical insight, as it focuses on more general metacognitive processes. Therefore, it could be relevant to diverse disorders and non-clinical subjects. There is a growing body of research on cognitive insight in individuals with and without psychosis. This review has summarised the current state of the art regarding this topic. We conclude that while cognitive insight in its current form seems valid for use in individuals with psychosis, it is less so for individuals without psychosis. Additionally, higher cognitive insight not always leads to better psychological functioning. For instance, higher levels of self-reflection are often associated with depressive mood. We therefore recommend the sub-components of cognitive insight to be studied separately. Also, it is unclear what position cognitive insight takes within the spectrum of metacognitive processes and how it relates to other self-related concepts that have been defined previously in literature. Combining future and past research on cognitive insight and its analogue concepts will help in the formation of a uniform definition that fits all subjects discussed here. Copyright © 2017. Published by Elsevier Ltd.

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

    PubMed

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

    2015-04-01

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

  4. [Medical indications for acupuncture: Systematic review].

    PubMed

    Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme

    2016-09-16

    Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies.

  5. 10 CFR 1045.43 - Systematic review for declassification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  6. 10 CFR 1045.43 - Systematic review for declassification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review of...

  7. 10 CFR 1045.43 - Systematic review for declassification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review of...

  8. 10 CFR 1045.43 - Systematic review for declassification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review of...

  9. 10 CFR 1045.43 - Systematic review for declassification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Systematic review for declassification. 1045.43 Section... Systematic review for declassification. (a) The Secretary shall ensure that RD documents, and the DoD shall... Classification (and with the DoD for FRD) to ensure the systematic review of RD and FRD documents. (c) Review of...

  10. Quality of reporting in systematic reviews of adverse events: systematic review

    PubMed Central

    Zorzela, Liliane; Golder, Su; Liu, Yali; Pilkington, Karen; Hartling, Lisa; Joffe, Ari; Loke, Yoon

    2014-01-01

    Objectives To examine the quality of reporting of harms in systematic reviews, and to determine the need for a reporting guideline specific for reviews of harms. Design Systematic review. Data sources Cochrane Database of Systematic Reviews (CDSR) and Database of Abstracts of Reviews of Effects (DARE). Review methods Databases were searched for systematic reviews having an adverse event as the main outcome, published from January 2008 to April 2011. Adverse events included an adverse reaction, harms, or complications associated with any healthcare intervention. Articles with a primary aim to investigate the complete safety profile of an intervention were also included. We developed a list of 37 items to measure the quality of reporting on harms in each review; data were collected as dichotomous outcomes (“yes” or “no” for each item). Results Of 4644 reviews identified, 309 were systematic reviews or meta-analyses primarily assessing harms (13 from CDSR; 296 from DARE). Despite a short time interval, the comparison between the years of 2008 and 2010-11 showed no difference on the quality of reporting over time (P=0.079). Titles in fewer than half the reviews (proportion of reviews 0.46 (95% confidence interval 0.40 to 0.52)) did not mention any harm related terms. Almost one third of DARE reviews (0.26 (0.22 to 0.31)) did not clearly define the adverse events reviewed, nor did they specify the study designs selected for inclusion in their methods section. Almost half of reviews (n=170) did not consider patient risk factors or length of follow-up when reviewing harms of an intervention. Of 67 reviews of complications related to surgery or other procedures, only four (0.05 (0.01 to 0.14)) reported professional qualifications of the individuals involved. The overall, unweighted, proportion of reviews with good reporting was 0.56 (0.55 to 0.57); corresponding proportions were 0.55 (0.53 to 0.57) in 2008, 0.55 (0.54 to 0.57) in 2009, and 0.57 (0.55 to 0.58) in

  11. Nasal Septal Deviations: A Systematic Review of Classification Systems.

    PubMed

    Teixeira, Jeffrey; Certal, Victor; Chang, Edward T; Camacho, Macario

    2016-01-01

    Objective. To systematically review the international literature for internal nasal septal deviation classification systems and summarize them for clinical and research purposes. Data Sources. Four databases (including PubMed/MEDLINE) were systematically searched through December 16, 2015. Methods. Systematic review, adhering to PRISMA. Results. After removal of duplicates, this study screened 952 articles for relevance. A final comprehensive review of 50 articles identified that 15 of these articles met the eligibility criteria. The classification systems defined in these articles included C-shaped, S-shaped, reverse C-shaped, and reverse S-shaped descriptions of the septal deviation in both the cephalocaudal and anteroposterior dimensions. Additional studies reported use of computed tomography and categorized deviation based on predefined locations. Three studies graded the severity of septal deviations based on the amount of deflection. The systems defined in the literature also included an evaluation of nasal septal spurs and perforations. Conclusion. This systematic review ascertained that the majority of the currently published classification systems for internal nasal septal deviations can be summarized by C-shaped or reverse C-shaped, as well as S-shaped or reverse S-shaped deviations in the anteroposterior and cephalocaudal dimensions. For imaging studies, predefined points have been defined along the septum. Common terminology can facilitate future research.

  12. Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

    PubMed

    Akram, Yasmin; Copello, Alex; Moore, David

    2014-08-15

    Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. Extensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded. The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted. This systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of

  13. Public health interventions in midwifery: a systematic review of systematic reviews

    PubMed Central

    2012-01-01

    Background Maternity care providers, particularly midwives, have a window of opportunity to influence pregnant women about positive health choices. This aim of this paper is to identify evidence of effective public health interventions from good quality systematic reviews that could be conducted by midwives. Methods Relevant databases including MEDLINE, Pubmed, EBSCO, CRD, MIDIRS, Web of Science, The Cochrane Library and Econlit were searched to identify systematic reviews in October 2010. Quality assessment of all reviews was conducted. Results Thirty-six good quality systematic reviews were identified which reported on effective interventions. The reviews were conducted on a diverse range of interventions across the reproductive continuum and were categorised under: screening; supplementation; support; education; mental health; birthing environment; clinical care in labour and breast feeding. The scope and strength of the review findings are discussed in relation to current practice. A logic model was developed to provide an overarching framework of midwifery public health roles to inform research policy and practice. Conclusions This review provides a broad scope of high quality systematic review evidence and definitively highlights the challenge of knowledge transfer from research into practice. The review also identified gaps in knowledge around the impact of core midwifery practice on public health outcomes and the value of this contribution. This review provides evidence for researchers and funders as to the gaps in current knowledge and should be used to inform the strategic direction of the role of midwifery in public health in policy and practice. PMID:23134701

  14. Biliary Dyskinesia in Children: A Systematic Review.

    PubMed

    Santucci, Neha R; Hyman, Paul E; Harmon, Carroll M; Schiavo, Julie H; Hussain, Sunny Z

    2017-02-01

    Cholecystectomy rates for biliary dyskinesia in children are rising in the United States, but not in other countries. Biliary dyskinesia is a validated functional gallbladder disorder in adults, requiring biliary colic in the diagnosis. In contrast, most studies in children require upper abdominal pain, absent gallstones on ultrasound, and an abnormal gallbladder ejection fraction (GBEF) on cholecystokinin-stimulated cholescintigraphy for diagnosis. We aimed to systematically review existing literature in biliary dyskinesia in children, determine the validity and reliability of diagnostic criteria, GBEF, and to assess outcomes following cholecystectomy. We performed a systematic review following the PRISMA checklist and searched 7 databases including PubMed, Scopus, Embase, Ovid, MEDLINE, ProQuest, Web of Science, and the Cochrane library. Bibliographies of articles were screened for additional studies. Our search terms yielded 916 articles of which 28 were included. Three articles were manually added from searched references. We reviewed 31 peer-reviewed publications, all retrospective chart reviews. There was heterogeneity in diagnostic criteria and GBEF values. Outcomes after laparoscopic cholecystectomy varied from 34% to 100% success, and there was no consensus concerning factors influencing outcomes. The observational, retrospective study designs that comprised our review limited interpretation of safety and efficacy of the investigations and treatment in biliary dyskinesia in children. Symptoms of biliary dyskinesia overlapped with functional dyspepsia. There is a need for consensus on symptoms defining biliary dyskinesia, validation of testing required for diagnosis of biliary dyskinesia, and randomized controlled trials comparing medical versus surgical management in children with upper abdominal pain.

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

    PubMed

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

    2017-03-01

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

  16. Using multiple types of studies in systematic reviews of health care interventions--a systematic review.

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  18. [Counseling interventions for smoking cessation: systematic review].

    PubMed

    Alba, Luz Helena; Murillo, Raúl; Castillo, Juan Sebastián

    2013-04-01

    A systematic review on efficacy and safety of smoking cessation counseling was developed. The ADAPTE methodology was used with a search of Clinical Practice Guidelines (CPG) in Medline, EMBASE, CINAHL, LILACS, and Cochrane. DELBI was used to select CPG with score over 60 in methodological rigor and applicability to the Colombian health system. Smoking cessation rates at 6 months were assessed according to counseling provider, model, and format. In total 5 CPG out of 925 references were selected comprising 44 systematic reviews and meta-analyses. Physician brief counseling and trained health professionals' intensive counseling (individual, group, proactive telephone) are effective with abstinence rates between 2.1% and 17.4%. Only practical counseling and motivational interview were found effective intensive interventions. The clinical effect of smoking cessation counseling is low and long term cessation rates uncertain. Cost-effectiveness analyses are recommended for the implementation of counseling in public health programs.

  19. Somatization in Parkinson's Disease: A systematic review.

    PubMed

    Carrozzino, Danilo; Bech, Per; Patierno, Chiara; Onofrj, Marco; Morberg, Bo Mohr; Thomas, Astrid; Bonanni, Laura; Fulcheri, Mario

    2017-08-01

    The current systematic review study is aimed at critically analyzing from a clinimetric viewpoint the clinical consequence of somatization in Parkinson's Disease (PD). By focusing on the International Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive electronic literature research strategy on ISI Web-of-Science, PsychINFO, PubMed, EBSCO, ScienceDirect, MEDLINE, Scopus, and Google Scholar databases. Out of 2.926 initial records, only a total of 9 studies were identified as clearly relevant and analyzed in this systematic review. The prevalence of somatization in PD has been found to range between 7.0% and 66.7%, with somatoform disorders acting as clinical factor significantly contributing to predict a progressive cognitive impairment. We highlighted that somatization is a highly prevalent comorbidity affecting PD. However, the clinical consequence of such psychiatric symptom should be further evaluated by replacing the clinically inadequate diagnostic label of psychogenic parkinsonism with the psychosomatic concept of persistent somatization as conceived by the Diagnostic Criteria for Psychosomatic Research (DCPR). Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Echocardiography in chronic liver disease: systematic review.

    PubMed

    Mota, Vitor Gomes; Markman Filho, Brivaldo

    2013-04-01

    Doppler echocardiography (Echo) is a non-invasive method of excellent accuracy to screen portopulmonary hypertension (PPH) and to assess intrapulmonary shunts (IPS) in chronic liver disease (CLD). In the past decade, Echo proved to play a fundamental role in the diagnosis of cirrhotic cardiomyopathy (CCM). To perform a systematic review of relevant articles on the subject 'Echo in CLD'. In November 2011, a systematic review was performed in the PubMed, LILACS and SciELO databases, and the characteristics of the studies selected were reported. The search based on descriptors and free terms obtained 204 articles (179 in Pubmed, 21 in LILACS, and 1 in SciELO). Of those 204 articles, 22 were selected for systematic review. A meta-analysis could not be performed because of the heterogeneity of the articles. Echo should be part of CLD stratification for screening PPH, IPS and CCM, because, most of the time, such complications are diagnosed only when patients are already waiting for a liver transplant.

  1. Acupuncture for primary dysmenorrhoea: a systematic review.

    PubMed

    Cho, S-H; Hwang, E-W

    2010-04-01

    The effectiveness of acupuncture in primary dysmenorrhoea is not fully understood. To assess the effectiveness of acupuncture for the symptomatic treatment of primary dysmenorrhoea from randomised controlled trials (RCTs). Nineteen electronic databases, including English, Korean, Japanese and Chinese databases, were systematically searched for RCTs investigating acupuncture for primary dysmenorrhoea up to July 2008 with no language restrictions. All RCTs that evaluated the effects of acupuncture compared with controls were included. Studies that assessed the effect of moxibustion or body acupressure were excluded. The study abstraction and quality assessment of all studies were undertaken following the detailed descriptions of these categories as described in the Cochrane Handbook for Systematic Reviews of Interventions. Twenty-seven RCTs were systematically reviewed. Only nine of the 27 trials clearly described their methods of randomisation and none of the trials stated the methods of allocation concealment. Compared with pharmacological treatment or herbal medicine, acupuncture was associated with a significant reduction in pain. Three studies reported reduced pain within groups from baseline; however, two RCTs did not find a significant difference between acupuncture and sham acupuncture. The review found promising evidence in the form of RCTs for the use of acupuncture in the treatment of primary dysmenorrhoea compared with pharmacological treatment or herbal medicine. However, the results were limited by methodological flaws. The evidence for the effectiveness of acupuncture for the treatment of primary dysmenorrhoea is not convincing compared with sham acupuncture. Further rigorous nonpenetrating placebo-controlled RCTs are warranted.

  2. Amitraz, an underrecognized poison: A systematic review

    PubMed Central

    Dhooria, Sahajal; Agarwal, Ritesh

    2016-01-01

    Background & objectives: Amitraz is a member of formamidine family of pesticides. Poisoning from amitraz is underrecognized even in areas where it is widely available. It is frequently misdiagnosed as organophosphate poisoning. This systematic review provides information on the epidemiology, toxicokinetics, mechanisms of toxicity, clinical features, diagnosis and management of amitraz poisoning. Methods: Medline and Embase databases were searched systematically (since inception to January 2014) for case reports, case series and original articles using the following search terms: ‘amitraz’, ‘poisoning’, ‘toxicity’, ‘intoxication’ and ‘overdose’. Articles published in a language other than English, abstracts and those not providing sufficient clinical information were excluded. Results: The original search yielded 239 articles, of which 52 articles described human cases. After following the inclusion and exclusion criteria, 32 studies describing 310 cases (151 females, 175 children) of human poisoning with amitraz were included in this systematic review. The most commonly reported clinical features of amitraz poisoning were altered sensorium, miosis, hyperglycaemia, bradycardia, vomiting, respiratory failure, hypotension and hypothermia. Amitraz poisoning carried a good prognosis with only six reported deaths (case fatality rate, 1.9%). Nearly 20 and 11.9 per cent of the patients required mechanical ventilation and inotropic support, respectively. The role of decontamination methods, namely, gastric lavage and activated charcoal was unclear. Interpretation & conclusions: Our review shows that amitraz is an important agent for accidental or suicidal poisoning in both adults and children. It has a good prognosis with supportive management. PMID:28139533

  3. Adipokines and Migraine: A Systematic Review

    PubMed Central

    Peterlin, B. Lee; Sacco, Simona; Bernecker, Claudia; Scher, Ann I.

    2016-01-01

    Background Migraine is comorbid with obesity. Recent research suggests an association between migraine and adipocytokines, proteins that are predominantly secreted from adipose tissue and which participate in energy homeostasis and inflammatory processes. Objectives In this review, we first briefly discuss the association between migraine and obesity and the importance of adipose tissue as a neuroendocrine organ. We then present a systematic review of the extant literature evaluating circulating levels of adiponectin and leptin in those with migraine. Methods A search of the PubMed database was conducted using the keywords “migraine,” “adiponectin,” and “leptin.” In addition reference lists of relevant articles were reviewed for possible inclusion. English language studies published between 2005 and 2015 evaluating circulating blood concentration of adiponectin or leptin in those with migraine were included. Conclusions While the existing data are suggestive that adipokines may be associated with migraine, substantial study design differences and conflicting results limit definitive conclusions. Future research utilizing carefully considered designs and methodology is warranted. In particular careful and systematic characterization of pain states at the time of samples, as well as systematic consideration of demographic (eg, age, sex) and other vital covariates (eg, obesity status, lipids) are needed to determine if adipokines play a role in migraine pathophysiology and if any adipokine represents a viable, novel migraine biomarker, or drug target. PMID:27012149

  4. Surface electromyography in animals: A systematic review

    PubMed Central

    Valentin, Stephanie; Zsoldos, Rebeka R.

    2017-01-01

    The study of muscle activity using surface electromyography (sEMG) is commonly used for investigations of the neuromuscular system in man. Although sEMG has faced methodological challenges, considerable technical advances have been made in the last few decades. Similarly, the field of animal biomechanics, including sEMG, has grown despite being confronted with often complex experimental conditions. In human sEMG research, standardised protocols have been developed, however these are lacking in animal sEMG. Before standards can be proposed in this population group, the existing research in animal sEMG should be collated and evaluated. Therefore the aim of this review is to systematically identify and summarise the literature in animal sEMG focussing on (1) species, breeds, activities and muscles investigated, and (2) electrode placement and normalisation methods used. The databases PubMed, Web of Science, Scopus, and Vetmed Resource were searched systematically for sEMG studies in animals and 38 articles were included in the final review. Data on methodological quality was collected and summarised. The findings from this systematic review indicate the divergence in animal sEMG methodology and as a result, future steps required to develop standardisation in animal sEMG are proposed. PMID:26763600

  5. Metabolomics in bladder cancer: a systematic review

    PubMed Central

    Cheng, Yidong; Yang, Xiao; Deng, Xiaheng; Zhang, Xiaolei; Li, Pengchao; Tao, Jun; Qin, Chao; Wei, Jifu; Lu, Qiang

    2015-01-01

    Bladder cancer (BC) is the most common urological malignancy. Early diagnosis of BC is crucial to improve patient outcomes. Currently, metabolomics is a potential technique that can be used to detect BC. We reviewed current publications and synthesised the findings on BC and metabolomics, i.e. metabolite upregulation and downregulation. Fourteen metabolites (lactic acid, leucine, valine, phenylalanine, glutamate, histidine, aspartic acid, tyrosine, serine, uracil, hypoxanthine, carnitine, pyruvic acid and citric acid) were identified as potential biomarkers for BC. In conclusion, this systematic review presents new opportunities for the diagnosis of BC. PMID:26379905

  6. Diffusion tensor imaging (DTI) findings in adult civilian, military, and sport-related mild traumatic brain injury (mTBI): a systematic critical review.

    PubMed

    Asken, Breton Michael; DeKosky, Steven T; Clugston, James R; Jaffee, Michael S; Bauer, Russell M

    2017-03-24

    This review seeks to summarize diffusion tensor imaging (DTI) studies that have evaluated structural changes attributed to the mechanisms of mild traumatic brain injury (mTBI) in adult civilian, military, and athlete populations. Articles from 2002 to 2016 were retrieved from PubMed/MEDLINE, EBSCOhost, and Google Scholar, using a Boolean search string containing the following terms: "diffusion tensor imaging", "diffusion imaging", "DTI", "white matter", "concussion", "mild traumatic brain injury", "mTBI", "traumatic brain injury", and "TBI". We added studies not identified by this method that were found via manually-searched reference lists. We identified 86 eligible studies from English-language journals using, adult, human samples. Studies were evaluated based on duration between injury and DTI assessment, categorized as acute, subacute/chronic, remote mTBI, and repetitive brain trauma considerations. Since changes in brain structure after mTBI can also be affected by other co-occurring medical and demographic factors, we also briefly review DTI studies that have addressed socioeconomic status factors (SES), major depressive disorder (MDD), and attention-deficit hyperactivity disorder (ADHD). The review describes population-specific risks and the complications of clinical versus pathophysiological outcomes of mTBI. We had anticipated that the distinct population groups (civilian, military, and athlete) would require separate consideration, and various aspects of the study characteristics supported this. In general, study results suggested widespread but inconsistent differences in white matter diffusion metrics (primarily fractional anisotropy [FA], mean diffusivity [MD], radial diffusivity [RD], and axial diffusivity [AD]) following mTBI/concussion. Inspection of study designs and results revealed potential explanations for discrepant DTI findings, such as control group variability, analytic techniques, the manner in which regional differences were reported, and

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

    PubMed

    McDougall, Rosalind

    2014-02-01

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

  8. Contrast therapy--a systematic review.

    PubMed

    Hing, Wayne A; White, Steven G; Bouaaphone, Anousith; Lee, Peter

    2008-08-01

    Contrast therapy is a strategy that is widely utilised in a number of sporting codes to aid recovery. This wide use might suggest that contrast therapy is an effective recovery modality however support for this assumption appears to be mainly anecdotal. The purpose of this paper is to review the efficacy of contrast therapy. To achieve this objective, a systematic review of randomised controlled trials (RCTs) that have specifically evaluated the therapeutic efficacy of contrast therapy was performed. A search to identify appropriate literature was conducted across a number of electronic databases. The titles and abstracts of the papers identified were reviewed to select papers specifically relating to contrast therapy. Twelve RCTs met the inclusion and exclusion criteria. The PEDro Scale, a systematic tool used to critique RCTs, was employed to critique the methodological quality of these studies. This review highlights both the lack in quantity and quality of research regarding the efficacy of contrast therapy for sports recovery. There appears to be insufficient evidence that contrast therapy aids in recovery and the limited methodological quality of the reviewed studies makes it difficult to draw clear conclusions about this form of therapy. Future research needs to re-examine the use of contrast therapy and in particular whole body immersion recovery strategies within the appropriate sports setting. This research will need to be of sufficient quality to enable appropriate conclusions to be made with regards to its use as a recovery strategy.

  9. Educational attainment and obesity: A systematic review

    PubMed Central

    Cohen, Alison K.; Rai, Manisha; Rehkopf, David H.; Abrams, Barbara

    2013-01-01

    Background Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. Methods The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese, and Spanish were included. Results This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables, and/or attempted to assess causality through the use of quasi-experimental designs. Conclusions Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention. PMID:23889851

  10. Educational attainment and obesity: a systematic review.

    PubMed

    Cohen, A K; Rai, M; Rehkopf, D H; Abrams, B

    2013-12-01

    Although previous systematic reviews considered the relationship between socioeconomic status and obesity, almost 200 peer-reviewed articles have been published since the last review on that topic, and this paper focuses specifically on education, which has different implications. The authors systematically review the peer-reviewed literature from around the world considering the association between educational attainment and obesity. Databases from public health and medicine, education, psychology, economics, and other social sciences were searched, and articles published in English, French, Portuguese and Spanish were included. This paper includes 289 articles that report on 410 populations in 91 countries. The relationship between educational attainment and obesity was modified by both gender and the country's economic development level: an inverse association was more common in studies of higher-income countries and a positive association was more common in lower-income countries, with stronger social patterning among women. Relatively few studies reported on lower-income countries, controlled for a comprehensive set of potential confounding variables and/or attempted to assess causality through the use of quasi-experimental designs. Future research should address these gaps to understand if the relationship between educational attainment and obesity may be causal, thus supporting education policy as a tool for obesity prevention.

  11. What is open peer review? A systematic review.

    PubMed

    Ross-Hellauer, Tony

    2017-01-01

     "Open peer review" (OPR), despite being a major pillar of Open Science, has neither a standardized definition nor an agreed schema of its features and implementations. The literature reflects this, with a myriad of overlapping and often contradictory definitions. While the term is used by some to refer to peer review where the identities of both author and reviewer are disclosed to each other, for others it signifies systems where reviewer reports are published alongside articles. For others it signifies both of these conditions, and for yet others it describes systems where not only "invited experts" are able to comment. For still others, it includes a variety of combinations of these and other novel methods.  Recognising the absence of a consensus view on what open peer review is, this article undertakes a systematic review of definitions of "open peer review" or "open review", to create a corpus of 122 definitions. These definitions are then systematically analysed to build a coherent typology of the many different innovations in peer review signified by the term, and hence provide the precise technical definition currently lacking.  This quantifiable data yields rich information on the range and extent of differing definitions over time and by broad subject area. Quantifying definitions in this way allows us to accurately portray exactly how  ambiguously the phrase "open peer review"  has been used thus far, for the literature offers a total of 22 distinct configurations of seven traits, effectively meaning that there are 22 different definitions of OPR in the literature.  Based on this work, I propose a pragmatic definition of open peer review as an umbrella term for a number of overlapping ways that peer review models can be adapted in line with the ethos of Open Science, including making reviewer and author identities open, publishing review reports and enabling greater participation in the peer review process.

  12. Evidence-based interventions to reduce adverse events in hospitals: a systematic review of systematic reviews

    PubMed Central

    Zegers, Marieke; Hesselink, Gijs; Geense, Wytske; Vincent, Charles; Wollersheim, Hub

    2016-01-01

    Objective To provide an overview of effective interventions aimed at reducing rates of adverse events in hospitals. Design Systematic review of systematic reviews. Data sources PubMed, CINAHL, PsycINFO, the Cochrane Library and EMBASE were searched for systematic reviews published until October 2015. Study selection English-language systematic reviews of interventions aimed at reducing adverse events in hospitals, including studies with an experimental design and reporting adverse event rates, were included. Two reviewers independently assessed each study's quality and extracted data on the study population, study design, intervention characteristics and adverse patient outcomes. Results Sixty systematic reviews with moderate to high quality were included. Statistically significant pooled effect sizes were found for 14 types of interventions, including: (1) multicomponent interventions to prevent delirium; (2) rapid response teams to reduce cardiopulmonary arrest and mortality rates; (3) pharmacist interventions to reduce adverse drug events; (4) exercises and multicomponent interventions to prevent falls; and (5) care bundle interventions, checklists and reminders to reduce infections. Most (82%) of the significant effect sizes were based on 5 or fewer primary studies with an experimental study design. Conclusions The evidence for patient-safety interventions implemented in hospitals worldwide is weak. The findings address the need to invest in high-quality research standards in order to identify interventions that have a real impact on patient safety. Interventions to prevent delirium, cardiopulmonary arrest and mortality, adverse drug events, infections and falls are most effective and should therefore be prioritised by clinicians. PMID:27687901

  13. 32 CFR 2001.31 - Systematic declassification review.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Systematic declassification review. 2001.31... Declassification § 2001.31 Systematic declassification review. (a) General. Agencies shall establish systematic review programs for those records containing information exempted from automatic declassification. This...

  14. 32 CFR 2001.31 - Systematic declassification review.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false Systematic declassification review. 2001.31... Declassification § 2001.31 Systematic declassification review. (a) General. Agencies shall establish systematic review programs for those records containing information exempted from automatic declassification. This...

  15. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Systematic declassification review. 9.11... Systematic declassification review. The Information and Privacy Coordinator shall be responsible for conducting a program for systematic declassification review of historically valuable records that were...

  16. 12 CFR 403.6 - Systematic review for declassification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Systematic review for declassification. 403.6..., AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION § 403.6 Systematic review for declassification... permanent retention will be subject to systematic declassification review by the Archivist in accordance...

  17. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Systematic declassification review. 9.11... Systematic declassification review. The Information and Privacy Coordinator shall be responsible for conducting a program for systematic declassification review of historically valuable records that were...

  18. 32 CFR 2001.31 - Systematic declassification review.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false Systematic declassification review. 2001.31... Declassification § 2001.31 Systematic declassification review. (a) General. Agencies shall establish systematic review programs for those records containing information exempted from automatic declassification. This...

  19. 32 CFR 2001.31 - Systematic declassification review.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false Systematic declassification review. 2001.31... Declassification § 2001.31 Systematic declassification review. (a) General. Agencies shall establish systematic review programs for those records containing information exempted from automatic declassification. This...

  20. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Systematic declassification review. 9.11... Systematic declassification review. The Information and Privacy Coordinator shall be responsible for conducting a program for systematic declassification review of historically valuable records that were...

  1. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Systematic declassification review. 9.11... Systematic declassification review. The Information and Privacy Coordinator shall be responsible for conducting a program for systematic declassification review of historically valuable records that were...

  2. 12 CFR 403.6 - Systematic review for declassification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Systematic review for declassification. 403.6..., AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION § 403.6 Systematic review for declassification... permanent retention will be subject to systematic declassification review by the Archivist in accordance...

  3. 32 CFR 2001.31 - Systematic declassification review.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false Systematic declassification review. 2001.31... Declassification § 2001.31 Systematic declassification review. (a) General. Agencies shall establish systematic review programs for those records containing information exempted from automatic declassification. This...

  4. 12 CFR 403.6 - Systematic review for declassification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 5 2013-01-01 2013-01-01 false Systematic review for declassification. 403.6..., AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION § 403.6 Systematic review for declassification... permanent retention will be subject to systematic declassification review by the Archivist in accordance...

  5. 22 CFR 9.11 - Systematic declassification review.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Systematic declassification review. 9.11... Systematic declassification review. The Information and Privacy Coordinator shall be responsible for conducting a program for systematic declassification review of historically valuable records that were...

  6. 12 CFR 403.6 - Systematic review for declassification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. 12 CFR 403.6 - Systematic review for declassification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 5 2014-01-01 2014-01-01 false Systematic review for declassification. 403.6..., AND SAFEGUARDING OF NATIONAL SECURITY INFORMATION § 403.6 Systematic review for declassification... permanent retention will be subject to systematic declassification review by the Archivist in accordance...

  8. Developing a library systematic review service: a case study.

    PubMed

    Ludeman, Emilie; Downton, Katherine; Shipper, Andrea Goldstein; Fu, Yunting

    2015-01-01

    Systematic review searching is a standard job responsibility for many health sciences librarians. The strategies a library uses to market its expertise may affect the number of researchers requesting librarian assistance as well as how researchers perceive librarians as systematic review collaborators. This article describes how one health sciences library developed, launched, and promoted its systematic review service to researchers on campus.

  9. Systematic Imaging Module in Complete Hindgut Duplication

    PubMed Central

    Verma, Ashish; Gupta, Prashant Nath; Pandey, Vaibhav; Jain, Shivi; Upadhyay, Ashish; Sharma, Jitendra; Shukla, Ram C.

    2015-01-01

    Complete hind gut and anal canal duplication is a rare entity, usually remaining asymptomatic till the disease comes to light due to associated anomalies or due to cosmetic reasons. Classical imaging consisting of barium enema examination served a limited role, in terms of depicting the length of gut segment involved. Technical advances in magnetic resonance imaging (MRI) with three-dimensional (3D) reformations cannot only solve the above purpose but further evaluate key points needed for surgical planning. The present technical report lays out a systematic module for evaluation of various aspects of complete hindgut duplication, critical for management. The role of 3D MRI is emphasized upon, for evaluation of pelvic floor and anorectum, even in infants with a distorted anatomy. PMID:26171317

  10. Mediating Policy-Relevant Evidence at Speed: Are Systematic Reviews of Systematic Reviews a Useful Approach?

    ERIC Educational Resources Information Center

    Caird, Jenny; Sutcliffe, Katy; Kwan, Irene; Dickson, Kelly; Thomas, James

    2015-01-01

    When swift, accurate appraisal of evidence is required to inform policy concerning broad research questions, and budgetary constraints limit the employment of large research teams, researchers face a significant challenge which is sometimes met by reviewing existing systematic reviews. In this paper we highlight the challenges inherent in the…

  11. Child maltreatment prevention: a systematic review of reviews

    PubMed Central

    Butchart, Alexander

    2009-01-01

    Abstract Objective To synthesize recent evidence from systematic and comprehensive reviews on the effectiveness of universal and selective child maltreatment prevention interventions, evaluate the methodological quality of the reviews and outcome evaluation studies they are based on, and map the geographical distribution of the evidence. Methods A systematic review of reviews was conducted. The quality of the systematic reviews was evaluated with a tool for the assessment of multiple systematic reviews (AMSTAR), and the quality of the outcome evaluations was assessed using indicators of internal validity and of the construct validity of outcome measures. Findings The review focused on seven main types of interventions: home visiting, parent education, child sex abuse prevention, abusive head trauma prevention, multi-component interventions, media-based interventions, and support and mutual aid groups. Four of the seven – home-visiting, parent education, abusive head trauma prevention and multi-component interventions – show promise in preventing actual child maltreatment. Three of them – home visiting, parent education and child sexual abuse prevention – appear effective in reducing risk factors for child maltreatment, although these conclusions are tentative due to the methodological shortcomings of the reviews and outcome evaluation studies they draw on. An analysis of the geographical distribution of the evidence shows that outcome evaluations of child maltreatment prevention interventions are exceedingly rare in low- and middle-income countries and make up only 0.6% of the total evidence base. Conclusion Evidence for the effectiveness of four of the seven main types of interventions for preventing child maltreatment is promising, although it is weakened by methodological problems and paucity of outcome evaluations from low- and middle-income countries. PMID:19551253

  12. Genetic variation and dopamine D2 receptor availability: a systematic review and meta-analysis of human in vivo molecular imaging studies

    PubMed Central

    Gluskin, B S; Mickey, B J

    2016-01-01

    The D2 dopamine receptor mediates neuropsychiatric symptoms and is a target of pharmacotherapy. Inter-individual variation of D2 receptor density is thought to influence disease risk and pharmacological response. Numerous molecular imaging studies have tested whether common genetic variants influence D2 receptor binding potential (BP) in humans, but demonstration of robust effects has been limited by small sample sizes. We performed a systematic search of published human in vivo molecular imaging studies to estimate effect sizes of common genetic variants on striatal D2 receptor BP. We identified 21 studies examining 19 variants in 11 genes. The most commonly studied variant was a single-nucleotide polymorphism in ANKK1 (rs1800497, Glu713Lys, also called ‘Taq1A'). Fixed- and random-effects meta-analyses of this variant (5 studies, 194 subjects total) revealed that striatal BP was significantly and robustly lower among carriers of the minor allele (Lys713) relative to major allele homozygotes. The weighted standardized mean difference was −0.57 under the fixed-effect model (95% confidence interval=(−0.87, −0.27), P=0.0002). The normal relationship between rs1800497 and BP was not apparent among subjects with neuropsychiatric diseases. Significant associations with baseline striatal D2 receptor BP have been reported for four DRD2 variants (rs1079597, rs1076560, rs6277 and rs1799732) and a PER2 repeat polymorphism, but none have yet been tested in more than two independent samples. Our findings resolve apparent discrepancies in the literature and establish that rs1800497 robustly influences striatal D2 receptor availability. This genetic variant is likely to contribute to important individual differences in human striatal function, neuropsychiatric disease risk and pharmacological response. PMID:26926883

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

    PubMed

    Lee, Joseph G L; Ylioja, Thomas; Lackey, Mellanye

    2016-01-01

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

  14. Latino Veterans with PTSD: A Systematic Review

    PubMed Central

    Pittman, James O. E.

    2014-01-01

    Latinos have a long history of military service with recent service including combat conditions and multiple deployments, which are highly associated with posttraumatic stress disorder (PTSD). Clinical acumen underscores the importance of culture in assessment and treatment, but there has been little scientific literature that investigates the unique needs of veteran Latinos with PTSD. The primary goal of this systematic review was to analyze the existing literature on Latino veterans with PTSD and to critically evaluate attention to cultural issues. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were used to guide this review. Peer-reviewed, research reports written in English on Latino Veterans with PTSD since 1980 were included; 20 were assessment related, and nine were treatment related. All studies were quantitative. Only 13 studies mentioned culture as part of the context for Latino veterans, and only seven included cultural factors as part of the study design. Present findings highlight a lack of research focused on understanding cultural factors related to the assessment and treatment of Latino veterans with PTSD. Culturally-informed research on Latino veterans from current wars, Latina veterans and Latino veteran treatment outcomes are necessary to provide culturally-appropriate care to this growing veteran subgroup. PMID:25379284

  15. Health effects of indebtedness: a systematic review

    PubMed Central

    2014-01-01

    Background In the aftermath of the global financial crisis, millions of households have been left with debts that they are unable to manage. Indebtedness may impair the wellbeing of those affected by it for years to come. This systematic review focuses on the long-term consequences of indebtedness on health. Methods The method used in the paper is a systematic review. First, bibliographic databases were searched for peer-reviewed articles. Second, the references and citations of the included articles were searched for additional articles. Results The results from our sample of 33 peer-reviewed studies demonstrate serious health effects related to indebtedness. Individuals with unmet loan payments had suicidal ideation and suffered from depression more often than those without such financial problems. Unpaid financial obligations were also related to poorer subjective health and health-related behaviour. Debt counselling and other programmes to mitigate debt-related stress are needed to alleviate the adverse effects of indebtedness on health. Conclusions The results demonstrate that indebtedness has serious effects on health. PMID:24885280

  16. Disasters and Perinatal Health: A Systematic Review

    PubMed Central

    Harville, EW; Xiong, X; Buekens, P

    2012-01-01

    Background The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. Methods A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birthweight, congenital anomalies), mental health, and child development. 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. Results Studies addressing the World Trade Center disaster of September 11th and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, though there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. The mother's mental health after a disaster may more strongly influence on child development than any direct effect of disaster-related prenatal stress. Conclusions There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly-exposed women. Future research should focus on under-studied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health. PMID:21375788

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  19. Vending machine assessment methodology. A systematic review.

    PubMed

    Matthews, Melissa A; Horacek, Tanya M

    2015-07-01

    The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Infliximab-Related Infusion Reactions: Systematic Review

    PubMed Central

    Ron, Yulia; Kivity, Shmuel; Ben-Horin, Shomron; Israeli, Eran; Fraser, Gerald M.; Dotan, Iris; Chowers, Yehuda; Confino-Cohen, Ronit; Weiss, Batia

    2015-01-01

    Objective: Administration of infliximab is associated with a well-recognised risk of infusion reactions. Lack of a mechanism-based rationale for their prevention, and absence of adequate and well-controlled studies, has led to the use of diverse empirical administration protocols. The aim of this study is to perform a systematic review of the evidence behind the strategies for preventing infusion reactions to infliximab, and for controlling the reactions once they occur. Methods: We conducted extensive search of electronic databases of MEDLINE [PubMed] for reports that communicate various aspects of infusion reactions to infliximab in IBD patients. Results: We examined full texts of 105 potentially eligible articles. No randomised controlled trials that pre-defined infusion reaction as a primary outcome were found. Three RCTs evaluated infusion reactions as a secondary outcome; another four RCTs included infusion reactions in the safety evaluation analysis; and 62 additional studies focused on various aspects of mechanism/s, risk, primary and secondary preventive measures, and management algorithms. Seven studies were added by a manual search of reference lists of the relevant articles. A total of 76 original studies were included in quantitative analysis of the existing strategies. Conclusions: There is still paucity of systematic and controlled data on the risk, prevention, and management of infusion reactions to infliximab. We present working algorithms based on systematic and extensive review of the available data. More randomised controlled trials are needed in order to investigate the efficacy of the proposed preventive and management algorithms. PMID:26092578

  1. Treatment of acute gout: a systematic review.

    PubMed

    Khanna, Puja P; Gladue, Heather S; Singh, Manjit K; FitzGerald, John D; Bae, Sangmee; Prakash, Shraddha; Kaldas, Marian; Gogia, Maneesh; Berrocal, Veronica; Townsend, Whitney; Terkeltaub, Robert; Khanna, Dinesh

    2014-08-01

    Acute gout is traditionally treated with NSAIDs, corticosteroids, and colchicine; however, subjects have multiple comorbidities that limit the use of some conventional therapies. We systematically reviewed the published data on the pharmacologic and non-pharmacologic agents used for the treatment of acute gouty arthritis. A systematic search was performed using PubMed and Cochrane database through May 2013. We included only randomized controlled trials (RCTs) that included NSAIDs, corticosteroids, colchicine, adrenocorticotropic hormone (ACTH), interleukin-1 (IL-1) inhibitors, topical ice, or herbal supplements. Thirty articles were selected for systematic review. The results show that NSAIDs and COX-2 inhibitors are effective agents for the treatment of acute gout attacks. Systemic corticosteroids have similar efficacy to therapeutic doses of NSAIDs, with studies supporting oral and intramuscular use. ACTH is suggested to be efficacious in acute gout. Oral colchicine demonstrated to be effective, with low-dose colchicine demonstrating a comparable tolerability profile as placebo and a significantly lower side effect profile to high-dose colchicine. The IL-1β inhibitory antibody, canakinumab, was effective for the treatment of acute attacks in subjects refractory to and in those with contraindications to NSAIDs and/or colchicine. However, rilonacept was demonstrated to be not as effective, and there are no RCTs for the use of anakinra. NSAIDs, COX-2 selective inhibitors, corticosteroids, colchicine, ACTH, and canakinumab have evidence to suggest efficacy in treatment of acute gout. Published by Elsevier Inc.

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

    PubMed Central

    Wallace, John; Byrne, Charles; Clarke, Mike

    2014-01-01

    Objective Little is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved. Selection criteria Studies were included if they addressed interventions enhancing the uptake of systematic reviews. Reports in any language were included. All decisionmakers were eligible. Studies could be randomised trials, cluster-randomised trials, controlled-clinical trials and before-and-after studies. Data sources We searched 19 databases including PubMed, EMBASE and The Cochrane Library, covering the full range of publication years from inception to December 2010. Two reviewers independently extracted data and assessed quality according to the Effective Practice and Organisation of Care criteria. Results 10 studies from 11 countries, containing 12 interventions met our criteria. Settings included a hospital, a government department and a medical school. Doctors, nurses, mid-wives, patients and programme managers were targeted. Six of the studies were geared to improving knowledge and attitudes while four targeted clinical practice. Synthesis of results Three studies of low-to-moderate risk of bias, identified interventions that showed a statistically significant improvement: educational visits, short summaries of systematic reviews and targeted messaging. Promising interventions include e-learning, computer-based learning, inactive workshops, use of knowledge brokers and an e-registry of reviews. Juxtaposing barriers and facilitators alongside the identified interventions, it was clear that the three effective approaches addressed a wide range of barriers and facilitators. Discussion A limited number of studies were found for inclusion. However, the extensive literature search is one of the strengths of this review. Conclusions Targeted messaging, educational visits and summaries are recommended to enhance systematic review uptake. Identified

  3. The prevalence of stillbirths: a systematic review

    PubMed Central

    Say, Lale; Donner, Allan; Gülmezoglu, A Metin; Taljaard, Monica; Piaggio, Gilda

    2006-01-01

    Background Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Obtaining overall estimates across various regions of the world is not straightforward due to variation in definitions, data collection methods and reporting. Methods We conducted a systematic review of a range of pregnancy-related conditions including stillbirths and performed meta-analysis of the subset of studies reporting stillbirth rates. We examined variation across rates and used meta-regression techniques to explain observed variation. Results We identified 389 articles on stillbirth prevalence among the 2580 included in the systematic review. We included 70 providing 80 data sets from 50 countries in the meta-analysis. Pooled prevalence rates show variation across various subgroup categories. Rates per 100 births are higher in studies conducted in less developed country settings as compared to more developed (1.17 versus 0.50), of inadequate quality as compared to adequate (1.12 versus 0.66), using sub-national sample as compared to national (1.38 versus 0.68), reporting all stillbirths as compared to late stillbirths (0.95 versus 0.63), published in non-English as compared to English (0.91 versus 0.59) and as journal articles as compared to non-journal (1.37 versus 0.67). The results of the meta-regression show the significance of two predictor variables – development status of the setting and study quality – on stillbirth prevalence. Conclusion Stillbirth prevalence at the community level is typically less than 1% in more developed parts of the world and could exceed 3% in less developed regions. Regular reviews of stillbirth rates in appropriately designed and reported studies are useful in monitoring the adequacy of care. Systematic reviews of prevalence studies are helpful in explaining sources of variation across rates. Exploring these methodological issues will lead to improved standards for assessing the burden of reproductive ill

  4. Epidemiology and Reporting Characteristics of Systematic Reviews

    PubMed Central

    Moher, David; Tetzlaff, Jennifer; Tricco, Andrea C; Sampson, Margaret; Altman, Douglas G

    2007-01-01

    Background Systematic reviews (SRs) have become increasingly popular to a wide range of stakeholders. We set out to capture a representative cross-sectional sample of published SRs and examine them in terms of a broad range of epidemiological, descriptive, and reporting characteristics, including emerging aspects not previously examined. Methods and Findings We searched Medline for SRs indexed during November 2004 and written in English. Citations were screened and those meeting our inclusion criteria were retained. Data were collected using a 51-item data collection form designed to assess the epidemiological and reporting details and the bias-related aspects of the reviews. The data were analyzed descriptively. In total 300 SRs were identified, suggesting a current annual publication rate of about 2,500, involving more than 33,700 separate studies including one-third of a million participants. The majority (272 [90.7%]) of SRs were reported in specialty journals. Most reviews (213 [71.0%]) were categorized as therapeutic, and included a median of 16 studies involving 1,112 participants. Funding sources were not reported in more than one-third (122 [40.7%]) of the reviews. Reviews typically searched a median of three electronic databases and two other sources, although only about two-thirds (208 [69.3%]) of them reported the years searched. Most (197/295 [66.8%]) reviews reported information about quality assessment, while few (68/294 [23.1%]) reported assessing for publication bias. A little over half (161/300 [53.7%]) of the SRs reported combining their results statistically, of which most (147/161 [91.3%]) assessed for consistency across studies. Few (53 [17.7%]) SRs reported being updates of previously completed reviews. No review had a registration number. Only half (150 [50.0%]) of the reviews used the term “systematic review” or “meta-analysis” in the title or abstract. There were large differences between Cochrane reviews and non-Cochrane reviews

  5. Borderline intellectual functioning: a systematic literature review.

    PubMed

    Peltopuro, Minna; Ahonen, Timo; Kaartinen, Jukka; Seppälä, Heikki; Närhi, Vesa

    2014-12-01

    The literature related to people with borderline intellectual functioning (BIF) was systematically reviewed in order to summarize the present knowledge. Database searches yielded 1,726 citations, and 49 studies were included in the review. People with BIF face a variety of hardships in life, including neurocognitive, social, and mental health problems. When adults with BIF were compared with the general population, they held lower-skilled jobs and earned less money. Although some risk factors (e.g., low birth weight) and preventive factors (e.g., education) were reported, they were not specific to BIF. The review finds that, despite the obvious everyday problems, BIF is almost invisible in the field of research. More research, societal discussion, and flexible support systems are needed.

  6. Neurologic involvement in scleroderma: a systematic review.

    PubMed

    Amaral, Tiago Nardi; Peres, Fernando Augusto; Lapa, Aline Tamires; Marques-Neto, João Francisco; Appenzeller, Simone

    2013-12-01

    To perform a systematic review of neurologic involvement in Systemic sclerosis (SSc) and Localized Scleroderma (LS), describing clinical features, neuroimaging, and treatment. We performed a literature search in PubMed using the following MeSH terms, scleroderma, systemic sclerosis, localized scleroderma, localized scleroderma "en coup de sabre", Parry-Romberg syndrome, cognitive impairment, memory, seizures, epilepsy, headache, depression, anxiety, mood disorders, Center for Epidemiologic Studies Depression (CES-D), SF-36, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Patient Health Questionnaire-9 (PHQ-9), neuropsychiatric, psychosis, neurologic involvement, neuropathy, peripheral nerves, cranial nerves, carpal tunnel syndrome, ulnar entrapment, tarsal tunnel syndrome, mononeuropathy, polyneuropathy, radiculopathy, myelopathy, autonomic nervous system, nervous system, electroencephalography (EEG), electromyography (EMG), magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA). Patients with other connective tissue disease knowingly responsible for nervous system involvement were excluded from the analyses. A total of 182 case reports/studies addressing SSc and 50 referring to LS were identified. SSc patients totalized 9506, while data on 224 LS patients were available. In LS, seizures (41.58%) and headache (18.81%) predominated. Nonetheless, descriptions of varied cranial nerve involvement and hemiparesis were made. Central nervous system involvement in SSc was characterized by headache (23.73%), seizures (13.56%) and cognitive impairment (8.47%). Depression and anxiety were frequently observed (73.15% and 23.95%, respectively). Myopathy (51.8%), trigeminal neuropathy (16.52%), peripheral sensorimotor polyneuropathy (14.25%), and carpal tunnel syndrome (6.56%) were the most frequent peripheral nervous system involvement in SSc. Autonomic neuropathy involving cardiovascular and gastrointestinal systems was regularly described

  7. Inuit Elderly: A Systematic Review of Peer Reviewed Journal Articles.

    PubMed

    Somogyi, Balvinder K; Barker, Melanie; MacLean, Calvin; Grischkan, Pamela

    2015-01-01

    Over the last century, Inuit have experienced rapid social changes that have greatly impacted their way of life, health, and intergenerational traditions. Although there is a growing body of research concerning Inuit youth, relatively little is known about elderly Inuit. In an effort to bridge this knowledge gap, a systematic review of peer-reviewed journal articles was conducted. This review identified a dearth of research on older Inuit, and highlighted limitations in service provision to this primarily rural and isolated population. Implications for policy and practice and recommendations for future research are also discussed.

  8. What is open peer review? A systematic review

    PubMed Central

    Ross-Hellauer, Tony

    2017-01-01

    Background: “Open peer review” (OPR), despite being a major pillar of Open Science, has neither a standardized definition nor an agreed schema of its features and implementations. The literature reflects this, with numerous overlapping and contradictory definitions. While for some the term refers to peer review where the identities of both author and reviewer are disclosed to each other, for others it signifies systems where reviewer reports are published alongside articles. For others it signifies both of these conditions, and for yet others it describes systems where not only “invited experts” are able to comment. For still others, it includes a variety of combinations of these and other novel methods. Methods: Recognising the absence of a consensus view on what open peer review is, this article undertakes a systematic review of definitions of “open peer review” or “open review”, to create a corpus of 122 definitions. These definitions are systematically analysed to build a coherent typology of the various innovations in peer review signified by the term, and hence provide the precise technical definition currently lacking. Results: This quantifiable data yields rich information on the range and extent of differing definitions over time and by broad subject area. Quantifying definitions in this way allows us to accurately portray exactly how ambiguously the phrase “open peer review” has been used thus far, for the literature offers 22 distinct configurations of seven traits, effectively meaning that there are 22 different definitions of OPR in the literature reviewed. Conclusions: I propose a pragmatic definition of open peer review as an umbrella term for a number of overlapping ways that peer review models can be adapted in line with the aims of Open Science, including making reviewer and author identities open, publishing review reports and enabling greater participation in the peer review process. PMID:28580134

  9. Processing of food, body and emotional stimuli in anorexia nervosa: a systematic review and meta-analysis of functional magnetic resonance imaging studies.

    PubMed

    Zhu, Yikang; Hu, Xiaochen; Wang, Jijun; Chen, Jue; Guo, Qian; Li, Chunbo; Enck, Paul

    2012-11-01

    The characteristics of the cognitive processing of food, body and emotional information in patients with anorexia nervosa (AN) are debatable. We reviewed functional magnetic resonance imaging studies to assess whether there were consistent neural basis and networks in the studies to date. Searching PubMed, Ovid, Web of Science, The Cochrane Library and Google Scholar between January 1980 and May 2012, we identified 17 relevant studies. Activation likelihood estimation was used to perform a quantitative meta-analysis of functional magnetic resonance imaging studies. For both food stimuli and body stimuli, AN patients showed increased hemodynamic response in the emotion-related regions (frontal, caudate, uncus, insula and temporal) and decreased activation in the parietal region. Although no robust brain activation has been found in response to emotional stimuli, emotion-related neural networks are involved in the processing of food and body stimuli among AN. It suggests that negative emotional arousal is related to cognitive processing bias of food and body stimuli in AN.

  10. Comparison of cerebral blood flow measurement with [15O]-water positron emission tomography and arterial spin labeling magnetic resonance imaging: A systematic review.

    PubMed

    Fan, Audrey P; Jahanian, Hesamoddin; Holdsworth, Samantha J; Zaharchuk, Greg

    2016-05-01

    Noninvasive imaging of cerebral blood flow provides critical information to understand normal brain physiology as well as to identify and manage patients with neurological disorders. To date, the reference standard for cerebral blood flow measurements is considered to be positron emission tomography using injection of the [(15)O]-water radiotracer. Although [(15)O]-water has been used to study brain perfusion under normal and pathological conditions, it is not widely used in clinical settings due to the need for an on-site cyclotron, the invasive nature of arterial blood sampling, and experimental complexity. As an alternative, arterial spin labeling is a promising magnetic resonance imaging technique that magnetically labels arterial blood as it flows into the brain to map cerebral blood flow. As arterial spin labeling becomes more widely adopted in research and clinical settings, efforts have sought to standardize the method and validate its cerebral blood flow values against positron emission tomography-based cerebral blood flow measurements. The purpose of this work is to critically review studies that performed both [(15)O]-water positron emission tomography and arterial spin labeling to measure brain perfusion, with the aim of better understanding the accuracy and reproducibility of arterial spin labeling relative to the positron emission tomography reference standard.

  11. Acne and Nutrition: A Systematic Review.

    PubMed

    Fiedler, Friederike; Stangl, Gabriele I; Fiedler, Eckhard; Taube, Klaus-Michael

    2017-01-04

    Few well-defined, evidence-based nutritional recommendations for people with skin diseases have been published in the scientific literature and standard dermatological textbooks. Using a systematic review of acne vulgaris as an example, the aim of this study was to determine whether there are systematic studies on the topic and, if so, of what quality. Four evidence levels were defined: (A) double-blind randomized study; (B) randomized study with serious limitations/low number of cases; (C) case-control or cohort study; and (D) expert opinion/case report. PubMed and Cochrane searches were performed using combinations of the terms "diet", "nutrition", "meal" and "food" with "acne". Foodstuffs mentioned in relevant articles were subdivided by evidence level and recorded as having a beneficial (+), neutral (0) or adverse (-) effect. However, only a small proportion of studies met sufficiently high scientific standards that would enable therapeutic recommendations to be made in practice.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  14. Cycling with an amputation: A systematic review.

    PubMed

    Dyer, Bryce

    2016-10-01

    Cycling with any form of limb amputation has progressed from an activity of leisure or rehabilitation to elite level competition as part of the Paralympic Games programme. While it is often proposed that research into sport with an amputation can be extremely limited, this study intended to identify the volume, type and historical strategy in this area. This study comprises a documented systematic literature review of cycling undertaken with any form of limb amputation. This study used four online search engines to identify relevant peer-reviewed literature. These included SPORTDiscus, CINAHL, Scopus and MEDLINE. Google Scholar was also used as a secondary source. The initial results were then subjected to a set of pre-defined inclusion criteria. The resulting publications were then analysed for content and thematic commonality. The review identified 20 articles which met pre-defined inclusion criteria. The identified peer-reviewed publications were dated from the period 2004 to 2014. Three clear themes emerged from the historical research. There was both a paucity of peer-reviewed literature with respect to cycling with an amputation and the design of adaptive or assistive technology to replace limb loss. However, publications have been rising substantially over the last 5 years. This review study established the historical strategy and content of cycling with an amputation and identified the existing research themes. This will assist in summarising the current level of knowledge and help signpost such work in the future. © The International Society for Prosthetics and Orthotics 2015.

  15. A Systematic Review of Non-Echo Planar Diffusion-Weighted Magnetic Resonance Imaging for Detection of Primary and Postoperative Cholesteatoma.

    PubMed

    van Egmond, Sylvia L; Stegeman, Inge; Grolman, Wilko; Aarts, Mark C J

    2016-02-01

    To investigate the diagnostic value of non-echo planar diffusion-weighted magnetic resonance imaging (DW-MRI) for primary and recurrent/residual (postoperative) cholesteatoma in adults (≥18 years) after canal wall up surgery. We conducted a systematic search in PubMed, Embase, and Cochrane up to October 22, 2014. All studies investigating non-echo planar DW-MRI for primary and postoperative cholesteatoma were selected and critically appraised for relevance and validity. In total, 779 unique articles were identified, of which 23 articles were included for critical appraisal. Seven articles met our criteria for relevance and validity for postoperative cholesteatoma. Four studies were additionally included for subgroup analysis of primary cases only. Ranges of sensitivity, specificity, positive predictive value, and negative predictive value yielded 43%-92%, 58%-100%, 50%-100% and 64%-100%, respectively. Results for primary subgroup analysis were 83%-100%, 50%-100%, 85%-100%, and 50%-100%, respectively. Results for subgroup analysis for only postoperative cases yielded 80%-82%, 90%-100%, 96%-100%, 64%-85%, respectively. Despite a higher prevalence of cholesteatoma in the primary cases, there was no clinical difference in added value of DW-MRI between primary and postoperative cases. We found a high predictive value of non-echo planar DW-MRI for the detection of primary and postoperative cholesteatoma. Given the moderate quality of evidence, we strongly recommend both the use of non-echo planar DW-MRI scans for the follow-up after cholesteatoma surgery, and when the correct diagnosis is questioned in primary preoperative cases. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  16. Systematic review of factors affecting pharmaceutical expenditures.

    PubMed

    Mousnad, Mohamed Awad; Shafie, Asrul Akmal; Ibrahim, Mohamed Izham

    2014-06-01

    To systematically identify the main factors contributing to the increase in pharmaceutical expenditures. A systematic search of published studies was conducted utilising major widely used electronic databases using the search terms 'factors,' 'financing,' 'pharmaceutical,' and 'expenditures.' To be included, the studies needed to: (1) measure at least one of the following outcomes: total growth in pharmaceutical expenditures, price growth or quantity growth; (2) mention a clear method for analysing the impact of factors affecting the increases in drug expenditures; (3) be written in English. Nonprimary articles that were published only as an abstract, a review, a commentary or a letter were excluded. From a total of 2039 studies, only 25 were included in the full review. The main determinant categories that were identified in the review were factors related to price, utilisation, therapeutic choice, demand and health care system. The major cost drivers were found to be changes in drug quantities and therapies as well as new drugs. It is important for policymakers to understand pharmaceutical spending trends and the factors that influence them in order to formulate effective cost containment strategies and design optimum drug policy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Melatonin influence in ovary transplantation: systematic review.

    PubMed

    Shiroma, M E; Botelho, N M; Damous, L L; Baracat, E C; Soares-Jr, J M

    2016-06-10

    Melatonin is an indolamine produced by the pineal gland and it can exert a potent antioxidant effect. Its free radical scavenger properties have been used to advantage in different organ transplants in animal experiments. Several concentrations and administration pathways have been tested and melatonin has shown encouraging beneficial results in many transplants of organs such as the liver, lungs, heart, pancreas, and kidneys. The objective of the present study was to review the scientific literature regarding the use of melatonin in ovary transplantation. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was carried out using the Cochrane and Pubmed databases and employing the terms 'melatonin' AND 'ovary' AND 'transplantation.' After analysis, 5 articles were extracted addressing melatonin use in ovary transplants and involving 503 animals. Melatonin enhanced various graft aspects like morphology, apoptosis, immunological reaction, revascularization, oxidative stress, and survival rate. Melatonin's antioxidative and antiapoptotic properties seemingly produce positive effects on ovarian graft activity. Despite the promising results, further studies in humans need to be conducted to consolidate its use, as ovary transplantation for fertility preservation is gradually being moved from the experimental stage to a clinical setting.

  18. Prevention of Internet addiction: A systematic review

    PubMed Central

    Vondráčková, Petra; Gabrhelík, Roman

    2016-01-01

    Background and aims Out of a large number of studies on Internet addiction, only a few have been published on the prevention of Internet addiction. The aim of this study is provide a systematic review of scientific articles regarding the prevention of Internet addiction and to identify the relevant topics published in this area of interest. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted. The EBSCO, ProQuest Central, and PubMed databases were searched for texts published in English and Spanish between January 1995 and April 2016. A total of 179 original texts were obtained. After de-duplication and topic-relevance review, 108 texts were systematically classified and subjected to descriptive analysis and subsequent content analysis. Results The results of the content analysis yielded the following thematic areas: (a) target groups, (b) the improvement of specific skills, (c) program characteristics, and (d) environmental interventions. Discussion and conclusion Literature on the prevention of Internet addiction is scarce. There is an urgent need to introduce and implement new interventions for different at-risk populations, conduct well-designed research, and publish data on the effectiveness of these interventions. Developing prevention interventions should primarily target children and adolescents at risk of Internet addiction but also parents, teachers, peers, and others who are part of the formative environment of children and adolescents at risk of Internet addiction. Newly designed interventions focused on Internet addiction should be rigorously evaluated and the results published. PMID:27998173

  19. Prevention of Internet addiction: A systematic review.

    PubMed

    Vondráčková, Petra; Gabrhelík, Roman

    2016-12-01

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

  20. Probiotics and oral health: A systematic review.

    PubMed

    Seminario-Amez, M; López-López, J; Estrugo-Devesa, A; Ayuso-Montero, R; Jané-Salas, E

    2017-05-01

    Probiotics are microorganisms, mainly bacteria, which benefit the host's health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. An electronic search in PubMed database with the keywords "oral health AND probiotics AND dentistry" was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles.

  1. Mentoring in academic medicine: a systematic review.

    PubMed

    Sambunjak, Dario; Straus, Sharon E; Marusić, Ana

    2006-09-06

    Mentoring, as a partnership in personal and professional growth and development, is central to academic medicine, but it is challenged by increased clinical, administrative, research, and other educational demands on medical faculty. Therefore, evidence for the value of mentoring needs to be evaluated. To systematically review the evidence about the prevalence of mentorship and its relationship to career development. MEDLINE, Current Contents, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, PsycINFO, and Scopus databases from the earliest available date to May 2006. We identified all studies evaluating the effect of mentoring on career choices and academic advancement among medical students and physicians. Minimum inclusion criteria were a description of the study population and availability of extractable data. No restrictions were placed on study methods or language. The literature search identified 3640 citations. Review of abstracts led to retrieval of 142 full-text articles for assessment; 42 articles describing 39 studies were selected for review. Of these, 34 (87%) were cross-sectional self-report surveys with small sample size and response rates ranging from 5% to 99%. One case-control study nested in a survey used a comparison group that had not received mentoring, and 1 cohort study had a small sample size and a large loss to follow-up. Less than 50% of medical students and in some fields less than 20% of faculty members had a mentor. Women perceived that they had more difficulty finding mentors than their colleagues who are men. Mentorship was reported to have an important influence on personal development, career guidance, career choice, and research productivity, including publication and grant success. Mentoring is perceived as an important part of academic medicine, but the evidence to support this perception is not strong. Practical recommendations on mentoring in

  2. The use of magnetic resonance imaging in the evaluation of upper airway structures in paediatric obstructive sleep apnoea syndrome: a systematic review and meta-analysis

    PubMed Central

    Arrica, Mariantonietta; Di Stasio, Enrico; Gallenzi, Patrizia; Cordaro, Massimo

    2016-01-01

    Objectives: A systematic review was conducted to assess the effectiveness of MRI in evaluating upper airway structures in children affected by obstructive sleep apnoea syndrome (OSAS). Methods: A literature search was performed in the Cochrane Central Register of Controlled Trials, Web of Science, Scopus and PubMed databases from their inception to 31/03/2016, including available randomized controlled trials and controlled clinical trials published in English assessing the use of MRI integrated with traditional polysomnography (PSG) among children up to 15 years of age affected by OSAS. The primary outcome to be evaluated was the efficacy of MRI in analyzing the upper airway total volume among healthy children compared with children affected by OSAS. Secondary outcomes were to compare the efficacy of MRI in analyzing the upper airway cross-sectional area in the areas adjacent to the adenoids and tonsils, adenoid and tonsil volume, and soft-tissue and maxillofacial bone parameters in the same sample. Results were expressed using a random-effects model and mean differences (MD) with 95% confidence intervals (CI). Results: The search yielded 1005 titles in total; the selection process narrowed to 3 titles, which were all assessed as indicating an unclear level of risk of bias. The meta-analysis found evidence of MRI effectiveness in evaluating differences in the upper airway total volume between paediatric patients affected by OSAS and paediatric patients not affected by OSAS (MD −0.56 cm3; 95% CI: −1.05 to −0.07). Conclusions: Although MRI could be considered effective in evaluating upper airway structures in children affected by OSAS, based on the present evidence, PSG is still the golden standard and further studies are required to verify MRI reliability. PMID:27440304

  3. Emotional intelligence and addictions: a systematic review.

    PubMed

    Kun, Bernadette; Demetrovics, Zsolt

    2010-06-01

    Since the millennium, an expanding number of research articles have examined the relationship between emotional intelligence (EI) and physical and mental health. The relationship between EI and addictive disorders has, however, remained relatively well-hidden. We therefore systematically reviewed and critically evaluated the literature on this relationship. We identified 51 articles on the topic of which 36 fulfilled our inclusion criteria. Results indicate that a lower level of EI is associated with more intensive smoking, alcohol use, and illicit drug use and two components of EI play a key role in addictions: "decoding and differentiation of emotions" and "regulation of emotions."

  4. Eosinophilic oesophagitis: a systematic review for otolaryngologists.

    PubMed

    Bahgat, M; Dawe, N; Flood, L

    2015-12-01

    Eosinophilic oesophagitis is a chronic, immune/antigen-mediated oesophageal disease, only recently, but increasingly, recognised in the world literature. It is diagnosed and managed primarily by medical gastroenterologists and allergy specialists, and is a distinct disease entity, affecting both children and adults. Few studies have been published in otolaryngology journals, although otolaryngologists will encounter patients with undiagnosed eosinophilic oesophagitis. Patients may present with dysphagia, bolus obstruction or with other ENT disorders, such as atopic rhinitis, reflecting the underlying systemic allergic disorder. This paper systematically reviews the evidence base published on the epidemiology, clinical presentation, diagnosis, treatment and prognosis of eosinophilic oesophagitis, particularly as it relates to otolaryngology practice.

  5. Systematic review of childhood obesity prevention.

    PubMed

    Wofford, Linda G

    2008-02-01

    This systematic review identified the current state of the evidence related to the prevention of obesity in young children. The results indicate five areas of emphasis in the literature: prevalence of the problem; prevention as the best option; preschool population as the target; crucial parental involvement; and numerous guidelines. Because the gap between clear articulation of the problem as well as population and the best strategies to impact the prevention of the problem is evident, health care practitioners must be involved in well-constructed implementation and evaluation studies that build on the limited base of current evidence.

  6. Manual therapies for migraine: a systematic review.

    PubMed

    Chaibi, Aleksander; Tuchin, Peter J; Russell, Michael Bjørn

    2011-04-01

    Migraine occurs in about 15% of the general population. Migraine is usually managed by medication, but some patients do not tolerate migraine medication due to side effects or prefer to avoid medication for other reasons. Non-pharmacological management is an alternative treatment option. We systematically reviewed randomized clinical trials (RCTs) on manual therapies for migraine. The RCTs suggest that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally effective as propranolol and topiramate in the prophylactic management of migraine. However, the evaluated RCTs had many methodological shortcomings. Therefore, any firm conclusion will require future, well-conducted RCTs on manual therapies for migraine.

  7. Feverfew for migraine prophylaxis: a systematic review.

    PubMed

    Saranitzky, Elisa; White, C Michael; Baker, Erica L; Baker, William L; Coleman, Craig I

    2009-01-01

    Feverfew has been studied for the treatment of migrane in several studies and the pharmacologic mechanisms are preliminarily understood. We performed a systematic review of randomized controlled trials and present the clinical findings and potential implications. The modality of data collection and reporting in the individual studies does not support a pooling of results, but does suggest benefit of feverfew in migraine prophylaxis for at least subsets of the population with the disorder. Pharmacologically, there is some potential for concern with long-term dosing given its cyclooxygenase-2 inhibiting effects and longer-term studies will be needed to ameliorate these concerns in coronary disease patients.

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

    PubMed

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

    2015-01-14

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

  9. Schistosomiasis in Malawi: a systematic review.

    PubMed

    Makaula, Peter; Sadalaki, John R; Muula, Adamson S; Kayuni, Sekeleghe; Jemu, Samuel; Bloch, Paul

    2014-12-10

    Schistosomiasis remains an important public health problem that undermines social and economic development in tropical regions of the world, mainly Sub-Saharan Africa. We are not aware of any systematic review of the literature of the epidemiology and transmission of schistosomiasis in Malawi since 1985. Therefore, we reviewed the current state of knowledge of schistosomiasis epidemiology and transmission in this country and identified knowledge gaps and relevant areas for future research and research governance. We conducted computer-aided literature searches of Medline, SCOPUS and Google Scholar using the keywords: "schistosomiasis", "Bilharzia", "Bulinus" and "Biomphalaria" in combination with "Malawi". These searches were supplemented by iterative reviews of reference lists for relevant publications in peer reviewed international scientific journals or other media. The recovered documents were reviewed for their year of publication, location of field or laboratory work, authorship characteristics, ethics review, funding sources as well as their findings regarding parasite and intermediate host species, environmental aspects, geographical distribution, seasonality of transmission, and infection prevalence and intensities. A total of 89 documents satisfied the inclusion criteria and were reviewed. Of these, 76 were published in international scientific journals, 68 were peer reviewed and 54 were original research studies. Most of the documents addressed urinary schistosomiasis and about two thirds of them dealt with the definitive host. Few documents addressed the parasites and the intermediate hosts. While urinary schistosomiasis occurs in most parts of Malawi, intestinal schistosomiasis mainly occurs in the central and southern highlands, Likoma Island and Lower Shire. Studies in selected communities estimated prevalence rates of up to 94.9% for Schistosoma haematobium and up to 67.0% for Schistosoma mansoni with considerable geographical variation. The main

  10. Obesity and dental caries: systematic review.

    PubMed

    Silva, Alexandre Emidio Ribeiro; Menezes, Ana Maria Baptista; Demarco, Flávio Fernando; Vargas-Ferreira, Fabiana; Peres, Marco Aurélio

    2013-08-01

    Identifying, through a systematic literature review, evidence of a possible association between obesity and dental caries. A search of articles published between 2005 and January 2012 was performed in the Medline/PubMed, LILACS and Web of Science databases. The quality of scientific evidence of the selected articles was assessed by the items proposed for observational studies in the Downs & Black instrument. Initially, 537 references were found; after checking the titles and abstracts by two independent researchers, twenty-eight articles were selected for complete reading. Ten of them that assessed the primary and/or permanent dentition observed a positive association between obesity and dental caries and one study found an inverse association. According to the Downs & Black classification, thirteen articles with good scientific evidence were found. The present review did not find sufficient evidence regarding the association between obesity and dental caries, and it did not clarify the possible role of diet and other possible effect modifiers on this association.

  11. Tinnitus and arterial hypertension: a systematic review.

    PubMed

    Figueiredo, Ricardo Rodrigues; de Azevedo, Andréia Aparecida; Penido, Norma de Oliveira

    2015-11-01

    Tinnitus is considered a multi-factorial symptom. Arterial hypertension has been cited as a tinnitus etiological factor. To assess the scientific evidence on the associations between arterial hypertension and tinnitus. A systematic review was performed using PubMed, ISI Web, Lilacs and SciELO scientific databases. This review included articles published in Portuguese, Spanish, French and English correlating tinnitus with hypertension. Letters to editors and case reports were excluded. A total of 424 articles were identified, of which only 20 met the inclusion criteria. Studies that analyzed the incidence of hypertension in tinnitus patients tended to show an association, while those that evaluated the incidence of tinnitus in hypertensive patients did not. There is evidence of an association between tinnitus and hypertension, although a cause and effect relationship is uncertain. Changes in the cochlear microcirculation, resulting in hearing loss, may be an adjuvant factor in tinnitus pathophysiology.

  12. Is Pethidine Safe during Labor? Systematic Review.

    PubMed

    Nunes, Rogevando Rodrigues; Colares, Paulo Giordano Baima; Montenegro, Juliana Pinto

    2017-06-30

    Purpose To verify if pethidine is safe for the conceptus when used during labor. Methods Systematic review in the Capes Periodicals/PubMed and MEDLINE/Virtual Health Library (BVS, in the Portuguese acronym) databases. Results A total of 17 studies published from January 1st, 2000, to September 2nd, 2016, with a total of 1,688 participants involved were included in the present review. There was no record of conceptus vitality decrease associated with low doses of pethidine being administered to mothers during labor. Conclusions Intramuscular (IM) or intravenous (IV) pethidine at low doses, of up to 50 mg, is safe to administer during labor. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  13. [Cutaneous and visceral loxoscelism: a systematic review].

    PubMed

    Manríquez, Juan J; Silva, Sergio

    2009-10-01

    Loxoscelism represents a major public health problem for which there are no standard therapeutic interventions. To review available scientific evidence on management of Loxoscelism Systematic review of clinical studies. The search included multiple databases (Medline, Lilacs, Embase, Web of Sciences, Cinahl, Pre-Cinahl, Paperfirst, Proceedingsfirst, Dissertations and Theses, Toxline, Cochrane Library), handsearch of references, and contact with experts. Three clinical trials of poor methodological quality were identified from 5,207 references found. One trial (n = 31), concluded that the use of dapsone was associated with fewer local complications than surgical treatment. A second study (n = 46), concluded that the use of dapsone was superior to clorfenamine for skin lesions. A third study (n = 95) concluded that there was no differences between the use of oral dapsone, antivenom against anti-Loxosceles reclusa or a combination of both. There is insufficient evidence based on good quality studies to recommend treatment guidelines for individuals with skin or visceral loxoscelism.

  14. Rhinoplasty Complications and Reoperations: Systematic Review

    PubMed Central

    Crosara, Paulo Fernando Tormin Borges; Nunes, Flávio Barbosa; Rodrigues, Danilo Santana; Figueiredo, Ana Rosa Pimentel; Becker, Helena Maria Gonçalves; Becker, Celso Goncalves; Guimarães, Roberto Eustáquio Santos

    2016-01-01

    Introduction This article is related to complications of rhinoplasty and its main causes of reoperations. Objectives The objective of this study is to perform a systematic review of literature on complications in rhinoplasty. Data Synthesis The authors conducted a survey of articles related to key terms in the literature by using three important databases within 11 years, between January 2002 and January 2013. We found 1,271 abstracts and selected 49 articles to this review. Conclusion The main results showed that the number of primary open rhinoplasty was 7902 (89%) and 765 closed (11%) and the percentage of reoperations in primary open complete rhinoplasties was 2.73% and closed complete was 1.56%. The statistical analysis revealed a value of p = 0.071. The standardization of terms can improve the quality of scientific publications about rhinoplasty. There is no difference between primary open or closed rhinoplasty techniques in relation to reoperations. PMID:28050215

  15. Systematic review of human papillomavirus vaccine coadministration.

    PubMed

    Noronha, Alinea S; Markowitz, Lauri E; Dunne, Eileen F

    2014-05-13

    Human papillomavirus (HPV) vaccination is recommended in early adolescence, at an age when other vaccines are also recommended. Administration of multiple vaccines during one visit is an opportunity to improve uptake of adolescent vaccines. We conducted a systematic review of safety and immunogenicity of HPV vaccines coadministered with other vaccines. Our review included 9 studies, 4 of quadrivalent HPV vaccine and 5 of bivalent HPV vaccine; coadministered vaccines included: meningococcal conjugate, hepatitis A, hepatitis B, combined hepatitis A and B, tetanus, diphtheria, acellular pertussis, and inactivated poliovirus vaccines. Studies varied in methods of data collection and measurement of immunogenicity and safety. Noninferiority of immune response and an acceptable safety profile were demonstrated when HPV vaccine was coadministered with other vaccines.

  16. A Systematic Review of Exercise Systematic Reviews in the Cancer Literature (2005-2017).

    PubMed

    Stout, Nicole L; Baima, Jennifer; Swisher, Anne K; Winters-Stone, Kerri M; Welsh, Judith

    2017-09-01

    Evidence supports the benefits of exercise for patients with cancer; however, specific guidance for clinical decision making regarding exercise timing, frequency, duration, and intensity is lacking. Efforts are needed to optimize clinical recommendations for exercise in the cancer population. To aggregate information regarding the benefit of exercise through a systematic review of existing systematic reviews in the cancer exercise literature. PubMed, CINAHL Plus, Scopus, Web of Science, and EMBASE. Systematic reviews and meta-analyses of the impact of movement-based exercise on the adult cancer population. Two author teams reviewed 302 abstracts for inclusion with 93 selected for full-text review. A total of 53 studies were analyzed. A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used as a quality measure of the reviews. Information was extracted using the PICO format (ie, participants, intervention, comparison, outcomes). Descriptive findings are reported. Mean AMSTAR score = 7.66/11 (±2.04) suggests moderate quality of the systematic reviews. Exercise is beneficial before, during, and after cancer treatment, across all cancer types, and for a variety of cancer-related impairments. Moderate-to-vigorous exercise is the best level of exercise intensity to improve physical function and mitigate cancer-related impairments. Therapeutic exercises are beneficial to manage treatment side effects, may enhance tolerance to cancer treatments, and improve functional outcomes. Supervised exercise yielded superior benefits versus unsupervised. Serious adverse events were not common. Movement-based exercise intervention outcomes are reported. No analysis of pooled effects was calculated across reviews due to significant heterogeneity within the systematic reviews. Findings do not consider exercise in advanced cancers or pediatric populations. Exercise promotes significant improvements in clinical, functional, and in some populations, survival outcomes and can be

  17. Why prospective registration of systematic reviews makes sense.

    PubMed

    Stewart, Lesley; Moher, David; Shekelle, Paul

    2012-02-09

    Prospective registration of systematic reviews promotes transparency, helps reduce potential for bias and serves to avoid unintended duplication of reviews. Registration offers advantages to many stakeholders in return for modest additional effort from the researchers registering their reviews.

  18. Telemonitoring can assist in managing cardiovascular disease in primary care: a systematic review of systematic reviews

    PubMed Central

    2014-01-01

    Background There has been growing interest regarding the impact of telemonitoring and its ability to reduce the increasing burden of chronic diseases, including chronic cardiovascular disease (CVD), on healthcare systems. A number of randomised trials have been undertaken internationally and synthesised into various systematic reviews to establish an evidence base for this model of care. This study sought to synthesise and critically evaluate this large body of evidence to inform clinicians, researchers and policy makers. Methods A systematic review of systematic reviews investigating the impact of telemonitoring interventions in the primary care management of CVD was conducted. Reviews were included if they explored primary care based telemonitoring in either CVD, heart failure or hypertension, were reported in the English language and were published between 2000 and 2013. Data was extracted by one reviewer and checked by a second reviewer using a standardised form. Two assessors then rated the quality of each review using the Overview Quality Assessment Questionnaire (OQAQ). Results Of the 13 included reviews, four focused on telemonitoring interventions in hypertension or CVD management and the remaining 9 reviews investigated telemonitoring in HF management. Seven reviews scored a five or above on the OQAQ evidencing good quality reviews. Findings suggest that telemonitoring can contribute to significant reductions in blood pressure, decreased all-cause and HF related hospitalisations, reduced all-cause mortality and improved quality of life. Telemonitoring was also demonstrated to reduce health care costs and appears acceptable to patients. Conclusion Telemonitoring has the potential to enhance primary care management of CVD by improving patient outcomes and reducing health costs. However, further research needs to explore the specific elements of telemonitoring interventions to determine the relative value of the various elements. Additionally, the ways in

  19. Automatic evidence retrieval for systematic reviews.

    PubMed

    Choong, Miew Keen; Galgani, Filippo; Dunn, Adam G; Tsafnat, Guy

    2014-10-01

    Snowballing involves recursively pursuing relevant references cited in the retrieved literature and adding them to the search results. Snowballing is an alternative approach to discover additional evidence that was not retrieved through conventional search. Snowballing's effectiveness makes it best practice in systematic reviews despite being time-consuming and tedious. Our goal was to evaluate an automatic method for citation snowballing's capacity to identify and retrieve the full text and/or abstracts of cited articles. Using 20 review articles that contained 949 citations to journal or conference articles, we manually searched Microsoft Academic Search (MAS) and identified 78.0% (740/949) of the cited articles that were present in the database. We compared the performance of the automatic citation snowballing method against the results of this manual search, measuring precision, recall, and F1 score. The automatic method was able to correctly identify 633 (as proportion of included citations: recall=66.7%, F1 score=79.3%; as proportion of citations in MAS: recall=85.5%, F1 score=91.2%) of citations with high precision (97.7%), and retrieved the full text or abstract for 490 (recall=82.9%, precision=92.1%, F1 score=87.3%) of the 633 correctly retrieved citations. The proposed method for automatic citation snowballing is accurate and is capable of obtaining the full texts or abstracts for a substantial proportion of the scholarly citations in review articles. By automating the process of citation snowballing, it may be possible to reduce the time and effort of common evidence surveillance tasks such as keeping trial registries up to date and conducting systematic reviews.

  20. Facilitated communication and authorship: a systematic review.

    PubMed

    Schlosser, Ralf W; Balandin, Susan; Hemsley, Bronwyn; Iacono, Teresa; Probst, Paul; von Tetzchner, Stephen

    2014-12-01

    Facilitated Communication (FC) is a technique whereby individuals with disabilities and communication impairments allegedly select letters by typing on a keyboard while receiving physical support, emotional encouragement, and other communication supports from facilitators. The validity of FC stands or falls on the question of who is authoring the typed messages--the individual with a disability or the facilitator. The International Society for Augmentative and Alternative Communication (ISAAC) formed an Ad Hoc Committee on FC and charged this committee to synthesize the evidence base related to this question in order to develop a position statement. The purpose of this paper is to report this synthesis of the extant peer-reviewed literature on the question of authorship in FC. A multi-faceted search was conducted including electronic database searches, ancestry searches, and contacting selected authors. The authors considered synopses of systematic reviews, and systematic reviews, which were supplemented with individual studies not included in any prior reviews. Additionally, documents submitted by the membership were screened for inclusion. The evidence was classified into articles that provided (a) quantitative experimental data related to the authorship of messages, (b) quantitative descriptive data on the output generated through FC without testing of authorship, (c) qualitative descriptive data on the output generated via FC without testing of authorship, and (d) anecdotal reports in which writers shared their perspectives on FC. Only documents with quantitative experimental data were analyzed for authorship. Results indicated unequivocal evidence for facilitator control: messages generated through FC are authored by the facilitators rather than the individuals with disabilities. Hence, FC is a technique that has no validity.

  1. A systematic review of military head injuries.

    PubMed

    Carr, Debra J; Lewis, E; Horsfall, I

    2017-02-01

    This commissioned review discusses military head injuries caused by non-ballistic impacts, penetrating fragments and bullets (including parts of bullets) and behind helmet blunt trauma (BHBT). A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. The openly accessible literature was reviewed to investigate military head injuries and their severity. Fifty-four sources were identified that included pertinent openly accessible information relevant to this topic. Limited injury data exist for non-ballistic head injuries for UK forces, although some international data exist for parachutists. The majority of fatal head injuries are due to projectiles penetrating through the face rather than through the area of the head covered by the helmet. Penetrating head injuries are primarily caused by fragments, but helmets are more commonly perforated by high-energy rifle bullets than by fragments. No reports of a BHBT injury have been located in the literature. The description of body segment varies among articles and this makes comparisons among datasets difficult. There is a lack of detail regarding the precise position and severity of injuries, and long-term outcome for casualties. It is demonstrated that wearing military helmets reduces fatalities on and off the battlefield. The risk of BHBT injuries is widely referred to, but evidence of their occurrence is not provided by the authors that describe the risk of BHBT occurring. Further research into the causes and severity of head injuries would be useful for designers of military helmets and other associated personal protective equipment, particularly as advances in materials technology means lighter, thinner and more protective helmets are achievable. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Determinants of patient adherence: a review of systematic reviews

    PubMed Central

    Kardas, Przemyslaw; Lewek, Pawel; Matyjaszczyk, Michal

    2013-01-01

    Purpose: A number of potential determinants of medication non-adherence have been described so far. However, the heterogenic quality of existing publications poses the need for the use of a rigorous methodology in building a list of such determinants. The purpose of this study was a systematic review of current research on determinants of patient adherence on the basis of a recently agreed European consensus taxonomy and terminology. Methods: MEDLINE, EMBASE, CINAHL, Cochrane Library, IPA, and PsycINFO were systematically searched for systematic reviews published between 2000/01/01 and 2009/12/31 that provided determinants on non-adherence to medication. The searches were limited to reviews having adherence to medication prescribed by health professionals for outpatient as a major topic. Results: Fifty-one reviews were included in this review, covering 19 different disease categories. In these reviews, exclusively assessing non-adherence to chronic therapies, 771 individual factor items were identified, of which most were determinants of implementation, and only 47—determinants of persistence with medication. Factors with an unambiguous effect on adherence were further grouped into 8 clusters of socio-economic-related factors, 6 of healthcare team- and system-related factors, 6 of condition-related factors, 6 of therapy-related factors, and 14 of patient-related factors. The lack of standardized definitions and use of poor measurement methods resulted in many inconsistencies. Conclusions: This study provides clear evidence that medication non-adherence is affected by multiple determinants. Therefore, the prediction of non-adherence of individual patients is difficult, and suitable measurement and multifaceted interventions may be the most effective answer toward unsatisfactory adherence. The limited number of publications assessing determinants of persistence with medication, and lack of those providing determinants of adherence to short-term treatment identify

  3. Surgery for epilepsy: a systematic review of current evidence.

    PubMed

    West, Siobhan; Nolan, Sarah J; Newton, Richard

    2016-06-01

    This seminar discusses the history and development of techniques for surgical intervention for people with refractory focal epilepsy. Published surgical success rates and prognostic factors associated with post-operative seizure freedom from individual studies have been variable and contradictory. We present here the key findings of a Cochrane systematic review of all evidence published since the introduction of magnetic resonance imaging (MRI) to pre-operative surgical assessment in 1984. Our findings show the usefulness of uncontrolled case series is now past. Future studies with a prospective controlled design should focus on specific research questions to help improve results and provide better-informed advice.

  4. Systematic reviews addressing microsurgical head and neck reconstruction.

    PubMed

    Momeni, Arash; Jacobson, Joshua Y; Lee, Gordon K

    2015-01-01

    Systematic reviews frequently form the basis for clinical decision making and guideline development. Yet, the quality of systematic reviews has been variable, thus raising concerns about the validity of their conclusions. In the current study, a quality analysis of systematic reviews was performed, addressing microsurgical head and neck reconstruction. A PubMed search was performed to identify all systematic reviews published up to and including December 2012 in 12 surgical journals. Two authors independently reviewed the literature and extracted data from the included reviews. Discrepancies were resolved by consensus. Quality assessment was performed using AMSTAR. The initial search retrieved 1020 articles. After screening titles and abstracts, 987 articles were excluded. Full-text review of the remaining 33 articles resulted in further exclusion of 18 articles, leaving 15 systematic reviews for final analysis. A marked increase in the number of published systematic reviews over time was noted (P = 0.07). The median AMSTAR score was 5, thus reflecting a "fair" quality. No evidence for improvement in methodological quality over time was noted. The trend to publish more systematic reviews in microsurgical head and neck reconstruction is encouraging. However, efforts are indicated to improve the methodological quality of systematic reviews. Familiarity with criteria of methodological quality is critical to ensure future improvements in the quality of systematic reviews conducted in microsurgery.

  5. Enteral Nutrition in Dementia: A Systematic Review

    PubMed Central

    Brooke, Joanne; Ojo, Omorogieva

    2015-01-01

    The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life. PMID:25854831

  6. Enteral nutrition in dementia: a systematic review.

    PubMed

    Brooke, Joanne; Ojo, Omorogieva

    2015-04-03

    The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.

  7. Motor Rehabilitation Using Kinect: A Systematic Review.

    PubMed

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

    2015-04-01

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

  8. Hypersensitivity reactions to dapsone: a systematic review.

    PubMed

    Lorenz, Maria; Wozel, Gottfried; Schmitt, Jochen

    2012-03-01

    Dapsone is widely used in the treatment of leprosy and several chronic inflammatory dermatological conditions. Hypersensitivity reactions to dapsone are potentially fatal adverse drug reactions with unknown prevalence and risk factors. We performed a systematic review covering all reported cases of hypersensitivity reactions, in order to systematically summarize the published evidence on prevalence, clinical course and fatality rate. Articles were identified through standardized search strategies. Included studies were reviewed for hypersensitivity characteristics and odds ratios were calculated in univariate and multivariate regression models to assess the risk factors for fatal outcome. A total of 114 articles (17 epidemiological studies, 97 case reports) totalling 336 patients with hypersensitivity reactions were included for analysis. From the epidemiological studies a total hypersensitivity reaction prevalence rate of 1.4% (95% confidence interval 1.2–1.7%) was determined. Mucosal involvement, hepatitis, higher age and disease occurrence in non-affluent countries were associated with higher risk of fatal outcome. Overall, the fatality rate was 9.9%.

  9. Systematic Review of Breastfeeding and Herbs

    PubMed Central

    Budzynska, Katarzyna; Gardner, Zoë E.; Dugoua, Jean-Jacques; Low Dog, Tieraona

    2012-01-01

    Abstract Objectives Despite popular and historical use, there has been little modern research conducted to determine the safety and efficacy of herb use during breastfeeding. The purpose of this study was to systematically review the clinical literature on herbal medicine and lactation. Methods The databases PubMed, CAB Abstracts, Cochrane Central Register of Controlled Trials, HealthSTAR, Cumulative Index to Nursing and Allied Health Literature, and Reprotox were systematically searched for human trials from 1970 until 2010. Reference lists from relevant articles were hand-searched. Results Thirty-two studies met the inclusion criteria. Clinical studies were divided into three categories: survey studies (n=11), safety studies (n=8), and efficacy studies (n=13). Six studies were randomized controlled trials. The most common herbs studied were St. John's wort (Hypericum perforatum L.) (n=3), garlic (Allium sativum L.) extract (n=2), and senna (Cassia senna L.) (n=2). Studies were very heterogeneous with regard to study design, herbal intervention, and outcome measures. Overall, poor methodological quality predominated among the studies. Conclusions Our review concludes that further research is needed to assess the prevalence, efficacy, and safety of commonly used herbs during breastfeeding. PMID:22686865

  10. Cardiac rehabilitation for women: a systematic review.

    PubMed

    Budnick, Karen; Campbell, Jennifer; Esau, Lauren; Lyons, Jessica; Rogers, Nikki; Haennel, R G

    2009-01-01

    Current cardiac rehabilitation (CR) evidence was systematically evaluated to identify program components that may yield improvements in physiological and psychosocial outcomes in women. A search was conducted in the electronic databases: MEDLINE, Embase, CINAHL, Scopus, Sport Discus and Cochrane Library. Search terms included women, heart disease, exercise therapy, and cardiac rehabilitation. A systematic elimination process was used with specific inclusion/exclusion criteria. Included articles were independently evaluated by four reviewers for level of evidence and internal validity. Specific recommendations were made based on trends in the literature and strength of supporting evidence. Thirty-seven articles were included with a combined sample of 3,807 subjects. Ten studies included an analysis of physiological effects of exercise. Aerobic, resistance, and combined exercise interventions all yield physiological benefits. CR yielded favourable health-related quality of life outcomes and women benefited from psychosocial support in both formal and informal environments. The following recommendations are based on the review: 1) For patients with good cardiac function, community/home-based programs are as effective as supervised programs (Level II, B); 2) resistance training should be included as an adjunct to aerobic training (Level I, A); 3) programs need to address the specific educational needs of women (Level I, A) and a stronger emphasis needs to be placed on social support (Level II, B).

  11. Adolescent time use clusters: a systematic review.

    PubMed

    Ferrar, Katia; Chang, Cindy; Li, Ming; Olds, Tim S

    2013-03-01

    Recent research suggests that patterns or clusters of time use may affect health in ways that cannot be explained by the effect of individual behaviors alone. The aim of this research was to systematically review the literature examining adolescent time use clusters and associated correlates. Systematic searches of six online databases for relevant observational studies were conducted. At least two authors reviewed abstract and full text selection meeting eligibility criteria. Included studies were quality scored, had data extracted, and cluster types and cluster associations interpreted. Nineteen studies were identified for inclusion, and 18 of them investigated cluster-correlate associations. Twenty-nine cluster types were identified, characterized by both individual (e.g., church) and co-occurring behaviors (e.g., physical activity and screen [technoactive]). Nineteen correlate categories were identified (e.g., socioeconomic and weight status). Consistent patterns of cluster-correlate association were found. For example, the technoactive cluster type is more likely to be male and to have low school orientation. Despite the between-study differences, consistent cluster and cluster-correlate patterns were still evident. Cluster analysis of adolescent time use behaviors appears to be an emerging and useful classification technique, one which may have implications for targeted health-related interventions. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Pharmaceutical supply chain risks: a systematic review

    PubMed Central

    2013-01-01

    Introduction Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. Objective In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Methods Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Results Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. Conclusion It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies. PMID:24355166

  13. Pharmaceutical supply chain risks: a systematic review.

    PubMed

    Jaberidoost, Mona; Nikfar, Shekoufeh; Abdollahiasl, Akbar; Dinarvand, Rassoul

    2013-12-19

    Supply of medicine as a strategic product in any health system is a top priority. Pharmaceutical companies, a major player of the drug supply chain, are subject to many risks. These risks disrupt the supply of medicine in many ways such as their quantity and quality and their delivery to the right place and customers and at the right time. Therefore risk identification in the supply process of pharmaceutical companies and mitigate them is highly recommended. In this study it is attempted to investigate pharmaceutical supply chain risks with perspective of manufacturing companies. Scopus, PubMed, Web of Science bibliographic databases and Google scholar scientific search engines were searched for pharmaceutical supply chain risk management studies with 6 different groups of keywords. All results found by keywords were reviewed and none-relevant articles were excluded by outcome of interests and researcher boundaries of study within 4 steps and through a systematic method. Nine articles were included in the systematic review and totally 50 main risks based on study outcome of interest extracted which classified in 7 categories. Most of reported risks were related to supply and supplier issues. Organization and strategy issues, financial, logistic, political, market and regulatory issues were in next level of importance. It was shown that the majority of risks in pharmaceutical supply chain were internal risks due to processes, people and functions mismanagement which could be managed by suitable mitigation strategies.

  14. How to conduct systematic reviews more expeditiously?

    PubMed

    Tsertsvadze, Alexander; Chen, Yen-Fu; Moher, David; Sutcliffe, Paul; McCarthy, Noel

    2015-11-12

    Healthcare consumers, researchers, patients and policy makers increasingly use systematic reviews (SRs) to aid their decision-making process. However, the conduct of SRs can be a time-consuming and resource-intensive task. Often, clinical practice guideline developers or other decision-makers need to make informed decisions in a timely fashion (e.g. outbreaks of infection, hospital-based health technology assessments). Possible approaches to address the issue of timeliness in the production of SRs are to (a) implement process parallelisation, (b) adapt and apply innovative technologies, and/or (c) modify SR processes (e.g. study eligibility criteria, search sources, data extraction or quality assessment). Highly parallelised systematic reviewing requires substantial resources to support a team of experienced information specialists, reviewers and methodologists working alongside with clinical content experts to minimise the time for completing individual review steps while maximising the parallel progression of multiple steps. Effective coordination and management within the team and across external stakeholders are essential elements of this process. Emerging innovative technologies have a great potential for reducing workload and improving efficiency of SR production. The most promising areas of application would be to allow automation of specific SR tasks, in particular if these tasks are time consuming and resource intensive (e.g. language translation, study selection, data extraction). Modification of SR processes involves restricting, truncating and/or bypassing one or more SR steps, which may risk introducing bias to the review findings. Although the growing experiences in producing various types of rapid reviews (RR) and the accumulation of empirical studies exploring potential bias associated with specific SR tasks have contributed to the methodological development for expediting SR production, there is still a dearth of research examining the actual

  15. Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews

    PubMed Central

    Laver, Kate; Dyer, Suzanne; Whitehead, Craig; Clemson, Lindy; Crotty, Maria

    2016-01-01

    Objective To summarise existing systematic reviews that assess the effects of non-pharmacological, pharmacological and alternative therapies on activities of daily living (ADL) function in people with dementia. Design Overview of systematic reviews. Methods A systematic search in the Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE and PsycInfo in April 2015. Systematic reviews of randomised controlled trials conducted in people with Alzheimer's disease or dementia measuring the impact on ADL function were included. Methodological quality of the systematic reviews was independently assessed by two authors using the AMSTAR tool. The quality of evidence of the primary studies for each intervention was assessed using GRADE. Results A total of 23 systematic reviews were included in the overview. The quality of the reviews varied; however most (65%) scored 8/11 or more on the AMSTAR tool, indicating high quality. Interventions that were reported to be effective in minimising decline in ADL function were: exercise (6 studies, 289 participants, standardised mean difference (SMD) 0.68, 95% CI 0.08 to 1.27; GRADE: low), dyadic interventions (8 studies, 988 participants, SMD 0.37, 95% CI 0.05 to 0.69; GRADE: low) acetylcholinesterase inhibitors and memantine (12 studies, 4661 participants, donepezil 10 mg SMD 0.18, 95% CI 0.03 to 0.32; GRADE: moderate), selegiline (7 studies, 810 participants, SMD 0.27, 95% CI 0.13 to 0.41; GRADE: low), huperzine A (2 studies, 70 participants, SMD 1.48, 95% CI 0.95 to 2.02; GRADE: very low) and Ginkgo biloba (7 studies, 2530 participants, SMD 0.36, 95% CI 0.28 to 0.44; GRADE: very low). Conclusions Healthcare professionals should ensure that people with dementia are encouraged to exercise and that primary carers are trained and supported to provide safe and effective care for the person with dementia. Acetylcholinesterase inhibitors or memantine should be trialled unless contraindicated. Trial registration number CRD

  16. Interventions to delay functional decline in people with dementia: a systematic review of systematic reviews.

    PubMed

    Laver, Kate; Dyer, Suzanne; Whitehead, Craig; Clemson, Lindy; Crotty, Maria

    2016-04-27

    To summarise existing systematic reviews that assess the effects of non-pharmacological, pharmacological and alternative therapies on activities of daily living (ADL) function in people with dementia. Overview of systematic reviews. A systematic search in the Cochrane Database of Systematic Reviews, DARE, Medline, EMBASE and PsycInfo in April 2015. Systematic reviews of randomised controlled trials conducted in people with Alzheimer's disease or dementia measuring the impact on ADL function were included. Methodological quality of the systematic reviews was independently assessed by two authors using the AMSTAR tool. The quality of evidence of the primary studies for each intervention was assessed using GRADE. A total of 23 systematic reviews were included in the overview. The quality of the reviews varied; however most (65%) scored 8/11 or more on the AMSTAR tool, indicating high quality. Interventions that were reported to be effective in minimising decline in ADL function were: exercise (6 studies, 289 participants, standardised mean difference (SMD) 0.68, 95% CI 0.08 to 1.27; GRADE: low), dyadic interventions (8 studies, 988 participants, SMD 0.37, 95% CI 0.05 to 0.69; GRADE: low) acetylcholinesterase inhibitors and memantine (12 studies, 4661 participants, donepezil 10 mg SMD 0.18, 95% CI 0.03 to 0.32; GRADE: moderate), selegiline (7 studies, 810 participants, SMD 0.27, 95% CI 0.13 to 0.41; GRADE: low), huperzine A (2 studies, 70 participants, SMD 1.48, 95% CI 0.95 to 2.02; GRADE: very low) and Ginkgo biloba (7 studies, 2530 participants, SMD 0.36, 95% CI 0.28 to 0.44; GRADE: very low). Healthcare professionals should ensure that people with dementia are encouraged to exercise and that primary carers are trained and supported to provide safe and effective care for the person with dementia. Acetylcholinesterase inhibitors or memantine should be trialled unless contraindicated. CRD42015020179. Published by the BMJ Publishing Group Limited. For permission to

  17. A practical overview of how to conduct a systematic review.

    PubMed

    Davis, Dilla

    2016-11-16

    With an increasing focus on evidence-based practice in health care, it is important that nurses understand the principles underlying systematic reviews. Systematic reviews are used in healthcare to present a comprehensive, policy-neutral, transparent and reproducible synthesis of evidence. This article provides a practical overview of the process of undertaking systematic reviews, explaining the rationale for each stage. It provides guidance on the standard methods applicable to every systematic review: writing and registering a protocol; planning a review; searching and selecting studies; data collection; assessing the risk of bias; and interpreting results.

  18. Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: a systematic review of epidemiologic research

    PubMed Central

    Power, Melinda C.; Adar, Sara D.; Yanosky, Jeff D.; Weuve, Jennifer

    2016-01-01

    Background Dementia is a devastating condition typically preceded by a long prodromal phase characterized by accumulation of neuropathology and accelerated cognitive decline. A growing number of epidemiologic studies have explored the relation between air pollution exposure and dementia-related outcomes. Methods We undertook a systematic review, including quality assessment, to interpret the collective findings and describe methodological challenges that may limit study validity. Articles, which were identified according to a registered protocol, had to quantify the association of an air pollution exposure with cognitive function, cognitive decline, a dementia-related neuroimaging feature, or dementia. Results We identified 18 eligible published articles. The quality of most studies was adequate to exemplary. Almost all reported an adverse association between at least one pollutant and one dementia-related outcome. However, relatively few studies considered outcomes that provide the strongest evidence for a causal effect, such as within-person cognitive or pathologic changes. Reassuringly, differential selection would likely bias toward a protective association in most studies, making it unlikely to account for observed adverse associations. Likewise, using a formal sensitivity analysis, we found that unmeasured confounding is also unlikely to explain reported adverse associations. Discussion We also identified several common challenges. First, most studies of incident dementia identified cases from health system records. As dementia in the community is underdiagnosed, this could generate either non-differential or differential misclassification bias. Second, almost all studies used recent air pollution exposures as surrogate measures of long-term exposure. Although this approach may be reasonable if the measured and etiologic exposure windows are separated by a few years, its validity is unknown over longer intervals. Third, comparing the magnitude of associations

  19. Exposure to air pollution as a potential contributor to cognitive function, cognitive decline, brain imaging, and dementia: A systematic review of epidemiologic research.

    PubMed

    Power, Melinda C; Adar, Sara D; Yanosky, Jeff D; Weuve, Jennifer

    2016-09-01

    Dementia is a devastating condition typically preceded by a long prodromal phase characterized by accumulation of neuropathology and accelerated cognitive decline. A growing number of epidemiologic studies have explored the relation between air pollution exposure and dementia-related outcomes. We undertook a systematic review, including quality assessment, to interpret the collective findings and describe methodological challenges that may limit study validity. Articles, which were identified according to a registered protocol, had to quantify the association of an air pollution exposure with cognitive function, cognitive decline, a dementia-related neuroimaging feature, or dementia. We identified 18 eligible published articles. The quality of most studies was adequate to exemplary. Almost all reported an adverse association between at least one pollutant and one dementia-related outcome. However, relatively few studies considered outcomes that provide the strongest evidence for a causal effect, such as within-person cognitive or pathologic changes. Reassuringly, differential selection would likely bias toward a protective association in most studies, making it unlikely to account for observed adverse associations. Likewise, using a formal sensitivity analysis, we found that unmeasured confounding is also unlikely to explain reported adverse associations. We also identified several common challenges. First, most studies of incident dementia identified cases from health system records. As dementia in the community is underdiagnosed, this could generate either non-differential or differential misclassification bias. Second, almost all studies used recent air pollution exposures as surrogate measures of long-term exposure. Although this approach may be reasonable if the measured and etiologic exposure windows are separated by a few years, its validity is unknown over longer intervals. Third, comparing the magnitude of associations may not clearly pinpoint which, if

  20. Osseoperception in Dental Implants: A Systematic Review.

    PubMed

    Mishra, Sunil Kumar; Chowdhary, Ramesh; Chrcanovic, Bruno Ramos; Brånemark, Per-Ingvar

    2016-04-01

    Replacement of lost teeth has significant functional and psychosocial effects. The capability of osseointegrated dental implants to transmit a certain amount of sensibility is still unclear. The phenomenon of developing a certain amount of tactile sensibility through osseointegrated dental implants is called osseoperception. The aim of this article is to evaluate the available literature to find osseoperception associated with dental implants. To identify suitable literature, an electronic search was performed using Medline and PubMed database. Articles published in English and articles whose abstract is available in English were included. The articles included in the review were based on osseoperception, tactile sensation, and neurophysiological mechanoreceptors in relation to dental implants. Articles on peri-implantitis and infection-related sensitivity were not included. Review articles without the original data were excluded, although references to potentially pertinent articles were noted for further follow-up. The phenomenon of osseoperception remains a matter of debate, so the search strategy mainly focused on articles on osseoperception and tactile sensibility of dental implants. This review presents the histological, neurophysiological, and psychophysical evidence of osseoperception and also the role of mechanoreceptors in osseoperception. The literature on osseoperception in dental implants is very scarce. The initial literature search resulted in 90 articles, of which 81 articles that fulfilled the inclusion criteria were included in this systematic review. Patients restored with implant-supported prostheses reported improved tactile and motor function when compared with patients wearing complete dentures. © 2016 by the American College of Prosthodontists.

  1. Work-related leukemia: a systematic review

    PubMed Central

    2013-01-01

    Leukemia is a complex disease, which only became better understood during the last decades following the development of new laboratory techniques and diagnostic methods. Despite our improved understanding of the physiology of the disease, little is yet known about the causes of leukemia. A variety of potential risk factors have been suggested so far, including personal habits and lifestyle, and a wide range of occupational or environmental exposures. A causal association with leukemia has only been documented to date for ionizing radiation, benzene and treatment with cytostatic drugs, but there is an ongoing scientific debate on the possible association of leukemia with a number of other work-related hazards. In this article, we have reviewed scientific studies, published over the past 5 years, which investigated potential associations between leukemia and exposure to occupational risk factors. The systematic literature review took place via electronic databases, using specific search criteria, and independent reviewers have further filtered the search results to identify the number of articles, presented in our paper. A large number of studies included in the review referred to the effects of ionizing radiation, where new data suggest that the effects of exposure to small doses of ionizing radiation should probably be reevaluated. Some other works appear to substantiate a potential association of the disease with certain pesticides. Further research is also suggested regarding the role of infectious agents or exposure to certain chemicals like formaldehyde or butadiene in the pathogenesis of leukemia. PMID:23697536

  2. Personal resource questionnaire: a systematic review.

    PubMed

    Tawalbeh, Loai I; Ahmad, Muayyad M

    2013-09-01

    Social support is a key nursing variable. No review has yet systematically assessed the effectiveness of the personal resource questionnaire (PRQ) as a measure of perceived social support. This article reviewed nine previous studies that used the PRQ (Brandt & Weinert, 1981). Completed studies were identified through searches of indexes that included PubMed, the Cumulative Index for Nursing and EBSCO host, and Ovid. Studies that reported PRQ scores, sample descriptions, and sample sizes and that tested the relationship between the PRQ and study variables were included in the present review. Three other studies were included that did not report on PRQ correlations with other health variables. The included studies addressed a variety of health problems and different population in different settings. Cronbach's alphas for the included studies ranged from .87 to .93, supporting the internal consistency of the PRQ. Hypothesized relationships between the PRQ and study variables including health promotion behavior, self-care behavior, self-efficacy, self-esteem, stress, depression, loneliness, pain, and disability were supported, providing positive evidence for PRQ construct validity. Included studies used the PRQ to address disparate populations in terms of age, socioeconomic status, ethnicity, and educational background. This review found the PRQ to be a reliable and valid tool for measuring perceived social support across a wide range of populations. Further studies are necessary to examine the relationship between social support and selected demographics among populations with different cultural backgrounds.

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

    PubMed Central

    Lee, Joseph G. L.; Ylioja, Thomas; Lackey, Mellanye

    2016-01-01

    Research on the health of lesbian, gay, bisexual, and transgender (LGBT) populations can provide important information to address existing health inequalities. Finding existing research in LGBT health can prove challenging due to the plethora of terminology used. We sought to describe existing search strategies and to identify more comprehensive LGBT search terminology. We iteratively created a search string to identify systematic reviews and meta-analyses about LGBT health and implemented it in Embase, PubMed/MEDLINE, and PsycINFO databases on May 28–29, 2015. We hand-searched the journal LGBT Health. Inclusion criteria were: systematic reviews and meta-analyses that addressed LGBT health, used systematic searching, and used independent coders for inclusion. The published search terminology in each record and search strings provided by authors on request were cross-referenced with our original search to identify additional terminology. Our search process identified 19 systematic reviews meeting inclusion criteria. The number of search terms used to identify LGBT-related records ranged from 1 to 31. From the included studies, we identified 46 new search terms related to LGBT health. We removed five search terms as inappropriate and added five search terms used in the field. The resulting search string included 82 terms. There is room to improve the quality of searching and reporting in LGBT health systematic reviews. Future work should attempt to enhance the positive predictive value of LGBT health searches. Our findings can assist LGBT health reviewers in capturing the diversity of LGBT terminology when searching. PMID:27219460

  4. Retractions in orthopaedic research: A systematic review.

    PubMed

    Yan, J; MacDonald, A; Baisi, L-P; Evaniew, N; Bhandari, M; Ghert, M

    2016-06-01

    Despite the fact that research fraud and misconduct are under scrutiny in the field of orthopaedic research, little systematic work has been done to uncover and characterise the underlying reasons for academic retractions in this field. The purpose of this study was to determine the rate of retractions and identify the reasons for retracted publications in the orthopaedic literature. Two reviewers independently searched MEDLINE, EMBASE, and the Cochrane Library (1995 to current) using MeSH keyword headings and the 'retracted' filter. We also searched an independent website that reports and archives retracted scientific publications (www.retractionwatch.com). Two reviewers independently extracted data including reason for retraction, study type, journal impact factor, and country of origin. One hundred and ten retracted studies were included for data extraction. The retracted studies were published in journals with impact factors ranging from 0.000 (discontinued journals) to 13.262. In the 20-year search window, only 25 papers were retracted in the first ten years, with the remaining 85 papers retracted in the most recent decade. The most common reasons for retraction were fraudulent data (29), plagiarism (25) and duplicate publication (20). Retracted articles have been cited up to 165 times (median 6; interquartile range 2 to 19). The rate of retractions in the orthopaedic literature is increasing, with the majority of retractions attributed to academic misconduct and fraud. Orthopaedic retractions originate from numerous journals and countries, indicating that misconduct issues are widespread. The results of this study highlight the need to address academic integrity when training the next generation of orthopaedic investigators.Cite this article: J. Yan, A. MacDonald, L-P. Baisi, N. Evaniew, M. Bhandari, M. Ghert. Retractions in orthopaedic research: A systematic review. Bone Joint Res 2016;5:263-268. DOI: 10.1302/2046-3758.56.BJR-2016-0047. © 2016 Ghert et al.

  5. Sodium Hypochlorite Accident: A Systematic Review.

    PubMed

    Guivarc'h, Maud; Ordioni, Ugo; Ahmed, Hany Mohamed Aly; Cohen, Stephen; Catherine, Jean-Hugues; Bukiet, Frédéric

    2017-01-01

    Sodium hypochlorite (NaOCl) extrusion beyond the apex, also known as "a hypochlorite accident," is a well-known complication that seldom occurs during root canal therapy. These "accidents" have been the subject of several case reports published over the years. Until now, no publication has addressed the global synthesis of the general and clinical data related to NaOCl extrusion. The main purpose of this article was to conduct a systematic review of previously published case reports to identify, synthesize, and present a critical analysis of the available data. A second purpose was to propose a standardized presentation of reporting data concerning NaOCl extrusions to refine and develop guidelines that should be used in further case report series. A review of clinical cases reporting NaOCl accidents was conducted in June 2016 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; it combined an electronic search of the PubMed database and an extensive manual search. Forty full-text articles corresponding to 52 case reports published between 1974 and 2015 were selected. Four main categories of data were highlighted: general and clinical information, clinical signs and symptoms of NaOCl extrusions, management of NaOCl extrusions, and healing and prognosis. Overall, up to now, clinical cases were reported in a very unsystematic manner, and some relevant information was missing. A better understanding of the potential causes, management, and prognosis of NaOCl accidents requires a standardization of reported data; this study proposes a template that can fulfill this objective. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  6. Contribution of Systematic Reviews to Management Decisions

    PubMed Central

    COOK, CARLY N; POSSINGHAM, HUGH P; FULLER, RICHARD A

    2014-01-01

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

  7. Medical hyperspectral imaging: a review.

    PubMed

    Lu, Guolan; Fei, Baowei

    2014-01-01

    Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires a three-dimensional dataset called hypercube, with two spatial dimensions and one spectral dimension. Spatially resolved spectral imaging obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This review paper presents an overview of the literature on medical hyperspectral imaging technology and its applications. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application.

  8. Medical hyperspectral imaging: a review

    PubMed Central

    Lu, Guolan; Fei, Baowei

    2014-01-01

    Abstract. Hyperspectral imaging (HSI) is an emerging imaging modality for medical applications, especially in disease diagnosis and image-guided surgery. HSI acquires a three-dimensional dataset called hypercube, with two spatial dimensions and one spectral dimension. Spatially resolved spectral imaging obtained by HSI provides diagnostic information about the tissue physiology, morphology, and composition. This review paper presents an overview of the literature on medical hyperspectral imaging technology and its applications. The aim of the survey is threefold: an introduction for those new to the field, an overview for those working in the field, and a reference for those searching for literature on a specific application. PMID:24441941

  9. Smoking in Video Games: A Systematic Review.

    PubMed

    Forsyth, Susan R; Malone, Ruth E

    2016-06-01

    Video games are played by a majority of adolescents, yet little is known about whether and how video games are associated with smoking behavior and attitudes. This systematic review examines research on the relationship between video games and smoking. We searched MEDLINE, psycINFO, and Web of Science through August 20, 2014. Twenty-four studies met inclusion criteria. Studies were synthesized qualitatively in four domains: the prevalence and incidence of smoking imagery in video games (n = 6), video game playing and smoking behavior (n = 11), video game addiction and tobacco addiction (n = 5) and genre-specific game playing and smoking behavior (n = 3). Tobacco content was present in a subset of video games. The literature is inconclusive as to whether exposure to video games as a single construct is associated with smoking behavior. Four of five studies found an association between video game addiction and smoking. For genre-specific game playing, studies suggest that the type of game played affected association with smoking behavior. Research on how playing video games influences adolescents' perceptions of smoking and smoking behaviors is still in its nascence. Further research is needed to understand how adolescents respond to viewing and manipulating tobacco imagery, and whether engaging in game smoking translates into changes in real-world attitudes or behavior. Smoking imagery in video games may contribute to normalizing adolescent smoking. A large body of research has shown that smoking imagery in a variety of media types contributes to adolescent smoking uptake and the normalization of smoking behavior, and almost 90% of adolescents play video games, yet there has never been a published systematic review of the literature on this important topic. This is the first systematic review to examine the research on tobacco and video games.We found that tobacco imagery is indeed present in video games, the relationship between video game playing and smoking

  10. Immediate angioplasty after thrombolysis: a systematic review

    PubMed Central

    Cantor, Warren J.; Brunet, Fabrice; Ziegler, Carolyn P.; Kiss, Alex; Morrison, Laurie J.

    2005-01-01

    Background The role of immediate transfer for percutaneous coronary intervention (PCI) after thrombolysis for ST-segment elevation myocardial infarction remains controversial. We performed a systematic review of the related literature to determine whether thrombolysis followed by transfer for immediate or early PCI is safe, feasible and superior to conservative management. Methods A systematic literature search of MEDLINE, EMBASE, the Cochrane Database for Systematic Reviews and Cochrane Central Register of Controlled Trials, and the American Heart Association EndNote 7 Master Library databases, was performed to 2004 for relevant published studies. The level of evidence and the quality of the study design and methods were rated by 2 reviewers according to a standardized classification. A quantitative meta-analysis was performed to assess the effect at 6–12 months on mortality of immediate or early PCI after thrombolysis. Results We found 13 articles that were supportive of immediate or early PCI after thrombolysis and 16 that were neutral or provided evidence opposing it. The largest randomized trials and meta-analyses showed no benefit of routine PCI immediately or shortly after thrombolysis. The studies that were supportive were generally more recent and more frequently involved coronary stents. One large trial supported early PCI after thrombolysis for patients with myocardial infarction complicated by cardiogenic shock. Overall, the difference in mortality rates between the invasive strategy and conservative care was nonsignificant. The 3 stent-era trials showed a significantly lower mortality among patients randomly assigned to the invasive strategy (5.8% v. 10.0%, odds ratio 0.55, 95% confidence interval 0.32–0.92). Analysis of variance found a significant difference in treatment effect between stent-era and pre–stent-era trials. Interpretation At present, there is inadequate evidence to recommend routine transfer of patients for immediate or early PCI

  11. Systematic review of kidney transplantation functional predictors.

    PubMed

    Miret Alomar, E; Trilla Herrera, E; Lorente Garcia, D; Regis Placido, L; López Del Campo, R; Cuadras Solé, M; Pont Castellana, T; Moreso Mateos, F; Serón Micas, D; Morote Robles, J

    2017-08-10

    Kidney transplantation from donors with expanded criteria has increased the pool of kidneys at the cost of a higher risk of short and long-term graft dysfunction. The main issue lies in determining which kidneys will offer acceptable function and survival compared with the risk represented by surgery and subsequent immunosuppression. The objective of our article is to review the current evidence on the tools for predicting the functionality of kidney transplantation from cadaveric donors with expanded criteria and determining the validity for their use in standard practice. We conducted a systematic literature review according to the PRISM criteria, through Medline (http://www.ncbi.nlm.nih.gov) and using the keywords (in isolation or in conjunction) "cadaveric renal transplantation; kidney graft function appraisal, graft function predictors". We selected prospective and retrospective series and review articles. A total of 375 articles were analysed, 39 of which were ultimately selected for review. The predictors of functionality include the following: The donor risk indices; the calculation of the renal functional weight or the assessment of the nephronic mass; the measurement of vascular resistances during perfusion in hypothermia; the measurement of the donor's biomarkers in urine and in the perfusion liquid; the measurement of functional and reperfusion parameters in normothermia; and the measurement of morphological parameters (microscopic and macroscopic) of the target organ. In this article, we present an explanatory summary of each of these parameters, as well as their most recent evidence on this issue. None of the reviewed parameters in isolation could reliably predict renal function and graft survival. There is a significant void in terms of the macroscopic assessment of kidney transplantation. We need to continue developing predictors of renal functionality to accurately define the distribution of each currently available donor kidney. Copyright © 2017

  12. Systematic review of public health branding.

    PubMed

    Evans, W Douglas; Blitstein, Jonathan; Hersey, James C; Renaud, Jeanette; Yaroch, Amy L

    2008-12-01

    Brands build relationships between consumers and products, services, or lifestyles by providing beneficial exchanges and adding value to their objects. Brands can be measured through associations that consumers hold for products and services. Public health brands are the associations that individuals hold for health behaviors, or lifestyles that embody multiple health behaviors. We systematically reviewed the literature on public health brands; developed a methodology for describing branded health messages and campaigns; and examined specific branding strategies across a range of topic areas, campaigns, and global settings. We searched the literature for published studies on public health branding available through all relevant, major online publication databases. Public health branding was operationalized as any manuscripts in the health, social science, and business literature on branding or brands in health promotion marketing. We developed formalized decision rules and applied them in identifying articles for review. We initially identified 154 articles and reviewed a final set of 37, 10 from Africa, Australia, and Europe. Branded health campaigns spanned most of the major domains of public health and numerous communication strategies and evaluation methodologies. Most studies provided clear information on planning, development, and evaluation of the branding effort, while some provided minimal information. Branded health messages typically are theory based, and there is a body of evidence on their behavior change effectiveness, especially in nutrition, tobacco control, and HIV/AIDS. More rigorous research is needed, however, on how branded health messages impact specific populations and behaviors.

  13. Processing medical data: a systematic review

    PubMed Central

    2013-01-01

    Background Medical data recording is one of the basic clinical tools. Electronic Health Record (EHR) is important for data processing, communication, efficiency and effectiveness of patients’ information access, confidentiality, ethical and/or legal issues. Clinical record promote and support communication among service providers and hence upscale quality of healthcare. Qualities of records are reflections of the quality of care patients offered. Methods Qualitative analysis was undertaken for this systematic review. We reviewed 40 materials Published from 1999 to 2013. We searched these materials from databases including ovidMEDLINE and ovidEMBASE. Two reviewers independently screened materials on medical data recording, documentation and information processing and communication. Finally, all selected references were summarized, reconciled and compiled as one compatible document. Result Patients were dying and/or getting much suffering as the result of poor quality medical records. Electronic health record minimizes errors, saves unnecessary time, and money wasted on processing medical data. Conclusion Many countries have been complaining for incompleteness, inappropriateness and illegibility of records. Therefore creating awareness on the magnitude of the problem has paramount importance. Hence available correct patient information has lots of potential in reducing errors and support roles. PMID:24107106

  14. Inflammatory papillary hyperplasia: A systematic review.

    PubMed

    Gual-Vaqués, P; Jané-Salas, E; Egido-Moreno, S; Ayuso-Montero, R; Marí-Roig, A; López-López, J

    2017-01-01

    Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. A search was carried out in PubMed (January 2005 to October 2015) with the key words "inflammatory papillary hyperplasia", "denture stomatitis", "granular stomatitis" and "Newton's type III" The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies. Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among non-denture-wearers is extremely unusual.

  15. Topiramate and the vision: a systematic review

    PubMed Central

    Abtahi, Mohammad-Ali; Abtahi, Seyed-Hossein; Fazel, Farhad; Roomizadeh, Peyman; Etemadifar, Masoud; Jenab, Keivan; Akbari, Mojtaba

    2012-01-01

    Background and purpose Topiramate (TPM) is a sulfa-derivative monosaccharide that is used mainly for treating epilepsy and preventing migraine. Within the gamut of side effects attributable to this drug, ophthalmologic manifestations are of crucial importance. In this study, for the first time, the aim was to provide a systematic literature review regarding this issue. Methods For the time period 1996–2011, a PubMed search was made for the studies concerning the adverse/beneficial effects of TPM on vision. Overall, 404 citations out of a total of 2756 TPM-related studies were examined for relevance. Results A total of 74 relevant studies were reviewed, 65 of which comprise small observational studies describing the ophthalmic side effects of TPM in 84 patients. Of these patients, 66 were affected by ciliochoroidal effusion syndrome as the cardinal ocular side effect of TPM (17 cases of myopic shift and 49 cases of angle closure glaucoma). A comprehensive statistical analysis is provided on these 66 subjects. Other rare side effects of TPM on the vision were also reviewed, including massive choroidal effusion, ocular inflammatory reactions, visual field defects, probable effects on retina, cornea, and sclera, and neuroophthalmologic complications. In addition, a framework is provided to classify these results. Discussion Due to the expanding spectrum of indications for the administration of TPM, neurologists and psychiatrists should be aware of its diverse ocular side effects. In conclusion, ocular complications following this drug should be taken seriously and be subjected to ophthalmic counseling. PMID:22275816

  16. Triterpenes with healing activity: A systematic review.

    PubMed

    Agra, Lais C; Ferro, Jamylle N S; Barbosa, Fabiano T; Barreto, Emiliano

    2015-10-01

    The purpose of this review was to systematically evaluate the literature on the efficacy of triterpenes for wound healing. We searched for original studies in the Medline, SCIDIRECT and LILACS databases published from 1910 to 2013. For each study, the title, abstract and full article were evaluated by two reviewers. We identified 2181 studies; however, after application of the inclusion and exclusion criteria, only 12 studies were subjected to further review. In surgical wounds, the triterpenes induced a reduction in time to closure, and this effect was reported in virtually all wound types. Triterpenes also modulate the production of ROS in the wound microenvironment, accelerating the process of tissue repair. Triterpenes may also induce cell migration, cell proliferation and collagen deposition. Although the pharmacological effects of triterpenes are well characterized, little is known about their effects in cells involved in healing, such as keratinocytes and fibroblasts. In addition, the lack of studies on the risks associated with the therapeutic use of triterpenes is worrisome. Our study reveals that triterpenes seem to favor wound healing; however, toxicological studies with these compounds are required. Taken together, these findings show that the triterpenes are a class of molecules with significant promise that leads for the development of new drugs to treat skin injury.

  17. Systematic review: craniocervical posture and craniofacial morphology.

    PubMed

    Gomes, Liliane de C Rosas; Horta, Karla O Carpio; Gonçalves, João Roberto; Santos-Pinto, Ary Dos

    2014-02-01

    The purpose of this study was to investigate the published evidence regarding the association between head and cervical posture and craniofacial morphology. An electronic search was conducted in PubMed, Medline, Embase, Scopus, and Cochrane databases up to 23 March 2012. Abstracts that seemed to correspond with the goals of this review were selected by a consensus between two independent reviewers. The original articles were retrieved and evaluated to ensure they match the inclusion criteria. Only articles that directly compared head and/or cervical posture with craniofacial morphology were included. A total of 84 articles were found of which 12 matched all inclusion criteria. Detailed analysis of the methodology in selected articles revealed quality scores ranging from 'weak' to 'moderate'. Nine articles were cross-sectional studies, whereas only three were longitudinal studies. The findings of selected articles were linked together in order to clarify the evidence on sagittal and vertical craniofacial features as well as growth prediction regarding different postures of the head and neck. On the basis of the data obtained from the literature, significant associations were found between variables concerning head and cervical posture and craniofacial morphology. However, the results of this systematic review suggest that such associations should be carefully interpreted, considering that correlation coefficients found ranged from low to moderate. Moreover, conflicting results were observed regarding some postural variables. Further longitudinal studies are required to elucidate the relationship between the development of craniofacial morphology and functional aspects of head and cervical posture.

  18. Science of floorball: a systematic review

    PubMed Central

    Tervo, Taru; Nordström, Anna

    2014-01-01

    Background The purpose of this study was to comprehensively review the scientific research on floorball at the competitive and recreational levels according to field of study. Methods Full articles containing original data on floorball that had been published in English in peer-reviewed journals were considered for inclusion. Results Of 75 articles screened, 19 were included in this systematic review. One article each was identified in the fields of sports management and sports psychology, and the remaining 17 articles were in the field of sports medicine. Injury epidemiology in floorball players was the most thoroughly examined topic of research. To date, no research has been performed on the incidence of floorball-related injury, or any aspect of the sport, in children and adolescents. Conclusion Collaborative research among sports science disciplines is needed to identify strategies to reduce the incidence of injury and enhance the performance of licensed floorball players. Despite the increasing popularity of floorball in recent years, surprisingly little research has examined this sport. PMID:25349484

  19. Cognitive impairment in COPD: a systematic review*

    PubMed Central

    Torres-Sánchez, Irene; Rodríguez-Alzueta, Elisabeth; Cabrera-Martos, Irene; López-Torres, Isabel; Moreno-Ramírez, Maria Paz; Valenza, Marie Carmen

    2015-01-01

    The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD. PMID:25909154

  20. Systematic review on cashew nut allergy.

    PubMed

    van der Valk, J P M; Dubois, A E J; Gerth van Wijk, R; Wichers, H J; de Jong, N W

    2014-06-01

    Recent studies on cashew nut allergy suggest that the prevalence of cashew nut allergy is increasing. Cashew nut consumption by allergic patients can cause severe reactions, including anaphylaxis. This review summarizes current knowledge on cashew nut allergy to facilitate timely clinical recognition and to promote awareness of this emerging food allergy amongst clinicians. The goal of this study is to present a systematic review focused on the clinical aspects of allergy to cashew nut including the characteristics of cashew nut, the prevalence, allergenic components, cross-reactivity, diagnosis and management of cashew nut allergy. The literature search yielded 255 articles of which 40 met our selection criteria and were considered to be relevant for this review. The 40 articles included one prospective study, six retrospective studies and seven case reports. The remaining 26 papers were not directly related to cashew nut allergy. The literature suggests that the prevalence of cashew nut allergy is increasing, although the level of evidence for this is low. A minimal amount of cashew nut allergen may cause a severe allergic reaction, suggesting high potency comparable with other tree nuts and peanuts. Cashew allergy is clearly an underestimated important healthcare problem, especially in children. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Predictors of poststroke mobility: systematic review.

    PubMed

    Craig, Louise E; Wu, Olivia; Bernhardt, Julie; Langhorne, Peter

    2011-08-01

    Regaining poststroke mobility is considered a primary goal of the stroke patient in early rehabilitation. Predictive recovery of poststroke mobility is clinically important, and provides important information to healthcare professionals, patients and their families. We conducted a systematic review aimed at identifying the predictive or associated baseline factors, assessed within one-week of stroke onset, and the recovery of poststroke mobility within 30 days. A comprehensive search strategy was applied to all major electronic databases to identify potentially relevant studies. Included in the review are two studies that evaluate the predictive value of baseline factors by developing a prognostic model, and three studies that assess the baseline factors that were associated with the outcome by univariate analysis. Walking is the most commonly assessed mobility outcome; age, the severity of paresis, reduced leg power, presence of hemianopia, size of brain lesion and type of stroke were shown to be predictive or associated with walking within 30 days poststroke. This review has identified the potential predictors of the recovery of mobility poststroke. There is a need to explore and validate these predictors in other patient cohorts, and consider additional factors believed to be associated with mobility. The recovery of mobility other than walking also needs investigation. In order to move prognostic research in stroke forward, a collaborative approach to sharing and collecting data is recommended. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

  2. Speed Management Strategies; A Systematic Review

    PubMed Central

    Sadeghi-Bazargani, Homayoun; Saadati, Mohammad

    2016-01-01

    Objective: To systematically identify the various methods of speed management and their effects. Methods: A systematic search was performed in Science Direct, Ovid Medline, Scopus, PubMed and ProQuest databases from April to June 2015. Hand searching and reference of selected articles were used to improve article identification. Articles published after 1990 which had reported on efficacy/effectiveness of speed management strategies were included. Data were extracted using pre-defined extraction table. Results: Of the 803 retrieved articles, 22 articles were included in this review. Most of the included articles (63%) had before-after design and were done in European countries. Speed cameras, engineering schemes, intelligent speed adaption (ISA), speed limits and zones, vehicle activated sign and integrated strategies were the most common strategies reported in the literature. Various strategies had different effects on mean speed of the vehicles ranging from 1.6 to 10 km/h. Moreover, 8-65% and 11-71% reduction was reported in person injured accidents and fatal accidents, respectively as a result of employing various strategies. Conclusion: Literature revealed positive effects of various speed management strategies. Using various strategies was mostly dependent on road characteristics, driver’s attitude about the strategy as well as economic and technological capabilities of the country. Political support is considered as a main determinant in selecting speed management strategies. PMID:27540546

  3. Serious Games for Psychotherapy: A Systematic Review.

    PubMed

    Eichenberg, Christiane; Schott, Markus

    2017-06-01

    In the evolving digital age, media applications are increasingly playing a greater role in the field of psychotherapy. While the Internet is already in the phase of being established when it comes to the care of mental disorders, experimentation is going on with other modern media such as serious games. A serious game is a game in which education and behavior change is the goal, alongside with entertainment. The objective of the present article was to provide a first empirical overview of serious games applied to psychotherapy and psychosomatic rehabilitation. Therefore, a systematic literature search, including the terms "serious game" or "computer game" and "psychotherapy" or "rehabilitation" or "intervention" or "mental disorders" in the databases Medline and PsycINFO, was performed. Subsequently, an Internet search was conducted to identify studies not published in journals. Publications not providing empirical data about effectiveness were excluded. On the basis of this systematic literature review, the results of N = 15 studies met inclusion criteria. They utilized primarily cognitive behavioral techniques and can be useful for treating a range of mental disorders. Serious games are effective both as a stand-alone intervention or part of psychotherapy and appeal to patients independent of age and sex. Included serious games proved to be an effective therapeutic component. Nonetheless, findings are not conclusive and more research is needed to further investigate the effectiveness of serious games for psychotherapeutic purposes.

  4. Suicide in Children: A Systematic Review.

    PubMed

    Soole, Rebecca; Kõlves, Kairi; De Leo, Diego

    2015-01-01

    The objective of this study was to provide a review of studies on suicide in children aged 14 years and younger. Articles were identified through a systematic search of Scopus, MEDLINE, and PsychINFO. Key words were "children, suicide, psychological autopsy, and case-study." Additional articles were identified through manual search of reference lists and discussion with colleagues. Fifteen published articles were identified, 8 psychological autopsy studies (PA), and 7 retrospective case-study series. Suicide incidence and gender asymmetry increases with age. Hanging is the most frequent method. Lower rates of psychopathology are evident among child suicides compared to adolescents. Previous suicide attempts were an important risk factor. Children were less likely to consume alcohol prior to suicide. Parent-child conflicts were the most common precipitant.

  5. Priorities for tuberculosis research: a systematic review

    PubMed Central

    Rylance, Jamie; Pai, Madhukar; Lienhardt, Christian; Garner, Paul

    2010-01-01

    Summary Reliable and relevant research can help to improve tuberculosis control worldwide. In recent years, various organisations have assessed research needs and proposed priorities for tuberculosis. We summarise existing priority statements and assess the rigour of the methods used to generate them. We found 33 documents that specifically outline priorities in tuberculosis research. The top priority areas were drug development (28 articles), diagnosis and diagnostic tests (27), epidemiology (20), health services research (16), basic research (13), and vaccine development and use (13). The most focused questions were on the treatment and prevention of multidrug-resistant tuberculosis in people co-infected with HIV. Methods used to identify these priorities were varied. Improvements can be made to ensure the process is more rigorous and transparent, and to use existing research or systematic reviews more often. WHO, Stop TB Partnership, and other organisations could adopt an incremental process of priority development, building on the existing knowledge base. PMID:21050822

  6. Biomarkers in Arthroplasty: A Systematic Review

    PubMed Central

    Mertens, Marty T; Singh, Jasvinder A

    2011-01-01

    We performed a systematic review of all MEDLINE-published studies of biomarkers in arthroplasty. Thirty studies met the inclusion criteria; majority evaluated biomarkers for osteolysis, aseptic prosthetic loosening, and prosthetic infections. Four studies reported an elevated Cross-linked N-telopeptides of type I collagen (urine or serum) in patients with osteolysis or aseptic prosthetic loosening when compared to appropriate controls. Two or more studies each found elevated C-reactive protein, erythrocyte sedimentation rate, and interleukin-6 in patients with infected prosthetic joints compared to controls. Most other biomarkers were either examined by single studies or had inconsistent or insignificant associations with outcomes. We conclude that the majority of the biomarkers currently lack the evidence to be considered as biomarkers for arthroplasty outcomes. Further studies are needed. PMID:21584201

  7. Obesity and lung function: a systematic review

    PubMed Central

    Melo, Luciana Costa; da Silva, Maria Alayde Mendonça; Calles, Ana Carolina do Nascimento

    2014-01-01

    ABSTRACT Obesity is a chronic disease characterized by the excessive accumulation of body fat that is harmful to the individuals. Respiratory disorders are among the comorbidities associated with obesity. This study had the objective of investigating the alterations in respiratory function that affect obese individuals. A systematic review was performed, by selecting publications in the science databases MEDLINE and LILACS, using PubMed and SciELO. The articles that assessed pulmonary function by plethysmography and/or spirometry in obese individuals aged under 18 years were included. The results demonstrated that the obese individuals presented with a reduction in lung volume and capacity as compared to healthy individuals. Reduction of total lung capacity and reduction of forced vital capacity, accompanied by reduction of the forced expiratory volume after one second were the most representative findings in the samples. The articles analyzed proved the presence of a restrictive respiratory pattern associated with obesity. PMID:24728258

  8. Rescue intracytoplasmic sperm injection: a systematic review.

    PubMed

    Beck-Fruchter, Ronit; Lavee, Michal; Weiss, Amir; Geslevich, Yoel; Shalev, Eliezer

    2014-03-01

    To assess the feasibility, efficacy, and safety of rescue intracytoplasmic sperm injection (ICSI) in cases of fertilization failure, using a scientific literature search. Systematic review. Centers for reproductive care. Infertility patients with total or partial fertilization failure during an IVF cycle. An electronic literature search was performed in PubMed from 1992 through May 2013. The search was then expanded by using listed references from selected articles. Pregnancy rate. The secondary outcome measures were fertilization rate, normal fertilization rate, cleavage rate, birth rate, and malformation rate. Thirty-eight studies including 1,863 patients were included. The pooled pregnancy rate was 14.4%; 194 babies were delivered. Rescue ICSI can result in the delivery of a healthy newborn, although the pregnancy rates are low. The clinical evidence did not indicate an elevated rate of malformations, although the data are limited and incomplete. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Religion and Suicide Risk: A Systematic Review.

    PubMed

    Lawrence, Ryan E; Oquendo, Maria A; Stanley, Barbara

    2016-01-01

    Although religion is reported to be protective against suicide, the empirical evidence is inconsistent. Research is complicated by the fact that there are many dimensions to religion (affiliation, participation, doctrine) and suicide (ideation, attempt, completion). We systematically reviewed the literature on religion and suicide over the last 10 years (89 articles) with a goal of identifying what specific dimensions of religion are associated with specific aspects of suicide. We found that religious affiliation does not necessarily protect against suicidal ideation, but does protect against suicide attempts. Whether religious affiliation protects against suicide attempts may depend on the culture-specific implications of affiliating with a particular religion, since minority religious groups can feel socially isolated. After adjusting for social support measures, religious service attendance is not especially protective against suicidal ideation, but does protect against suicide attempts, and possibly protects against suicide. Future qualitative studies might further clarify these associations.

  10. Diet and breast cancer: a systematic review.

    PubMed

    Mourouti, Niki; Kontogianni, Meropi D; Papavagelis, Christos; Panagiotakos, Demosthenes B

    2015-02-01

    Breast cancer occurs as a result between genes-diet interactions. Concerning diet, only alcohol is widely recognized for being most consistently associated with breast cancer risk. The purpose of this review is to report through a systematic way the current scientific evidence relating breast cancer and diet, through original-research studies published in English language during the last decade, assessing the consumption of specific foodstuffs/food-nutrients in relation to the disease. The available literature suggests that soy food intake seems to be inversely associated with the disease, while no association seems to be reported for dietary carbohydrates and dietary fiber intake. The consumption of dietary fat, is probably suggestive of an increase in breast cancer risk, while studies evaluating the role of fruit/vegetable, meat as well as dietary patterns and breast cancer risk, provide inconsistent results. Diet seems to be modestly associated with the disease, highlighting the need for more studies to be conducted.

  11. Priorities for tuberculosis research: a systematic review.

    PubMed

    Rylance, Jamie; Pai, Madhukar; Lienhardt, Christian; Garner, Paul

    2010-12-01

    Reliable and relevant research can help to improve tuberculosis control worldwide. In recent years, various organisations have assessed research needs and proposed priorities for tuberculosis. We summarise existing priority statements and assess the rigour of the methods used to generate them. We found 33 documents that specifically outline priorities in tuberculosis research. The top priority areas were drug development (28 articles), diagnosis and diagnostic tests (27), epidemiology (20), health services research (16), basic research (13), and vaccine development and use (13). The most focused questions were on the treatment and prevention of multidrug-resistant tuberculosis in people co-infected with HIV. Methods used to identify these priorities were varied. Improvements can be made to ensure the process is more rigorous and transparent, and to use existing research or systematic reviews more often. WHO, Stop TB Partnership, and other organisations could adopt an incremental process of priority development, building on the existing knowledge base. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Activation in Bipolar Disorders: A Systematic Review.

    PubMed

    Scott, Jan; Murray, Greg; Henry, Chantal; Morken, Gunnar; Scott, Elizabeth; Angst, Jules; Merikangas, Kathleen R; Hickie, Ian B

    2017-02-01

    Increased activity and energy alongside mood change are identified in the DSM-5 as cardinal symptoms of mania and hypomania. A wide range of existing research suggests that this revision may be valid, but systematic integration of the evidence has not been reported. The term activation is understood as emerging from underlying physiological change and having objective (observable motor activity) and related subjective (energy) levels. To systematically review studies of the clinical phenomenon of activation in bipolar disorder, to determine whether activation is statistically abnormal in bipolar disorder and demonstrably distinct from mood, and to identify any significant between- and within-individual differences in the dynamics of activation. This systematic review of MEDLINE, PsycINFO, EMBASE, CINAHL, and PubMed databases from January 1, 1970, until September 30, 2016, identified 56 of a possible 3284 citations for (1) data-driven analyses of the dimensions and factor structure of mania and bipolar depression and (2) longitudinal studies reporting real-time objective monitoring or momentary assessment of daytime activity in individuals with bipolar disorder compared with other clinical or healthy control samples. Hand search of reference lists, specialty journals, websites, published conference proceedings, and dissertation abstracts and contact with other researchers ensured inclusion of gray literature and additional analyses as well as raw data if appropriate. Quality assessment was perfomed using the National Institutes of Health quality assessment tool. A total of 56 studies met eligibility criteria for inclusion in the review including 29 analyses of the factor structure of bipolar disorder, 3 of activity data from experimental sampling or ecological momentary assessment, and 20 actigraphy and 4 laboratory-based studies. Synthesizing findings across the studies revealed that the most robust finding was that mean levels of activity are lower during euthymia

  13. Brain Structure and Executive Functions in Children with Cerebral Palsy: A Systematic Review

    ERIC Educational Resources Information Center

    Weierink, Lonneke; Vermeulen, R. Jeroen; Boyd, Roslyn N.

    2013-01-01

    This systematic review aimed to establish the current knowledge about brain structure and executive function (EF) in children with cerebral palsy (CP). Five databases were searched (up till July 2012). Six articles met the inclusion criteria, all included structural brain imaging though no functional brain imaging. Study quality was assessed using…

  14. Brain Structure and Executive Functions in Children with Cerebral Palsy: A Systematic Review

    ERIC Educational Resources Information Center

    Weierink, Lonneke; Vermeulen, R. Jeroen; Boyd, Roslyn N.

    2013-01-01

    This systematic review aimed to establish the current knowledge about brain structure and executive function (EF) in children with cerebral palsy (CP). Five databases were searched (up till July 2012). Six articles met the inclusion criteria, all included structural brain imaging though no functional brain imaging. Study quality was assessed using…

  15. Diabetic nephropathy in Africa: A systematic review

    PubMed Central

    Noubiap, Jean Jacques N; Naidoo, Jashira; Kengne, Andre P

    2015-01-01

    AIM: To determine the prevalence and incidence of diabetic nephropathy in Africa. METHODS: We performed a systematic narrative review of published literature following the MOOSE Guidelines for Meta-Analysis and Systematic Reviews of Observational Studies. We searched PubMed-MEDLINE for all articles published in English and French languages between January 1994 and July 2014 using a predefined strategy based on the combination of relevant terms and the names of each of the 54 African countries and African sub-regions to capture the largest number of studies, and hand-searched the reference lists of retrieved articles. Included studies reported on the prevalence, incidence or determinants of chronic kidney disease (CKD) in people with diabetes within African countries. RESULTS: Overall, we included 32 studies from 16 countries; two being population-based studies and the remaining being clinic-based surveys. Most of the studies (90.6%) were conducted in urban settings. Methods for assessing and classifying CKD varied widely. Measurement of urine protein was the most common method of assessing kidney damage (62.5% of studies). The overall prevalence of CKD varied from 11% to 83.7%. Incident event rates were 94.9% for proteinuria at 10 years of follow-up, 34.7% for end-stage renal disease at 5 years of follow-up and 18.4% for mortality from nephropathy at 20 years of follow-up. Duration of diabetes, blood pressure, advancing age, obesity and glucose control were the common determinants of kidney disease. CONCLUSION: The burden of CKD is important among people with diabetes in Africa. High quality data from large population-based studies with validated measures of kidney function are still needed to better capture the magnitude and characteristics of diabetic nephropathy in Africa. PMID:26069725

  16. Pregnancy after endometrial ablation: a systematic review.

    PubMed

    Kohn, J R; Shamshirsaz, A A; Popek, E; Guan, X; Belfort, M A; Fox, K A

    2017-09-27

    Pregnancies have been reported after endometrial ablation but there is little data regarding subsequent pregnancy outcomes. To review systematically the available evidence regarding pregnancy outcomes after endometrial ablation, in order to equip physicians effectively to counsel women considering endometrial ablation. MEDLINE, Embase, Cochrane, and ClinicalTrials.gov were searched through January 2017. Published and unpublished literature in any language describing pregnancy after endometrial ablation or resection was eligible. Data about preconception characteristics and pregnancy outcomes were extracted and analysed according to study design of source and pregnancy viability. We identified 274 pregnancies from 99 sources; 78 sources were case reports. Women aged 26-50 years (mean 37.5 ± 5 years) conceived a median of 1.5 years after ablation (range: 3 weeks prior to 13 years after). When reported, 80-90% had not used contraception. In all, 85% of pregnancies from trial/observational studies ended in termination, miscarriage or ectopic pregnancy. Pregnancies that continued (case report and non-case report sources) had high rates of preterm delivery, caesarean delivery, caesarean hysterectomy, and morbidly adherent placenta. Case reports also frequently described preterm premature rupture of membranes, intrauterine growth restriction, intrauterine fetal demise, uterine rupture, and neonatal demise. An unexpectedly high rate of pregnancy complications is reported in the available literature (which may reflect publication bias) and high-quality evidence is lacking. However, based on the existing evidence, women undergoing endometrial ablation should be informed that subsequent pregnancy may have serious complications and should be counselled to use reliable contraception after the procedure. Systematic review - pregnancies reported after endometrial ablation have an increased risk of adverse outcomes. © 2017 Royal College of Obstetricians and Gynaecologists.

  17. Pertuzumab in breast cancer: a systematic review.

    PubMed

    Zagouri, Flora; Sergentanis, Theodoros N; Chrysikos, Dimosthenis; Zografos, Constantine G; Filipits, Martin; Bartsch, Rupert; Dimopoulos, Meletios-Athanassios; Psaltopoulou, Theodora

    2013-10-01

    Pertuzumab is a monoclonal antibody that represents the first among a new class of agents known as human epidermal growth factor receptor (HER) dimerization inhibitors. This is the first systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to synthesize all available data of pertuzumab in breast cancer. The search strategy retrieved 11 studies that evaluated pertuzumab. One study was conducted in the neoadjuvant setting (417 patients), whereas all the others dealt with patients with recurrent, metastatic, or refractory disease (1023 patients). Six studies were conducted in HER2(+) breast cancer population (1354 patients), whereas 5 studies (86 patients) were conducted in HER2(-) (or unknown HER2 status) disease. Pertuzumab is the most recent agent approved by the US Food and Drug Administration in combination with trastuzumab and docetaxel for the treatment of patients with HER2(+) metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease. This approval has been based on data from a phase III Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) study. The antitumor activity with the significant reduction in the risk of progression or death, as reflected upon the increase of 6.1 months in median progression-free survival, indicates that pertuzumab may provide an avenue for achieving additional benefit for patients with HER2(+). Moreover, pertuzumab seems to have a putative role in the management of patients with HER2 who are resistant to trastuzumab. The promising role of pertuzumab in the neoadjuvant and adjuvant settings remains to be further investigated and established in the future.

  18. Career Choice in Academic Medicine: Systematic Review

    PubMed Central

    Straus, Sharon E; Straus, Christine; Tzanetos, Katina

    2006-01-01

    OBJECTIVES To review systematically the evidence about what factors influence the decision to choose or not choose a career in academic medicine. DESIGN A systematic review of relevant literature from 1990 to May 2005. DATA SOURCES Searches of The Cochrane Library, Medline (using Ovid and PubMed) from 1990 to May 2005, and EMBASE from 1990 to May 2005 were completed to identify relevant studies that explored the influential factors. Additional articles were identified from searching the bibliographies of retrieved articles. SELECTION OF STUDIES We attempted to identify studies that included residents, fellows, or staff physicians. No restrictions were placed on the study methodologies identified and all articles presenting empirical evidence were retrieved. For cohort, case-control, and cross-sectional studies, minimum inclusion criteria were the presence of defined groups, and the ability to extract relevant data. For surveys that involved case series, minimum inclusion criteria were a description of the population, and the availability of extractable data. Minimum inclusion criteria for qualitative studies were descriptions of the sampling strategy and methods. RESULTS The search identified 251 abstracts; 25 articles were included in this review. Completion of an MD with a graduate degree or fellowship program is associated with a career in academic medicine. Of the articles identified in this review, this finding is supported by the highest quality of evidence. Similarly, the completion of research and publication of this research in medical school and residency are associated with a career in academic medicine. The desire to teach, conduct research, and the intellectual stimulation and challenge provided in academia may also persuade people to choose this career path. The influence of a role model or a mentor was reported by physicians to impact their decision making. Trainees' interest in academic medicine wanes as they progress through their residency

  19. Iraq War mortality estimates: A systematic review

    PubMed Central

    Tapp, Christine; Burkle, Frederick M; Wilson, Kumanan; Takaro, Tim; Guyatt, Gordon H; Amad, Hani; Mills, Edward J

    2008-01-01

    Background In March 2003, the United States invaded Iraq. The subsequent number, rates, and causes of mortality in Iraq resulting from the war remain unclear, despite intense international attention. Understanding mortality estimates from modern warfare, where the majority of casualties are civilian, is of critical importance for public health and protection afforded under international humanitarian law. We aimed to review the studies, reports and counts on Iraqi deaths since the start of the war and assessed their methodological quality and results. Methods We performed a systematic search of 15 electronic databases from inception to January 2008. In addition, we conducted a non-structured search of 3 other databases, reviewed study reference lists and contacted subject matter experts. We included studies that provided estimates of Iraqi deaths based on primary research over a reported period of time since the invasion. We excluded studies that summarized mortality estimates and combined non-fatal injuries and also studies of specific sub-populations, e.g. under-5 mortality. We calculated crude and cause-specific mortality rates attributable to violence and average deaths per day for each study, where not already provided. Results Thirteen studies met the eligibility criteria. The studies used a wide range of methodologies, varying from sentinel-data collection to population-based surveys. Studies assessed as the highest quality, those using population-based methods, yielded the highest estimates. Average deaths per day ranged from 48 to 759. The cause-specific mortality rates attributable to violence ranged from 0.64 to 10.25 per 1,000 per year. Conclusion Our review indicates that, despite varying estimates, the mortality burden of the war and its sequelae on Iraq is large. The use of established epidemiological methods is rare. This review illustrates the pressing need to promote sound epidemiologic approaches to determining mortality estimates and to establish

  20. Physical activity in spondyloarthritis: a systematic review.

    PubMed

    O'Dwyer, Tom; O'Shea, Finbar; Wilson, Fiona

    2015-03-01

    Physical activity (PA) is associated with numerous health-related benefits among adults with chronic diseases and the general population. As the benefits are dose-dependent, this review aims to establish the PA levels of adults with spondyloarthritis and to compare these to the general population. Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE/PubMed, PEDro, AMED, CINAHL) were systematically searched from inception to May 2014 using medical subject headings and keywords. This was supplemented by searching conference abstracts and hand-searching reference lists of included studies. Eligible studies were randomized controlled trials and observational studies of adults with SpA in which free-living PA or energy expenditure levels were measured. Subjects less than 18 years or with juvenile-onset SpA were excluded. Outcomes included objective and self-report measurements. Two reviewers independently screened studies for inclusion and assessed methodological quality using the Cochrane risk of bias tool and the RTI item bank. From the 2,431 records reviewed, nine studies involving 2,972 participants were included. This review focused on qualitative synthesis. Meta-analyses were not undertaken due to differences in study design, measurement tools, and participant characteristics. This heterogeneity, coupled with the risk of bias inherent in the included observational studies, limits the generalizability of findings. Objective measurements suggest PA levels may be lower among adults with spondyloarthritis than in healthy population controls. Self-reported PA and self-reported rates of adherence to PA recommendations varied largely across studies; higher disease activity was associated with lower self-reported PA levels. Physical activity levels may be lower in adults with axial spondyloarthritis, with higher disease activity associated with lower PA levels.

  1. Publication bias in animal research: a systematic review protocol.

    PubMed

    Briel, Matthias; Müller, Katharina F; Meerpohl, Joerg J; von Elm, Erik; Lang, Britta; Motschall, Edith; Gloy, Viktoria; Lamontagne, Francois; Schwarzer, Guido; Bassler, Dirk

    2013-04-27

    Systematic reviews and meta-analyses of pre-clinical studies, in vivo animal experiments in particular, can influence clinical care. Publication bias is one of the major threats of validity in systematic reviews and meta-analyses. Previous empirical studies suggested that systematic reviews and meta-analyses have become more prevalent until 2010 and found evidence for compromised methodological rigor with a trend towards improvement. We aim to comprehensively summarize and update the evidence base on systematic reviews and meta-analyses of animal studies, their methodological quality and assessment of publication bias in particular. The objectives of this systematic review are as follows: •To investigate the epidemiology of published systematic reviews of animal studies until present. •To examine methodological features of systematic reviews and meta-analyses of animal studies with special attention to the assessment of publication bias. •To investigate the influence of systematic reviews of animal studies on clinical research by examining citations of the systematic reviews by clinical studies. Eligible studies for this systematic review constitute systematic reviews and meta-analyses that summarize in vivo animal experiments with the purpose of reviewing animal evidence to inform human health. We will exclude genome-wide association studies and animal experiments with the main purpose to learn more about fundamental biology, physical functioning or behavior. In addition to the inclusion of systematic reviews and meta-analyses identified by other empirical studies, we will systematically search Ovid Medline, Embase, ToxNet, and ScienceDirect from 2009 to January 2013 for further eligible studies without language restrictions. Two reviewers working independently will assess titles, abstracts, and full texts for eligibility and extract relevant data from included studies. Data reporting will involve a descriptive summary of meta-analyses and systematic reviews

  2. Melanotic Neuroectodermal Tumor of Infancy: A Systematic Review.

    PubMed

    Rachidi, Saleh; Sood, Amit J; Patel, Krishna G; Nguyen, Shaun A; Hamilton, Heidi; Neville, Brad W; Day, Terry A

    2015-10-01

    Melanotic neuroectodermal tumor of infancy (MNTI) is a rare tumor, usually diagnosed within the first year of age, with a predilection for the maxilla. Although the tumor is usually benign, its rapidly growing nature and ability to cause major deformities in surrounding structures necessitate early diagnosis and intervention. It is important that medical and dental specialists are prepared to make the diagnosis and proceed with appropriate intervention. The authors performed a systematic review of the 472 reported cases from 1918 through 2013 and provided a comprehensive update on this rare entity that can have devastating effects on young patients. This investigation uncovered age at diagnosis as an important prognostic indicator, because younger age correlated with a higher recurrence rate. The authors also present a case report of a 5-month-old girl diagnosed with MNTI and review her clinical presentation and imaging and histopathologic findings.

  3. How useful are systematic reviews for informing palliative care practice? Survey of 25 Cochrane systematic reviews

    PubMed Central

    Wee, Bee; Hadley, Gina; Derry, Sheena

    2008-01-01

    Background In contemporary medical research, randomised controlled trials are seen as the gold standard for establishing treatment effects where it is ethical and practical to conduct them. In palliative care such trials are often impractical, unethical, or extremely difficult, with multiple methodological problems. We review the utility of Cochrane reviews in informing palliative care practice. Methods Published reviews in palliative care registered with the Cochrane Pain, Palliative and Supportive Care Group as of December 2007 were obtained from the Cochrane Database of Systematic Reviews, issue 1, 2008. We reviewed the quality and quantity of primary studies available for each review, assessed the quality of the review process, and judged the strength of the evidence presented. There was no prior intention to perform any statistical analyses. Results 25 published systematic reviews were identified. Numbers of included trials ranged from none to 54. Within each review, included trials were heterogeneous with respect to patients, interventions, and outcomes, and the number of patients contributing to any single analysis was generally much lower than the total included in the review. A variety of tools were used to assess trial quality; seven reviews did not use this information to exclude low quality studies, weight analyses, or perform sensitivity analysis for effect of low quality. Authors indicated that there were frequently major problems with the primary studies, individually or in aggregate. Our judgment was that the reviewing process was generally good in these reviews, and that conclusions were limited by the number, size, quality and validity of the primary studies. We judged the evidence about 23 of the 25 interventions to be weak. Two reviews had stronger evidence, but with limitations due to methodological heterogeneity or definition of outcomes. No review provided strong evidence of no effect. Conclusion Cochrane reviews in palliative care are well

  4. Cortical thickness in bipolar disorder: a systematic review.

    PubMed

    Hanford, Lindsay C; Nazarov, Anthony; Hall, Geoffrey B; Sassi, Roberto B

    2016-02-01

    Bipolar disorder (BD) is a debilitating illness, the psychopathology of which is associated with aberrant structural and functional differences in the brain. Despite the many advances in psychiatric research, our understanding of the complex neurobiological underpinnings of BD remains incomplete. The aim of this review was to critically examine all available published magnetic resonance imaging (MRI) research reporting cortical thickness in BD with respect to a healthy population and/or other psychiatric samples. The systematic search encompassed all relevant studies published until November 2014. Relevant papers were identified through an online search of select databases (MEDLINE and EMBASE) using key terms bipolar disorder or mania, and cortical thickness. Two independent raters determined the eligibility of papers and performed separate data extraction to ensure quality and accuracy of reporting. A total of 17 papers met the criteria and were included in this review. Compared to a healthy population, the majority of studies reported decreased cortical thickness in the left anterior cingulate/paracingulate and the left superior temporal gyrus, as well as several prefrontal regions bilaterally in patients with BD. Studies also show consistency of cortical thinning in individuals with BD and schizophrenia in frontal and temporal regions, suggesting some common neuropathology. This systematic review further supports a link between specific structural brain abnormalities and BD. Future studies should investigate cortical thickness with respect to at-risk populations to determine whether these neuropathologies develop before or after the onset of BD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Lifestyles in suburban populations: A systematic review.

    PubMed

    Khayat, Samira; Dolatian, Mahrokh; Navidian, Ali; Mahmoodi, Zohreh; Sharifi, Nasibeh; Kasaeian, Amir

    2017-07-01

    Lifestyle and suburban population are important issues in the field of health. The living conditions of informal settlements can lead to acquisition of an unhealthy lifestyle. This study has been designed to investigate the articles that have been published regarding lifestyle in suburban populations. The present research was a systematic review of studies in databases including Iranmedex, Magiran, SID, Irandoc, PubMed, Google Scholar, Science Direct and Scopus, in 2017. All Persian and English papers written from 2000 to 2017 were evaluated by two reviewers using an advanced search of the databases with keywords related to lifestyles and suburban population. After completion of the search, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to evaluate the articles. In total, 19 articles were found to have addressed the lifestyle in suburban populations. The results of these studies showed an unhealthy lifestyle in the most informal settlements. There was no food diversity. Malnutrition was common, especially overweight. The majority of the people did not have enough physical activity, and smoking and alcohol consumption were common, especially in men. Studies showed that suburban populations are among the groups that have unfavorable environmental conditions to acquiring healthy lifestyle and maintaining appropriate health. Therefore, developing infrastructure, improving health services (environment, treatment of diseases, reduction of malnutrition and infant mortality, access to safe drinking water and sanitation, improving waste disposal and recycling it), improving education and smoking prevention programs in improving lifestyle is recommended.

  6. Toxocariasis in North America: a systematic review.

    PubMed

    Lee, Rachel M; Moore, Laura B; Bottazzi, Maria Elena; Hotez, Peter J

    2014-08-01

    Toxocariasis is an important neglected tropical disease that can manifest as visceral or ocular larva migrans, or covert toxocariasis. All three forms pose a public health problem and cause significant morbidity in areas of high prevalence. To determine the burden of toxocariasis in North America, we conducted a systematic review of the literature following PRISMA guidelines. We found 18 articles with original prevalence, incidence, or case data for toxocariasis. Prevalence estimates ranged from 0.6% in a Canadian Inuit community to 30.8% in Mexican children with asthma. Commonly cited risk factors included: African-American race, poverty, male sex, and pet ownership or environmental contamination by animal feces. Increased prevalence of Toxocara spp. infection was linked in a group of case control studies conducted in Mexico to several high risk groups including waste pickers, asthmatic children, and inpatient psychiatry patients. Further research is needed to determine the true current burden of toxocariasis in North America; however the prevalence estimates gathered in this review suggest that the burden of disease is significant.

  7. Floods and human health: a systematic review.

    PubMed

    Alderman, Katarzyna; Turner, Lyle R; Tong, Shilu

    2012-10-15

    Floods are the most common type of disaster globally, responsible for almost 53,000 deaths in the last decade alone (23:1 low- versus high-income countries). This review assessed recent epidemiological evidence on the impacts of floods on human health. Published articles (2004-2011) on the quantitative relationship between floods and health were systematically reviewed. 35 relevant epidemiological studies were identified. Health outcomes were categorized into short- and long-term and were found to depend on the flood characteristics and people's vulnerability. It was found that long-term health effects are currently not well understood. Mortality rates were found to increase by up to 50% in the first year post-flood. After floods, it was found there is an increased risk of disease outbreaks such as hepatitis E, gastrointestinal disease and leptospirosis, particularly in areas with poor hygiene and displaced populations. Psychological distress in survivors (prevalence 8.6% to 53% two years post-flood) can also exacerbate their physical illness. There is a need for effective policies to reduce and prevent flood-related morbidity and mortality. Such steps are contingent upon the improved understanding of potential health impacts of floods. Global trends in urbanization, burden of disease, malnutrition and maternal and child health must be better reflected in flood preparedness and mitigation programs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  8. Lifestyles in suburban populations: A systematic review

    PubMed Central

    Khayat, Samira; Dolatian, Mahrokh; Navidian, Ali; Mahmoodi, Zohreh; Sharifi, Nasibeh; Kasaeian, Amir

    2017-01-01

    Background Lifestyle and suburban population are important issues in the field of health. The living conditions of informal settlements can lead to acquisition of an unhealthy lifestyle. Objective This study has been designed to investigate the articles that have been published regarding lifestyle in suburban populations. Methods The present research was a systematic review of studies in databases including Iranmedex, Magiran, SID, Irandoc, PubMed, Google Scholar, Science Direct and Scopus, in 2017. All Persian and English papers written from 2000 to 2017 were evaluated by two reviewers using an advanced search of the databases with keywords related to lifestyles and suburban population. After completion of the search, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to evaluate the articles. Results In total, 19 articles were found to have addressed the lifestyle in suburban populations. The results of these studies showed an unhealthy lifestyle in the most informal settlements. There was no food diversity. Malnutrition was common, especially overweight. The majority of the people did not have enough physical activity, and smoking and alcohol consumption were common, especially in men. Conclusion Studies showed that suburban populations are among the groups that have unfavorable environmental conditions to acquiring healthy lifestyle and maintaining appropriate health. Therefore, developing infrastructure, improving health services (environment, treatment of diseases, reduction of malnutrition and infant mortality, access to safe drinking water and sanitation, improving waste disposal and recycling it), improving education and smoking prevention programs in improving lifestyle is recommended. PMID:28894537

  9. Measures of personal recovery: a systematic review.

    PubMed

    Shanks, Vicki; Williams, Julie; Leamy, Mary; Bird, Victoria J; Le Boutillier, Clair; Slade, Mike

    2013-10-01

    OBJECTIVE Mental health systems internationally have adopted a goal of supporting recovery. Measurement of the experience of recovery is, therefore, a priority. The aim of this review was to identify and analyze recovery measures in relation to their fit with recovery and their psychometric adequacy. METHODS A systematic search of six data sources for articles, Web-based material, and conference presentations related to measurement of recovery was conducted by using a defined search strategy. Results were filtered by title and by abstract (by two raters in the case of abstracts), and the remaining papers were reviewed to identify any suitable measures of recovery. Measures were then evaluated for their fit with the recovery processes identified in the CHIME framework (connectedness, hope, identity, meaning, and empowerment) and for demonstration of nine predefined psychometric properties. RESULTS Thirteen measures of personal recovery were identified from 336 abstracts and 35 articles. The Recovery Assessment Scale (RAS) was published most, and the Questionnaire About the Process of Recovery (QPR) was the only measure to have all items map to the CHIME framework. No measure demonstrated all nine psychometric properties. The Stages of Recovery Instrument demonstrated the most psychometric properties (N=6), followed by the Maryland Assessment of Recovery (N=5), and the QPR and the RAS (N=4). Criterion validity, responsiveness, and feasibility were particularly underinvestigated properties. CONCLUSIONS No recovery measure can currently be unequivocally recommended, although the QPR most closely maps to the CHIME framework of recovery and the RAS is most widely published.

  10. Short dental implants: a systematic review.

    PubMed

    Annibali, S; Cristalli, M P; Dell'Aquila, D; Bignozzi, I; La Monaca, G; Pilloni, A

    2012-01-01

    Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this review was to systematically evaluate clinical studies of implants < 10 mm in length, to determine short implant-supported prosthesis success in the atrophic jaw. Implant survival, incidence of biological and biomechanical complications, and radiographic peri-implant marginal bone loss were evaluated. Screening of eligible studies, quality assessment, and data extraction were conducted by two reviewers independently. Meta-analyses were performed by the pooling of survival data by implant surface, surgical technique, implant location, type of edentulism, and prosthetic restoration. Two randomized controlled trials and 14 observational studies were selected and analyzed for data extraction. In total, 6193 short-implants were investigated from 3848 participants. The observational period was 3.2 ± 1.7 yrs (mean ± SD). The cumulative survival rate (CSR) was 99.1% (95%CI: 98.8-99.4). The biological success rate was 98.8% (95%CI: 97.8-99.8), and the biomechanical success rate was 99.9% (95%CI: 99.4-100.0). A higher CSR was reported for rough-surfaced implants. The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

  11. Fetal deaths in Brazil: a systematic review

    PubMed Central

    Barbeiro, Fernanda Morena dos Santos; Fonseca, Sandra Costa; Tauffer, Mariana Girão; Ferreira, Mariana de Souza Santos; da Silva, Fagner Paulo; Ventura, Patrícia Mendonça; Quadros, Jesirée Iglesias

    2015-01-01

    OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners. RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history. CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary. PMID:25902565

  12. Multiple sclerosis in Brazil: A systematic review.

    PubMed

    Vasconcelos, C C F; Thuler, L C S; Rodrigues, B C; Calmon, A B; Alvarenga, R M P

    2016-12-01

    The natural history of multiple sclerosis (MS) in Brazil has been available in different regions of country. There is no nationwide population-based studies that express general data in Brazil. To review and synthesize available data about MS in Brazil. Systematic review was performed through a search of medical literature databases to identify Brazilian studies published during 1990-2012. PubMed, SciELO, and Lilacs. "Brazil" or "Brazilian" combined with the following terms: "multiple sclerosis", "clinical profile", "demographic profile", "natural history", "clinical course", "pediatric", or "familial form". In total of 45 pediatric and 1922 adult patients, the median age at onset was 10 years in pediatric patients and 32 years in adult patients. Women were more affected. Motor-control complaints and relapsing-remitting phenotype at onset were the most common. Predictors to disability and progression were number of relapses during the first year of disease, older age, male gender and African ancestry. The profile of the MS in Brazilian seems to correspond to that observed in high-MS-prevalence areas. African ancestry is a risk factor to disability and progression early. In Brazil, factors that limit MS incidence do not interfere with the clinical pattern and outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Creativity and psychopathology: a systematic review.

    PubMed

    Thys, Erik; Sabbe, Bernard; De Hert, Marc

    2014-01-01

    The possible link between creativity and psychopathology has been a long-time focus of research up to the present day. However, the research results in this field are heterogeneous and contradictory. Links between creativity and specific psychiatric disorders have been confirmed and refuted in different studies. This disparity is partly explained by the methodological challenges peculiar to this field. In this systematic review of the literature from 1950, research articles in the field of creativity and psychopathology are presented, focusing on the methodology and results of the collected studies. This review confirms the methodological problems and the heterogeneity of the study designs and results. The assessment of psychopathology, but more so of creativity, remains a fundamental challenge. On the whole, study results cautiously confirm an association between creativity and both bipolar disorder and schizotypy. The research on creativity and psychopathology is hampered by serious methodological problems. Study results are to be interpreted with caution and future research needs more methodological rigor. © 2014 S. Karger AG, Basel.

  14. Toxocariasis in North America: A Systematic Review

    PubMed Central

    Bottazzi, Maria Elena; Hotez, Peter J.

    2014-01-01

    Toxocariasis is an important neglected tropical disease that can manifest as visceral or ocular larva migrans, or covert toxocariasis. All three forms pose a public health problem and cause significant morbidity in areas of high prevalence. To determine the burden of toxocariasis in North America, we conducted a systematic review of the literature followin