ORCID Profile
0000-0002-7825-6765
Current Organisation
University of British Columbia
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Publisher: Research Square Platform LLC
Date: 28-06-2021
DOI: 10.21203/RS.3.RS-237881/V2
Abstract: Background: Overviews synthesising the results of multiple systematic reviews help inform evidence-based clinical practice. In this first of two companion papers, we evaluate the bibliometrics of overviews, including their prevalence and factors affecting citation rates and journal impact factor. Methods: We searched MEDLINE, Epistemonikos and Cochrane databases. We included overviews that: (a) synthesised reviews, (b) conducted a systematic search, (c) had a methods section, and (d) examined a healthcare intervention. Multivariate regression was conducted to determine the association between citation density, impact factor and 6 predictor variables. Results: We found 1218 overviews published from 2000 to 2020 the majority (73%) were published in the most recent 5-year period. We extracted a selection of these overviews (n=541 44%) dated from 2000 to 2018. The 541 overviews were published in 307 journals Cochrane Database (8%), PLOS ONE (3%) and Sao Paulo Medical Journal (2%) were the most prevalent. The majority (70%) were published in journals with impact factors between 0.05 and 3.97. We found a mean citation count of 10 overviews per year, published in journals with a mean impact factor of 4.4. In multivariate analysis, overviews with a high number of citations and impact factors had more authors, larger s le sizes, were open access and reported the funding source. Conclusions: An 8-fold increase in the number of overviews was found between 2009 and 2020. We identified 332 overviews published in 2020, which is equivalent to 1 overview published per day. Overviews perform above average for the journals in which they publish.
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-054223
Abstract: An increasing growth of systematic reviews (SRs) presents notable challenges for decision-makers seeking to answer clinical questions. In 1997, an algorithm was created by Jadad to assess discordance in results across SRs on the same question. Our study aims to (1) replicate assessments done in a s le of studies using the Jadad algorithm to determine if the same SR would have been chosen, (2) evaluate the Jadad algorithm in terms of utility, efficiency and comprehensiveness, and (3) describe how authors address discordance in results across multiple SRs. We will use a database of 1218 overviews (2000–2020) created from a bibliometric study as the basis of our search for studies assessing discordance (called discordant reviews). This bibliometric study searched MEDLINE (Ovid), Epistemonikos and Cochrane Database of Systematic Reviews for overviews. We will include any study using Jadad (1997) or another method to assess discordance. The first 30 studies screened at the full-text stage by two independent reviewers will be included. We will replicate the authors’ Jadad assessments. We will compare our outcomes qualitatively and evaluate the differences between our Jadad assessment of discordance and the authors’ assessment. No ethics approval was required as no human subjects were involved. In addition to publishing in an open-access journal, we will disseminate evidence summaries through formal and informal conferences, academic websites, and across social media platforms. This is the first study to comprehensively evaluate and replicate Jadad algorithm assessments of discordance across multiple SRs.
Publisher: Research Square Platform LLC
Date: 07-12-2021
DOI: 10.21203/RS.3.RS-237881/V3
Abstract: Background: Overviews synthesising the results of multiple systematic reviews help inform evidence-based clinical practice. In this first of two companion papers, we evaluate the bibliometrics of overviews, including their prevalence and factors affecting citation rates and JIF (JIF). Methods: We searched MEDLINE, Epistemonikos and Cochrane Database of Systematic Reviews (CDSR). We included overviews that: (a) synthesised reviews, (b) conducted a systematic search, (c) had a methods section, and (d) examined a healthcare intervention. Multivariable regression was conducted to determine the association between citation density, JIF and 6 predictor variables. Results: We found 1218 overviews published from 2000 to 2020 the majority (73%) were published in the most recent 5-year period. We extracted a selection of these overviews (n=541 44%) dated from 2000 to 2018. The 541 overviews were published in 307 journals CDSR (8%), PLOS ONE (3%) and Sao Paulo Medical Journal (2%) were the most prevalent. The majority (70%) were published in journals with impact factors between 0.05 and 3.97. We found a mean citation count of 10 overviews per year, published in journals with a mean JIF of 4.4. In multivariable analysis, overviews with a high number of citations and JIFs had more authors, larger s le sizes, were open access and reported the funding source. Conclusions: An 8-fold increase in the number of overviews was found between 2009 and 2020. We identified 332 overviews published in 2020, which is equivalent to 1 overview published per day. Overviews perform above average for the journals in which they publish.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.JCLINEPI.2022.08.004
Abstract: To investigate reporting and methodological characteristics of overviews on adverse (drug-associated) events (AEs) of pharmacological interventions. We searched MEDLINE, Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews from inception to May 17, 2021 for overviews exclusively investigating AEs of pharmacological interventions. We extracted general, reporting, and methodological characteristics and analyzed data descriptively. We included 27 overviews, 70% of which were published in 2016 or later. The most common nomenclature in the title was "overview" (56%), followed by "umbrella review" (26%). The median number of included systematic reviews (SRs) in each overview was 15 (interquartile range 7-34). Study selection methods were reported in 52%, methods for data extraction in 67%, and methods for critical appraisal in 63% of overviews. An assessment of methodological quality of included SRs was performed in 70% of overviews. Only 22% of overviews reported strategies for dealing with overlapping SRs. An assessment of the certainty of the evidence was performed in 33% of overviews. To ensure methodological rigor, authors of overviews on AEs should follow available guidance for the conduct and reporting of overviews.
Publisher: Research Square Platform LLC
Date: 15-02-2021
DOI: 10.21203/RS.3.RS-237881/V1
Abstract: Background: Overviews synthesizing the results of multiple systematic reviews help inform evidence-based clinical practice. In this first of two companion papers, we evaluate the bibliometrics of ‘overviews of systematic reviews’, including their prevalence, number of citations, and factors affecting citation rates and journal impact factor. Methods: We searched MEDLINE, Epistemonikos and the Cochrane library databases. We applied eligibility criteria to identify overviews that: (a) aimed to focus on synthesizing reviews, (b) conducted a systematic search, (c) had a full methods section, and (d) examined a health intervention or clinical treatment effect. A multivariate regression was conducted to determine the association between citation density and impact factor and 6 predictor variables of interest. Results: We found 1218 overviews published from 2000 to 2020 the majority (73%) of which were published in the most recent 5-year period (2016-2020). We extracted a selection of these overviews (n=541 44%) dated from 2000 to 2018. The 541 overviews were published in 307 journals the Cochrane Database of Systematic Reviews (8%), PLOS ONE (3%) and the Sao Paulo Medical Journal (2%) being the most prevalent. The majority of overviews (70%) were published in journals with impact factors between 0.05 and 3.97. The average citation rate was 90 (SD ±219.7) over 9 years, or 10 citations per overview per year. In multivariate analysis, overviews with a high number of citations and high journal impact factors tended to have more authors, larger s le sizes, be open access and report funding source. Conclusions: We found an 8 fold increase in the number of overviews from 2009 to 2020 and a representation of one published a day in 2020. Factors driving the increase in overviews include the exponential increase in the number of systematic reviews, the publication of Cochrane guidance on overview of reviews in 2009 and the subsequent publication of the first Cochrane overview in the same year. Our study found a significantly higher mean citation count of 10 overviews per year, published in journals with a mean impact factor of 4.4. These data indicate that, overall, overviews perform above average for the journals in which they publish. We also found that highly cited overviews in high impact factor journals had group authorship, large s le sizes, were openly accessible, and reported funding source.
Publisher: Springer Science and Business Media LLC
Date: 26-10-2022
DOI: 10.1186/S12874-022-01750-2
Abstract: The exponential growth of published systematic reviews (SRs) presents challenges for decision makers seeking to answer clinical, public health or policy questions. In 1997, an algorithm was created by Jadad et al. to choose the best SR across multiple. Our study aims to replicate author assessments using the Jadad algorithm to determine: (i) if we chose the same SR as the authors and (ii) if we reach the same results. We searched MEDLINE, Epistemonikos, and Cochrane Database of SRs. We included any study using the Jadad algorithm. We used consensus building strategies to operationalise the algorithm and to ensure a consistent approach to interpretation. We identified 21 studies that used the Jadad algorithm to choose one or more SRs. In 62% (13/21) of cases, we were unable to replicate the Jadad assessment and ultimately chose a different SR than the authors. Overall, 18 out of the 21 (86%) independent Jadad assessments agreed in direction of the findings despite 13 having chosen a different SR. Our results suggest that the Jadad algorithm is not reproducible between users as there are no prescriptive instructions about how to operationalise the algorithm. In the absence of a validated algorithm, we recommend that healthcare providers, policy makers, patients and researchers address conflicts between review findings by choosing the SR(s) with meta-analysis of RCTs that most closely resemble their clinical, public health, or policy question, are the most recent, comprehensive (i.e. number of included RCTs), and at the lowest risk of bias.
Publisher: Cold Spring Harbor Laboratory
Date: 30-10-2022
DOI: 10.1101/2022.10.26.22281577
Abstract: One of the most conflicting methodological issues when conducting an overview is the overlap of primary studies included across systematic reviews (SRs). Overlap in the pooled effect estimates across SRs may lead to overly precise effect estimates in the overview. SRs that focus on exercise-related interventions are often included in overviews aimed at grouping and determining the effectiveness of various interventions for the management of specific health conditions. The aim of this systematic methodological review is to describe the strategies used by authors of overviews focusing on exercise-related interventions to manage the overlap of primary studies. A comprehensive search strategy has been developed for different databases and their platforms. The databases to be consulted will be MEDLINE (Ovid), Embase (Ovid), The Cochrane Database of Systematic Reviews (Cochrane Library), and Epistemonikos. Two reviewers will independently screen the records identified through the search strategy and will extract the information from the included overviews. The frequency and the type of overlap management strategies of the primary studies included in the SRs will be considered as the main outcome. In addition, the recognition of the lack of use of any overlap management strategy and the congruence between planning and conducting the overview focusing on overlap management strategies will be assessed. A sub-group analysis will be carried out using the impact factor of the journals at the time of publication of the overviews as the variable. This methodological review will provide a complete and comprehensive summary of the frequency of use and types of strategies used for managing the overlap of primary studies across the SRs included in the overviews focusing on exercise-related interventions in different health conditions. Future studies should apply different overlap management strategies to understand their impact on results and conclusions. INPLASY202250161.
Publisher: Cold Spring Harbor Laboratory
Date: 16-06-2023
DOI: 10.1101/2023.06.16.23291488
Abstract: Overlap of primary studies among systematic reviews (SRs) included in an overview is a major challenge, as it may bias results or artificially increase the precision of the synthesis. Matrices of evidence and corrected covered area (CCA) calculation are recommended methods to manage overlap, but there is little guidance on how to construct these matrices. This research aims to explore variations in the estimation of overlap using CCA matrices under different assumptions. We will include overviews published in 2023. We will describe the methods used by authors to deal with overlap, and we will calculate a summary CCA (a CCA for the whole matrix of evidence) and a pairwise CCA (a CCA for each possible pair of included SRs), comparing the results under different assumptions that may modify the evidence matrix and thus the CCA. These assumptions include: publication-thread adjustments (i.e. the consideration of each set of references regarding a single primary study as a unique row in a matrix of evidence), scope adjustments (i.e. the consideration only of the SRs and primary studies providing useful data for a given outcome within an overview) and chronological structural missingness adjustments (i.e. the exclusion of primary studies published after a given SR for purposes of CCA calculation). We will assess overlap at an overview and outcome level. We propose clear definitions for the key assumptions for creating matrices of evidence. We expect to provide a guide for overview authors to better interpret their CCA estimations. This protocol explores the assumptions underlying the overlap assessment in overviews of systematic reviews, that so far have not been explicitly addressed. These assumptions include scope adjustments, publication-thread adjustments, structural missingness adjustments, and analysis at an overview or outcome level. We provide clear definitions for key overlap concepts that will guide authors for making their overlap assessments more explicit when using a matrix of evidence or corrected covered area approach. We plan to conduct exploratory analyses under different assumptions in a purposive s le of overview, hence, we will not comprehensively include all the overviews in the study period. We will conduct all the analysis calculating the corrected covered area for the whole matrices (overall approach) and for every possible pair of systematic reviews within each matrix (pairwise approach).
Publisher: Springer Science and Business Media LLC
Date: 08-01-2019
Publisher: Research Square Platform LLC
Date: 23-01-2021
DOI: 10.21203/RS.3.RS-40905/V1
Abstract: Introduction Assessing the process used to synthesise the evidence in clinical practice guidelines (CPGs) enables users to determine the trustworthiness of the recommendations. We aimed to assess whether systematic methods were used when synthesizing the evidence for CPGs and whether reviews or ‘overviews of reviews’ were cited in support of recommendations. Methods and analysis We followed a study protocol. CPGs published in 2017 and 2018 were retrieved from TRIP and Epistemonikos. We randomly sorted and sequentially screened the CPGs to select the first 50 that met our inclusion criteria. Our primary outcomes were the numbers and proportions of recommendations that were based on reviews and ‘overviews‘, and CPGs using either a systematic or non-systematic process to gather, assess, and synthesise evidence. We also looked for evidence that critical appraisal was conducted. We also performed a chi-square test of independence to examine the relationship between variables. Results Of the 50 guidelines, 34% did an exceptional job in systematically synthesising the evidence to inform recommendations. These guidelines clearly reported their objectives and eligibility criteria, conducted comprehensive search strategies, and assessed the quality of the studies. 66% of CPGs reported non-systematic methods to develop their recommendations. This percentage is likely an underestimation because we excluded some CPGs when selecting studies. Overall, 90% of CPGs cited reviews to inform recommendations, and one fifth cited a Cochrane systematic review. Of the 29 CPGs that included reviews, 21% critically appraised the review. 60% of CPGs assessed the quality of primary studies. Conclusions We used novel methodology to evaluate recommendations in a random s le of CPGs, and found that 62% did not use a systematic process to gather, appraise, and synthesise the evidence. Significant improvement is needed in the conduct and reporting of CPG methods. Guideline developers should use systematic methods endorsed by reputable evidence synthesis organisations.
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJOPEN-2019-031442
Abstract: Guidelines are systematically developed recommendations to assist practitioner and patient decisions about treatments for clinical conditions. High quality and comprehensive systematic reviews and ‘overviews of systematic reviews’ (overviews) represent the best available evidence. Many guideline developers, such as the WHO and the Australian National Health and Medical Research Council, recommend the use of these research syntheses to underpin guideline recommendations. We aim to evaluate the impact and use of systematic reviews with and without pairwise meta-analysis or network meta-analyses (NMAs) and overviews in clinical practice guideline (CPG) recommendations. CPGs will be retrieved from Turning Research Into Practice and Epistemonikos (2017–2018). The retrieved citations will be sorted randomly and then screened sequentially by two independent reviewers until 50 CPGs have been identified. We will include CPGs that provide at least two explicit recommendations for the management of any clinical condition. We will assess whether reviews or overviews were cited in a recommendation as part of the development process for guidelines. Data extraction will be done independently by two authors and compared. We will assess the risk of bias by examining how each guideline developed clinical recommendations. We will calculate the number and frequency of citations of reviews with or without pairwise meta-analysis, reviews with NMAs and overviews, and whether they were systematically or non-systematically developed. Results will be described, tabulated and categorised based on review type (reviews or overviews). CPGs reporting the use of the Grading of Recommendations, Assessment, Development and Evaluation approach will be compared with those using a different system, and pharmacological versus non-pharmacological CPGs will be compared. No ethics approval is required. We will present at the Cochrane Colloquium and the Guidelines International Network conference.
Publisher: Public Library of Science (PLoS)
Date: 21-06-2018
Publisher: Research Square Platform LLC
Date: 17-12-2021
DOI: 10.21203/RS.3.RS-1143357/V1
Abstract: Introduction: The exponential growth of published SRs (SRs) presents challenges for clinicians seeking to answer clinical questions. In 1997, an algorithm was created by Jadad et al. to choose the best SR across multiple but similar SRs with conflicting results. Our study aims to replicate assessments done by authors using the Jadad algorithm to determine: (i) if we chose the same SR as the authors and (ii) if we would reach the same results. Methods and Analysis: We searched MEDLINE, Epistemonikos, and Cochrane Database of SRs. We included any study using the Jadad algorithm. We used consensus building strategies to operationalise the algorithm and to ensure a consistent approach to interpretation. Results: We identified 21 studies that used the Jadad algorithm to choose one or more SRs. In 62% (13/21) of cases, we were unable to replicate the Jadad assessment and ultimately chose a different SR than the authors. Overall, 18 out of the 21 (86%) independent Jadad assessments agreed in direction of the findings despite 13 having chosen a different SR. Conclusions: Our results suggest that the Jadad algorithm is not reproducible between users as there are no prescriptive instructions about how to operationalise the algorithm. In the absence of a validated algorithm, we recommend that healthcare providers, policy makers, patients and researchers address conflicts between review findings by choosing the SR(s) with meta-analysis of RCTs that most closely resemble their clinical, public health, or policy question, are the most recent, comprehensive (i.e. in terms of number of included RCTs), and at the lowest risk of bias.
Publisher: Research Square Platform LLC
Date: 26-01-2022
DOI: 10.21203/RS.3.RS-1143357/V2
Abstract: Introduction: The exponential growth of published systematic reviews (SRs) presents challenges for clinicians seeking to answer clinical questions. In 1997, an algorithm was created by Jadad et al. to choose the best SR across multiple. Our study aims to replicate author assessments using the Jadad algorithm to determine: (i) if we chose the same SR as the authors and (ii) if we reach the same results.Methods and Analysis: We searched MEDLINE, Epistemonikos, and Cochrane Database of SRs. We included any study using the Jadad algorithm. We used consensus building strategies to operationalise the algorithm and to ensure a consistent approach to interpretation.Results: We identified 21 studies that used the Jadad algorithm to choose one or more SRs. In 62% (13/21) of cases, we were unable to replicate the Jadad assessment and ultimately chose a different SR than the authors. Overall, 18 out of the 21 (86%) independent Jadad assessments agreed in direction of the findings despite 13 having chosen a different SR. Conclusions: Our results suggest that the Jadad algorithm is not reproducible between users as there are no prescriptive instructions about how to operationalise the algorithm. In the absence of a validated algorithm, we recommend that healthcare providers, policy makers, patients and researchers address conflicts between review findings by choosing the SR(s) with meta-analysis of RCTs that most closely resemble their clinical, public health, or policy question, are the most recent, comprehensive (i.e. in terms of number of included RCTs), and at the lowest risk of bias.
Publisher: BMJ
Date: 04-2023
DOI: 10.1136/BMJOPEN-2022-069906
Abstract: One of the most conflicting methodological issues when conducting an overview is the overlap of primary studies across systematic reviews (SRs). Overlap in the pooled effect estimates across SRs may lead to overly precise effect estimates in the overview. SRs that focus on exercise-related interventions are often included in overviews aimed at grouping and determining the effectiveness of various interventions for managing specific health conditions. The aim of this systematic methodological review is to describe the strategies used by authors of overviews focusing on exercise-related interventions to manage the overlap of primary studies. A comprehensive search strategy has been developed for different databases and their platforms. The databases to be consulted will be MEDLINE (Ovid), Embase (Ovid), The Cochrane Database of Systematic Reviews (Cochrane Library) and Epistemonikos. Two reviewers will independently screen the records identified through the search strategy and extract the information from the included overviews. The frequency and the type of overlap management strategies of the primary studies included in the SRs will be considered as the main outcome. In addition, the recognition of the lack of use of any overlap management strategy and the congruence between planning and conducting the overview focusing on overlap management strategies will be assessed. A subgroup analysis will be carried out according to the journal impact factor, year of publication and compliance with the Preferred Reporting Items for Overviews of Reviews statement. This study will not involve human subjects and therefore does not require ethics committee approval. However, the conduct and reporting of the findings of this review will be conducted in a rigorous, systematic and transparent manner, which relates to research ethics. The findings of this review will be presented at scientific conferences and published as one or more studies in peer-review scientific journals related to rehabilitation or research methods.
Publisher: Wiley
Date: 25-10-2021
DOI: 10.1002/JRSM.1530
Abstract: Overviews synthesising the results of multiple systematic reviews help inform evidence‐based clinical practice. In this first of two companion papers, we evaluate the bibliometrics of overviews, including their prevalence and factors affecting citation rates and journal impact factor (JIF). We searched MEDLINE, Epistemonikos and Cochrane Database of Systematic Reviews (CDSR). We included overviews that: (a) synthesised reviews, (b) conducted a systematic search, (c) had a methods section and (d) examined a healthcare intervention. Multivariable regression was conducted to determine the association between citation density, JIF and six predictor variables. We found 1218 overviews published from 2000 to 2020 the majority (73%) were published in the most recent 5‐year period. We extracted a selection of these overviews ( n = 541 44%) dated from 2000 to 2018. The 541 overviews were published in 307 journals CDSR (8%), PLOS ONE (3%) and Sao Paulo Medical Journal (2%) were the most prevalent. The majority (70%) were published in journals with impact factors between 0.05 and 3.97. We found a mean citation count of 10 overviews per year, published in journals with a mean JIF of 4.4. In multivariable analysis, overviews with a high number of citations and JIFs had more authors, larger s le sizes, were open access and reported the funding source. An eightfold increase in the number of overviews was found between 2009 and 2020. We identified 332 overviews published in 2020, which is equivalent to one overview published per day. Overviews perform above average for the journals in which they publish.
Publisher: Research Square Platform LLC
Date: 31-08-2022
DOI: 10.21203/RS.3.RS-2010358/V1
Abstract: Introduction: Network meta-analyses (NMAs) have gained popularity and grown in number due to their ability to provide estimates of comparative effectiveness of multiple treatments for the same condition. The aim of this study is to conduct a methodological review to compile a preliminary list of concepts related to bias in NMAs. Methods and Analysis: We included papers that present items related to bias, reporting, or methodological quality, papers assessing the quality of NMAs, or methods papers. We searched MEDLINE, the Cochrane library, and unpublished literature. We extracted items related to bias in NMAs. An item was excluded if it was an item related to general systematic review quality or bias, and included in currently available tools such as ROBIS or AMSTAR 2. We reworded items, typically structured as questions, into concepts (i.e. general notions). Results: 181 articles were assessed at full text and 57 were included. Of these articles, 12 were tools, checklists or journal standards, 12 were guidance documents for NMAs, 26 were articles related to bias or methods, and 7 were papers that assessed the quality of NMAs. These studies yielded 99 items of which the majority related to general systematic review quality and biases and were therefore excluded. The items we included were reworded into 22 concepts specific to bias in NMAs. Conclusions: A list of 22 concepts were included. This list is not intended to be used to assess biases in NMAs, but to inform the development of items to be included in our tool.
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.JCLINEPI.2015.12.002
Abstract: Locating overviews of systematic reviews is difficult because of an absence of appropriate indexing terms and inconsistent terminology used to describe overviews. Our objective was to develop a validated search strategy to retrieve overviews in MEDLINE. We derived a test set of overviews from the references of two method articles on overviews. Two population sets were used to identify discriminating terms, that is, terms that appear frequently in the test set but infrequently in two population sets of references found in MEDLINE. We used text mining to conduct a frequency analysis of terms appearing in the titles and abstracts. Candidate terms were combined and tested in MEDLINE in various permutations, and the performance of strategies measured using sensitivity and precision. Two search strategies were developed: a sensitivity-maximizing strategy, achieving 93% sensitivity (95% confidence interval [CI]: 87, 96) and 7% precision (95% CI: 6, 8), and a sensitivity-and-precision-maximizing strategy, achieving 66% sensitivity (95% CI: 58, 74) and 21% precision (95% CI: 17, 25). The developed search strategies enable users to more efficiently identify overviews of reviews compared to current strategies. Consistent language in describing overviews would aid in their identification, as would a specific MEDLINE Publication Type.
Publisher: Research Square Platform LLC
Date: 02-10-2023
Publisher: Springer Science and Business Media LLC
Date: 06-05-2013
Abstract: Although the precise etiology of multiple sclerosis is largely unknown, there is some speculation that a prior history of surgery may be associated with the subsequent risk for developing the disease. Therefore, we aimed to examine surgery as a risk factor for the diagnosis of multiple sclerosis. We searched for observational studies that evaluated the risk for developing multiple sclerosis after surgery that occurred in childhood (≤ 20 years of age) or “premorbid” ( 20 years of age). We specifically included surgeries classified as: tonsillectomy, appendectomy, adenoidectomy, or “surgery”. We performed a systematic review and meta-analyses and calculated odds ratios (OR) and their 95% confidence intervals (CIs) using a random effects model. We identified 33 case–control studies, involving 27,373 multiple sclerosis cases and 211,756 controls. There was a statistically significant association between tonsillectomy (OR = 1.32, 95% CI 1.08-1.61 12 studies, I 2 = 44%) and appendectomy (OR = 1.16, 95% CI 1.01-1.34 7 studies, I 2 = 0%) in in idual’s ≤ 20 years of age and the subsequent risk for developing multiple sclerosis. There was no statistically significant association between risk for multiple sclerosis and tonsillectomy occurring after age 20 (OR = 1.20, 95% CI 0.94-1.53 9 studies, I 2 = 32%), in those with appendectomy at 20 years (OR = 1.26, 95% CI 0.92-1.72 5 studies, I 2 = 46%), and in those with adenoidectomy at ≤ 20 years of age (OR = 1.06, 95% CI 0.68-1.68 3 studies, I 2 = 35%). The combined OR of 15 studies (N = 2,380) looking at “surgery” before multiple sclerosis diagnosis was not statistically significant (OR = 1.19, 95% CI 0.83-1.70 I 2 = 71%). We found a small but statistically significant and clinically important increased risk for developing multiple sclerosis, in those with tonsillectomy and appendectomy at ≤ 20 years of age. There was no convincing evidence to support the association of other surgeries and the risk for multiple sclerosis. Well-designed prospective etiological studies, pertaining to the risk for developing multiple sclerosis, ought to be conducted and should include the examination of various surgeries as risk factors.
Publisher: BMJ
Date: 10-08-2022
DOI: 10.1136/BMJEBM-2022-111944
Abstract: Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We aimed to develop a risk of bias (RoB) tool to assess NMAs (RoB NMA tool). An international steering committee recommended that the RoB NMA tool to be used in combination with the Risk of Bias in Systematic reviews (ROBIS) tool (i.e. because it was designed to assess biases only) or other similar quality appraisal tools (eg, A MeaSurement Tool to Assess systematic Reviews 2 [AMSTAR 2]) to assess quality of systematic reviews. The RoB NMA tool will assess NMA biases and limitations regarding how the analysis was planned, data were analysed and results were presented, including the way in which the evidence was assembled and interpreted. Conduct (a) a Delphi process to determine expert opinion on an item’s inclusion and (b) a knowledge user survey to widen its impact. Cross-sectional survey and Delphi process. Delphi panellists were asked to rate whether items should be included. All agreed-upon item were included in a second round of the survey (defined as 70% agreement). We surveyed knowledge users’ views and preferences about the importance, utility and willingness to use the RoB NMA tool to evaluate evidence in practice and in policymaking. We included 12 closed and 10 open-ended questions, and we followed a knowledge translation plan to disseminate the survey through social media and professional networks. 22 items were entered into a Delphi survey of which 28 respondents completed round 1, and 22 completed round 2. Seven items did not reach consensus in round 2. A total of 298 knowledge users participated in the survey (14% respondent rate). 75% indicated that their organisation produced NMAs, and 78% showed high interest in the tool, especially if they had received adequate training (84%). Most knowledge users and Delphi panellists preferred a tool to assess both bias in in idual NMA results and authors’ conclusions. Response bias in our s le is a major limitation as knowledge users working in high-income countries were more represented. One of the limitations of the Delphi process is that it depends on the purposive selection of experts and their availability, thus limiting the variability in perspectives and scientific disciplines. This Delphi process and knowledge user survey informs the development of the RoB NMA tool.
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.HEALTHPOL.2011.07.011
Abstract: Public health officials and health providers need to be aware of the legislation documenting contact tracing in their jurisdiction to advise HIV positive clients of their rights, and to systematically perform their duties. The objective is to outline and compare the contact tracing laws in 13 jurisdictions in Canada, and to provide policy recommendations. A systematic review was performed to outline and compare the laws in Canadian jurisdictions regarding HIV contact tracing. Specific manual searches were done in websites of Canadian provincial and territorial departments of health. For thirteen provinces and territories within Canada eleven laws were found. No laws directly pertaining to partner notification or contact tracing were found in Newfoundland and Labrador or Quebec. Public health officials should ensure that contact tracing practices and policies accurately reflect the current regulations without compromising their patients' confidentiality. It is recommended that each province/territory would benefit from standardized contact tracing regulations which are imbedded in communicable disease legislation. Regulations with provisions for informed consent, confidentiality, multiple counselling sessions, clear procedures in duty to warn cases, and domestic violence screening would be considered best practice.
Publisher: Research Square Platform LLC
Date: 10-01-2023
DOI: 10.21203/RS.3.RS-2416773/V1
Abstract: Background Systematic reviews (SRs) are being published at an accelerated rate. Decision makers are often faced with the challenge of comparing and choosing between multiple SRs on the same topic. We surveyed in iduals in the healthcare field to understand what criteria they use to compare and select one or more SRs from multiple on the same topic. Methods We developed a survey with 21 open and closed questions. We disseminated it through social media and professional networks. Results Of the 684 respondents, 25% were health practitioners, 9% policymakers, 39% researchers, and 13% were students. Policymakers, practitioners and researchers frequently sought out SRs (98.1%) as a source of evidence to inform decision making. They frequently (97.7%) found more than one SR on a given topic of interest to them. Half (50%) struggled to choose the most valid and trustworthy SR amongst multiple. These difficulties related to lack of time (55.2%), insufficient skills/ experience in quality appraisal (27.7%), and difficulty comparing different SRs (54.3%). Respondents compared SRs based on: relevance to their question of interest its methodological quality, and recency of SR search date. Conclusions The exponential growth in the number of SRs leads to duplication of research on similar questions and compounds the problem of identifying which evidence is of the highest quality for decision makers. Failure to critically appraise and choose the highest quality SRs means that practice and policy decisions may not reflect the best evidence, the implementation of better intervention strategies is delayed, and patients may unduly suffer.
Publisher: Research Square Platform LLC
Date: 24-09-2021
DOI: 10.21203/RS.3.RS-931213/V1
Abstract: Introduction: An increasing growth of systematic reviews (SRs) presents notable challenges for decision-makers seeking to answer clinical questions. Overviews of systematic reviews aim to address these challenges by summarising results of SRs and making sense of potentially discrepant SR results and conclusions. In 1997, an algorithm was created by Jadad to assess discordance in results across SRs on the same topic. Since this tool pre-dates the advent of overviews, it has been inconsistently applied in this context. Our study aims to (a) replicate assessments done in a s le of overviews using the Jadad algorithm to determine if the same SR would have been chosen, (b) evaluate the Jadad algorithm in terms of utility, efficiency, and comprehensiveness, and (c) describe how overviews address discordance in results across multiple SRs. Methods and Analysis: We will use a database of 1218 overviews (2000-2020) created from a bibliometric study as the basis of our search for overviews assessing discordance. This bibliometric study searched MEDLINE (Ovid), Epistemonikos, and Cochrane Database for overviews. We will include any overviews using Jadad (1997) or another method to assess discordance. The first 30 overviews screened at the full-text stage by two independent reviewers will be included. We will replicate Jadad assessments in overviews. We will compare our outcomes qualitatively and evaluate the differences between our Jadad assessment of discordance and the overviews’ assessment. Ethics and Dissemination: No ethics approval was required as no human subjects were involved. In addition to publishing in an open-access journal, we will disseminate evidence summaries through formal and informal conferences, academic websites, and across social media platforms. This is the first study to comprehensively evaluate and replicate Jadad algorithm assessments of discordance in SRs.
Publisher: Research Square Platform LLC
Date: 15-02-2021
DOI: 10.21203/RS.3.RS-242201/V1
Abstract: Introduction: Systematic reviews with network meta-analysis (NMA i.e., multiple treatment comparisons, indirect comparisons) have gained popularity and grown in number due to their ability to provide comparative effectiveness of multiple treatments for the same condition. The methodological review aims to develop a list of items relating to biases in reviews with NMA. Such a list will inform a new tool to assess the risk of bias in NMAs, and potentially other reporting or quality checklists for NMAs which are being updated. Methods and Analysis: We will include articles that present items related to bias, reporting, or methodological quality, articles assessing the methodological quality of reviews with NMA, or papers presenting methods for NMAs. We will search Ovid MEDLINE, the Cochrane library, and difficult to locate/unpublished literature. Once all items have been extracted, we will combine conceptually similar items, classifying them as referring to bias or to other aspects of quality (e.g. reporting). When relevant, reporting items will be re-worded into items related to bias in NMA review conclusions, and then re-worded as signalling questions. Ethics and Dissemination: No ethics approval was required. Patients, healthcare providers and policy makers need the highest quality evidence to make decisions about which treatments should be used in healthcare practice. Being able to critically appraise the findings of systematic reviews that include NMA is central to informed decision-making in patient care.
Publisher: INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols
Date: 28-05-2022
DOI: 10.37766/INPLASY2022.5.0161
Abstract: Review question / Objective: This methodological review aims to find out how often strategies for handling overlapping data from primary studies are used across the systematic reviews considered by overviews authors focused on exercise-related interventions in different health conditions. Secondarily, we aim to describe the overlap strategies used, the authors' acknowledgment of not using any management strategy as a methodological weakness, and the congruence between the protocol and the final published overview in terms of overlap management. Study designs to be included: We will include overviews that consider SRs with or without meta-analysis (MA), without distinction of the methodological design of the primary studies included. The definition of SR adopted by the authors of the overviews will not be considered as an eligibility criterion. Overviews that also include primary studies not considered in the selected SRs will not be excluded.An overview is defined as any study: 1) aimed at synthesising general information, methods, and outcome data from SRs, 2) that makes explicit the inclusion and exclusion criteria for SRs, 3) that includes an explicit sear.
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.JNS.2013.08.011
Abstract: We aimed to examine physical trauma as a risk factor for the subsequent diagnosis of MS. We searched for observational studies that evaluated the risk for developing MS after physical trauma that occurred in childhood (≤20 years) or "premorbid" (>20 years). We performed a meta-analysis using a random effects model. We identified 1362 in idual studies, of which 36 case-control studies and 4 cohort studies met the inclusion criteria for the review. In high quality case-control studies, there were statistically significant associations between those sustaining head trauma in childhood (OR=1.27 95% CI, 1.12-1.44 p<0.001), premorbid head trauma (OR=1.40 95% CI, 1.08-1.81 p=0.01), and other traumas during childhood (OR=2.31 95% CI, 1.06-5.04 p=0.04) and the risk of being diagnosed with MS. In lesser quality studies, there was a statistical association between "other traumas" premorbid and spinal injury premorbid. No association was found between spinal injury during childhood, or fractures and burns at any age and the diagnosis of MS. The pooled OR of four cohort studies looking at premorbid head trauma was not statistically significant. The result of the meta-analyses of high quality case-control studies suggests a statistically significant association between premorbid head trauma and the risk for developing MS. However, cohort studies did not. Future prospective studies that define trauma based on validated instruments, and include frequency of traumas per study participant, are needed.
Publisher: Research Square Platform LLC
Date: 25-01-2022
DOI: 10.21203/RS.3.RS-931213/V3
Abstract: Introduction: An increasing growth of systematic reviews (SRs) presents notable challenges for decision-makers seeking to answer clinical questions. In 1997, an algorithm was created by Jadad to assess discordance in results across SRs on the same question. Our study aims to (a) replicate assessments done in a s le of studies using the Jadad algorithm to determine if the same SR would have been chosen, (b) evaluate the Jadad algorithm in terms of utility, efficiency, and comprehensiveness, and (c) describe how authors address discordance in results across multiple SRs. Methods and Analysis: We will use a database of 1218 overviews (2000-2020) created from a bibliometric study as the basis of our search for studies assessing discordance (called Discordant Reviews). This bibliometric study searched MEDLINE (Ovid), Epistemonikos, and Cochrane Database of Systematic Reviews for overviews. We will include any study using Jadad (1997) or another method to assess discordance. The first 30 studies screened at the full-text stage by two independent reviewers will be included. We will replicate the authors’ Jadad assessments. We will compare our outcomes qualitatively and evaluate the differences between our Jadad assessment of discordance and the authors’ assessment. Ethics and Dissemination: No ethics approval was required as no human subjects were involved. In addition to publishing in an open-access journal, we will disseminate evidence summaries through formal and informal conferences, academic websites, and across social media platforms. This is the first study to comprehensively evaluate and replicate Jadad algorithm assessments of discordance across multiple SRs.
Publisher: Research Square Platform LLC
Date: 07-12-2021
DOI: 10.21203/RS.3.RS-931213/V2
Abstract: Introduction: An increasing growth of systematic reviews (SRs) presents notable challenges for decision-makers seeking to answer clinical questions. In 1997, an algorithm was created by Jadad to assess discordance in results across SRs on the same question. Our study aims to (a) replicate assessments done in a s le of studies using the Jadad algorithm to determine if the same SR would have been chosen, (b) evaluate the Jadad algorithm in terms of utility, efficiency, and comprehensiveness, and (c) describe how authors address discordance in results across multiple SRs. Methods and Analysis: We will use a database of 1218 overviews (2000-2020) created from a bibliometric study as the basis of our search for studies assessing discordance (called Discordant Reviews). This bibliometric study searched MEDLINE (Ovid), Epistemonikos, and Cochrane Database of Systematic Reviews for overviews. We will include any study using Jadad (1997) or another method to assess discordance. The first 30 studies screened at the full-text stage by two independent reviewers will be included. We will replicate the authors’ Jadad assessments. We will compare our outcomes qualitatively and evaluate the differences between our Jadad assessment of discordance and the authors’ assessment. Ethics and Dissemination: No ethics approval was required as no human subjects were involved. In addition to publishing in an open-access journal, we will disseminate evidence summaries through formal and informal conferences, academic websites, and across social media platforms. This is the first study to comprehensively evaluate and replicate Jadad algorithm assessments of discordance across multiple SRs.
Publisher: Wiley
Date: 09-03-2018
Publisher: Springer Science and Business Media LLC
Date: 21-11-2017
Publisher: Springer Science and Business Media LLC
Date: 16-01-2014
Publisher: Springer Science and Business Media LLC
Date: 06-01-2016
Publisher: Springer Science and Business Media LLC
Date: 12-10-2018
Publisher: Public Library of Science (PLoS)
Date: 13-07-2015
Publisher: International Union Against Tuberculosis and Lung Disease
Date: 12-2015
Abstract: Although the global prevalence of chronic kidney disease (CKD) is increasing, the relationship between CKD and active TB is not well described. To conduct a systematic review to evaluate active TB risk in CKD populations. We searched Ovid Medline, EMBASE and Cochrane databases and relevant journals to identify multicentre or regional studies reporting quantitative effect estimates of an association between CKD and active TB. Risk ratios and rate ratios were used as common measures of association. Pooled estimates were generated using a random-effects model. Of 3406 papers screened, 12 eligible studies were identified with 71,374 end-stage renal disease (ESRD) patients and 560 TB cases. Meta-analysis of adjusted rate ratio data in dialysis populations showed an increased rate of 3.62 (95%CI 1.79-7.33, P < 0.001) compared to the general population, while unadjusted risk ratio data in transplant populations showed an increased risk of 11.35 (95%CI 2.97-43.41) compared to the general population. We found consistent evidence of an increased risk of active TB in ESRD compared to the general population. This relationship persisted despite variability in study population, design and renal replacement therapy (RRT) modality. Further research into the role of comorbidities, RRT modality and CKD stage is required to better understand the association between CKD and active TB.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.HLC.2017.08.026
Abstract: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery. Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Medline were systematically searched for blinded randomised controlled studies (RCT) evaluating adults with no history of atrial fibrillation randomised to a pharmacological agent (either beta blocker, calcium channel blocker or digoxin), compared to placebo. Utilising Cochrane guidance, three reviewers screened, extracted and the quality of the evidence was assessed. We used a random effects meta-analysis to compare a rate-control agent with placebo. Five RCTs (688 subjects, mean age 61±8.9, 69% male) were included. Beta blocker administration prior to elective cardiac surgery significantly reduced the incidence of POAF (OR 0.43, 95%Cl [0.30-0.61], I This review suggests that selective administration of prophylactic oral beta blockers prior to elective cardiac surgery is safe and may reduce the incidence of POAF.
Publisher: Wiley
Date: 15-04-2019
Abstract: In this series we address important topics for emergency clinicians who either participate in research as part of their work, or use the knowledge generated by research studies. Emergency clinicians are routinely in the position of applying new evidence in clinical practice. With an ever-increasing volume of evidence generated, this can be problematic when studies are conducted in different settings, and include different patient groups, different interventions and different outcomes. This is made even more difficult when the results of primary research studies do not agree. Systematic reviews are becoming increasingly valuable as they appraise and synthesise research findings using a clear methodology, and summarise the results of primary studies. As such, systematic reviews help translate research findings into clinical practice. This paper provides a practical starting point for understanding the steps involved in conducting a systematic review in emergency medicine and will help readers appraise the findings of systematic reviews.
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-045987
Abstract: Systematic reviews with network meta-analysis (NMA ie, multiple treatment comparisons, indirect comparisons) have gained popularity and grown in number due to their ability to provide comparative effectiveness of multiple treatments for the same condition. The methodological review aims to develop a list of items relating to biases in reviews with NMA. Such a list will inform a new tool to assess the risk of bias in NMAs, and potentially other reporting or quality checklists for NMAs which are being updated. We will include articles that present items related to bias, reporting or methodological quality, articles assessing the methodological quality of reviews with NMA, or papers presenting methods for NMAs. We will search Ovid MEDLINE, the Cochrane library and difficult to locate/unpublished literature. Once all items have been extracted, we will combine conceptually similar items, classifying them as referring to bias or to other aspects of quality (eg, reporting). When relevant, reporting items will be reworded into items related to bias in NMA review conclusions, and then reworded as signalling questions. No ethics approval was required. We plan to publish the full study open access in a peer-reviewed journal, and disseminate the findings via social media (Twitter, Facebook and author affiliated websites). Patients, healthcare providers and policy-makers need the highest quality evidence to make decisions about which treatments should be used in healthcare practice. Being able to critically appraise the findings of systematic reviews that include NMA is central to informed decision-making in patient care.
Publisher: Research Square Platform LLC
Date: 24-02-2022
DOI: 10.21203/RS.3.RS-1324758/V1
Abstract: Introduction: Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We engaged with stakeholders in early phases of the development of a new tool to assess risk of bias (RoB) in NMA to facilitate its later use and potentially widen its impact. Methods: We surveyed stakeholders’ views and preferences about the importance, utility, and willingness to use the RoB NMA tool to evaluate evidence in practice and in policymaking. We included 12 closed and 10 open-ended questions, and followed a knowledge translation plan to disseminate the survey through social media and professional networks. Results: A total of 298 stakeholders participated in the survey (14% respondent rate) which took on average 2 minutes to complete. 75% of stakeholders indicated that their organization produced NMAs, and 78% of respondents showed high interest in the tool. Most stakeholders (84%) reported they would use the tool to assess an NMA if they had received adequate training, while half reported they preferred a tool to assess both bias in in idual NMA results and authors’ conclusions. Twelve (8%) stakeholders said they would use the tool to conduct an overview of reviews, while 24 (17%) respondents indicated that they would use the tool to distinguish between NMAs at high and low risk of bias. Conclusions: This survey informs the development of a RoB tool for NMAs and is a pillar in an integrated knowledge translation approach. Stakeholders preferred a tool to assess both bias in in idual NMA results and authors’ conclusions.
Publisher: Research Square Platform LLC
Date: 13-02-2023
DOI: 10.21203/RS.3.RS-1324758/V2
Abstract: Background: Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We aimed to develop a risk of bias (RoB) tool to assess NMAs (RoB NMA tool). An international steering committee intended the RoB NMA tool to be used in combination with ROBIS (recommend as it was designed to assess biases only) or other similar quality appraisal tools (e.g., AMSTAR 2) to assess quality of systematic reviews. The RoB NMA tool will assess NMA biases and limitations regarding how the analysis was planned, data were analysed, and results were presented, including the way in which the evidence was assembled and interpreted. Objectives: Conduct (a) a Delphi process to determine expert opinion on an item’s inclusion, and (b) a knowledge user survey to widen its impact. Design: Cross sectional survey and Delphi process Methods: Delphi panellists were asked to rate whether items should be included. All agreed-upon item were included in a second round of the survey (defined as 70% agreement). We surveyed knowledge users’ views and preferences about the importance, utility, and willingness to use the RoB NMA tool to evaluate evidence in practice and in policymaking. We included 12 closed and 10 open-ended questions, and we followed a knowledge translation plan to disseminate the survey through social media and professional networks. Results: 22 items were entered into a Delphi survey of which 28 respondents completed round 1, and 22 completed round 2.Seven items did not reach consensus in round 2. A total of 298 knowledge users participated in the survey (14% respondent rate). 75% indicated that their organization produced NMAs, and 78% showedhigh interest in the tool, especially if they had received adequate training (84%). Most knowledge users and Delphi panellists preferred a tool to assess both bias in in idual NMA results and authors’ conclusions. Response bias in our s le is a major limitation as knowledge users working in higher income countries were more represented. One of the limitations of the Delphi process is that it depends on the purposive selection of experts and their availability, thus limiting the variability in perspectives and scientific disciplines. Conclusions: This Delphi process and knowledge user survey informs the development of the RoB NMA tool. Registration: We uploaded our study protocol on the Open Science Framework at osf.io/da4uy/
Publisher: BMJ
Date: 09-2021
DOI: 10.1136/BMJOPEN-2021-050596
Abstract: The objective of this rapid scoping review was to identify studies of dose-sparing strategies for administration of intramuscular seasonal influenza vaccines in healthy in iduals of all ages. Comprehensive literature searches were executed in MEDLINE, Embase and the Cochrane library. The grey literature was searched via international clinical trial registries for relevant studies published in English in the last 20 years. We included studies in healthy humans of any age that used any dose-sparing strategy to administer intramuscular seasonal influenza vaccines. Title/abstract and full-text screening were carried out by pairs of reviewers independently. Data extraction was conducted by a single reviewer and verified by a second reviewer. Our outcomes were influenza infections, intensive care unit admission, pneumonia, hospitalisations, adverse events and mortality. Results were summarised descriptively. A total of 13 studies with 10 351 participants were included in the review and all studies were randomised controlled trials (RCTs) conducted between 2006 and 2019. The most common interventions were the trivalent influenza vaccine (n=10), followed by the quadrivalent influenza vaccine (n=4). Nine studies included infants/toddlers 6–36 months old and one of these studies also included children and adolescents. In these nine studies, no clinical effectiveness outcomes were reported. Of the four adult studies (≥18 years), two studies reported on effectiveness outcomes, however, only one RCT reported on laboratory-confirmed influenza. Due to the low number of studies in healthy adults and the lack of studies assessing confirmed influenza and influenza-like illness, there remains a need for further evaluation.
Publisher: Wiley
Date: 23-01-2022
DOI: 10.1002/JRSM.1542
Abstract: Multiple ‘overviews of reviews’ conducted on the same topic (“overlapping overviews”) represent a waste of research resources and can confuse clinicians making decisions amongst competing treatments. We aimed to assess the frequency and characteristics of overlapping overviews. MEDLINE, Epistemonikos and Cochrane Database of Systematic Reviews were searched for overviews that: synthesized reviews of health interventions and conducted systematic searches. Overlap was defined as: duplication of PICO eligibility criteria, and not reported as an update nor a replication. We categorized overview topics according to 22 WHO ICD‐10 medical classifications, overviews as broad or narrow in scope, and overlap as identical, nearly identical, partial, or subsumed. Subsummation was defined as when broad overviews subsumed the populations, interventions and at least one outcome of another overview. Of 541 overviews included, 169 (31%) overlapped across similar PICO, fell within 13 WHO ICD‐10 medical classifications, and 62 topics. 148/169 (88%) overlapping overviews were broad in scope. Fifteen overviews were classified as having nearly identical overlap (9%) 123 partial overlap (73%), and 31 subsumed (18%) others. One third of overviews overlapped in content and a majority covered broad topic areas. A multiplicity of overviews on the same topic adds to the ongoing waste of research resources, time, and effort across medical disciplines. Authors of overviews can use this study and the s le of overviews to identify gaps in the evidence for future analysis, and topics that are already studied, which do not need to be duplicated.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Elsevier BV
Date: 11-2011
DOI: 10.1016/J.WHI.2011.06.009
Abstract: HIV/AIDS conferences provide an opportunity to review current research from around the world. Conferences are a good gauge of the amount of research conducted on HIV/AIDS and women because papers are disseminated widely and publicly, and can represent published or unpublished material. The objective of this study was to conduct content analysis and data coding to quantify trends in women-specific research in HIV/AIDS abstracts at the International AIDS Conferences (AIDS), the Canadian Association for HIV Research (CAHR) Conferences, and the Conferences on Retroviruses and Opportunistic Infections (CROI) over a 7-year time period. Abstracts titles and text containing female keywords were retrieved from the AIDS, CAHR, and CROI conferences between 2003 and 2009 and coded according to research category using content analysis. Over 34,000 abstracts were searched. A total of 5,221 abstracts related to women (13.7%) were found over 7 years. Women-specific abstracts represented 16.2% (n = 4,245/26,175) at AIDS, 13.7% (n = 257/1,876) at CAHR, and 11.1% (n = 719/6,370) at CROI. The AIDS and CAHR conferences demonstrated a slightly increasing trend in women-specific abstracts over 7 years. In categorical coding, the most prevalent research category was reproductive health, and the most infrequent was policy and program evaluation. The AIDS conferences showed an increase in women-specific abstracts over time, probably owing to a gender policy implemented in 2008 and a women's research award. The CAHR conference instituted a gender policy in 2011, and the CROI conference should follow suit. Conference abstracts should include breakdown and analysis by gender.
Publisher: Wiley
Date: 08-07-2010
DOI: 10.1016/J.JMWH.2009.10.015
Abstract: Introduction : Despite questionable efficacy and safety, many women use a variety of complementary and alternative medicine (CAM) therapies to relieve menopause symptoms. Methods : We examined the determinants and use of CAM therapies among a s le of menopausal‐aged women in Canada by using a cross‐sectional Web‐based survey. Results : Four hundred twenty‐three women who were contacted through list serves, e‐mail lists, and Internet advertisements provided complete data on demographics, use of CAM, therapies, and menopausal status and symptoms. Ninety‐one percent of women reported trying CAM therapies for their symptoms. Women reported using an average of five kinds of CAM therapies. The most common treatments were vitamins (61.5%), relaxation techniques (57.0%), yoga/meditation (37.6%), soy products (37.4%), and prayer (35.7%). The most beneficial CAM therapies reported were prayer/spiritual healing, relaxation techniques, counseling/therapy, and therapeutic touch/Reiki. Demographic factors and menopausal symptoms contributed to 14% of the variance ( P .001) in the number of CAM therapies tried. Discussion : Results support previous research showing that menopausal women have high user rates of CAM therapy and show that specific demographic factors and somatic symptomatology relate to use of CAM therapies. Health care providers can benefit from understanding the determinants and use of CAM by women during the menopause transition if they are to help and provide quality care for this population.
Publisher: Public Library of Science (PLoS)
Date: 22-04-2021
DOI: 10.1371/JOURNAL.PONE.0250356
Abstract: Assessing the process used to synthesize the evidence in clinical practice guidelines enables users to determine the trustworthiness of the recommendations. Clinicians are increasingly dependent on guidelines to keep up with vast quantities of medical literature, and guidelines are followed to avoid malpractice suits. We aimed to assess whether systematic methods were used when synthesizing the evidence for guidelines and to determine the type of review cited in support of recommendations. Guidelines published in 2017 and 2018 were retrieved from the TRIP and Epistemonikos databases. We randomly sorted and sequentially screened clinical guidelines on all topics to select the first 50 that met our inclusion criteria. Our primary outcomes were the number of guidelines using either a systematic or non-systematic process to gather, assess, and synthesise evidence and the numbers of recommendations within guidelines based on different types of evidence synthesis (systematic or non-systematic reviews). If a review was cited, we looked for evidence that it was critically appraised, and recorded which quality assessment tool was used. Finally, we examined the relation between the use of the GRADE approach, systematic review process, and type of funder. Of the 50 guidelines, 17 (34%) systematically synthesised the evidence to inform recommendations. These 17 guidelines clearly reported their objectives and eligibility criteria, conducted comprehensive search strategies, and assessed the quality of the studies. Of the 29/50 guidelines that included reviews, 6 (21%) assessed the risk of bias of the review. The quality of primary studies was reported in 30/50 (60%) guidelines. High quality, systematic review products provide the best available evidence to inform guideline recommendations. Using non-systematic methods compromises the validity and reliability of the evidence used to inform guideline recommendations, leading to potentially misleading and untrustworthy results.
No related grants have been discovered for Carole Lunny.