ORCID Profile
0000-0003-2198-3205
Current Organisations
Friedrich-Alexander-Universität Erlangen-Nürnberg - Technische Fakultät
,
University of Bristol
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Publisher: Oxford University Press (OUP)
Date: 25-06-2016
DOI: 10.1093/CID/CIW416
Publisher: Wiley
Date: 20-12-2019
DOI: 10.1111/JACE.16947
Publisher: Wiley
Date: 03-06-2020
Publisher: Elsevier BV
Date: 06-2022
Publisher: BMJ
Date: 26-10-2020
DOI: 10.1136/BJSPORTS-2020-102819
Abstract: To investigate the comparative effectiveness of all treatments for patellofemoral pain (PFP). Living systematic review with network meta-analysis (NMA). Sensitive search in seven databases, three grey literature resources and four trial registers. Randomised controlled trials evaluating any treatment for PFP with outcomes ‘any improvement’, and pain intensity. Two reviewers independently extracted data and assessed risk of bias with Risk of Bias Tool V.2. We used Grading of Recommendations, Assessment, Development and Evaluation to appraise the strength of the evidence. ‘Any improvement’ measured with a Global Rating of Change Scale. Twenty-two trials (with forty-eight treatment arms) were included, of which approximately 10 (45%) were at high risk of bias for the primary outcome. Most comparisons had a low to very low strength of the evidence. All treatments were better than wait and see for any improvement at 3 months (education (OR 9.6, 95% credible interval (CrI): 2.2 to 48.8) exercise (OR 13.0, 95% CrI: 2.4 to 83.5) education+orthosis (OR 16.5, 95% CrI: 4.9 to 65.8) education+exercise+patellar taping/mobilisations (OR 25.2, 95% CrI: 5.7 to 130.3) and education+exercise+patellar taping/mobilisations+orthosis (OR 38.8, 95% CrI: 7.3 to 236.9)). Education+exercise+patellar taping/mobilisations, with (OR 4.0, 95% CrI: 1.5 to 11.8) or without orthosis (OR 2.6, 95% CrI: 1.7 to 4.2), were superior to education alone. At 12 months, education or education+any combination yielded similar improvement rates. Education combined with a physical treatment (exercise, orthoses or patellar taping/mobilisation) is most likely to be effective at 3 months. At 12 months, education appears comparable to education with a physical treatment. There was insufficient evidence to recommend a specific type of physical treatment over another. All treatments in our NMA were superior to wait and see at 3 months, and we recommend avoiding a wait-and-see approach. PROSPERO registration CRD42018079502.
Publisher: BMJ
Date: 10-06-2020
DOI: 10.1136/BJSPORTS-2019-101872
Abstract: To provide a consistently updated overview of the comparative effectiveness of treatments for Achilles tendinopathy. Living systematic review and network meta-analysis. Multiple databases including grey literature sources were searched up to February 2019. Randomised controlled trials examining the effectiveness of any treatment in patients with both insertional and/or midportion Achilles tendinopathy. We excluded trials with 10 or fewer participants per treatment arm or trials investigating tendon ruptures. Reviewers independently extracted data and assessed the risk of bias. We used the Grading of Recommendations Assessment, Development and Evaluation to appraise the certainty of evidence. The validated patient-reported Victorian Institute of Sport Assessment-Achilles questionnaire. 29 trials investigating 42 different treatments were included. 22 trials (76%) were at high risk of bias and 7 (24%) had some concerns. Most trials included patients with midportion tendinopathy (86%). Any treatment class seemed superior to wait-and-see for midportion Achilles tendinopathy at 3 months (very low to low certainty of evidence). At 12 months, exercise therapy, exercise+injection therapy and exercise+night splint therapy were all comparable with injection therapy for midportion tendinopathy (very low to low certainty). No network meta-analysis could be performed for insertional Achilles tendinopathy. In our living network meta-analysis no trials were at low risk of bias and there was large uncertainty in the comparative estimates. For midportion Achilles tendinopathy, wait-and-see is not recommended as all active treatments seemed superior at 3-month follow-up. There seems to be no clinically relevant difference in effectiveness between different active treatments at either 3-month or 12-month follow-up. As exercise therapy is easy to prescribe, can be of low cost and has few harms, clinicians could consider starting treatment with a calf-muscle exercise programme. CRD42018086467.
Publisher: Oxford University Press (OUP)
Date: 08-07-2008
DOI: 10.1111/J.1467-985X.2008.00548.X
Abstract: We present models for the combined analysis of evidence from randomized controlled trials categorized as being at either low or high risk of bias due to a flaw in their conduct. We formulate a bias model that incorporates between-study and between-meta-analysis heterogeneity in bias, and uncertainty in overall mean bias. We obtain algebraic expressions for the posterior distribution of the bias-adjusted treatment effect, which provide limiting values for the information that can be obtained from studies at high risk of bias. The parameters of the bias model can be estimated from collections of previously published meta-analyses. We explore alternative models for such data, and alternative methods for introducing prior information on the bias parameters into a new meta-analysis. Results from an illustrative ex le show that the bias-adjusted treatment effect estimates are sensitive to the way in which the meta-epidemiological data are modelled, but that using point estimates for bias parameters provides an adequate approximation to using a full joint prior distribution. A sensitivity analysis shows that the gain in precision from including studies at high risk of bias is likely to be low, however numerous or large their size, and that little is gained by incorporating such studies, unless the information from studies at low risk of bias is limited. We discuss approaches that might increase the value of including studies at high risk of bias, and the acceptability of the methods in the evaluation of health care interventions.
Publisher: Wiley
Date: 17-12-2021
DOI: 10.1111/JACE.18269
Abstract: External thermal, electrical, and mechanical fields can induce structural phase transitions in lead‐free Li‐modified Na 0.5 K 0.5 NbO 3 ferroelectrics, which significantly influence the macroscopic electromechanical response. In particular, the relative stability of the polar monoclinic (or orthorhombic) and tetragonal phases under temperature and stress is critical to realize the ferroelectric and piezoelectric response. In this study, the effect of mechanical and thermal fields on the local structure in the vicinity of the monoclinic‐tetragonal (M‐T) phase boundary was investigated using a novel in situ combined uniaxial compressive stress‐ and temperature‐dependent Raman spectroscopy experimental arrangement. Experiments were performed up to 300°C and −200 MPa, clearly demonstrating stress‐induced M‐T phase transition in Li‐modified Na 0.5 K 0.5 NbO 3 . A stress‐temperature phase diagram has been established based on the change in vibrational modes. It was possible to correlate the relative permittivity singularities previously observed to a given stage of the M‐T phase transition using ratio between characteristic Raman band areas. In addition, the measurement method reported here can be applied to other functional ceramics to investigate the influence of mechanical fields on local structure.
Publisher: BMJ
Date: 08-07-2021
Publisher: Elsevier BV
Date: 12-2019
Publisher: F1000 Research Ltd
Date: 03-01-2019
DOI: 10.12688/F1000RESEARCH.15869.1
Abstract: Introduction: Globally, stroke is the second leading cause of death. Despite the burden of illness and death, few acute interventions are available to patients with ischemic stroke. Over 1,000 potential neuroprotective therapeutics have been evaluated in preclinical models. It is important to use robust evidence synthesis methods to appropriately assess which therapies should be translated to the clinical setting for evaluation in human studies. This protocol details planned methods to conduct a systematic review to identify and appraise eligible studies and to use a network meta-analysis to synthesize available evidence to answer the following questions: in preclinical in vivo models of focal ischemic stroke, what are the relative benefits of competing therapies tested in combination with the gold standard treatment alteplase in (i) reducing cerebral infarction size, and (ii) improving neurobehavioural outcomes? Methods: We will search Ovid Medline and Embase for articles on the effects of combination therapies with alteplase. Controlled comparison studies of preclinical in vivo models of experimentally induced focal ischemia testing the efficacy of therapies with alteplase versus alteplase alone will be identified. Outcomes to be extracted include infarct size (primary outcome) and neurobehavioural measures. Risk of bias and construct validity will be assessed using tools appropriate for preclinical studies. Here we describe steps undertaken to perform preclinical network meta-analysis to synthesise all evidence for each outcome and obtain a comprehensive ranking of all treatments. This will be a novel use of this evidence synthesis approach in stroke medicine to assess pre-clinical therapeutics. Combining all evidence to simultaneously compare mutliple therapuetics tested preclinically may provide a rationale for the clinical translation of therapeutics for patients with ischemic stroke. Dissemination : Review findings will be submitted to a peer-reviewed journal and presented at relevant scientific meetings to promote knowledge transfer. Registration: PROSPERO number to be submitted following peer review.
Location: Germany
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Nicky J Welton.