Systematic Reviews最新文献

{"title":"Experiences and challenges of acute coronary syndrome patients in care provision: a qualitative systematic review.","authors":"Daniel Ameen, Kate Kynoch, Hanan Khalil","doi":"10.1186/s13643-024-02578-1","DOIUrl":"10.1186/s13643-024-02578-1","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease including acute coronary syndrome (ACS) constitutes the most common cause of death in people with cardiovascular disease. Prompt diagnosis and early initiation of treatment significantly impact on patient outcomes. Positive patient experience with their initial care is linked to positive clinical outcomes.</p><p><strong>Objective: </strong>This qualitative review aimed to investigate patients' experience of care provision and the challenges faced by them during their different stages of care following an ACS.</p><p><strong>Methods: </strong>Searches of four databases - MEDLINE, Embase, CINAHL and PsychINFO - were conducted from inception until July 13, 2022, and were limited to English-language publications. Assessment of methodological quality of studies was performed using the Jonna Briggs Institute (JBI) qualitative assessment and review instrument. Data were extracted using the standardised data extraction tool from JBI. Data synthesis following the JBI approach of meta-aggregation was performed. The level of confidence for each synthesised finding was established based on ConQual.</p><p><strong>Results: </strong>Overall, from 578 records, 10 studies were included with 39 findings extracted from the included studies. The main synthesised findings were the need to provide tailored information and appropriate management at different stages of care, and that timely management and trust in health care workers are associated with greater patient satisfaction and more positive experiences.</p><p><strong>Conclusion: </strong>Patients with an ACS experience many challenges during different stages of their care. Clinicians should be aware of the challenges they face and provide tailored information to patients that is appropriate for their different stages of management in order to best optimise patient experience and improve patient outcomes.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between dietary potassium intake and urinary potassium excretion: a protocol for systematic review and meta-analysis.","authors":"Nobuhisa Morimoto, Hasan Jamil, Mohab Alakkari, Yuki Joyama, Tatsuhiko Anzai, Kunihiko Takahashi, Soichiro Iimori","doi":"10.1186/s13643-024-02603-3","DOIUrl":"10.1186/s13643-024-02603-3","url":null,"abstract":"<p><strong>Background: </strong>While numerous studies have reported associations between low dietary potassium intake and adverse clinical outcomes, methods to estimate potassium intake, mainly self-reported dietary measures and urinary potassium excretion, entail certain limitations. Self-reported measures are subject to underreporting and overreporting. Urinary potassium excretion is affected by multiple factors including renal function. Revealing the degree of bias inherent in these measures would help accurately assess potassium intake and its association with disease risk. We aim to summarize evidence on the strength of the associations between potassium intake estimated from 24-h urinary potassium excretion and potassium intake estimated from self-reported dietary measures or objective quantification methods in populations with different kidney function levels and age groups. We also aim to identify factors that affect the association strength.</p><p><strong>Methods: </strong>We will search for potentially eligible studies that examined associations between self-reported potassium intake, 24-h urinary potassium excretion, and objectively quantified potassium intake, using MEDLINE (PubMed), Embase, Web of Science, and Scopus. Studies on children, adolescents, adults, and the elderly are eligible. Studies of patients on dialysis will be excluded. Collective study results, including a meta-analysis, will be synthesized if an adequate number of studies examining similar dietary potassium intake estimation methods are found. Analyses will be performed separately according to age groups and renal function. For the meta-analysis, fixed-effects or random-effect models will be employed depending on the degree of study heterogeneity to combine across studies the correlation coefficient, ratio, or standardized mean difference for potassium intake, comparing dietary potassium intake based on self-reported or objectively quantified methods and intake based on 24-h urinary potassium excretion. The degree of heterogeneity among included studies will be examined by calculating I² statistics. To investigate sources of study heterogeneity, random-effects meta-regression analyses will be performed.</p><p><strong>Discussion: </strong>Revealing the strength of the association between dietary and urinary measures in populations with different levels of kidney function and age groups will enhance researchers' and clinicians' ability to interpret studies that utilize these measures and help establish a more solid evidence base for the role of potassium intake in changing chronic disease risk. Identifying factors that modify the associations between these measures may aid in developing predictive models to estimate actual potassium intake.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022357847.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11253472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of the evidence to guide decision-making in the treatment of gastroesophageal reflux disease with acupuncture: protocol for an overview of systematic reviews.","authors":"Jinke Huang, Jiali Liu, Fengyun Wang, Xudong Tang","doi":"10.1186/s13643-024-02591-4","DOIUrl":"10.1186/s13643-024-02591-4","url":null,"abstract":"<p><strong>Background: </strong>Growing numbers of randomized clinical trials-based systematic reviews and meta-analyses (SRs/MAs) have been conducted to examine the effectiveness of acupuncture in treating gastroesophageal reflux disease (GERD). An overview of SRs/MAs will be conducted with the aim of systematically compiling, evaluating, and synthesizing the evidence regarding acupuncture for GERD.</p><p><strong>Methods: </strong>SRs/MAs of acupuncture on GERD will be searched in eight databases. Two independent reviewers will conduct the literature search, data extraction, and review quality assessment. Utilizing the AMSTAR-2 tool, PRISMA checklists, and GRADE system, respectively, the methodological quality, reporting quality, and evidence quality will be evaluated. In relation to the subject and the overview's objects, the results will be given. This study will aid in identifying gaps between evidence and its clinical application and serve as a roadmap for further high-quality research.</p><p><strong>Discussion: </strong>The results of the overview will aid in closing the gap between clinical evidence and its use in clinical practice. This study will identify significant faults in the use of evidence, point out areas where methodology needs to be improved, and provide guidance for future high-quality research.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022371850.</p><p><strong>Ethics and dissemination: </strong>Ethics approval is not necessary because no personal information about individuals is collected. A peer-reviewed journal or pertinent conferences will publish the results, whichever comes first.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of iron supplementation on physical capacity in non-anaemic iron-deficient individuals: protocol for an individual patient data meta-analysis.","authors":"Cory Dugan, Peter Peeling, Richard Burden, Toby Richards","doi":"10.1186/s13643-024-02559-4","DOIUrl":"10.1186/s13643-024-02559-4","url":null,"abstract":"<p><strong>Background: </strong>A deficiency in iron stores is associated with various adverse health complications, which, if left untreated, can progress to states of anaemia, whereby there is significant detriment to an individual's work capacity and quality of life due to compromised erythropoiesis. The most common methods employed to treat an iron deficiency include oral iron supplementation and, in persistent and/or unresponsive cases, intravenous iron therapy. The efficacy of these treatments, particularly in states of iron deficiency without anaemia, is equivocal. Indeed, both randomised control trials and aggregate data meta-analyses have produced conflicting evidence. Therefore, this study aims to assess the efficacy of both oral and intravenous iron supplementation on physical capacity, quality of life, and fatigue scores in iron-deficient non-anaemic individuals using individual patient data (IPD) meta-analysis techniques.</p><p><strong>Methods: </strong>All potential studies, irrespective of design, will be sourced through systematic searches on the following databases: Cochrane Central Register of Controlled Trials, MEDLINE Ovid, Embase Ovid, Web of Science: Science Citation Index Expanded, Web of Science: Conference Proceedings Citation Index-Science, ClinicalTrials.gov, and World Health Organization (WHO) International Clinical Trials Registry Platform. Individual patient data from all available trials will be included and subsequently analysed in a two-stage approach. Predetermined subgroup and sensitivity analyses will be employed to further explain results.</p><p><strong>Discussion: </strong>The significance of this IPD meta-analysis is one of consolidating a clear consensus to better inform iron-deficient individuals of the physiological response associated with iron supplementation. The IPD approach, to the best of our knowledge, is novel for this research topic. As such, the findings will significantly contribute to the current body of evidence.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42020191739.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Indigenous-informed scoping review study methodology: advancing the science of scoping reviews.","authors":"Wanda Phillips-Beck, Bryden L J Bukich, Kellie Thiessen, Josée G Lavoie, Annette Schultz, Julianne Sanguins, Geraldine Beck, Brenda Longclaws, Geraldine Shingoose, Matta Palmer, Janice Linton, Bekelu Negash, Taylor Morriseau","doi":"10.1186/s13643-024-02586-1","DOIUrl":"10.1186/s13643-024-02586-1","url":null,"abstract":"<p><strong>Background: </strong>Historically, Indigenous voices have been silent in health research, reflective of colonial academic institutions that privilege Western ways of knowing. However, Indigenous methodologies and methods with an emphasis on the active involvement of Indigenous peoples and centering Indigenous voices are gaining traction in health education and research. In this paper, we map each phase of our scoping review process and weave Indigenous research methodologies into Arksey and O'Malley's (2005) framework for conducting scoping reviews.</p><p><strong>Methods: </strong>Guided by an advisory circle consisting of Indigenous Knowledge Keepers and allied scholars, we utilized both Indigenous and Western methods to conduct a scoping review. As such, a circle of Knowledge Keepers provided guidance and informed our work, while our methods of searching and scoping the literature remained consistent with PRISMA-ScR guidelines. In keeping with an Indigenous methodology, the scoping review protocol was not registered allowing for an organic development of the research process.</p><p><strong>Results: </strong>We built upon Arksey and O'Malley's 5-stages and added an additional 3 steps for a combined 8-stage model to guide our research: (1) Exploration and Listening, (2) Doing the Groundwork, (3) Identifying and Refining the Research Question, (4) Identifying Relevant Studies, (5) Study Selection, (6) Mapping Data, (7) Collating, Summarizing and Synthesizing the Data, and lastly, (8) Sharing and Making Meaning. Engagement and listening, corresponding to Arksey and O'Malley (2005)'s optional \"consultation stage,\" was embedded throughout, but with greater intensity in stages 1 and 8.</p><p><strong>Conclusion: </strong>An Indigenous approach to conducting a scoping review includes forming a team with a wide array of experience in both Indigenous and Western methodologies, meaningful Indigenous representation, and inclusion of Indigenous perspectives to shape the analysis and presentation of findings. Engaging Indigenous peoples throughout the entire research process, listening, and including Indigenous voices and perspectives is vital in reconciliation research, producing both credible and useable information for both Indigenous communities and academia. Our Indigenous methodology for conducting a scoping review can serve as a valuable framework for summarizing Indigenous health-related research.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV1 drug resistance among patients experiencing first-line treatment failure in Ethiopia: protocol for a systematic review and meta-analysis.","authors":"Melashu Balew, Gedefaw Abeje, Alemtsehay Mekonnen, Getu Degu","doi":"10.1186/s13643-024-02605-1","DOIUrl":"10.1186/s13643-024-02605-1","url":null,"abstract":"<p><strong>Background: </strong>The emergence of HIV drug resistance presents a substantial challenge. Current antiretroviral treatments, along with current classes, face the danger of becoming partially or entirely inactive. As a result, alternative treatment regimens are limited, and treatment choices are complicated. According to the recommendation of the WHO, nations should consider changing their first-line ART regimen if HIV drug resistance exceeds 10%. In spite of the fact that a number of primary studies have been performed on HIV drug resistance in Ethiopia, their pooled prevalence rate has not been determined in a systematic review and meta-analysis, which may provide stronger evidence. Therefore, the objective of this systematic review and meta-analysis will be to estimate the pooled prevalence rate of HIV1 drug resistance in patients with first-line treatment failure in Ethiopia.</p><p><strong>Methods: </strong>Primary studies will be identified from PubMed/MEDLINE, Scopus, Embase, Web of Science Core Collection, and Google Scholar. The period of search will be from 01 April to 30 June 2024. Studies identified through the search strategies will first be screened by titles and abstracts. Included studies meeting established criteria will be evaluated for risk of bias using the JBI checklist. Data will be extracted, and the pooled prevalence rate of HIV drug resistance will be computed using STATA 14 software. Random effect models will be used when heterogeneity is suspected. The I² statistic and its corresponding P value will be checked to distinguish heterogeneity. Additionally, publication bias and heterogeneity will be checked using visual funnel plots, Egger's test, trim-and-fill tests, meta-regression, and subgroup analysis. To present and synthesize the results, narrative synthesis will be performed to describe study characteristics and findings, and forest plots will be used to visually represent effect sizes and confidence intervals from individual studies.</p><p><strong>Discussion: </strong>Estimating the pooled prevalence rate of HIV drug resistance through a systematic review and meta-analysis improves the reliability of the evidence, the availability of effective HIV treatment options, and the ability to assist in making decisions for both clinical practice and public health policy in Ethiopia.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024533975.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare delivery to patients from culturally and linguistically diverse backgrounds in emergency care: a scoping review protocol.","authors":"Ya-Ling Huang, Sarah Thorning, Chun-Chih Lin, Robert Lee, Elizabeth Elder, Julia Crilly","doi":"10.1186/s13643-024-02579-0","DOIUrl":"10.1186/s13643-024-02579-0","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the culturally and linguistically diverse (CALD) population is increasing, and is predicted to reach 405 million by 2050. The delivery of emergency care for the CALD population can be complex due to cultural, social, and language factors. The extent to which cultural, social, and contextual factors influence care delivery to patients from CALD backgrounds throughout their emergency care journey is unclear. Using a systematic approach, this review aims to map the existing evidence regarding emergency healthcare delivery for patients from CALD backgrounds and uses a social ecological framework to provide a broader perspective on cultural, social, and contextual influence on emergency care delivery.</p><p><strong>Methods: </strong>The Joanna Briggs Institute (JBI) scoping review methodology will be used to guide this review. The population is patients from CALD backgrounds who received care and emergency care clinicians who provided direct care. The concept is healthcare delivery to patients from CALD backgrounds. The context is emergency care. This review will include quantitative, qualitative, and mixed-methods studies published in English from January 1, 2012, onwards. Searches will be conducted in the databases of CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), SocINDEX (EBSCO), Scopus (Elsevier), and a web search of Google Scholar. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram will be used to present the search decision process. All included articles will be appraised using the Mixed Methods Appraisal Tool (MMAT). Data will be presented in tabular form and accompanied by a narrative synthesis of the literature.</p><p><strong>Discussion: </strong>Despite the increased use of emergency care service by patients from CALD backgrounds, there has been no comprehensive review of healthcare delivery to patients from CALD backgrounds in the emergency care context (ED and prehospital settings) that includes consideration of cultural, social, and contextual influences. The results of this scoping review may be used to inform future research and strategies that aim to enhance care delivery and experiences for people from CALD backgrounds who require emergency care.</p><p><strong>Systematic review registration: </strong>This scoping review has been registered in the Open Science Framework https://doi.org/10.17605/OSF.IO/HTMKQ.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11241862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of smoking cessation interventions among adults: an overview of systematic reviews.","authors":"Mona Hersi, Andrew Beck, Candyce Hamel, Leila Esmaeilisaraji, Kusala Pussegoda, Bradley Austin, Nadera Ahmadzai, Misty Pratt, Micere Thuku, Fatemeh Yazdi, Alexandria Bennett, Nicole Shaver, Niyati Vyas, Becky Skidmore, Brian Hutton, Douglas Manuel, Matt Morrow, Smita Pakhale, Justin Presseau, Beverley J Shea, Julian Little, David Moher, Adrienne Stevens","doi":"10.1186/s13643-024-02570-9","DOIUrl":"10.1186/s13643-024-02570-9","url":null,"abstract":"<p><strong>Background: </strong>This overview of reviews aims to identify evidence on the benefits (i.e. tobacco use abstinence and reduction in smoking frequency) and harms (i.e. possible adverse events/outcomes) of smoking cessation interventions among adults aged 18 years and older.</p><p><strong>Methods: </strong>We searched Medline, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, the CADTH Health Technology Assessment Database and several other websites for grey literature. Searches were conducted on November 12, 2018, updated on September 24, 2020, with publication years 2008 to 2020. Two reviewers independently performed title-abstract and full-text screening considering pre-determined inclusion criteria. Data extraction and quality assessments were initially completed by two reviewers independently (i.e. 73% of included studies (n = 22)) using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR 2), and the remainder done by one reviewer and verified by another due to resources and feasibility. The application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) was performed by one independent reviewer and verified by another.</p><p><strong>Results: </strong>A total of 22 Cochrane systematic reviews evaluating the impact of smoking cessation interventions on outcomes such as tobacco use abstinence, reduction in smoking frequency, quality of life and possible adverse events were included. Pharmaceutical (i.e. varenicline, cytisine, nicotine replacement therapy (NRT), bupropion) and behavioural interventions (i.e. physician advice, non-tailored print-based self-help materials, stage-based individual counselling, etc.) showed to have increased smoking cessation; whereas, data for mobile phone-based interventions including text messaging, hypnotherapy, acupuncture, continuous auricular stimulation, laser therapy, electrostimulation, acupressure, St John's wort, S-adenosyl-L-methionine (SAMe), interactive voice response systems and other combination treatments were unclear. Considering harms related to smoking cessation interventions, small/mild harms (i.e. increased palpitations, chest pain, nausea, insomnia, headache) were observed following NRT, varenicline and cytisine use. There were no data on harms related to behavioural therapies (i.e. individual or group counselling self-help materials, internet interventions), combination therapies or other therapies (i.e. laser therapy, electrostimulation, acupressure, St John's wort, SAMe).</p><p><strong>Conclusion: </strong>Results suggest that pharmacological and behavioural interventions may help the general smoking population quit smoking with observed small/mild harms following NRT or varenicline. Consequently, evidence regarding ideal intervention strategies and the long-term impact of these interventions for preventing smoking was unclear.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD4","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11242003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning to optimize literature screening in medical guideline development","authors":"Wouter Harmsen, Janke de Groot, Albert Harkema, Ingeborg van Dusseldorp, Jonathan de Bruin, Sofie van den Brand, Rens van de Schoot","doi":"10.1186/s13643-024-02590-5","DOIUrl":"https://doi.org/10.1186/s13643-024-02590-5","url":null,"abstract":"In a time of exponential growth of new evidence supporting clinical decision-making, combined with a labor-intensive process of selecting this evidence, methods are needed to speed up current processes to keep medical guidelines up-to-date. This study evaluated the performance and feasibility of active learning to support the selection of relevant publications within medical guideline development and to study the role of noisy labels. We used a mixed-methods design. Two independent clinicians’ manual process of literature selection was evaluated for 14 searches. This was followed by a series of simulations investigating the performance of random reading versus using screening prioritization based on active learning. We identified hard-to-find papers and checked the labels in a reflective dialogue. Inter-rater reliability was assessed using Cohen’s Kappa (ĸ). To evaluate the performance of active learning, we used the Work Saved over Sampling at 95% recall (WSS@95) and percentage Relevant Records Found at reading only 10% of the total number of records (RRF@10). We used the average time to discovery (ATD) to detect records with potentially noisy labels. Finally, the accuracy of labeling was discussed in a reflective dialogue with guideline developers. Mean ĸ for manual title-abstract selection by clinicians was 0.50 and varied between − 0.01 and 0.87 based on 5.021 abstracts. WSS@95 ranged from 50.15% (SD = 17.7) based on selection by clinicians to 69.24% (SD = 11.5) based on the selection by research methodologist up to 75.76% (SD = 12.2) based on the final full-text inclusion. A similar pattern was seen for RRF@10, ranging from 48.31% (SD = 23.3) to 62.8% (SD = 21.20) and 65.58% (SD = 23.25). The performance of active learning deteriorates with higher noise. Compared with the final full-text selection, the selection made by clinicians or research methodologists deteriorated WSS@95 by 25.61% and 6.25%, respectively. While active machine learning tools can accelerate the process of literature screening within guideline development, they can only work as well as the input given by human raters. Noisy labels make noisy machine learning.","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":3.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141588519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood PFAS exposure and immunotoxicity: a systematic review and meta-analysis of human studies.","authors":"Evangelia E Antoniou, Wolfgang Dekant","doi":"10.1186/s13643-024-02596-z","DOIUrl":"10.1186/s13643-024-02596-z","url":null,"abstract":"<p><strong>Background: </strong>Exposure to poly- and perfluoroalkyl substances (PFAS) may affect infant and childhood health through immunosuppression. However, the findings of epidemiological literature examining relationships between prenatal/childhood PFAS exposure and vaccine response and infection in humans are still inconclusive. The aim of this review was to examine the effects of PFAS exposure on vaccine antibody response and infection in humans.</p><p><strong>Methods: </strong>The MEDLINE/Pubmed database was searched for publications until 1 February 2023 to identify human studies on PFAS exposure and human health. Eligible for inclusion studies had to have an epidemiological study design and must have performed logistic regression analyses of gestational or childhood exposure to PFAS against either antibody levels for pediatric vaccines or the occurrence of children's infectious diseases. Information on baseline exposure to PFAS (in ng/mL), the age of PFAS exposure (gestational or in years), and the outcome was measured, potentially leading to multiple exposure-outcome comparisons within each study was collected. Percentage change and standard errors of antibody titers and occurrence of infectious diseases per doubling of PFAS exposure were calculated, and a quality assessment of each study was performed.</p><p><strong>Results: </strong>Seventeen articles were identified matching the inclusion criteria and were included in the meta-analysis. In general, a small decrease in antibody response and some associations between PFAS exposure and childhood infections were observed.</p><p><strong>Conclusions: </strong>This meta-analysis summarizes the findings of PFAS effects on infant and childhood immune health. The immunosuppression findings for infections yielded suggestive evidence related to PFAS exposure, particularly PFOS, PFOA, PFHxS, and PFNA but moderate to no evidence regarding antibody titer reduction.</p><p><strong>Systematic review registration: </strong>The research protocol of this systematic review is registered and accessible at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/5M2VU ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}