Systematic Reviews最新文献

{"title":"The impact of antimicrobial stewardship interventions on appropriate use of surgical antimicrobial prophylaxis in low- and middle-income countries: a systematic review.","authors":"Israel Abebrese Sefah, Sarentha Chetty, Peter Yamoah, Varsha Bangalee","doi":"10.1186/s13643-024-02731-w","DOIUrl":"10.1186/s13643-024-02731-w","url":null,"abstract":"<p><strong>Background: </strong>Surgical antimicrobial prophylaxis (SAP) is an effective infection prevention strategy used to reduce postoperative surgical site infection. Inappropriate use of SAP is a concern in low-middle-income countries (LMICs) due to increased mortality risks, adverse reactions, re-admission rates and length of hospital stay. Antimicrobial Stewardship Programs (ASP) have been shown to be effective in improving the appropriate use of antibiotics including the use of SAP. The aim of this review was to evaluate the impact of ASP on the appropriate use of SAP and its implication on patient outcomes in LMICs.</p><p><strong>Method: </strong>The protocol for this review was registered in PROSPERO. Studies published between 1st January 2010 and 31st December 2023 were searched electronically from Medline, Central Cochrane Library, web of science, CINAHL and APA PsychInfo databases. Studies were included if they assessed the impact of ASP interventions on SAP use in low- and middle-income countries (LMICs). Studies were evaluated using the Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tool for non-randomized and before and after studies as well as the Cochrane Risk of Bias 2 (ROB 2) tool for randomized studies. Findings were summarized in tables.</p><p><strong>Results: </strong>Twenty studies comprising of seventeen before-after studies, two interrupted time series, and one randomized controlled trial were included. Penicillins and cephalosporins were the most commonly used antibiotics for SAP. Most (50%) of the studies were conducted in Asia followed by Africa (45%). While 80% of the studies showed the impact of ASP on compliance to SAP guidelines, only 45% showed an impact on antibiotic utilization. Again, 50% and 60% showed an impact on reducing antibiotic costs and patient length of stay at hospitals respectively. Patient outcomes including rates of surgical site infections and mortality showed no significant change. The studies showed a high risk of bias mainly due to the choice of study designs.</p><p><strong>Conclusion: </strong>ASP interventions in LMICs are effective in improving SAP guideline adherence, antibiotic utilization and their cost. Deliberate effort must be made to improve on the quality of future interventional studies in these settings to guide practice and encourage other LMICs to conduct such studies to assess the influence of different geographical contexts on SAP use.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"306"},"PeriodicalIF":6.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865430","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":"The best ovarian reserve marker to predict ovarian response following controlled ovarian hyperstimulation: a systematic review and meta-analysis.","authors":"Fateme Salemi, Sara Jambarsang, Amir Kheirkhah, Amin Salehi-Abargouei, Zahra Ahmadnia, Haniye Ali Hosseini, Marzieh Lotfi, Saad Amer","doi":"10.1186/s13643-024-02684-0","DOIUrl":"10.1186/s13643-024-02684-0","url":null,"abstract":"<p><strong>Background: </strong>One of the most challenging aspects of treating patients facing primary ovarian insufficiency, especially those eligible for controlled ovarian hyperstimulation (COH), is the assessment of ovarian function and response to stimulatory protocols in terms of the number of oocytes retrieved. The lack of consistency between studies regarding the best parameter for response evaluation necessitates a comprehensive statistical analysis of the most commonly utilized ovarian reserve markers (ORM). This systematic review and meta-analysis aims to establish the optimal metric for assessing ovarian reserve among COH candidates.</p><p><strong>Methods: </strong>The PubMed/MEDLINE, Scopus, and ISI Web of Science databases were searched until July 2024, with no date or language limitations. The Newcastle-Ottawa scale was used to evaluate the validity of anti-Mullerian hormone (AMH), antral follicle count (AFC), follicle-stimulating hormone (FSH), and estradiol (E2) in patients receiving controlled ovarian hyperstimulation. Studies on the diagnostic accuracy of ovarian reserve markers in predicting ovarian response to controlled ovarian hyperstimulation in assisted reproduction technology (ART) candidates were reviewed. The diagnostic odds ratio (DOR) was determined using the Der Simonian-Laird random effects model meta-analysis to assess the likelihood of detecting low or high ovarian responses in COH candidates. Cochran's Q, and I-squared, were used to analyze between-study heterogeneity.</p><p><strong>Results: </strong>This systematic review and meta-analysis included 26 studies including 17 cohorts, 4 case controls, and 5 cross-sectional studies. AFC and AMH demonstrated significant diagnostic performance compared to FSH and E2 in poor and high response category. AMH slightly outperformed AMH and had the highest logarithm of DOR for detecting poor [2.68 (95% CI 1.90, 3.45)] and high ovarian response [2.76 (95% CI 1.57, 3.95)]. However, it showed a high between-study heterogeneity (I² = 95.65, Q = 189.65, p < 0.05).</p><p><strong>Conclusions: </strong>AFC and AMH were the most accurate predictors of poor and high ovarian response to controlled ovarian hyperstimulation. However, further research is needed to develop models assessing the combined impact of AMH and AFC on ovarian response prediction.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42021245380.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"303"},"PeriodicalIF":6.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855419","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":"The blinding status and characteristics in acupuncture clinical trials: a systematic reviews and meta-analysis.","authors":"Tinglan Liu, Lijiao Jiang, Shuangjing Li, Shuyang Cheng, Rong Zhuang, Zhiyi Xiong, Chongyang Sun, Baoyan Liu, Haoran Zhang, Shiyan Yan","doi":"10.1186/s13643-024-02692-0","DOIUrl":"10.1186/s13643-024-02692-0","url":null,"abstract":"<p><strong>Background: </strong>Sham acupuncture is a widely accepted control in acupuncture clinical trials. Given the nature of acupuncture, it is warranted to assess the blinding of sham-controlled trials. Despite the sham acupuncture design having been widely used, the overall blinding of sham acupuncture and the characteristics of blinding assessment in acupuncture trials are unclear. This research aims to assess the blinding status of acupuncture clinical trials and explore the blinding assessment characteristics in acupuncture trials.</p><p><strong>Methods: </strong>This meta-analysis included all the acupuncture clinical trials published in English that performed blinding assessments and reported the results. We searched PubMed, Embase, and Web of Science for randomized controlled trials (RCTs) from inception to April 2024. The primary outcome is Bang's Blinding Index (Bang's BI) and 95% credibility interval (CrI) was pooled using a Bayesian hierarchical model. The study adheres to the PRISMA guidelines.</p><p><strong>Results: </strong>Sixty-four eligible studies published from 1999 to 2024 were included. The mean of Bang's BI was - 0.24 (95% CrI - 0.34 to - 0.14, tau² = 0.13) for the sham acupuncture group and 0.41 (95% CrI 0.32 to 0.49, tau² = 0.10) for the verum acupuncture group. The characteristics of blinding showed that 62.50% of the trials had a Bang's BI greater than 0 in the verum group and less than 0 in the sham group; in 28.15% of the trials, the Bang's BI was greater than 0 in the verum group and greater than 0 in the sham group. Subgroup analysis revealed that area, number of research centers, treatment sessions, acupoints number, and evaluation timepoint can influence blinding results.</p><p><strong>Conclusion: </strong>Overall blinding status in current acupuncture clinical trials shows a majority correctly guessing for the verum group and opposite guessing for the sham group. However, in some acupuncture trials, the blinding of sham acupuncture might be compromised. Factors such as the Asian population, penetrating sham needling, and querying participants about their group assignment during the study increase the risk of unblinding and warrant careful consideration in sham acupuncture control design. Furthermore, researchers should closely monitor the blinding status of sham acupuncture and transparently report details of blinding assessments.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023403595.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"302"},"PeriodicalIF":6.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792334","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":"Acceptance and use of extended reality in surgical training: an umbrella review.","authors":"Esmaeel Toni, Elham Toni, Mahsa Fereidooni, Haleh Ayatollahi","doi":"10.1186/s13643-024-02723-w","DOIUrl":"10.1186/s13643-024-02723-w","url":null,"abstract":"<p><strong>Background: </strong>Extended reality (XR) technologies which include virtual, augmented, and mixed reality have significant potential in surgical training, because they can help to eliminate the limitations of traditional methods. This umbrella review aimed to investigate factors that influence the acceptance and use of XR in surgical training using the unified theory of acceptance and use of technology (UTAUT) model.</p><p><strong>Methods: </strong>An umbrella review was conducted in 2024 by searching various databases until the end of 2023. Studies were selected based on the predefined eligibility criteria and analyzed using the components of the UTAUT model. The quality and risk of bias of the selected studies were assessed, and the findings were reported descriptively.</p><p><strong>Results: </strong>A total of 44 articles were included in this study. In most studies, XR technologies were used for surgical training of orthopedics, neurology, and laparoscopy. Based on the UTAUT model, the findings indicated that XR technologies improved surgical skills and procedural accuracy while simultaneously reducing risks and operating room time (performance expectancy). In terms of effort expectancy, user-friendly systems were accessible for the trainees with various levels of expertise. From a social influence standpoint, XR technologies enhanced learning by providing positive feedback from experienced surgeons during surgical training. In addition, facilitating conditions emphasized the importance of resource availability and addressing technical and financial limitations to maximize the effectiveness of XR technologies in surgical training.</p><p><strong>Conclusions: </strong>XR technologies significantly improve surgical training by increasing skills and procedural accuracy. Although adoption is facilitated by designing user-friendly interfaces and positive social influences, financial and resource challenges must be overcome, too. The successful integration of XR into surgical training necessitates careful curriculum design and resource allocation. Future research should focus on overcoming these barriers, so that XR can fully realize its potential in surgical training.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"299"},"PeriodicalIF":6.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781015","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":"Exploring the role of digital technology for feedback exchange in clinical training: a scoping review.","authors":"Veena S Singaram, Rayishnee Pillay, Esther L Mbobnda Kapche","doi":"10.1186/s13643-024-02705-y","DOIUrl":"10.1186/s13643-024-02705-y","url":null,"abstract":"<p><strong>Background: </strong>Feedback plays an integral role in clinical training and can profoundly impact students' motivation and academic progression. The shift to online teaching, accelerated by the COVID-19 pandemic, highlighted the necessity of transitioning traditional feedback mechanisms to digital platforms. Despite this, there is still a lack of clarity regarding effective strategies and tools for delivering digital feedback in clinical education. This scoping review aimed to assess the current utilization of digital feedback methods in clinical education, with a focus on identifying potential directions for future research and innovation.</p><p><strong>Methods: </strong>A database search using a published protocol based on the Joanna Briggs Institute framework was conducted between January 2010 and December 2023. Six databases were searched, PubMed/MEDLINE, EBSCOhost, Scopus, Google Scholar, Union Catalogue of Theses and Dissertations, and WorldCat Dissertations and Theses. Reviewers independently screened the papers against eligibility criteria and discussed the papers to attain consensus. Extracted data were analyzed qualitatively and descriptively.</p><p><strong>Results: </strong>Of the 2412 records identified, 33 reports met the inclusion criteria. Digital tools explored for feedback included web-based and social sites, smart device applications, virtual learning environments, virtual reality, and artificial intelligence. Convenience and immediate, personalized feedback and enhanced formative assessment outcomes were major facilitators of digital feedback utility. Technical constraints, limited content development, training, and data security issues hindered the adoption of these tools. Reports mostly comprised empirical research, published in the global North and conducted on undergraduates studying medicine.</p><p><strong>Conclusion: </strong>This review highlighted a geographical imbalance in research on feedback exchange via digital tools for clinical training and stressed the need for increased studies in the global South. Furthermore, there is a call for broader exploration across other health professions and postgraduate education. Additionally, student perceptions of digital tools as intrusive necessitate a balanced integration with traditional feedback dialogues. The incorporation of virtual reality and artificial intelligence presents promising opportunities for personalized, real-time feedback, but requires vigilant governance to ensure data integrity and privacy. SCOPING REVIEW PROTOCOL: https://doi.org/10.1186/s13643-022-02151-8.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"298"},"PeriodicalIF":6.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781034","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":"Association between impairment of lung function and risk of anxiety and depression in patients with chronic obstructive pulmonary disease-a systematic review.","authors":"Johanne Hermann Karlsen, Kirstine Hermann Jørgensen, Ulla Møller Weinreich","doi":"10.1186/s13643-024-02720-z","DOIUrl":"10.1186/s13643-024-02720-z","url":null,"abstract":"<p><strong>Background: </strong>This systematic review aims to examine the association between impairment of lung function and risk of anxiety and depression, respectively, in patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>Literature search were performed 29/01-2024 using Embase and PubMed. Publications reporting association between forced expiratory volume in one second in percentage of expected value (FEV1(%)) and either anxiety or depression or both in patients with COPD were included. The studies were quality assessed using the Newcastle Ottawa Scale. The studies were analysed by assessing whether they showed significant results or not, and if they showed a negative or positive association between lung function and risk anxiety or depression and a pooled analysis was conducted.</p><p><strong>Results: </strong>Thirty-seven studies were included in the review, 15 reported anxiety and 31 reported depression, with 9 reporting both outcomes. Most were observational studies. Study population sizes ranged from 40 to 2147 patients. Three studies found a significant negative association between anxiety and FEV1(%), while five studies found a positive non-significant association between anxiety and FEV1(%). Fifteen studies found a significant negative association between FEV1(%) and depression. Especially the studies with larger study population sizes showed significant results. The pooled analysis supported this, as the depression studies showed a significant association between depression and FEV1(%), while the anxiety studies showed part non-significant, part significant associations between anxiety and FEV1(%).</p><p><strong>Conclusion: </strong>This systematic review did not support an association between anxiety and impairment of pulmonary function as only 3/15 studies showed significant negative associations, and some studies showed positive associations. This review indicated an association between depression and impairment pulmonary function in patients with COPD, as most studies with a larger study population size showed a significant negative association. Sytematic review registration. PROSPERO 2024 CRD42024506065 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024506065.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"300"},"PeriodicalIF":6.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781026","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":"Barriers and facilitators to using feedback from clinical quality registries: a scoping review protocol.","authors":"Hussein Al-Qarni, Sabine M Allida, Julee McDonagh, Caleb Ferguson","doi":"10.1186/s13643-024-02693-z","DOIUrl":"10.1186/s13643-024-02693-z","url":null,"abstract":"<p><strong>Background: </strong>A clinical quality registry (CQR) is a structured database that systematically collects data to monitor clinical quality and improve healthcare outcomes. The aims of CQRs are to improve treatment plans, assist in decision-making, increase healthcare value, enhance care quality, and reduce healthcare costs by providing feedback to healthcare providers. Feedback to clinicians is used as a quality improvement tool. It provides data to clinicians about their performance, which may contribute to improvement in healthcare outcomes. To the best of our knowledge, previous research on CQRs has primarily focused on factors affecting their use and their impact on healthcare outcomes. In this study, a scoping review is conducted to understand the barriers to and facilitators of using feedback systems from clinical quality registries in acute healthcare settings.</p><p><strong>Methods: </strong>For this review, Arksey and O'Malley's framework for scoping reviews will be applied. The following electronic databases (MEDLINE via Ovid, CINAHL, and Scopus) and grey literature (Google Scholar) will be systematically searched for qualitative and mixed-method studies (only including qualitative findings) published after 2000 in the English language. Two reviewers will independently screen the articles and extract the data which, subsequently, will be mapped against the COM-B model.</p><p><strong>Discussion: </strong>This review is conducted with the aim of providing valuable insights into the factors that influence the utilisation of feedback from Clinical Quality Registries by healthcare providers, which, in the context of quality improvement, may have significant implications for clinical research, registry science, health policy, and clinical practice.</p><p><strong>Scoping review registration: </strong>This protocol has been registered prospectively with the Open Science Framework (OSF) ( https://osf.io/fhm4n/ ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"301"},"PeriodicalIF":6.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781029","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":"Barriers and facilitators of benzathine penicillin G adherence among rheumatic heart disease patients: a mixed methods systematic review using the COM-B (capability, opportunity, and motivation for behavior) model.","authors":"Habtamu Abera Areri, Henok Tadele, Sale Workneh","doi":"10.1186/s13643-024-02691-1","DOIUrl":"10.1186/s13643-024-02691-1","url":null,"abstract":"<p><strong>Background: </strong>Benzathine penicillin G (BPG) is a proven preventive agent for preventing the progression of rheumatic heart disease (RHD) and is recognized as a standard of care. However, ensuring adherence to BPG remains a global challenge. The objective of this review was to synthesize the available evidence on the barriers to and facilitators of BPG adherence among RHD patients.</p><p><strong>Methods: </strong>This systematic review included both qualitative and quantitative studies on RHD patients published in the English language. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search strategy involved PubMed, Embase, CINAHL, Global Health, Scopus, and Web of Sciences databases to identify keywords and terms contained in the title and abstract and the index terms used to describe articles. The review included papers published from January 1, 2000, to March 30, 2024. Two independent reviewers screened, appraised, and extracted the data. The data analysis was carried out deductively to fit onto the components of the COM-B (Capability, Opportunity, Motivation-Behaviour) model.</p><p><strong>Results: </strong>In this review, 1067 records were screened, and 22 studies with 7338 participants were included. Thirty-five barriers and twenty facilitators were identified and mapped onto COM-B components. Physical capability (e.g., felt healthy), psychological capability (e.g., lack of knowledge), reflective motivation (e.g., poor patient handling), automatic motivation (e.g., BPG injection pain), physical opportunity (e.g., BPG unavailability) and social opportunity (e.g., inadequate counseling) were identified as barriers. The most discussed barrier was automatic motivation, followed by psychological capability and physical opportunity.</p><p><strong>Conclusions: </strong>Our review revealed variable levels of BPG adherence across studies and identified significant barriers and facilitators. Further research is recommended to identify contextual interventions to address barriers and capitalize on facilitators.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024535398.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"297"},"PeriodicalIF":6.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772502","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":"Spinal manipulations for migraine: an updated systematic review and meta-analysis of randomized clinical trials.","authors":"Pawel Posadzki, Andrzej T Klimek, Edzard Ernst","doi":"10.1186/s13643-024-02719-6","DOIUrl":"10.1186/s13643-024-02719-6","url":null,"abstract":"<p><strong>Objective: </strong>This update of a systematic review evaluates the effectiveness of spinal manipulations as a treatment for migraine headaches.</p><p><strong>Background: </strong>Spinal manipulation therapy (SMT) is sometimes used to treat migraine headaches; however, the biological plausibility and safety of SMT have repeatedly been questioned.</p><p><strong>Methods: </strong>Amed, Embase, MEDLINE, CINAHL, Mantis, Index to Chiropractic Literature, and Cochrane Central were searched from inception to September 2023. Randomized clinical trials (RCTs) investigating spinal manipulations (performed by various healthcare professionals including physiotherapists, osteopaths, and chiropractors) for treating migraine headaches in human subjects were considered. Other types of manipulative therapy, i.e., cranial, visceral, and soft tissue were excluded. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the certainty of evidence.</p><p><strong>Results: </strong>Three more RCTs were published since our first review; amounting to a total of 6 studies with 645 migraineurs meeting the inclusion criteria. Meta-analysis of six trials showed that, compared with various controls (placebo, drug therapy, usual care), SMT (with or without usual care) has no effect on migraine intensity/severity measured with a range of instruments (standardized mean difference [SMD] - 0.22, 95% confidence intervals [CI] - 0.65 to 0.21, very low certainty evidence), migraine duration (SMD - 0.10; 95% CI - 0.33 to 0.12, 4 trials, low certainty evidence), or emotional quality of life (SMD - 14.47; 95% CI - 31.59 to 2.66, 2 trials, low certainty evidence) at post-intervention. A meta-analysis of two trials showed that compared with various controls, SMT (with or without usual care) increased the risk of AEs (risk ratio [RR] 2.06; 95% CI 1.24 to 3.41, numbers needed to harm = 6; very low certainty evidence). The main reasons for downgrading the evidence were study limitations (studies judged to be at an unclear or high risk of bias), inconsistency (for pain intensity/severity), imprecision (small sizes and wide confidence intervals around effect estimates) and indirectness (methodological and clinical heterogeneity of populations, interventions, and comparators).</p><p><strong>Conclusions: </strong>The effectiveness of SMT for the treatment of migraines remains unproven. Future, larger, more rigorous, and independently conducted studies might reduce the existing uncertainties.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"296"},"PeriodicalIF":6.3,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755694","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":"End-of-life care for people with chronic obstructive pulmonary disease: a scoping review protocol.","authors":"Kotoko Minami, Chihiro Unozawa, Arina Matsunaga, Tomoko Kamei","doi":"10.1186/s13643-024-02712-z","DOIUrl":"10.1186/s13643-024-02712-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory disease that has a typical illness trajectory. Awareness of unique disease courses as well as providing end-of-life care (EOLC) for COPD patients is important as most patients experience varied degrees of suffering toward the end-of-life. The purpose of this scoping review is to map out key concepts, main sources, and types of evidence available in the area of research on EOLC with multiple interventions for people with COPD.</p><p><strong>Methods: </strong>This scoping review will be conducted following the latest Joanna Briggs Institute (JBI) guidelines. In addition, this review process will adhere to the preferred reporting items for systematic reviews and meta-analysis extension for scoping reviews (PRISMA-ScR). The initial simple search concepts will be set out as \"chronic obstructive pulmonary disease\" and \"end-of-life care\". Based on the eligibility criteria, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL Ultimate, Embase, and Google Scholar databases will be searched, and all quantitative and qualitative studies of the after-year publication of each electronic database will be included. This process of literature selection will be carried out independently by each researcher. The results will be summarised in a narrative synthesis approach and the gaps and potential biases of the evidence identified by comparing the adopted articles for EOLC with multiple interventions for people with COPD.</p><p><strong>Discussion: </strong>This scoping review will outline in detail the evidence and the gaps from primary studies that have been gathered from the qualitative and quantitative literature based on all eligibility criteria. Therefore, the results of this review will contribute to a new field of systematic reviews. Furthermore, providing an outline of an EOLC for COPD in this study may improve the practice of healthcare professionals in this area. Ethical approval and consent are not required as no human participants were involved in this study.</p><p><strong>Systematic review registration: </strong>This research has been registered in the Open Science Framework (OSF) ( https://osf.io/upd4a ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"294"},"PeriodicalIF":6.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751206","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}