A Measurement Tool To Assess Systematic Reviews Research Articles

Human papillomavirus infection and the risk of cancer at specific sites other than anogenital tract and oropharyngeal region: an umbrella review

Despite numerous studies having evaluated the associations between human papillomavirus (HPV) infection and risk of specific cancers other than anogenital tract and oropharyngeal, the findings are inconsistent and the quality of evidence has not been systematically quantified. We aimed to summarise the existing evidence as well as to evaluate the strength and credibility of these associations. We conducted an umbrella review of systematic reviews and meta-analyses of observational studies. PubMed, EMBASE, and Web of Science were searched from inception to March 2024. Studies with systematic reviews and meta-analyses that examined associations between HPV or HPV-associated genotypes infection and specific cancers were eligible for this review. The quality of the methodology was evaluated using A Measurement Tool to Assess systematic Reviews (AMSTAR). The credibility of the evidence was assessed using GRADE. The protocol was preregistered with PROSPERO (CRD42023439070). The umbrella review identified 31 eligible studies reporting 87 associations with meta-analytic estimates, including 1191 individual studies with 336,195 participants. Of those, 29 (93.5%) studies were rated as over moderate quality by AMSTAR. Only one association indicating HPV-18 infection associated with an increased risk of breast cancer (odds ratio [OR]=3.48, 95% confidence interval [CI]=2.24-5.41) was graded as convincing evidence. There were five unique outcomes identified as highly suggestive evidence, including HPV infection increased the risk of oral squamous cell carcinoma (OR=7.03, 95% CI=3.87-12.76), oesophageal cancer (OR=3.32, 95% CI=2.54-4.34), oesophageal squamous cell carcinoma (OR=2.69, 95% CI=2.05-3.54), lung cancer (OR=3.60, 95% CI=2.59-5.01), and breast cancer (OR=6.26, 95% CI=4.35-9.00). According to GRADE, one association was classified as high, indicating that compared with the controls in normal tissues, HPV infection was associated with an increased risk of breast cancer. The umbrella review synthesised up-to-date observational evidence on HPV infection with the risk of breast cancer, oral squamous cell carcinoma, oesophageal cancer, oesophageal squamous cell carcinoma, and lung cancer. Further larger prospective cohort studies are needed to verify the associations, providing public health recommendations for prevention of disease. National Key Research and Development Program of China, Natural Science Foundation of China, Outstanding Scientific Fund of Shengjing Hospital of China Medical University, and 345 Talent Project of Shengjing Hospital of China Medical University.

Quality of systematic reviews and meta‐analyses in dermatology

AbstractIntroductionAlthough the number of published systematic reviews and meta‐analyses in dermatology has increased over the past decade, their quality is unknown.ObjectiveThe objective of this study was to determine the change in risk of bias, methodological quality and reporting quality of systematic reviews and meta‐analyses in dermatology between 2010 and 2019.MethodsWe conducted a comparative study of systematic reviews and meta‐analyses published in the 10 highest‐ranked dermatology journals in 2010 and 2019. Studies were identified through electronic searches of MEDLINE, Embase, and eight other bibliographic databases. Risk of bias and methodological quality were assessed in duplicate with the risk of bias in systematic reviews (ROBIS) and A MeaSurement Tool to Assess systematic Reviews‐2 (AMSTAR‐2) tools, respectively, with the latter only applied to studies of interventions. Reporting quality was assessed with the Preferred Reporting Items of systematic reviews and Meta‐Analyses (PRISMA) 2009 and PRISMA for abstracts (PRISMA‐A) 2013 statements.ResultsWe included 27 systematic reviews and meta‐analyses published in 2010 and 127 published in 2019. There was no evidence of a difference in the proportion of systematic reviews and meta‐analyses at high/unclear risk of bias with ROBIS (Fisher's exact test = 1.00) or critically low methodological quality using AMSTAR‐2 (Fisher's exact test = 0.456), between 2010 and 2019. There was evidence of a difference in proportion of PRISMA (t(26) = 2.7, p = 0.01), and very strong evidence of a difference in proportion of PRISMA‐A (t(26) = 4.2, p < 0.001) checklist items adequately reported between 2010 and 2019. The difference in mean proportion of PRISMA checklist items adequately reported was 3.6 items more (95% confidence interval [CI]: 1.8–5.4 items more) in 2019 (mean = 10.7 items, SD = 2.4 items) than in 2010 (mean = 7.1 items, SD = 2.9 items), and of PRISMA‐A checklist items adequately reported was 1.1 items more (95% CI: 0.2–2.0 items more) in 2019 (mean = 5.6 items, SD = 1.5 items) than in 2010 (mean = 4.4 items, SD = 1.7 items)ConclusionsNo improvement was observed in the overall methodological quality of included systematic reviews and meta‐analyses; however, there was strong evidence of improvement in the overall reporting quality.

Intermittent fasting and health outcomes: an umbrella review of systematic reviews and meta-analyses of randomised controlled trials

Benefits of Intermittent fasting (IF) on health-related outcomes have been found in a range of randomised controlled trials (RCTs). Our umbrella review aimed to systematically analyze and synthesize the available causal evidence on IF and its impact on specific health-related outcomes while evaluating its evidence quality. We comprehensively searched the PubMed, Embase, Web of Science, and Cochrane databases (from inception up to 8 January 2024) to identify related systematic reviews and meta-analyses of RCTs investigating the association between IF and human health outcomes. We recalculated the effect sizes for each meta-analysis as mean difference (MD) or standardized mean difference (SMD) with corresponding 95% confidence intervals (CIs). Subgroup analyses were performed for populations based on three specific status: diabetes, overweight or obesity, and metabolic syndrome. The quality of systematic reviews was evaluated using A Measurement Tool to Assess Systematic Reviews (AMSTAR), and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. This study is registered with PROSPERO (CRD42023382004). A total of 351 associations from 23 meta-analyses with 34 health outcomes were included in the study. A wide range of outcomes were investigated, including anthropometric measures (n=155), lipid profiles (n=83), glycemic profiles (n=57), circulatory system index (n=41), appetite (n=9), and others (n=6). Twenty-one (91%) meta-analyses with 346 associations were rated as high confidence according to the AMSTAR criteria. The summary effects estimates were significant at p<0.05 in 103 associations, of which 10 (10%) were supported by high certainty of evidence according to GRADE. Specifically, compared with non-intervention diet in adults with overweight or obesity, IF reduced waist circumference (WC) (MD=-1.02cm; 95% CI:-1.99 to-0.06; p=0.038), fat mass (MD=-0.72kg; 95% CI:-1.32 to-0.12; p=0.019), fasting insulin (SMD=-0.21; 95% CI:-0.40 to-0.02; p=0.030), low-density lipoprotein cholesterol (LDL-C) (SMD=-0.20; 95% CI:-0.38 to-0.02; p=0.027), total cholesterol (TC) (SMD=-0.29; 95% CI:-0.48 to-0.10; p=0.003), and triacylglycerols (TG) (SMD=-0.23; 95% CI:-0.39 to-0.06; p=0.007), but increased fat free mass (FFM) (MD=0.98kg; 95% CI: 0.18-1.78; p=0.016). Of note, compared with the non-intervention diet, modified alternate-day fasting (MADF) reduced fat mass (MD=-0.70kg; 95% CI:-1.38 to-0.02; p=0.044). In people with overweight or obesity, and type 2 diabetes, IF increases high-density lipoprotein cholesterol (HDL-C) levels compared to continuous energy restriction (CER) (MD=0.03mmol/L; 95% CI: 0.01-0.05; p=0.010). However, IF was less effective at reducing systolic blood pressure (SBP) than a CER diet in adults with overweight or obesity (SMD=0.21; 95% CI: 0.05-0.36; p=0.008). Our findings suggest that IF may have beneficial effects on a range of health outcomes for adults with overweight or obesity, compared to CER or non-intervention diet. Specifically, IF may decreased WC, fat mass, LDL-C, TG, TC, fasting insulin, and SBP, while increasing HDL-C and FFM. Notably, it is worth noting that the SBP lowering effect of IF appears to be weaker than that of CER. This work was supported by the National Key Research and Development Program of China (Q-JW), the Natural Science Foundation of China (Q-JW and T-TG), Outstanding Scientific Fund of Shengjing Hospital of China Medical University (Q-JW), and 345 Talent Project of Shengjing Hospital of China Medical University (T-TG).

Effect of blood flow restriction with low-intensity resistance training in patients with osteoarthritis and rheumatoid arthritis: a systematic review and meta-analysis based on randomized controlled trials.

This study evaluated the effects of blood flow restriction with low-intensity resistance training (BFR + LIRT) on pain, adverse events, muscle strength, and function in patients with osteoarthritis (OA) and rheumatoid arthritis (RA) through a systematic review and meta-analysis. This study adhered to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 (PRISMA 2020) and applied the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR2) standards to ensure the high quality of the systematic review. A comprehensive literature search was conducted until August 2023 using four selected keywords (osteoarthritis, rheumatoid arthritis, blood flow restriction training, and resistance training) across five search engines (PubMed, Embase, Web of Science, CENTRAL, and PEDro). Ten studies were analyzed. The results showed that BFR + LIRT had similar effects on pain, risk of adverse events, muscle strength, self-reported function, and physical function compared with resistance training (RT). This systematic review and meta-analysis further support the potential of BFR + LIRT in the disease management of patients with OA or RA. According to this analysis, BFR + LIRT had a lower risk of adverse events than high-intensity resistance training (HIRT) and may be a safer training modality. BFR + LIRT offers greater advantages in improving physical function than LIRT and was able to provide similar benefits to HIRT without increasing the training load. These findings suggest that BFR + LIRT is a safe and effective strategy for treating patients with OA or RA. However, owing to the limited number of studies covered in this analysis, additional higher-quality studies are needed to strengthen this conclusion.

Relationships between sodium, fats and carbohydrates on blood pressure, cholesterol and HbA1c: an umbrella review of systematic reviews

BackgroundThe relationship between nutrition and health is complex and the evidence to describe it broad and diffuse. This review brings together evidence for the effect of nutrients on cardiometabolic risk factors.MethodsAn umbrella review identified systematic reviews of randomised controlled trials and meta-analyses estimating the effects of fats, carbohydrates and sodium on blood pressure, cholesterol and haemoglobin A1c (HbA1c). Medline, Embase, Cochrane Library and Science Citation Index were search through 26 May 2020, with supplementary searches of grey literature and websites. English language systematic reviews and meta-analyses were included that assessed the effect of sodium, carbohydrates or fat on blood pressure, cholesterol and HbA1c. Reviews were purposively selected using a sampling framework matrix. The quality of evidence was assessed with A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR2) checklist, evidence synthesised in a narrative review and causal pathways diagram.ResultsForty-three systematic reviews were included. Blood pressure was significantly associated with sodium, fibre and fat. Sodium, fats and carbohydrates were significantly associated with cholesterol. Monounsaturated fat, fibre and sugars were associated with HbA1c.ConclusionMultiple relationships between nutrients and cardiometabolic risk factors were identified and summarised in an accessible way for public health researchers. The review identifies associations, inconsistencies and gaps in evidence linking nutrition to cardiometabolic health.

Appraising and highlighting gaps among prophylactic intervention studies for reducing the incidence of postoperative nausea and vomiting in children: a systematic review

ObjectivesPostoperative nausea and vomiting (PONV) is a leading perioperative morbidity outcome following general anaesthesia. This systematic review aims to identify, appraise and summarise the evidence synthesis studies of prophylactic interventions...

An Appraisal of the Evidence behind the Use of the CHRODIS Plus Initiative for Chronic Pain: A Scoping Review

Background: Chronic conditions, especially pain conditions, have a very significant impact on quality of life and on workplaces. Workplace interventions for chronic conditions are heterogenous, multidimensional, and sometimes poorly evidenced. The Joint Action for Chronic Disease Plus (CHRODIS Plus), including The CHRODIS Plus Workbox on Employment and Chronic Conditions (CPWEC), aimed to combat this, prevent chronic disease and multimorbidity, and influence policy in Europe. However, the supporting evidence behind CHRODIS Plus has not been formally assessed. Methods: A scoping review was carried out; Embase, MEDLINE, and CINAHL were searched for literature related to CHRODIS Plus and pain. Title and abstract and full-text screening were carried out in duplicate and independently. Additionally, CHRODIS Plus authors were approached for unpublished data. Secondly, the search was broadened to CHRODIS Plus and pain-causing conditions. Grey literature was also searched. Appropriateness appraisal was derived from the Trial Forge Guidance. Systematic reviews, on which CPWEC was based, were appraised using the A Measurement Tool to Assess systematic Reviews (AMSTAR) 2 tool. Results: The initial search yielded two results, of which zero were suitable to be included in the scoping review. The second, broader search revealed 14 results; however, none were deemed suitable for inclusion. AMSTAR 2 scores revealed that the three systematic reviews influencing CPWEC were of varying quality (from critically low to moderate). Conclusions: CPWEC is based on heterogenous reviews of varying quality. However, comparable tools are designed using alternative forms of evidence. Further research evaluating the post-implementation efficacy of the tool is needed.

Music, occupational, physical, and speech therapy interventions for patients in disorders of consciousness: An umbrella review.

Current clinical guidelines recommend that a multidisciplinary team inclusive of allied healthcare practitioners deliver assessment and intervention for disorders of consciousness. Allied health professionals include music, occupational, physical, and speech therapists. These allied health clinicians are challenged to select interventions due to a lack of evidence-based recommendations regarding rehabilitation interventions that support recovery of consciousness. This umbrella review synthesizes available systematic reviews (SRs) that describe occupational, speech and language, physical and/or musical therapeutic interventions for people with disorders of consciousness. Identify and summarize evidence from systematic reviews (SRs) that examine allied healthcare interventions for patients with disorders of consciousness. Additionally, this umbrella review aims to evaluate the impact of allied health interventions on recovery of consciousness, methodological quality and risk of bias for the included systematic reviews. An umbrella review was completed. The review was reported according to the Preferred Reporting Items for Overview of Reviews (PRIOR) guidance. Five academic databases (PubMed, CINAHL, PsycInfo, Web of Science, and the Cochrane Library) were searched for SRs and/or meta-analyses of allied health (i.e., music, occupational, physical, and speech therapy) interventions for disorders of consciousness. For included studies, data were extracted and quality of the SRs appraised using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 checklist. Data extracted from each SR identified the authors and years of primary studies, interventions, comparators, and outcomes related to recovery of consciousness (i.e., neurobehavioral/cognitive), functional status, physiological response pain, and adverse events. Rehabilitation interventions were categorized and described. Fifteen SRs were included and three of these reviews conducted meta-analyses. Identified rehabilitation interventions included: 1) sensory stimulation, 2) median nerve stimulation, 3) communication/environmental control through assistive technology, 4) mobilization, and 5) music-based therapy. SRs were published between 2002 and 2022 and included 2286 participants. Using the AMSTAR 2, the quality of reviews was critically low (k = 6), low (k = 3), moderate (k = 4), and high (k = 2). SRs within this umbrella review demonstrated significant heterogeneity in research methods and use of outcome measures to evaluate the recovery of consciousness within the primary studies. These factors influenced the ability to conduct meta-analyses. Sensory stimulation, median nerve stimulation, music therapy and mobilization are all interventions that demonstrate some level of benefit, but current SRs fail to prove benefit through high-level quality evidence. There is an indisputable need for continued rehabilitation research to expand options for treatment modalities and to ensure that the interventions being applied to DoC rehabilitation are evidence-based to improve consciousness and recovery.

Barriers and facilitators to sustainable operating theatres: a systematic review using the Theoretical Domains Framework.

The health sector contributes significantly to the climate crisis. Operating theatres in particular are a major contributor of greenhouse gas emissions and waste, and while there are several evidence-based guidelines to reduce this impact, these are often not followed. We systematically reviewed the literature to identify barriers and facilitators of sustainable behaviour in operating theatres, categorising these using the Theoretical Domains Framework (TDF). Medline, Embase, PsychInfo, and Global Health databases were searched for articles published between January 2000 - June 2023, using the concepts: barriers and facilitators, sustainability, and surgery. Two reviewers screened abstracts from identified studies, evaluated quality, and extracted data. Identified determinants were mapped to TDF domains and further themes as required. The results were reported in line with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and AMSTAR (A MeaSurement Tool to Assess Systematic Reviews) guidelines. Twenty-one studies were selected for analysis and assessment (seventeen surveys and four interview studies) comprising 8286 participants, including surgeons, nurses and anaesthetists. Eighteen themes across ten TDF domains were identified. The most common barriers to adoption of green behaviours in operating theatres were in domains of: 'knowledge' (N=18) e.g. knowledge of sustainable practices; 'environmental context and resources' (N=16) e.g.'personnel shortage and workload and inadequate recycling facilities; 'social influences' (N=9) e.g. lack of leadership/organisational mandate or support; 'beliefs about consequences' (N=9) e.g. concerns regarding safety. Intention was the most common facilitator, with eleven studies citing it. Despite intentions to adopt sustainable practices in operating theatres, this review identified several barriers to doing so. Interventions should focus on mitigating these, especially by improving staff's knowledge of sustainability practices and working within the environmental context and time pressures. Furthermore, institutional change programmes and policies are needed to prioritise sustainability at the Hospital and Trust level. Additional qualitative work should also be conducted using behavioural frameworks, to more comprehensively investigate barriers and determinants to decarbonise operating theatres.

The Role of Movement, Exercise, and Breathing in the Prevention and Treatment of COVID-19: An Umbrella Review

Objective: To identify the published review literature regarding movement, exercise, and breathing in the prevention and/ or treatment of the coronavirus 2019 disease (COVID-19) and long COVID, with the goal of describing the literature and identifying areas for further research and clinical application. Movement and exercise incorporate sedentary behaviours, various forms of exercise, breathing and respiratory therapies, and yoga-asanas (postures). Methods: This paper progresses from a live review and incorporates systematic reviews and narrative reviews. A literature search occurred monthly using PubMed and Google Scholar from May 2022 to May 2023. A measurement tool to assess systematic reviews (AMSTAR) scoring assessed systematic review quality, while the scale for the assessment of narrative review articles (SANRA) guidelines were used to evaluate narrative reviews. Only information and data focused on movement and exercise relevant to COVID-19 prevention and/or treatment were extracted from each review. Results: Three narrative reviews and five systematic reviews were included. Sedentary behaviours increased significantly during the pandemic. Decreased physical activity level was associated with risk of hospitalization from COVID-19. Physical activity and breathing exercises, whether conducted face-to-face (F-2-F) or via telerehabilitation were associated with improvement in dyspnea (shortness of breath), exercise capacity, lung function, fatigue, and quality of life (QoL). Extreme exercise is best avoided for at least 2 to 3 weeks after severe COVID-19 symptoms. Conclusion: Sedentary behaviour and lack of regular physical activity is correlated with an increased risk of COVID-19. Various forms of movement, exercise, and breathing may be beneficial in the treatment of COVID-19 and in long COVID. Further research and understanding of the importance of movement, exercise, and breathing as it relates to immune health is warranted.

Methodological quality of systematic reviews on sepsis treatments: A cross-sectional study

ObjectiveSystematic reviews (SRs) offer updated evidence to support decision-making on sepsis treatments. However, the rigour of SRs may vary, and methodological flaws may limit their validity in guiding clinical practice. This cross-sectional study appraised the methodological quality of SRs on sepsis treatments. MethodsWe searched MEDLINE, EMBASE, and Cochrane Database for eligible SRs on randomised controlled trials on sepsis treatments with at least one meta-analysis published between 2018 and 2023. We extracted SRs' bibliographical characteristics with a pre-designed form and appraised their methodological quality using AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. We applied logistic regressions to explore associations between bibliographical characteristics and methodological quality ratings. ResultsAmong the 102 SRs, two (2.0%) had high overall quality, while respectively four (3.9%), seven (6.9%) and 89 (87.3%) were of moderate, low, and critically low quality. Performance in several critical methodological domains was poor, with only 32 (31.4%) considering the risk of bias in primary studies in result interpretation, 22 (21.6%) explaining excluded primary studies, and 16 (15.7%) applying comprehensive searching strategies. SRs published in higher impact factor journals (adjusted odds ratio: 1.19; 95% confidence interval: 1.05 to 1.36) was associated with higher methodological quality. ConclusionsThe methodological quality of recent SRs on sepsis treatments is unsatisfactory. Future reviewers should address the above critical methodological aspects. More resources should also be allocated to support continuous training in critical appraisal among healthcare professionals and other evidence users.

The Reporting and Methodological Quality of Systematic Reviews Underpinning Clinical Practice Guidelines Focused on the Management of Cutaneous Melanoma: Cross-Sectional Analysis.

Clinical practice guidelines (CPGs) inform evidence-based decision-making in the clinical setting; however, systematic reviews (SRs) that inform these CPGs may vary in terms of reporting and methodological quality, which affects confidence in summary effect estimates. Our objective was to appraise the methodological and reporting quality of the SRs used in CPGs for cutaneous melanoma and evaluate differences in these outcomes between Cochrane and non-Cochrane reviews. We conducted a cross-sectional analysis by searching PubMed for cutaneous melanoma guidelines published between January 1, 2015, and May 21, 2021. Next, we extracted SRs composing these guidelines and appraised their reporting and methodological rigor using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) checklists. Lastly, we compared these outcomes between Cochrane and non-Cochrane SRs. All screening and data extraction occurred in a masked, duplicate fashion. Of the SRs appraised, the mean completion rate was 66.5% (SD 12.29%) for the PRISMA checklist and 44.5% (SD 21.05%) for AMSTAR. The majority of SRs (19/50, 53%) were of critically low methodological quality, with no SRs being appraised as high quality. There was a statistically significant association (P<.001) between AMSTAR and PRISMA checklists. Cochrane SRs had higher PRISMA mean completion rates and higher methodological quality than non-Cochrane SRs. SRs supporting CPGs focused on the management of cutaneous melanoma vary in reporting and methodological quality, with the majority of SRs being of low quality. Increasing adherence to PRISMA and AMSTAR checklists will likely increase the quality of SRs, thereby increasing the level of evidence supporting cutaneous melanoma CPGs.

Pre-Exposure Prophylaxis Care Continuum for HIV Risk Populations: An Umbrella Review of Systematic Reviews and Meta-Analyses.

Pre-exposure prophylaxis (PrEP) is an effective biomedical strategy for HIV prevention. This umbrella review is aimed at providing a comprehensive summary of the current status of each stage of the PrEP care cascade. A systematic literature search was conducted in PubMed, Embase, and Cochrane. Additionally, a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) tool and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist were used to evaluate their methodological and reporting quality, respectively. A total of 30 systematic reviews met the inclusion criteria. According to the results of methodological quality assessment, 3 reviews were rated as low, while 27 as critically low. Furthermore, the results of the reporting quality evaluation revealed a mean score of 23.03 for the included reviews. Across all the reviews, awareness of PrEP was generally moderate in all populations, and the acceptability was even higher compared with awareness. Unfortunately, the PrEP uptake among different groups was even less optimal, although the adherence was almost above moderate, and several barriers that hindered the utilization of PrEP were identified, and the most common are as follows: cost, stigma, lack of knowledge, mistrust, low risk perception, and more. Although PrEP has proven to be an effective prevention method to date, the promotion of PrEP failed to achieve the anticipated outcome. To reinforce the generalization of and use of PrEP, and effectively control HIV transmission, it is urgent to identify the underlying causes of low uptake rates so that efficient interventions can be implemented.

An Overview of Systematic Reviews on the Surgical Management of Obstructive Sleep Apnoea.

Obstructive Sleep Apnoea (OSA) is a common sleep disorder marked by partial or total obstruction of the upper airway while a person is asleep leading to breathing difficulty, reduced oxygenation and frequent awakenings. This condition affects the general health significantly compromising quality of life. The objective of this overview is to thoroughly assess the systematic reviews on current surgical therapies for the management ofOSA in terms of patient outcomes. A thorough literature search was performed from inception till 31st December 2022 using PubMed, and Cochrane databases. Studies evaluating the effectiveness and safety of different surgical techniques for the management of OSA were considered. The quality of articles was assessed using AMSTAR (A MeaSurement Tool to Assess systematic Reviews)and Glenny et al. checklist. Out of eighteen studies, only seven studies met the inclusion and exclusion criteria. Results showed that the majority of studies were in the pediatric age group except one systematic reviewwhich assessed the adult age group. None of the published articles had compared all surgical procedures based on the standard evaluating procedure nor followed all reporting guidelines in the primary studies. For better implementation, furthermulti center studies are warranted with unique reporting criteria and guidelines about pre- as well as post-operative phases. Future research should concentrate on contrasting strategies, combination therapies, and evaluating long-term effects. The online version contains supplementary material available at 10.1007/s12663-023-02051-x.

Diet in the management of type 2 diabetes: umbrella review of systematic reviews with meta-analyses of randomised controlled trials

ObjectiveTo systematically summarise and evaluate the existing evidence on the effect of diet on the management of type 2 diabetes and prevention of complications.DesignUmbrella review of systematic reviews with meta-analyses...

Comparing the safety and efficacy of sleeve gastrectomy versus Roux-en-Y gastric bypass in elderly (>60 years) with severe obesity: an umbrella systematic review and meta-analysis.

Today, bariatric surgeons face the challenge of treating older adults with class III obesity. The indications and outcomes of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG) also constitute a controversy. PubMed, Web of Science and Scopus were searched to retrieve systematic reviews/meta-analyses published by 1 March 2022. The selected articles were qualitatively evaluated using A Measurement Tool to Assess systematic Reviews (AMSTAR). An umbrella review included six meta-analyses retrieved from the literature. The risk of early-emerging and late-emerging complications decreased by 55% and 41% in the patients underwent SG than in those receiving RYGB, respectively. The chance of the remission of hypertension and obstructive sleep apnoea, respectively increased by 43% and 6%, but type-2 diabetes mellitus decreased by 4% in the patients underwent RYGB than in those receiving SG. RYGB also increased excess weight loss by 15.23% in the patients underwent RYGB than in those receiving SG. Lower levels of mortality and early-emerging and late-emerging complications were observed in the older adults undergoing SG than in those receiving RYGB, which was, however, more efficient in term of weight loss outcomes and recurrence of obesity-related diseases.

The Effectiveness of Tai Chi for Knee Osteoarthritis: An Overview of Systematic Reviews.

Knee Osteoarthritis (KOA) has become a serious health issue for elderly patients. Several systematic reviews (SRs) have reported Tai Chi has widely been used in the treatment of KOA. However, the methodology and conclusions of these SRs are controversial. This overview aims to summarize and evaluate the available evidence for the efficacy and safety of Tai Chi for KOA. Two independent researchers searched eight databases from the inception to April 30, 2022. The included SRs were assessed respectively by A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of the included SRs in terms of outcome indicators. Six SRs were finally included in this overview. The results of methodological quality, reporting quality, and risk of bias of the included SRs were generally unsatisfactory. The limitations were a lack of explaining the reasons for selection, a list of excluded literature, reporting bias assessment, and reporting the potential sources of conflict of interest. In addition, only 1 item was assessed as moderate quality by using the GRADE tool. Limitations were the most common downgraded factors. Tai Chi is effective as a non-pharmacological intervention in the integrative treatment of KOA. However, the quality of evidence and methodological quality of SRs is generally unsatisfactory, suggesting that these results must be interpreted with caution. PROSPERO registration number: CRD42022315146.

Early mobility and family partnerships in the intensive care unit: A scoping review of reviews.

Critical illness significantly impacts the well-being of patients and families. Previous studies show that family members are willing to participate in patient care. Involving families in early mobility interventions may contribute to improved recovery and positive outcomes for patients and families. In this scoping review, we investigated early mobility interventions for critically ill patients evaluated in randomized controlled trials and the extent to which family engagement in those interventions are reported in the literature. In this scoping review of reviews, EMBASE, CINAHL, PubMed and Cochrane Central databases were searched in October 2019 and updated in February 2022. Systematic reviews were included and assessed using A MeaSurement Tool to Assess Systematic Reviews (AMSTAR) 2. Data were synthesized using a narrative approach. PRISMA-ScR guidelines were adhered to for reporting. Thirty-three reviews were included which described a range of early mobility interventions for critically ill patients; none explicitly mentioned family engagement. Almost half of the reviews were of low or critically low quality. Insufficient detail of early mobility interventions prompted information to be extracted from the primary studies. There are a range of early mobility interventions for critically ill patients but few involve families. Given the positive outcomes of family participation, and family willingness to participate in care, there is a need to explore the feasibility and acceptability of family participation in early mobility interventions. Family engagement in early mobility interventions for critically ill patients should be encouraged and supported. How to best support family members and clinicians in enacting family involvement in early mobility requires further investigation.

Quality of evidence supporting the role of acupuncture for breast cancer-related lymphoedema: an overview of systematic reviews and meta-analyses.

Breast cancer-related lymphedema (BCRL) may benefit from acupuncture as a therapeutic. However, the findings of systematic reviews (SRs) and meta-analyses (MAs) are inconsistent and their quality needs to be evaluated critically. We aimed to provide an overview of the methodological quality, risk of bias, quality of reporting, and quality of evidence for SRs/MAs of acupuncture for BCRL. Publications were retrieved from four Chinese databases and four English databases. The methodological quality, risk of bias, reporting quality, and evidence quality of the included SRs/MAs were assessed by two independent researchers using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Risk of Bias in Systematic Reviews (ROBIS), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Grading of Recommendations, Assessment, Development and Evaluation (GRADE), respectively. There were a total of 8 SRs/MAs included. By AMSTAR-2, all SRs/MAs were graded as having low or very low methodological quality. By ROBIS, all SRs/MAs in phase 1, domain 1, and domain 4 of phase 2 were at low risk, while in domain 2 were at high risk. By PRISMA, reporting weaknesses in protocol and registration, as well as search method, were identified. By GRADE, the level of evidence quality was "low" to "very low", and the most commonly downgraded factor was the risk of bias. Acupuncture may be beneficial in improving BCRL. However, due to the identified limitations and conflicting findings, further more prescriptive and rigorous SRs/MAs are required to give strong evidence for final judgments.

Fortification of Staple Foods for Household Use with Vitamin D: An Overview of Systematic Reviews.

Vitamin D deficiency is a global public health concern with significant implications for bone health and chronic disease prevention. Our aim was to summarize the evidence from Cochrane and other systematic reviews evaluating the benefits or harms of vitamin D fortification of staple foods for household use. In April 2023, we systematically searched Ovid MEDLINE, Embase, Epistemonikos and the Cochrane Database of Systematic Reviews for systematic reviews investigating the effects of vitamin D fortification of food in general populations of any age. We used Cochrane methodology and assessed the methodological quality of included studies using AMSTAR (A MeaSurement Tool to Assess Systematic Reviews). We assessed the degree of overlap among reviews. All outcomes included in systematic reviews were assessed. The protocol is registered in PROSPERO (registration number: CRD42023420991). We included 27 systematic reviews out of 5028 records for analysis. Overall, 11 out of 12 systematic reviews calculating pooled estimates reported a significant increase in serum 25(OH)D concentrations. The mean change in serum 25(OH)D concentrations per additional 100 units of vitamin D ranged from 0.7 to 10.8 nmol/L. Fortification of food with vitamin D showed a reduction in the prevalence of vitamin D deficiency based on high-certainty evidence. Parathormone (PTH) levels were described to decrease, bone mineral density to increase, while the effects on other bone turnover markers were inconsistent. Fortification did not significantly impact most anthropometric parameters, but it seemed to positively influence lipid profiles. In summary, fortification of food with vitamin D results in a reduction of vitamin D deficiency and might increase serum 25(OH)D concentrations, to varying extents depending on the fortified vehicle and population characteristics. Additionally, fortification may have a positive impact on bone turnover and lipid metabolism but may only have a limited effect on anthropometric parameters.