Eligibility Criteria For Systematic Review Research Articles

Treatment of Recurrent Low-grade Serous Ovarian Cancer With MEK Inhibitors: A Systematic Review.

Low-grade serous ovarian cancer (LGSC) represents 5% of all epithelial ovarian cancers. They are characterized by indolent growth and KRAS and BRAF mutations, differing from high-grade serous ovarian cancer both clinically and molecularly. LGSC has low response rates to traditional systemic therapies, including chemotherapy and hormonal therapy. The objective of this systematic review was to appraise the literature describing the efficacy of MEK inhibitors in the treatment of LGSC. A comprehensive search was conducted of the following databases: Medline ALL, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Sciences, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICFRP), and International Standard Randomized Controlled Trials Number (ISRCTN) Registry. All studies investigating MEKi in the treatment of LGSC in the adjuvant or recurrent setting for patients 18 years of age or older were included. All titles/abstracts were then screened by 2 independent reviewers (A.K. and C.C.). The full-text articles were then screened. All disagreements were resolved by a third independent reviewer (T.Z.). Two independent reviewers (A.K. and C.C.) extracted data from the studies deemed eligible for final review. A total of 2108 studies were identified in the initial search. Of these, a total of 4 studies met the eligibility criteria for systematic review. In these studies, 416 patients were treated with an MEKi alone. All patients included in the studies were being treated for LGSC in the recurrent setting. Varied results and efficacy of the MEKi were reported in each study. The results highlighted in this systematic review demonstrate varied responses to MEKi for recurrent LGSC. Further research is needed in this field comparing the efficacy to current therapies, as well as to further evaluate the safety and toxicity profile with long-term use of MEKi.

Survival and clinical success of endovascular intervention in patients with Budd-Chiari syndrome: A systematic review.

Budd-Chiari syndrome is a complex clinical disorder of hepatic venous outflow obstruction, originating from the accessory hepatic vein (HV), large HV, and suprahepatic inferior vena cava (IVC). This disorder includes both HV and IVC obstructions and hepatopathy. This study aimed to conduct a systematic review of the survival rate and clinical success of different types of endovascular treatments for Budd-Chiari syndrome (BCS). All participant studies were retrieved from four databases and selected according to the eligibility criteria for systematic review of patients with BCS. The survival rate, clinical success of endovascular treatments in BCS, and survival rates at 1 and 5 years of publication year were calculated accordingly. A total of 3398 patients underwent an endovascular operation; among them, 93.6% showed clinical improvement after initial endovascular treatment. The median clinical success rates for recanalization, transjugular intrahepatic portosystemic shunt (TIPS), and combined procedures were 51%, 17.50%, and 52.50%, respectively. The median survival rates at 1 and 5 years were 51% and 51% for recanalization, 17.50% and 16% for TIPS, and 52.50% and 49.50% for combined treatment, respectively. Based on the year of publication, the median survival rates at 1 and 5 years were 23.50% and 22.50% before 2000, 41% and 41% in 2000‒2005, 35% and 35% in 2006‒2010, 51% and 48.50% in 2010‒2015, and 56% and 55.50% after 2015, respectively. Our findings indicate that the median survival rate at 1 and 5 years of recanalization treatment is higher than that of TIPS treatment, and recanalization provides better clinical improvement. The publication year findings strongly suggest progressive improvements in interventional endovascular therapy for BCS. Thus, interventional therapy restoring the physiologic hepatic venous outflow of the liver can be considered as the treatment of choice for patients with BCS which is a physiological modification procedure.

Anti-Inflammatory and Anti-Bacterial Effects of Mouthwashes in Intensive Care Units: A Systematic Review and Meta-Analysis.

Mouthwashes are used as oral care for critical care patients to prevent infections. However, there are conflicting data concerning whether mouthwashes are needed as a part of daily oral care for critical care patients. This study aimed to evaluate the anti-inflammatory and anti-bacterial effects of mouthwashes for critical care patients. The PubMed, EMBASE, CENTRAL, and grey literature databases were searched by descriptors combining population (intensive care unit patients) and intervention (mouthwashes). After the screening, only randomized controlled trials (RCTs) evaluating the anti-inflammatory and anti-bacterial effects of mouthwashes in patient critical care were included. From the 1531 articles, 16 RCTs satisfied the eligibility criteria for systematic review and 10 were included in the meta-analyses. A significant difference was found in the incidence of ventilator associated pneumonia (VAP) (odds ratio [OR] 0.53, 95% confidential interval [95% CI] 0.33 to 0.86) between the mouthwash and placebo groups, while no significant difference was found in the mortality (OR 1.49, 95%CI 0.92 to 2.40); the duration of mechanical ventilation (weighted mean difference [WMD] -0.10, 95%CI -2.01 to 1.81); and the colonization of Staphylococcus aureus (OR 0.88, 95%CI 0.34 to 2.30), Escherichia coli (OR 1.19, 95%CI 0.50 to 2.82), and Pseudomonas aeruginosa (OR 1.16, 95%CI 0.27 to 4.91) between the two groups. In conclusion, mouthwashes were effective in decreasing the incidence of VAP. Thus, mouthwashes can be used as part of daily oral care for critical care patients.

E‐cigarettes effect on periodontal health: a systematic review

Background: Smoking is well known risk factors that promote periodontal tissue destruction. Both smoking and periodontitis nowadays consider as a common health problem globally. As smoking habit evolution, electronic cigarettes (E-cigs) have emerged as an alternative to cigarettes. The number of E-cigs smoker or vaping users around the world are increasing. However, information about the effect of E-cigs on periodontium is very lacking lately. The study aimed to compare the effect of cigarette consumption on periodontium by clinical health parameters between all smokers’ type.Method: This review follows the PRISMA guidelines. Document search was carried out in PubMed, Ebsco Host and Scopus using the keywords or phrases: (periodontal health) AND (((((electronic cigarette) OR Vaping) OR e-cig) OR electronic nicotine delivery system) OR nicotine delivery system). A total of 137 articles were obtained after the duplicates were eliminated and five articles were considered met the eligibility criteria for systematic review. Result: This review found that E-cigs are less harmful compared to tobacco cigarettes, with comparable result between E-cigs smoker and non-smoker on some clinical periodontal health parameters for mean probing depth, clinical attachment loss, score of plaque index (PI) and papillary bleeding index (PBI) as well. In contrast, the study reveals that bleeding on probing level was higher among non-smokers than smokers.Conclusion: E-cigs are less harmful compared to tobacco cigarettes on some clinical periodontal health parameters. This result should be interpreted with caution because there is currently insufficient data to investigate the effect of E-cigs on periodontal health through clinical parameters.

Association Between Socioeconomic Status and Outcomes in Critical Care: A Systematic Review and Meta-Analysis.

Socioeconomic status is well established as a key determinant of inequalities in health outcomes. Existing literature examining the impact of socioeconomic status on outcomes in critical care has produced inconsistent findings. Our objective was to synthesize the available evidence on the association between socioeconomic status and outcomes in critical care. A systematic search of CINAHL, Ovid MEDLINE, and EMBASE was undertaken on September 13, 2022. Observational cohort studies of adults assessing the association between socioeconomic status and critical care outcomes including mortality, length of stay, and functional outcomes were included. Two independent reviewers assessed titles, abstracts, and full texts against eligibility and quality criteria. Details of study methodology, population, exposure measures, and outcomes were extracted. Thirty-eight studies met eligibility criteria for systematic review. Twenty-three studies reporting mortality to less than or equal to 30 days following critical care admission, and eight reporting length of stay, were included in meta-analysis. Random-effects pooled analysis showed that lower socioeconomic status was associated with higher mortality at less than or equal to 30 days following critical care admission, with pooled odds ratio of 1.13 (95% CIs, 1.05-1.22). Meta-analysis of ICU length of stay demonstrated no significant difference between socioeconomic groups. Socioeconomic status may also be associated with functional status and discharge destination following ICU admission. Lower socioeconomic status was associated with higher mortality following admission to critical care.

Tumour necrosis factor-α as a prognostic biomarker of severe malaria: a systematic review and meta-analysis.

Tumour necrosis factor-alpha (TNF-α) levels are reportedly altered during malaria. In this systematic review and meta-analysis, we aimed to collect and compare data on TNF-α levels between patients with malaria of varying severity and healthy asymptomatic positive controls. We searched PubMed, Scopus and Web of Science for studies that reported TNF-α levels in malaria cases of different severity and healthy asymptomatic positive controls using a combination of search terms. The quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. To compare the TNF-α levels among fatal cases, severe cases, uncomplicated cases and healthy asymptomatic positive controls, we applied the random-effects model that assumed the existence of variations between studies. The effect estimate was pooled mean difference (MD) with a 95% confidence interval (CI). From 1694 studies, we included 31 studies that met our eligibility criteria for systematic review and meta-analysis. Patients with severe malaria showed higher mean TNF-α levels than those with uncomplicated malaria (P < 0.001, pooled MD = 79.02pg/ml, 95% CI: 63.68-94.35pg/ml, I2: 99.5%, n = 26 studies). Furthermore, fatal cases had no difference in the mean TNF-α levels in comparison with survived cases (P = 0.055, pooled MD = 82.38pg/ml, 95% CI: -1.93 to 166.69pg/ml, I2: 99.54%, n = 5 studies). Finally, patients with uncomplicated malaria showed higher mean TNF-α levels than those with asymptomatic malaria (P < 0.001, pooled MD = 45.10pg/ml, 95% CI: 18.45-71.76pg/ml, I2: 97.09%, n = 5 studies). This systematic review and meta-analysis confirmed the increase of TNF-α levels in patients with severe malaria. Therefore, TNF-α may be alternatively used as a prognostic biomarker of severe malaria. Not applicable.

Predictors of quality of life in Brazilian medical students: a systematic review and meta-analysis.

Objective:To examine predictors associated with quality of life (QoL) in Brazilian medical students.Methods:PubMed, PsycINFO, EMBASE, LILACS, and Google Scholar were searched for research articles in English or Portuguese published through August 2018. Observational studies that measured QoL with standard instruments were selected. Three instruments were used to evaluate QoL: the World Health Organization QoL questionnaires (WHOQOL-Bref and WHOQOL-100) and 36-item Short Form Health Survey (SF-36). Hedges’ g was used to calculate effect sizes. A random-effects model was used in meta-analyses. PRISMA guidelines were followed.Results:The initial search retrieved 8,504 articles; 24 met the eligibility criteria for systematic review, and seven for meta-analyses of gender (n=3,402 students). Predictors of QoL such as gender, years of medical school(years of study), economic class, educational environment, academic efficacy, depression, burnout, resilience, empathic concern, sleep difficulties, chronic illness, body mass index, and leisure-time physical activity were identified in the systematic review. The most frequent predictors of QoL detected in Brazilian medical students were associated with gender and years of study.Conclusions:Female medical students had lower QoL scores in the physical health and psychological domains of WHOQOL-Bref compared to male students. Specific interventions should be designed for this group as appropriate.Systematic review registry number:PROSPERO CRD-42018102259.

Eligibility criteria in systematic reviews published in prominent medical journals: a methodological review.

Clear and logical eligibility criteria are fundamental to the design and conduct of a systematic review. This methodological review examined the quality of reporting and application of eligibility criteria in systematic reviews published in three leading medical journals. All systematic reviews in the BMJ, JAMA and The Lancet in the years 2013 and 2014 were extracted. These were assessed using a refined version of a checklist previously designed by the authors. A total of 113 papers were eligible, of which 65 were in BMJ, 17 in The Lancet and 31 in JAMA. Although a generally high level of reporting was found, eligibility criteria were often problematic. In 67% of papers, eligibility was specified after the search sources or terms. Unjustified time restrictions were used in 21% of reviews, and unpublished or unspecified data in 27%. Inconsistency between journals was apparent in the requirements for systematic reviews. The quality of reviews in these leading medical journals was high; however, there were issues that reduce the clarity and replicability of the review process. As well as providing a useful checklist, this methodological review informs the continued development of standards for systematic reviews.

Eligibility criteria in systematic reviews: A methodological review.

Systematic reviews of literature are increasingly important in healthcare. While reviewers are expected to follow reporting guidelines, inconsistencies may be observed in presentation of reviews, potentially detracting from the credibility of findings. Predetermined eligibility criteria are fundamental to the systematic process of reviewing, and should be given primacy in authors' reports. This methodological review assessed the specification and application of eligibility criteria in systematic reviews in three leading generic nursing journals. While reporting guidelines were generally followed, major anomalies were revealed by this review. Over three-quarters of review papers placed eligibility criteria after description of the search strategy. Unjustified time restrictions were common, and many flowcharts omitted vital information. Greater scrutiny of systematic reviews submitted to nursing journals would enhance the quality of reports and contribute to more robust evidence-based practice.