Guidance For Systematic Reviews Research Articles

Effectiveness of silver diamine fluoride application with atraumatic restorative treatment in arresting the progression of dental caries: a systematic review protocol.

This review aims to evaluate the effectiveness of silver diamine fluoride application along with atraumatic restorative treatment in arresting the progression of dental caries when compared with other caries-arresting treatments in children and adults. A combination of silver diamine fluoride with atraumatic restorative treatment is a minimally invasive and cost-effective method to treat dental caries. It offers a solution for the progression of caries and restoration of cavitated lesions in both primary and permanent teeth. A comprehensive summary of the evidence will assist dental clinicians and guide subsequent clinical research. Randomized controlled trials involving human participants of any age with cavitated dental caries lesions will be included. The intervention arm will evaluate the effectiveness of silver diamine fluoride application with atraumatic restorative treatment in dental caries arrest with a control arm of either atraumatic restorative treatment (ART) or silver diamine fluoride (SDF) application; or composite restoration; or sodium fluoride varnish or a placebo; or a study group with no intervention. Systematic searches for relevant studies will be conducted across multiple databases, including MEDLINE, Scopus, Cochrane CENTRAL, Dentistry and Oral Sciences Source, CINAHL, and Web of Science. ProQuest Dissertations and Theses and Google Scholar will also be searched for gray literature. The databases will be searched from January 2016 to the present. No restrictions will be imposed on the country of publication. Data appraisal, extraction, and synthesis will follow JBI guidance for systematic reviews of effectiveness. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system will be used to grade the certainty of evidence, and a Summary of Findings will be prepared. PROSPERO CRD42023426766.

Guidance for systematic reviews in journal author instructions: Findings and recommendations for editorial teams

AbstractIntroductionSystematic reviews play a crucial role in informing clinical decision‐making, policy formulation, and evidence‐based practice. However, despite the existence of well‐established guidelines, inadequately executed and reported systematic reviews continue to be published. These highly cited reviews not only pose a threat to the credibility of science but also have substantial implications for medical decision‐making. This study aims to evaluate and recommend improvements to the author instructions of biomedical and health journals concerning the conducting and reporting of systematic reviews.MethodsA sample of 168 journals was selected based on systematic reviews published between 2020 and 2021, taking into account their Altmetric attention score, citation impact, and mentions in Altmetric Explorer. Author instructions were downloaded, and data extraction was carried out using a standardized web form. Two reviewers independently extracted data, and discrepancies were resolved by a third reviewer. The findings were presented using descriptive statistics, and recommendations for editorial teams were formulated. The protocol is registered with the Open Science Framework Registries (osf. io/bym8d).ResultsOne‐third of the journals lack tailored guidance for systematic reviews, as demonstrated by the absence of references to conducting or reporting guidelines, protocol registration, data sharing, and the involvement of an information specialist. Half of the author instructions do not include a dedicated section on systematic reviews, hampering the findability of tailored information. The involvement of information specialists is seldom acknowledged. Ultimately, the absence of an update date in most author instructions raises concerns about the incorporation of the most recent developments and tools for systematic reviews.ConclusionJournals that make substantial contributions to synthesizing evidence in biomedicine and health are missing an opportunity to provide clear guidance within their author instructions regarding the conducting and reporting of reliable systematic reviews. This not only fails to inform future authors but also potentially compromises the quality of this frequently published research type. Furthermore, there is a need for greater recognition of the added value of information specialists to the systematic review and publishing processes. This article provides recommendations drawn from the study's observations, aiming to help editorial teams enhance author instructions and, consequently, potentially assisting systematic reviewers in improving the quality of their reviews.

Barriers and facilitators to dementia care in long-term care facilities: protocol for a qualitative systematic review and meta-synthesis

IntroductionLong-term care needs for people with dementia are predicted to increase due to increased life expectancy and dementia diagnoses. Most published meta- syntheses of dementia care focus on hospitals or...

The Commercial Determinants of Health and Evidence Synthesis (CODES): methodological guidance for systematic reviews and other evidence syntheses

BackgroundThe field of the commercial determinants of health (CDOH) refers to the commercial products, pathways and practices that may affect health. The field is growing rapidly, as evidenced by the WHO programme on the economic and commercial determinants of health and a rise in researcher and funder interest. Systematic reviews (SRs) and evidence synthesis more generally will be crucial tools in the evolution of CDOH as a field. Such reviews can draw on existing methodological guidance, though there are areas where existing methods are likely to differ, and there is no overarching guidance on the conduct of CDOH-focussed systematic reviews, or guidance on the specific methodological and conceptual challenges.Methods/resultsCODES provides guidance on the conduct of systematic reviews focussed on CDOH, from shaping the review question with input from stakeholders, to disseminating the review. Existing guidance was used to identify key stages and to provide a structure for the guidance. The writing group included experience in systematic reviews and other forms of evidence synthesis, and in equity and CDOH research (both primary research and systematic reviews).ConclusionsThis guidance highlights the special methodological and other considerations for CDOH reviews, including equity considerations, and pointers to areas for future methodological and guideline development. It should contribute to the reliability and utility of CDOH reviews and help stimulate the production of reviews in this growing field.

Health-care leaders’ experiences of the competencies required for crisis management during COVID-19: a systematic review of qualitative studies

PurposeThis paper aims to synthesize health-care leaders’ experiences of the competencies required for crisis management.Design/methodology/approachThe systematic review followed the joanna briggs institute (JBI) guidance for systematic reviews of qualitative evidence. The search strategy included free text words and medical subject headings and peer-reviewed qualitative studies published in English, Finnish and Swedish and was not limited by year or country of publication. The databases searched in March 2022 were Scopus, PubMed, CINAHL, ABI/INFORM and the Finnish database Medic. Gray literature was searched using MedNar and EBSCO Open Dissertations. Studies were screened by title and abstract (n = 9,014) and full text (n = 43), and their quality was assessed by two independent reviewers. Eight studies were included. The data was analyzed using meta-aggregation.FindingsFifty-one findings (themes and subthemes) were extracted, and 11 categories were created based on their similarities. Five synthesized findings were developed: the competence to comprehend the operational environment; the competence to stay resilient amidst change; the competence to adapt to and manage change; the competence to manage and take care of staff; and the competence to co-operate and communicate with diverse stakeholders.Originality/valueThis systematic review produced novel information about health-care leaders’ experiences of the competencies required for crisis management during COVID-19. This study complements the field of research into crisis management in health care by introducing five original and unique competency clusters required for crisis management during the acute phase of COVID-19.

Patients' experiences of patient-centred care in hospital setting: A systematic review of qualitative studies.

Patient-centred care (PCC) has been proposed as an appropriate approach for addressing current shifts in healthcare needs. Although the importance of PCC is generally recognised, PCC is poorly understood by patients in the hospital settings. To identify patients' experiences of PCC in hospital settings. This systematic review followed the Joanna Briggs Institute's (JBI) guidance for systematic reviews of qualitative evidence and the PRISMA checklist for reporting systematic reviews. The search strategy included peer-reviewed qualitative studies published after 2010 in English or Finnish. The databases searched were SCOPUS, MEDLINE, CINAHL and Medic. Unpublished studies and grey literature were searched in MedNar. Ten qualitative studies were included, and their quality was assessed by two independent reviewers using JBI quality assessment criteria. The data were analysed using thematic analysis. Studies were included if they had explored adult patient experiences of PCC in hospital settings. A thematic analysis produced 14 subthemes which were grouped into five analytical themes: the presence of the professional, patient involvement in care, receiving information, the patient-professional relationship and being seen as a person. This review suggests that the implementation and provision of PCC in hospitals is incomplete and patients' involvement in their own care should be in the focus of PCC. The majority of patients experienced receiving PCC, but others did not. The need for improvement of patient involvement was strongly emphasised. Patients highlighted the importance of professionals being present and spending time with patients. Patients felt well-informed about their care but expressed the need for better communication. Meaningful patient-professional relationships were brokered by professionals demonstrating genuine care and respecting the patient as an individual. To improve the implementation of PCC, patient experiences should be considered in the development of relevant hospital care strategies. In addition, more training in PCC and patient-professional communication should be provided to health care professionals.

Associations between personality and musculoskeletal disorders in the general population: A systematic review protocol.

There is growing evidence of the comorbidity between personality disorder (PD) and musculoskeletal disorders (MSDs). However, there are no systematic reviews including critical appraisal and meta-analyses that identify, evaluate, and synthesize the available evidence on these associations. Therefore, we present here a protocol of the methodology to undertake a systematic review, with the objective to evaluate associations between PD and MSDs in epidemiological population-based studies. A systematic review of observational studies will be conducted. A complete search strategy will be developed in consultation with a health librarian. To identify peer-reviewed literature, the search will be translated for, and implemented in Medline Complete, CINAHL Complete, and PsycINFO via the EBSCOhost platform from 1990 to the present. Gray literature will be identified. Studies will be eligible if they examine general population participants aged 15 years and over. Associations of interest are the presence of threshold or positive screen according to the DSM-V/5 (groupings: any, Clusters A, B, C, specific PD) or ICD-10 for PD in relation to arthritis, back/neck conditions, fibromyalgia, osteopenia/osteoporosis, and/or "any" of these MSDs. Data extraction and critical appraisal will be conducted in line with the Joanna Briggs Institute (JBI) guidance for systematic reviews of etiology and risk. The results from all studies will be presented in tables, text, and figures. A descriptive synthesis will present the characteristics of included studies, critical appraisal results, and descriptions of the main findings. Where appropriate, meta-analyses will be performed. If heterogeneity (e.g., I 2 = 50%) is detected, subgroup/sensitivity analysis may be used to explore the possible sources. The systematic review does not require ethics approval. The proposed systematic review will strengthen the evidence base on what is known regarding associations between PD and MSDs by identifying, evaluating, and synthesizing the findings of existing observational studies including meta-analyses, where appropriate.

The effectiveness of low-dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: Asystematic review with meta-analysis.

To evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus active physical interventions on pain intensity and disability in adults with nonspecific chronic low back pain. Research has shown that primary care biopsychosocial interventions (PCBI) can reduce pain intensity and disability. While scattered studies support low-dosed (≤ 15 treatment hours) PCBI, no systematic review exists comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP). Randomized controlled trials that evaluate low-dosed PCBI compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older), who suffer from CLBP were included. Not recommended interventions that feature only passive therapies, spinal surgery or pharmacological treatment, and studies with inpatient multidisciplinary-based rehabilitation (MBR) were excluded. Databases were searched from inception to December 31, 2021. Language was restricted to English or German. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" were used. Sources were CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science. Search was finished on March 08, 2022. Data appraisal, extraction and synthesis followed JBI guidance for systematic reviews of effectiveness. Risk of Bias was assessed using JBI 13-item checklist for randomized controlled trials. The GRADE approach for grading the certainty of evidence was followed. PROSPERO 2022 CRD42022302771. Eighteen RCTs were found eligible and 15 trials comprising a total of 1531 participants suffering from CLBP were entered in the meta-analyses. Risk of Bias was low. Overall evidence was moderate. Significant effects in favor of PCBI were found for pain intensity post-treatment (standardized mean difference (SMD)=-1.09, 95% confidence interval (CI)=-1.84 to -0.34, I2 =97%, p=0.004) as well as at short-term (SMD=-0.23, 95% CI=-0.39 to -0.08, I2 =0%, p=0.004), long term (SMD=-0.79, 95% CI=-1.42 to -0.17, I2 =96%, p=0.01) and very long-term (SMD=-1.13, 95% CI=-1.93 to -0.33, I2 =94%, p=0.005) follow-up. Significant effects in favor of PCBI for physical function were found post-treatment (SMD=-1.33, 95% CI=-2.17 to -0.49, I2 =97%, p=0.002) at short-term (SMD=-0.20, 95% CI=-0.36 to -0.04, I2 =0%, p=0.01) and at long-term follow-up (SMD=-1.17, 95% CI=-2.06 to -0.28, I2 =98%, p=0.01). The results were characterized by high heterogeneity due to different types (cognitive behavioral therapy, pain-neuroscience education, mindfulness, and motivation), delivery modes (individual and/or group), durations (3-12 weeks) and contact times (2-15 h) of PCBI. In sensitivity analysis outliers were removed to reduce heterogeneity. The results remained significant for pain intensity at short-term (SMD=-0.23, 95% CI=-0.39 to -0.08, I2 =0%, p=0.004) and long-term follow-up (SMD=-0.22, 95% CI=-0.41 to -0.03, I2 =39%, p=0.02). This meta-analysis suggests that low-dosed PCBI has favorable effects in terms of disability and pain intensity compared to active physical treatments alone. All conducted meta-analyses indicate that biopsychosocial interventions produce better outcomes than active physical treatment alone. Therefore, we strongly recommend decision makers and clinical practitioners to analyze how psychosocial elements can be introduced into outpatient (low-dosed) CLBP interventions.

Bibliometric and visualization analysis of research trend in mental health problems of children and adolescents during the COVID-19 pandemic.

To analyze the evolution of research on children and adolescents mental health issues during COVID-19 pandemic and discuss research hotspots and cutting-edge developments. The literature obtained from the web of science core collection as of June 28, 2022, was analyzed using Citespace, VOSviewer bibliometric visualization mapping software. A total of 6,039 relevant papers were found, of which 5,594 were included in the study. The number of literatures is growing since 2020; and the country, institution, and journal publications were analyzed. The co-citation analysis shows that there are more research articles among the highly cited articles and a lack of systematic reviews that use critical thinking for review. In the cluster analysis, mental health and life change were the most representative. The timeline view of the keywords shows that Online learning (#0), Public health (#1), and Mental health (#2) are the three largest clusters and shows the change over time. This study helped analyze the mental health of children and adolescents during the COVID-19 pandemic and identified hot trends and shortcomings, which are important references for the theoretical basis of future research and decision making and technical guidance for systematic reviews.

Parents'/caregivers' fears and concerns about their child's epilepsy: A scoping review.

BackgroundChildhood epilepsy is a serious and common neurological condition and can have life-long consequences and its impact can pervade all aspects of family life. Whilst the medical management of seizures is important, much of the day-to-day home management of epilepsy is invisible to people external to the family, including health care professionals, and parents’/caregivers’ fears and concerns can go unacknowledged and unaddressed by health care professionals.ObjectiveThis objective of this review was to examine parents’/caregivers’ fears and concerns regarding their child’s epilepsy, the impact of these fears and concerns on family life, the social and emotional well-being of parents/caregivers and any factors which mitigate these fears and concerns.DesignScoping review using a modified version of Arksey and O’Malley’s framework.Data sourcesRelevant studies were identified using key search terms in Scopus, Medline, CINAHL and PsychInfo databases in March 2021 with hand checking of reference lists. Search terms were developed using population (parents/caregivers of children aged ≤ 18 years with epilepsy, families); concept (parents’/caregivers’ fears, concerns, anxiety about their child’s epilepsy); and context (any setting). A further search was run in April 2022. Other inclusion criteria: English language empirical studies, 2010–2021.Study appraisal methodsA minimum of two reviewers independently screened articles and undertook data extraction and decisions were consensually made.Methodological quality appraisal was undertaken using the Mixed Methods Appraisal Tool v2018. A data extraction table was created to chart all studies. The conduct and reporting of this study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) (S1 Table). There is no published copy of the review protocol.Main findingsThe search identified a total of 4077 papers (after duplicates were removed) of which 110 were assessed for eligibility. Twenty-four papers published between 2010–2021 were included in the review and each paper was treated as a separate study. The review findings indicate that parents’/caregivers’ fears and concerns stem from more than their child’s seizures and relate to many wider aspects of family life. These fears and concerns had far-reaching influences on their parenting/caregiving, and on the lifestyle and activities of their child and their family. What was less evident was what parents/caregivers wanted in terms of support or how they thought health professionals could acknowledge and/or allay their fears and concerns. The discussion is framed within the compassion-focused therapy model as a basis for generating new thinking about the impact of these fears and concerns and the need for a new agenda for clinical consultations in childhood epilepsy.ConclusionsThe review concludes with a proposal that a more compassionate agenda underpins the dialogue between parents/caregivers and clinicians to encompass and mitigate the wider emotional, psychosocial, and societal threats that impact on the parent/caregivers of children with epilepsy.

Global Prevalence of Osteoporosis in Chronic Kidney Disease: Protocol for a Systematic Review

Abnormalities in mineral metabolism, soft tissue calcifications, and bone health are common in people with chronic kidney disease (CKD). In this scenario, osteoporosis is a highly prevalent skeletal disorder characterized by reduced bone strength predisposing patients to adverse health outcomes. We will summarize the evidence of the prevalence of osteoporosis in adults with CKD. Methods: We will perform a comprehensive literature search using MEDLINE, EMBASE, Web of Science, CINAHL, and LILACS databases, without date or language restrictions from inception until January 2021. We will include cross-sectional, case–control, or cohort studies that report prevalence data of osteoporosis in adults aged ≥18 years with CKD in stages 3a–5, including those receiving kidney replacement therapies. We will exclude conference abstracts and experimental studies. The primary outcome will be the prevalence of osteoporosis according to the World Health Organization criteria (T-score ≤ −2.5). Two independent reviewers will screen title and abstract, full-text review, critical appraisal of the quality of studies, risk of bias, heterogeneity, and data extraction. The quality of the included studies will be assessed with the Joanna Briggs Institute (JBI) appraisal checklist. The overall prevalence of the studies will be synthesized using random-effects meta-analysis. This systematic review will be reported according to the guidelines for Meta-Analyses and Systematic Reviews of Observational Studies (MOOSE) and the JBI methodological guidance for systematic reviews of observational epidemiological studies. The qualitative and quantitative results will be synthesized and presented in tables, figures or graphs.

Exploring evidence of fatigue in survivors of paediatric brain tumours: a systematic review

AimsAs the number of survivors of childhood brain tumor grows, fatigue is being increasingly recorded as a long-term consequence of both the cancer itself and the treatment received. Survivors of childhood brain tumour report more significant fatigue than children with other cancers, often impacting all aspects of life, including academic attainment, self-concept and social relationships with peers, leading to reduced health-related quality of life.This study aimed to systematically evaluate the evidence for fatigue in paediatric brain tumour survivors.MethodA systematic search using EMBASE, MEDLINE and PsycINFO identified 20 papers meeting the inclusion criteria. Scientific rigor was used throughout by following Scottish Intercollegiate Guidelines Network (2015) guidance for systematic reviews. Quality Assessment of Evidence Rating tool - Fatigue (QAERT) was developed with substantial inter-rater agreement found.Result19 of the 20 studies reviewed showed conclusive evidence of fatigue in survivors of paediatric brain tumour. One study offered adequate evidence that there was no difference in levels of fatigue in paediatric cancer survivors, including survivors of paediatric brain tumour, when compared to healthy controls. Three studies found that fatigue was worse in survivors of paediatric brain tumour when compared to survivors of other paediatric cancersConclusionThis review provides evidence for the presence of fatigue in survivors of paediatric brain tumour. However, the construct of fatigue was poorly defined throughout, with fatigue associated with physical effects of treatment and fatigue associated with long-term cognitive impairment not distinguished. This poor construct validity, coupled with a lack of comparison groups in 12 of the 20 studies, reduces the generalizability of the data and its usefulness for developing effective psychological interventions. Further research is needed, built on a clear fatigue construct definition, and including well defined exclusion criteria, to provide a sound basis for improving the quality of life of these children.

Effectiveness of exercise interventions to prevent shoulder injuries in athletes: a systematic review protocol.

This review will evaluate the effectiveness of exercise intervention versus no intervention or alternate intervention to prevent shoulder injuries in athletes. Injury-prevention research has proven the effectiveness of exercise in preventing sports injuries in general and in the lower limb specifically. However, the results have been extrapolated to sport-related shoulder injuries from limited evidence. Similar reviews have been faced with insufficient high-quality evidence and limited studies due to restrictive target populations, resulting in reduced generalizability. Peer-reviewed randomized controlled trials, with adequate control arms, investigating shoulder-injury events after exercise intervention in athletes, both training or competing in sports, will be included. Studies with substitute end points for injury events and non-self-propelled athletes, or vehicle-assisted athletes, will be excluded. A comprehensive search of multiple databases will be used to find relevant studies. The databases will be searched from inception to April 2021, with no language restrictions imposed. Keywords and derivatives of "sport," "exercise intervention," "prevention," "shoulder injury," and "randomized controlled trials" will be used.Sources will include Academic Search Ultimate (EBSCO), CINAHL Plus (EBSCO), Cochrane Central Register of Controlled Trials (Wiley), MasterFILE Premier (EBSCO), MEDLINE (PubMed), Physiotherapy Evidence Database (PEDro), ProQuest Health and Medical Complete and Nursing and Allied Health Source (ProQuest Complete), ScienceDirect (Elsevier), Scopus (Elsevier), SPORTDiscus (EBSCO), and Web of Science (Clarivate Analytics). Data appraisal, extraction, and synthesis will follow JBI guidance for systematic reviews of effectiveness. PROSPERO CRD42020204141.

Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement

ObjectivesTo describe the processes used to update the PRISMA 2009 statement for reporting systematic reviews, present results of a survey conducted to inform the update, summarize decisions made at the PRISMA update meeting, and describe and justify changes made to the guideline. MethodsWe reviewed 60 documents with reporting guidance for systematic reviews to generate suggested modifications to the PRISMA 2009 statement. We invited 220 systematic review methodologists and journal editors to complete a survey about the suggested modifications. The results of these projects were discussed at a 21-member in-person meeting. Following the meeting, we drafted the PRISMA 2020 statement and refined it based on feedback from co-authors and a convenience sample of 15 systematic reviewers. ResultsThe review of 60 documents revealed that all topics addressed by the PRISMA 2009 statement could be modified. Of the 110 survey respondents, more than 66% recommended keeping six of the original checklist items as they were and modifying 15 of them using wording suggested by us. Attendees at the in-person meeting supported the revised wording for several items but suggested rewording for most to enhance clarity, and further refinements were made over six drafts of the guideline. ConclusionsThe PRISMA 2020 statement consists of updated reporting guidance for systematic reviews. We hope that providing this detailed description of the development process will enhance the acceptance and uptake of the guideline and assist those developing and updating future reporting guidelines.

Cochrane Rapid Reviews Methods Group offers evidence-informed guidance to conduct rapid reviews

ObjectivesTo develop methods guidance to support the conduct of rapid reviews (RRs) produced within Cochrane and beyond, in response to requests for timely evidence syntheses for decision-making purposes including urgent health issues of high priority. Study Design and SettingInterim recommendations were informed by a scoping review of the underlying evidence, primary methods studies conducted, and a survey sent to 119 representatives from 20 Cochrane entities, who were asked to rate and rank RR methods across stages of review conduct. Discussions among those with expertise in RR methods further informed the list of recommendations with accompanying rationales provided. ResultsBased on survey results from 63 respondents (53% response rate), 26 RR methods recommendations are presented for which there was a high or moderate level of agreement or scored highest in the absence of such agreement. Where possible, how recommendations align with Cochrane methods guidance for systematic reviews is highlighted. ConclusionThe Cochrane Rapid Reviews Methods Group offers new, interim guidance to support the conduct of RRs. Because best practice is limited by the lack of currently available evidence for some RR methods shortcuts taken, this guidance will need to be updated as additional abbreviated methods are evaluated.

CULTURE CONVERSION AND MORTALITY IN PATIENTS WITH MYCOBACTERIUM AVIUM COMPLEX LUNG DISEASE: A SYSTEMATIC REVIEW

SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Patients with mycobacterium avium complex (MAC) lung disease are at risk for disease progression (Park 2017) and may have a higher risk of death (Diel 2017). We sought to examine microbiological treatment outcomes (culture conversion) and the potential association with mortality in patients with MAC lung disease through a systematic literature review. METHODS: We used the National Institute for Health and Clinical Excellence guidance for systematic reviews to search Embase, PubMed, relevant congress abstracts, and the Cochrane Library (data cutoff, November 8, 2019). English-language studies of MAC lung disease that reported mortality and/or microbiological outcomes were included. Prospective (controlled trials, observational studies) and retrospective (claims databases, registries) studies with ≥ 25 patients were included. A total of 3451 indexed records were screened by 2 independent reviewers. Data were extracted from relevant studies and expressed as population-weighted means. RESULTS: Mean all-cause mortality across 56 studies (population size, n = 26,287) was 31% (range, 1%-67%); mortality attributable to MAC lung disease was 4% (range, 0.3%-35%). Culture conversion rate across 88 studies (population size, n= 8531) was 56.5% (range, 0%-95%). There was broad variance in treatments across the studies that included variations in duration, regimen, and follow-up period (3 months to > 10 years). Treatment duration was often 12 to 24 months and ranged from 8 weeks to “up to 19 years.” A total of 38 studies (population size, n= 6455) reported both mortality and culture conversion. Across these studies, the relationship between decreased culture conversion and increased all-cause mortality was negligible (R2 = 0.04), while the correlation between MAC-attributable mortality and lack of culture conversion showed a weak trend (R2 = 0.30). CONCLUSIONS: This systematic review highlights inconsistency in treatment approaches for patients with MAC lung disease. Analysis of the literature found variable rates of all-cause mortality in patients with MAC lung disease, with only half of patients achieving culture conversion with treatment. A limited number of studies included both mortality and culture conversion outcomes; available indirect data suggest that MAC-attributable mortality tended to be lower in studies with overall higher culture conversion rates. Limitations include a small number of studies, and inconsistency in methods and outcomes definitions. CLINICAL IMPLICATIONS: Despite the availability of treatment guidelines in MAC lung disease, published studies highlight inconsistencies in the approach to treatment. A wide variation in treatment success (culture conversion) was found, which may be influenced by treatment approach and duration. Some data suggest improved mortality outcomes in studies with higher culture conversion rates, but more evidence is needed to demonstrate a survival benefit associated with culture conversion. DISCLOSURES: Employee relationship with Insmed Please note: >$100000 Added 02/25/2020 by Kristan Cline, source=Web Response, value=Salary Consultant relationship with Insmed Please note: $5001 - $20000 Added 04/15/2020 by Patrick Flume, source=Web Response, value=Consulting fee Research grants relationship with Insmed Please note: >$100000 Added 04/15/2020 by Patrick Flume, source=Web Response, value=Grant/Research Support Employee relationship with Insmed Please note: >$100000 Added 04/15/2020 by Zhanna Jumadilova, source=Web Response, value=Salary No relevant relationships Added 05/12/2020 by Kevin Mange, source=Web Response, value=Ownership interest Removed 05/12/2020 by Kevin Mange, source=Web Response No relevant relationships by Kevin Winthrop, source=Web Response

“One more time”: why replicating some syntheses of evidence relevant to COVID-19 makes sense

• Given the urgent need for credible answers to high-priority questions about the health and social impacts of COVID-19, many systematic reviewers seek to contribute their skills and expertise. • Rather than embarking on unnecessary, duplicate reviews, we encourage the evidence synthesis community to prioritise purposeful replication of systematic reviews of evidence relevant to COVID-19. • We explain why replication of systematic reviews is important, how to carry out a replication, and when to consider replication of reviews.

How are systematic reviews of prevalence conducted? A methodological study

BackgroundThere is a notable lack of methodological and reporting guidance for systematic reviews of prevalence data. This information void has the potential to result in reviews that are inconsistent and inadequate to inform healthcare policy and decision making. The aim of this meta-epidemiological study is to describe the methodology of recently published prevalence systematic reviews.MethodsWe searched MEDLINE (via PubMed) from February 2017 to February 2018 for systematic reviews of prevalence studies. We included systematic reviews assessing the prevalence of any clinical condition using patients as the unit of measurement and we summarized data related to reporting and methodology of the reviews.ResultsA total of 235 systematic reviews of prevalence were analyzed. The median number of authors was 5 (interquartile range [IQR] 4–7), the median number of databases searched was 4 (3–6) and the median number of studies included in each review was 24 (IQR 15–41.5). Search strategies were presented for 68% of reviews. Forty five percent of reviews received external funding, and 24% did not provide funding information. Twenty three percent of included reviews had published or registered the systematic review protocol. Reporting guidelines were used in 72% of reviews. The quality of included studies was assessed in 80% of reviews. Nine reviews assessed the overall quality of evidence (4 using GRADE). Meta-analysis was conducted in 65% of reviews; 1% used Bayesian methods. Random effect meta-analysis was used in 94% of reviews; among them, 75% did not report the variance estimator used. Among the reviews with meta-analysis, 70% did not report how data was transformed; 59% percent conducted subgroup analysis, 38% conducted meta-regression and 2% estimated prediction interval; I2 was estimated in 95% of analysis. Publication bias was examined in 48%. The most common software used was STATA (55%).ConclusionsOur results indicate that there are significant inconsistencies regarding how these reviews are conducted. Many of these differences arose in the assessment of methodological quality and the formal synthesis of comparable data. This variability indicates the need for clearer reporting standards and consensus on methodological guidance for systematic reviews of prevalence data.

Mapping of reporting guidance for systematic reviews and meta-analyses generated a comprehensive item bank for future reporting guidelines

ObjectivesThe aim of the study was to generate a comprehensive bank of systematic review (SR) reporting items to inform an update of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2009 statement. MethodsWe searched the Enhancing the QUAlity and Transparency Of health Research Network library in May 2019 to identify all reporting guidelines for SRs that were published after 2009, regardless of the scope of the guideline. We also conducted a selective review of four guidance manuals for SRs, three tools for assessing the risk of bias in SRs, six meta-research studies evaluating the reporting quality of SRs using a tailored checklist, and five reporting guidelines for other study designs. One author screened and selected sources for inclusion, extracted reporting guidance from sources, and mapped guidance against the PRISMA 2009 checklist items. ResultsWe included 60 sources providing guidance on reporting of SRs and meta-analyses. From these, we collated a list of 221 unique reporting items. Items were categorized into title (four items), abstract (10 items), introduction (12 items), methods (111 items), results (61 items), discussion (12 items), funding and conflicts of interest (four items), administrative information (three items), and data availability (four items). This exercise generated 175 reporting items that could be added to the guidance in the PRISMA 2009 statement. ConclusionGeneration of a comprehensive item bank through review and mapping of the literature facilitates identification of missing items and those needing modification, which may not otherwise be identified by the guideline development team or from other activities commonly used to develop reporting guidelines.

The effect of mindfulness practice on aggression and violence levels in adults: A systematic review

Abstract Violence and aggression represent a serious problem, with significant cost and impact at individual and societal level. There has been increasing interest in the potential of mindfulness interventions to decrease levels of violence and aggression. This paper systematically reviews the evidence to assess the effectiveness of mindfulness interventions for the reduction of violence and aggression levels. Five electronic databases were searched, and methods followed published guidance for systematic reviews. Studies that used a mindfulness intervention and measured outcomes of aggression and violence in adult populations were included. The Quality Assessment Tool for Quantitative Studies was utilised to evaluate the quality of included studies. Twenty-two studies met the eligibility criteria, including fourteen randomised studies, three non-randomised studies and five cohort studies. The interventions investigated included mindfulness, acceptance and commitment therapy, dialectical behaviour therapy and yoga with meditation. Overall, the results suggest that mindfulness-based interventions, with the possible exception of DBT, may be effective in reducing aggression and violence. They also suggest that mindfulness may relate to the processes of aggression through emotion regulation. However, papers were of variable quality, with weaknesses in both methodology and the reporting of data. Further good quality controlled studies with full and transparent reporting are needed to confirm these results, and to explore the elements of mindfulness which interact with mechanisms of aggression.