Health Sciences Information Research Articles

Tocilizumab for giant cell arteritis.

Tocilizumab for giant cell arteritis.

Algorithm-based pain management for people with dementia in nursing homes.

Algorithm-based pain management for people with dementia in nursing homes.

Systemic Immunomodulatory Treatments for Atopic Dermatitis

Systemic treatments for atopic dermatitis are being evaluated primarily in placebo-controlled trials; network meta-analysis can provide relative efficacy and safety estimates for treatments that have not been compared head to head. To compare reported measures of efficacy and assessments of safety in clinical trials of systemic treatments for atopic dermatitis in a living systematic review and network meta-analysis. The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Latin American and Caribbean Health Science Information database, Global Resource of EczemA Trials database, and trial registries were searched through June 15, 2021. Randomized clinical trials examining 8 or more weeks of treatment with systemic immunomodulatory medications for moderate-to-severe atopic dermatitis were included after screening titles, abstracts, and papers in duplicate. Data were abstracted in duplicate. Bayesian network meta-analyses and assessed Grading of Recommendations Assessment, Development and Evaluation certainty of evidence were performed. The updated analysis was completed from June to December 2021. Outcomes include change in Eczema Area and Severity Index (EASI), Patient Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), and Peak Pruritus Numeric Rating Scales (PP-NRS). Since October 2019, 21 new studies were added, for a total of 60 trials with 16 579 patients. Up to 16 weeks of treatment in adults, abrocitinib, 200 mg daily (mean difference [MD], 2.2; 95% credible interval [CrI], 0.2-4.0; high certainty) and upadacitinib, 30 mg daily (MD, 2.7; 95% CrI, 0.6-4.7; high certainty) were associated with reduced EASI slightly more than dupilumab, 600 mg then 300 mg every 2 weeks. Abrocitinib, 100 mg daily (MD, -2.1; 95% CrI, -4.1 to -0.3; high certainty), baricitinib, 4 mg daily (MD, -3.2; 95% CrI, -5.7 to -0.8; high certainty), baricitinib, 2 mg daily (MD, -5.2; 95% CrI, -7.5 to -2.9; high certainty) and tralokinumab, 600 mg then 300 mg every 2 weeks (MD, -3.5; 95% CrI, -5.8 to -1.3; high certainty) were associated with reduced EASI slightly less than dupilumab. There was little or no difference between upadacitinib, 15 mg daily, and dupilumab (MD, 0.2; 95% CrI, -1.9 to 2.2; high certainty). The pattern of results was similar for POEM, DLQI, and PP-NRS. In this systematic review and meta-analysis, abrocitinib, 200 mg; and upadacitinib, 30 mg daily, were associated with slightly better scores than dupilumab, and upadacitinib, 15 mg daily, was associated with similar scores to dupilumab. Abrocitinib, 100 mg daily, baricitinib, 4 mg and 2 mg daily, and tralokinumab, 300 mg, every 2 weeks were associated with slightly worse scores.

A Data-Driven Assessment of the U.S. Health Informatics Programs and Job Market.

Health Informatics (HI) is an interdisciplinary field, integrating health sciences, computer science, information science, and cognitive science to assist health information management, analysis, and utilization. As the HI field is broad, it is impossible that a student will be able to master all the diverse HI topics. Thus, it is important to train the HI students based on the offering of the various HI programs and needs of the current market. This project will study the U.S. HI programs, training materials, HI job market, the skillset required by the employers, competencies taught in HI programs, and comparisons between them. We collected the training information for the 238 U.S. universities that offered MS, PhD, or postbaccalaureate certificate programs in HI or related professions. Next, we explored the HI job market by randomly checking 200 jobs and their required skillsets and domain knowledge. Then, we compared these skillsets with those offered by the HI programs and identified the gaps and overlaps for program enhancements. Among the 238 U.S. universities, 94 universities offer HI programs: 92 universities with MS (Master of Science), 43 with doctoral, 42 with both MS and doctoral, and 54 with certificate programs. The most offered HI courses are related to practicum, data analytics, research, and ethics. For the HI job postings, the three most technical skillsets required in HI job posting are data analysis, database management, and knowledge of electronic health records. However, only 58% of HI programs offer courses in database management and analytics. Compared with American Medical Informatics Association's recommended 10 fundamental domains, the HI curriculum generally lacks training in socio-technical systems, social-behavioral aspects of health, and interprofessional collaborative practice. There are gaps between the industry expectations of HI and the training received in HI programs. Advance level technical courses are needed in HI programs to meet industry expectations.

Telemedicine Workflow Modeling in Pediatric Gastroenterology.

∗Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD †Division of Pediatric Gastroenterology, Rady Children's Hospital and University of California San Diego, San Diego, CA ‡Anesthesiology and Critical Care, Emergency Medicine, and Health Sciences Informatics, School of Medicine, Armstrong Institute Center for Health Care Human Factors, Johns Hopkins University, Baltimore, MD. Address correspondence and reprint requests to Steven D. Miller, MD, MBE, Division of Pediatric Gastroenterology, Johns Hopkins University School of Medicine, 600N. Wolfe Street, CMSC 2-116, Baltimore, MD 21287 (e-mail: [email protected]). Received 4 November, 2020 Accepted 17 November, 2020 The authors report no conflicts of interest.

Fighting Nutrition and Health Misinformation

The twin phenomena of scientific misinformation and disinformation have recently been the object of an intense discussion among communicators of nutrition, health, and other science information. Especially with the rapidly evolving social media ecosystem, issues of public trust in consensus science have increasingly concerned those professionals whose mission it is to convey truthful and credible information. For several years, the National Academies of Sciences, Engineering, and Medicine have been studying the “Science of Science Communication” and other aspects of public credulity in scientific findings, and recently, the National Academy of Medicine published a discussion article proposing strategies for combatting the spread of health misinformation—including the creation of source-vetting guidance to be enacted by the major social media platforms. In the present article, the authors, who for years have explored issues around public trust and new media communication of science, explore the Academy's proposals and offer their own guidance on reconciling public perceptions with “authoritative” health and other science communications.

Column: JMLA Health Sciences Information Professional, Distinguished: a case report

Column: JMLA Health Sciences Information Professional, Distinguished: a case report

Advances in the diagnosis and therapy of liver cirrhosis: a systematic review / Avanços no diagnóstico e terapia da cirrose hepática: uma revisão sistemática

Hepatic cirrhosis (HC) is a diffuse pathophysiological state of the liver considered to be the end-stage of several liver injuries. It is essential to highlight the need to implement new diagnostic and treatment methods to contain subsequent damage to liver cirrhosis, so that we can better understand the pathophysiological process of the disease and obtain better therapeutic results. Thus, this study aimed to identify advances in diagnostic methods and treatments for liver cirrhosis. This is a systematic literature review study, conducted by searching the descriptors “Liver cirrhosis”, “Alcoholic liver cirrhosis”, “Liver fibrosis” and “Liver”, in the databases: Scielo- Scientific Electronic Library Online, Lilacs - Latin American and Caribbean Center on Health Sciences Information, NIH-NCBI-Pubmed- National Center for Biotechnological Information – National Library of Medicine, following a search strategy according to descriptors in Portuguese and English, years 2015 to 2021. At the end of the search with the descriptors, 835 articles were found in the databases, of which 88 were in the Scielo platform, 286 in Lilacs and 461 in Pubmed. After the three selection steps, 811 articles were excluded and 23 articles that met the inclusion and exclusion criteria were selected for analysis. Based on this systematic review, it is pointed out that there has been a lot of development regarding the diagnosis and treatment of cirrhosis that, for many years, required scientific evidence to combat morbidity and mortality and reverse the condition of liver cirrhosis.

Seeking Scientific Health Information for Empowerment: Empowered-Get-More-Empowered Effects

To explore the scientific value of information elements in health news, this article reports on common information elements that are associated with scientific value, according to the findings of surveys conducted in the United States and Taiwan. The design of two further studies in Taiwan reflects an effort to understand whether scientific information elements benefit only health conscious people, through empowered-get-more-empowered effects. A survey-based analysis of perceptions and an experimental test of causal effects of information exposure reveal that health conscious people seek health information, value scientific information elements in it, are persuaded by them, and act on advice.

Chemotherapy for second-stage human African trypanosomiasis: drugs in use.

BackgroundHuman African trypanosomiasis, or sleeping sickness, is a severe disease affecting people in the poorest parts of Africa. It is usually fatal without treatment. Conventional treatments require days of intravenous infusion, but a recently developed drug, fexinidazole, can be given orally. Another oral drug candidate, acoziborole, is undergoing clinical development and will be considered in subsequent editions. ObjectivesTo evaluate the effectiveness and safety of currently used drugs for treating second‐stage Trypanosoma brucei gambiense trypanosomiasis (gambiense human African trypanosomiasis, g‐HAT).Search methodsOn 14 May 2021, we searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Latin American and Caribbean Health Science Information database, BIOSIS, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. We also searched reference lists of included studies, contacted researchers working in the field, and contacted relevant organizations.Selection criteriaEligible studies were randomized controlled trials that included adults and children with second‐stage g‐HAT, treated with anti‐trypanosomal drugs currently in use.Data collection and analysisTwo review authors extracted data and assessed risk of bias; a third review author acted as an arbitrator if needed. The included trial only reported dichotomous outcomes, which we presented as risk ratio (RR) or risk difference (RD) with 95% confidence intervals (CI). Main resultsWe included one trial comparing fexinidazole to nifurtimox combined with eflornithine (NECT). This trial was conducted between October 2012 and November 2016 in the Democratic Republic of the Congo and the Central African Republic, and included 394 participants. The study reported on efficacy and safety, with up to 24 months' follow‐up. We judged the study to be at low risk of bias in all domains except blinding; as the route of administration and dosing regimens differed between treatment groups, participants and personnel were not blinded, resulting in a high risk of performance bias. Mortality with fexinidazole may be higher at 24 months compared to NECT. There were 9/264 deaths in the fexinidazole group and 2/130 deaths in the NECT group (RR 2.22, 95% CI 0.49 to 10.11; 394 participants; low‐certainty evidence). None of the deaths were related to treatment.Fexinidazole likely results in an increase in the number of people relapsing during follow‐up, with 14 participants in the fexinidazole group (14/264) and none in the NECT group (0/130) relapsing at 24 months (RD 0.05, 95% CI 0.02 to 0.08; 394 participants; moderate‐certainty evidence). We are uncertain whether there is any difference between the drugs regarding the incidence of serious adverse events at 24 months. (31/264 with fexinidazole and 13/130 with NECT group at 24 months). Adverse events were common with both drugs (247/264 with fexinidazole versus 121/130 with NECT), with no difference between groups (RR 1.01, 95% CI 0.95 to 1.06; 394 participants; moderate‐certainty evidence). Authors' conclusionsOral treatment with fexinidazole is much easier to administer than conventional treatment, but deaths and relapse appear to be more common. However, the advantages or an oral option are considerable, in terms of convenience, avoiding hospitalisation and multiple intravenous infusions, thus increasing adherence.

Characterizing machine learning studies on ADRD caregivers’ social media posts: A systematic review

AbstractBackgroundSocial media have increasingly been used by ADRD caregivers to share and seek information. An emerging trend in the literature is using machine learning (ML) methods to understand caregivers’ information behaviors on social media. To date no systematic review exists on what ML methods have been used, what the findings are, and what needs to be improved in order to better understand ADRD caregivers’ information behaviors on social media. This systematic review addresses these gaps in the literature.MethodFollowing the PRISMA guidelines, during October and November 2020, we performed three rounds of screening. First, we searched predetermined keywords in ACM Digital Library, IEEE Xplore Digital Library, and PubMed. This step generated 324 results. After removing 92 articles that were not peer‐reviewed journal/conference proceedings and 2 duplicate articles, 230 results remained. Next, we screened the titles and abstracts of the 230 articles using predetermined inclusion/exclusion criteria; 200 articles were excluded, and 30 remained. Finally, we screened the full text of the 30 articles to ensure that they met the inclusion/exclusion criteria; 12 articles were excluded, leaving a final sample of 18 studies for analysis.ResultAll 18 studies covered at least two of the three focal areas: ADRD, ML, and social media; only 6 covered all three areas. Study aims of these 18 studies were in two groups: 1) 4 papers focused on characterizing ADRD caregivers’ behaviors on social media; and 2) 14 papers aimed to build ML models to predict ADRD related activities. Twitter was the data source for 14 studies; other sources included Reddit, Youtube, Weibo, and AskaPatient. The key features for modeling ADRD related activities included semantic representations of post content, positive/negative sentiments, and network structures representing posting/answering activities.ConclusionML provides promising tools for extracting useful information from large amounts of social media posts about ADRD caregivers’ information behaviors. Research in this area is still at its infancy, and much more attention is needed to understand how ML methods can be best utilized. Due to the interdisciplinary nature of the task, effective collaborations leveraging expertise from health sciences, information science and social sciences will be critical.

Systematic review of the characteristics of LGBT homicides.

The lesbian, gay, bisexual and transgender (LGBT) population has long been excluded, a reality produced by social marginalization, which is still present in today's society. This article aims to present a quantitative profile of LGBT homicides, focusing on the crimes, victims, and perpetrators. We conducted a systematic review of quantitative studies on LGBT homicide using the following databases: PubMed Central (Medline), Latin American and Caribbean Center for Health Sciences Information (LILACS), Embase (Elsevier), Scopus (Elsevier), the Virtual Health Library (BVS), and APA PsycNet. The searches were run using terms taken from the Medical Subject Headings (MESHs) and Health Sciences Descriptors (DeCS - BVS). Sixteen studies were included. Homicides tended to involve a single victim and single perpetrator and occur at the victim's residence or in public locations. Victims were more likely to be older than the perpetrator and offenders were usually unknown to the victim. Transgender people were the most affected group and most of the victims in this group were aged under 30 years. The findings of this review confirm that LGBT homicides may be considered "hate crimes" and that victims are generally killed with firearms or non-firearms, beaten to death or suffocated.

Interventions for intermittent exotropia.

The clinical management of intermittent exotropia (X(T)) has been discussed extensively in the literature, yet there remains a lack of clarity regarding indications for intervention, the most effective form of treatment, and whether there is an optimal time in the evolution of the disease at which any given treatment should be carried out. The objective of this review was to analyze the effects of various surgical and non-surgical treatments in randomized controlled trials (RCTs) of participants with intermittent exotropia, and to report intervention criteria and determinewhether the treatment effect varies by age and subtype of X(T). We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 1), which contains the Cochrane Eyes and Vision Trials Register; Ovid MEDLINE; Ovid Embase; Latin American and Caribbean Health Science Information database (LILACS); the ISRCTN registry; ClinicalTrials.gov, and the WHO ICTRP. The date of the search was 20 January 2021. We performed manual searches of the British Orthoptic Journal up to 2002, and the proceedings of the European Strabismological Association (ESA), International Strabismological Association (ISA), and American Association for Pediatric Ophthalmology and Strabismus meeting (AAPOS) up to 2001. We included RCTs of any surgical or non-surgical treatment for intermittent exotropia. We followed standard Cochrane methodology. We included six RCTs, four of which took place in the United States, and the remaining two in Asia (Turkey, India). A total of 890 participants with basic or distance X(T) were included, most of whom were children aged 12 months to 10 years. Three of these six studies were from the 2013 version of this review. Overall, the included studies had a high risk of performance bias as masking of participants and personnel administering treatment was not possible. Two RCTs compared bilateral lateral rectus recession versus unilateral lateral rectus recession with medial rectus resection, but only one RCT (n = 197) reported on the primary outcomes of this review. Bilateral lateral rectus recession likely results in little difference in motor alignment at near (MD 1.00, 95% CI -2.69 to 4.69) and distance (MD 2.00, 95% CI -1.22 to 5.22) fixation as measured in pupillary distance using PACT (moderate-certainty evidence). Bilateral lateral rectus recession may result in little to no difference in stereoacuity at near fixation (risk ratio (RR) 0.77, 95% CI 0.35 to 1.71), adverse events (RR 7.36, 95% CI 0.39 to 140.65), or quality of life measures (low-certainty evidence). We conducted a meta-analysis of two RCTs comparing patching (n = 249) with active observation (n = 252), but were unable to conduct further meta-analyses due to the clinical and methodological heterogeneity in the remaining trials. We found evidence that patching was clinically more effective than active observation in improving motor alignment at near (mean difference (MD) -2.23, 95% confidence interval (CI) -4.02 to -0.44) and distance (MD -2.00, 95% CI -3.40 to -0.61) fixation as measured by prism and alternate cover test (PACT) at six months (high-certainty evidence). The evidence suggests that patching results in little to no difference in stereoacuity at near fixation (MD 0.00, 95% CI -0.07 to 0.07) (low-certainty evidence). Stereoacuity at distance, motor fusion test, and quality of life measures were not reported. Adverse events were also not reported, but study authors explained that they were not anticipated due to the non-surgical nature of patching. One RCT (n = 38) compared prism adaptation test with eye muscle surgery versus eye muscle surgery alone. No review outcomes were reported. One RCT (n = 60) compared lateral rectus recession and medial rectus plication versus lateral rectus recession and medial rectus resection. Lateral rectus recession and medial rectus plication may not improve motor alignment at distance (MD 0.66, 95% CI -1.06 to 2.38) (low-certainty evidence). The evidence for the effect of lateral rectus recession and medial rectus plication on motor fusion test performance is very uncertain (RR 0.92, 95% CI 0.48 to 1.74) (very low-certainty evidence). Patching confers a clinical benefit in children aged 12 months to 10 years of age with basic- or distance-type X(T)compared with active observation. There is insufficient evidence to determine whether interventions such as bilateral lateral rectus recession versus unilateral lateral rectus recession with medial rectus resection; lateral rectus recession and medial rectus plication versus lateral rectus recession and medial rectus resection; and prism adaptation test prior to eye muscle surgery versus eye muscle surgery alone may confer any benefit.

Tocilizumab for giant cell arteritis.

Tocilizumab for giant cell arteritis.

COMPLICAÇÕES FREQUENTES EM PACIENTES DURANTE TRATAMENTO HEMODIALÍTICO

Objective: to identify in the literature the most important complications during hemodialysis treatment. Materials and Method: this is an integrative review of exploratory type, with a qualitative analysis of the literature found in virtual librarians. A search for scientific data in the online databases: National Library of Medicine, Latin American and Caribbean Center on Health Sciences Information, Scientific Electronic Library Online and Google Scholar, associated with specific descriptors between the years of 2015 to 2020. Results: were identified 8 articles to compose two research: Main complications that affect the patient on hemodialysis and Nursing interventions in view of the main complications identified. Final considerations: Patients with Chronic Kidney Disease undergoing hemodialysis treatment are subject to complications that may arise during sessions. However, when nursing care is properly employed, it can revert and / or stabilize the patient's condition.

Laser therapy for dentinal hypersensitivity.

Dentinal hypersensitivity is characterized by short, sharp pain from exposed dentine that occurs in response to external stimuli such as cold, heat, osmotic, tactile or chemicals, and cannot be explained by any other form of dental defect or pathology. Laser therapy has become a commonly used intervention and might be effective for dentinal hypersensitivity. To assess the effects of in-office employed lasers versus placebo laser, placebo agents or no treatment for relieving pain of dentinal hypersensitivity. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 20 October 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2020, Issue 9), MEDLINE Ovid (1946 to 20 October 2020), Embase Ovid (1980 to 20 October 2020), CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 20 October 2020), and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; from 1982 to 20 October 2020). Conference proceedings were searched via the ISI Web of Science and ZETOC, and OpenGrey was searched for grey literature. The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. Randomized controlled trials (RCTs) in which in-office lasers were compared to placebo or no treatment on patients aged above 12 years with tooth hypersensitivity. Two review authors independently and in duplicate screened the search results, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. For continuous outcomes, we used mean differences (MD) and 95% confidence intervals (CI). We conducted meta-analyses only with studies of similar comparisons reporting the same outcome measures. We assessed the overall certainty of the evidence using GRADE. We included a total of 23 studies with 936 participants and 2296 teeth. We assessed five studies at overall low risk of bias, 13 at unclear, and five at high risk of bias. 17 studies contributed data to the meta-analyses. We divided the studies into six subgroups based on the type of laser and the primary outcome measure. We assessed the change in intensity of pain using quantitative pain scale (visual analogue scale (VAS) of 0 to 10 (no pain to worst possible pain)) when tested through air blast and tactile stimuli in three categories of short (0 to 24 hours), medium (more than 24 hours to 2 months), and long term (more than 2 months). Results demonstrated that compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through air blast stimuli at short term (MD -2.24, 95% CI -3.55 to -0.93; P = 0.0008; 13 studies, 978 teeth; low-certainty evidence), medium term (MD -2.46, 95% CI -3.57 to -1.35; P < 0.0001; 11 studies, 1007 teeth; very low-certainty evidence), and long term (MD -2.60, 95% CI -4.47 to -0.73; P = 0.006; 5 studies, 564 teeth; very low-certainty evidence). Similarly, compared to placebo or no treatment the application of all types of lasers combined may reduce pain intensity when tested through tactile stimuli at short term (MD -0.67, 95% CI -1.31 to -0.03; P = 0.04; 8 studies, 506 teeth; low-certainty evidence) and medium term (MD -1.73, 95% CI -3.17 to -0.30; P = 0.02; 9 studies, 591 teeth; very low-certainty evidence). However, there was insufficient evidence of a difference in pain intensity for all types of lasers when tested through tactile stimuli in the long term (MD -3.52, 95% CI -10.37 to 3.33; P = 0.31; 2 studies, 184 teeth; very low-certainty evidence). Most included studies assessed adverse events and reported that no obvious adverse events were observed during the trials. No studies investigated the impact of laser treatment on participants' quality of life. Limited and uncertain evidence from meta-analyses suggests that the application of laser overall may improve pain intensity when tested through air blast or tactile stimuli at short, medium, or long term when compared to placebo/no treatment. Overall, laser therapy appears to be safe. Future studies including well-designed double-blinded RCTs are necessary to further investigate the clinical efficacy of lasers as well as their cost-effectiveness.

What Comes after: Disruption and Care in Health Science Librarianship

As a university health science librarian at a public institution, I witnessed much of this past year from the sidelines, locked in my home, and communicating almost entirely through a computer screen. Although the transition to at-home work was disruptive, it was only a single source of disruption among many: the pandemic itself, healthcare systems, misinformation, political turmoil, and extreme weather conditions. At the same time, I was faced with the constant pressure to “disrupt” my own work by finding new pathways for students and employees to access health science information, new sources of money flowing into the institution, and new methods to helping people make sense of the information sources we already provide. In this column, I want to make sense of these many disruptions and how the interplay between them is indicative of a wider cultural emphasis on pressuring library workers to achieve greater success with increasingly fewer resources. I begin with an introduction to complex systems theory as a means of making sense of disruption. Second, I establish the different ways that disruption affects those of us working with health science e-resources. Finally, I consider how organizational pressure to achieve greater success is antithetical to self-nurture, and how we can develop new avenues of resistance to preserve and care for ourselves and those around us.

New Health Sciences Descriptors to classify and retrieve information on equity.

ABSTRACTThe Health Sciences Descriptors (DeCS) vocabulary establishes a unique and common language that allows the organization and facilitates the search and retrieval of technical and scientific literature on health available in the information sources of the Virtual Health Library. The DeCS, created by the Latin American and Caribbean Center on Health Sciences Information (BIREME), a specialized center of the Pan American Health Organization/World Health Organization (PAHO/WHO), is the translation and extension of the Medical Subject Headings (MeSH) vocabulary, maintained by the United States National Library of Medicine. BIREME, in coordination with experts from Latin America and the Caribbean, has included in the DeCS the topics of equity, gender, ethnicity and human rights—cross-cutting themes in the programmatic framework of PAHO/WHO technical cooperation—to ensure better retrieval and use of scientific information and evidence related to these topics. The objective of this article is to describe the methodology used during the terminology review of the DeCS and to report the results obtained and the impacts of the terminology expansion in the field of equity, which included the inclusion of 35 new descriptors.

Rubber dam isolation for restorative treatment in dental patients.

The effective control of moisture and microbes is necessary for the success of restoration procedures. The rubber dam, as an isolation method, has been widely used in dental restorative treatments. The effects of rubber dam usage on the longevity and quality of dental restorations still require evidence-based discussion. This review compares the effects of rubber dam with other isolation methods in dental restorative treatments. This is an update of the Cochrane Review first published in 2016. To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients. Cochrane Oral Health's Information specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 13 January 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 12) in the Cochrane Library (searched 13 January 2021), MEDLINE Ovid (1946 to 13 January 2021), Embase Ovid (1980 to 13 January 2021), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 13 January 2021), and SciELO BIREME Virtual Health Library (1998 to 13 January 2021). We also searched Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 13 January 2021), VIP database (in Chinese) (1989 to 13 January 2021), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 13 January 2021). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey, and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (including split-mouth trials) over one month in length assessing the effects of rubber dam compared with alternative isolation methods for dental restorative treatments. Two review authors independently screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. We strictly followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE. We included six studies conducted worldwide between 2010 and 2015 involving a total of 1342 participants (of which 233 participants were lost to follow-up). All the included studies were at high risk of bias. Five studies compared rubber dam with traditional cotton rolls isolation. One study was excluded from the analysis due to inconsistencies in the presented data. Of the four remaining trials, three reported survival rates of the restorations with a minimum follow-up of six months. Pooled results from two studies involving 192 participants indicated that the use of rubber dam isolation may increase the survival rates of direct composite restorations of non-carious cervical lesions (NCCLs) at six months (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.05 to 4.99; low-certainty evidence). However, the use of rubber dam in NCCLs composite restorations may have little to no effect on the survival rates of the restorations compared to cotton rolls at 12 months (OR 1.38, 95% CI 0.45 to 4.28; 1 study, 30 participants; very low-certainty evidence) and at 18 months (OR 1.00, 95% CI 0.45 to 2.25; 1 study, 30 participants; very low-certainty evidence) but the evidence is very uncertain. At 24 months, the use of rubber dam may decrease the risk of failure of the restorations in children undergoing proximal atraumatic restorative treatment in primary molars but the evidence is very uncertain (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97; 1 study, 559 participants; very low-certainty evidence). None of the included studies mentioned adverse effects or reported the direct cost of the treatment. This review found some low-certainty evidence that the use of rubber dam in dental direct restorative treatments may lead to a lower failure rate of the restorations compared with cotton roll usage after six months. At other time points, the evidence is very uncertain. Further high-quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.

Methods for evaluating the quality of information on health websites: Systematic Review (2001-2014)

The Internet is a major source of health information, but the poor quality of the information has been criticized for decades. We looked at methods for assessing the quality of health information, updating the findings of the first systematic review from 2002. We searched 9 Health Sciences, Information Sciences, and multidisciplinary databases for studies. We identified 7,718 studies and included 299. Annual publications increased from 9 (2001) to 53 (2013), with 89% from developed countries. We identified 20 areas of knowledge. Six tools have been used worldwide, but 43% of the studies did not use any of them. The methodological framework of criteria from the first review has been the same. The authors were the evaluators in 80% of the studies. This field of evaluation is expanding. No instrument simultaneously covers the evaluation criteria. There is still a need for a methodology involving experts and users and evidence-based indicators of accuracy.