Effects Meta-analysis Research Articles

Modular literature review: a novel systematic search and review method to support priority setting in health policy and practice

BackgroundThere is an unmet need for review methods to support priority-setting, policy-making and strategic planning when a wide variety of interventions from differing disciplines may have the potential to impact a health outcome of interest. This article describes a Modular Literature Review, a novel systematic search and review method that employs systematic search strategies together with a hierarchy-based appraisal and synthesis of the resulting evidence.MethodsWe designed the Modular Review to examine the effects of 43 interventions on a health problem of global significance. Using the PICOS (Population, Intervention, Comparison, Outcome, Study design) framework, we developed a single four-module search template in which population, comparison and outcome modules were the same for each search and the intervention module was different for each of the 43 interventions. A series of literature searches were performed in five databases, followed by screening, extraction and analysis of data. “ES documents”, source documents for effect size (ES) estimates, were systematically identified based on a hierarchy of evidence. The evidence was categorised according to the likely effect on the outcome and presented in a standardised format with quantitative effect estimates, meta-analyses and narrative reporting. We compared the Modular Review to other review methods in health research for its strengths and limitations.ResultsThe Modular Review method was used to review the impact of 46 antenatal interventions on four specified birth outcomes within 12 months. A total of 61,279 records were found; 35,244 were screened by title-abstract. Six thousand two hundred seventy-two full articles were reviewed against the inclusion criteria resulting in 365 eligible articles.ConclusionsThe Modular Review preserves principles that have traditionally been important to systematic reviews but can address multiple research questions simultaneously. The result is an accessible, reliable answer to the question of “what works?”. Thus, it is a well-suited literature review method to support prioritisation, decisions and planning to implement an agenda for health improvement.

Multimedia Design for Learning: An Overview of Reviews With Meta-Meta-Analysis

Multimedia is ubiquitous in 21st-century education. Cognitive load theory and the cognitive theory of multimedia learning both postulate that the quality of multimedia design heavily influences learning. We sought to identify how to best design multimedia and review how well those learning theories held up to meta-analyses. We conducted an overview of systematic reviews that tested the effects of multimedia design on learning or cognitive load. We found 29 reviews including 1,189 studies and 78,177 participants. We found 11 design principles that demonstrated significant, positive, meta-analytic effects on learning and five that significantly improved management of cognitive load. The largest benefits were for captioning second-language videos, temporal/spatial contiguity, and signaling. We also found robust evidence for modality, animation, coherence/removing seductive details, anthropomorphics, segmentation, personalization, pedagogical agents, and verbal redundancy effects. Good design was more important for more complex materials, and in system-paced environments (e.g., lectures) than self-paced ones (e.g., websites). Results supported many tenets of both theories. We highlight a range of evidence-based strategies that could be implemented by educators.

A Meta-Analysis of Effectiveness on Exercise Interventions to Improve Balance in Persons with Developmental Disabilities

A Meta-Analysis of Effectiveness on Exercise Interventions to Improve Balance in Persons with Developmental Disabilities

Does the term matter? The labeling effect on the perception of ethnic minorities: The case of The Romani in Serbia

Empirical research on the impact of linguistic labels on social perceptions is scarce, especially in the context of ethnic groups. Across three studies (N = 1185), we investigated the impact of labels on perceptions of the Romani ethnic group by non-Romani participants in Serbia. In Study 1 (N = 244), we found some evidence that the Romani elicit more positive perceptions (more sociable and competent) when labeled with the neutral (vs. derogatory) term. In two follow-up studies, we focused on investigating potential mechanisms. In Study 2, we tested whether positive perceptions emerged via perceived higher status, while in Study 3 we focused on the motivation to respond without prejudice and sensitivity to hate speech. Study 2 (N = 467) replicated the labeling effect showing that Romani were perceived more positively (more sociable and moral) when labeled with the neutral term. However, we found no support for perceived group status as a mechanism. Study 3 (N = 474) did not corroborate the labeling effect but found the higher external motivation to respond without prejudice (potential mechanism). Meta-analytic effects showed that Romani were perceived as more moral, sociable, and competent when the neutral term was used. These effects were to some extent moderated by ideology as they existed only for right-wing individuals. We conclude that the effect is much smaller than the effects in previous comparable studies.

The Effect of Phosphodiesterase-type 5 Inhibitors on Erectile Function: An Overview of Systematic Reviews.

Background: Multiple systematic reviews explore the effect of phosphodiesterase type 5 (PDE5) inhibitors on erectile dysfunction (ED), with each study addressing specific outcomes. However, physicians and policymakers require a holistic approach of this topic.Objective: To summarize the current evidence regarding the efficacy and safety of PDE5 inhibitors for the management of ED through an overview of systematic reviews.Methods: Studies were identified by searching PubMed, Web of Science, Cochrane Library and Scopus databases, as well as sources of grey literature until June 12, 2021 (PROSPERO: CRD42020216754). We considered systematic reviews, meta-analyses or network meta-analyses of randomized trials that provided outcomes about the efficacy and safety of any approved PDE5 inhibitor (avanafil, sildenafil, tadalafil and vardenafil). We constructed forest plots for meta-analytic effects regarding the change in erectile function, adverse events and dropouts after administration of PDE5 inhibitors in the general population and in specific patient groups.Results: We included 23 studies with 154,796 participants and a total of 258 meta-analytic effects. Sildenafil 25 mg [Weighted Mean Difference (WMD): 13.08, 95% Confidence Interval (CI): 10.1-16.06] seemed to be statistically superior to all interventions in improving erectile function compared to placebo, but studies with low-dose sildenafil are lacking. Moreover, comparing among different PDE5 inhibitors, sildenafil 50 mg or sildenafil 100 mg were considered the most effective compounds in the general population. The latter derived, however, predominantly from indirect comparisons among different PDE5 inhibitors. Still, sildenafil 100 mg was associated with more treatment-related adverse events and dropouts. Interestingly, low-dose daily tadalafil may be more effective than high-dose on-demand tadalafil (WMD: 1.24, 95% CI: 0.03-2.44). Furthermore, testosterone and PDE5 inhibitors in patients with ED and hypogonadism seem to further improve symptoms, while the addition of a-blockers in patients with urinary symptoms treated with PDE5 inhibitors does not provide additional benefits (WMD: −0.8, 95% CI: −1.65-0.06).Conclusion: Although the efficacy and safety of PDE5 inhibitors, compared to placebo, is well-documented, the existing evidence comparing different PDE5 inhibitors is low. Therefore, high-quality, head-to-head, trials comparing different PDE5 inhibitors are necessary to determine their ideal dosage and formulation based on their safety and efficacy profile.Systematic Review Registration: PROSPERO, identifier [CRD42020216754].

"I am what I am: A meta-analysis of the association between substance user identities and substance use-related outcomes." Correction to Montes and Pearson (2021).

Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations. Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (r w = .365, p < .001, rw² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity-outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity-outcome association was observed among younger individuals. Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity-outcome association. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

1463Impact of missing outcome data in meta-analyses of lifestyle interventions during pregnancy to reduce postpartum-weight-retention

Abstract Background High risk of bias associated with missing outcome data (MOD) in meta-analyses (MAs) of the effects of lifestyle interventions during pregnancy on postpartum weight retention (PPWR), casts doubt on whether such interventions can be relied upon as truly effective, since estimates are deemed valid only if MOD was missing at random (MAR). Methods We conducted a systematic overview of MAs to examine the impact of MOD on the estimation of meta-analytic summary intervention effects and conducted sensitivity analyses using pattern mixture models and informative missingness parameters (describing how the outcome in the missing participants may be related to the outcome in the completers), to ascertain the robustness of the estimates to reasonable deviations from the MAR assumption. Results Three relevant MAs were identified, all with high MOD rates in the RCTs included (median&amp;gt;30%), and all reporting beneficial intervention effects on PPWR (in kg) estimated based on complete case analyses: [-0.78 (95%CI: -1.39,-0.16), -0.81 (-1.57,-0.06), and -0.94 (-1.52,-0.37)] in MAs of any lifestyle, exercise, or diet + exercise interventions, respectively. In plausible scenarios where the outcome for the intervention group in participants with vs without MOD was worse (by 0.5kg), effect estimates were attenuated in all and no longer significant in 2 of the MAs [-0.58 (-1.29,0.13), -0.70 (-1.50,0.10) and -0.88 (-1.73,-0.02)]. Conclusions Statistical significance was retained when all 19 RCTs identified across MAs were meta-analysed: -0.63 (-0.17,-0.08). Key messages The clinical relevancy of effects of this magnitude remains unclear.

정서중심치료를 기반으로 한 국내 상담프로그램 효과의 메타분석

본 연구는 정서중심치료를 기반으로 한 국내 상담프로그램의 효과를 살펴보고자 2010년 1월부터 2020년 9월까지 출판된 연구 중 최종적으로 분석 기준에 부합하는 25편의 논문을 선정하여 메타분석을 실시하였다. 개별 연구들의 효과크기는 R프로그램을 이용하여 분석하였다. 정서중심치료 상담프로그램의 전체 효과크기는 .89(p<.001)였으며. 불안정애착과 정서조절곤란에 대하여 큰 효과크기를 보이는 것으로 나타났다. 하위집단에 대한 조절효과 분석 결과, 효과크기는 중재회기가 10회 이상인 상담프로그램이 8회 이하보다 컸으며, 매체기반 상담프로그램이 대화기반 상담프로그램보다 큰 것으로 나타났다. 또한 연구대상으로는 부부, 성인, 아동청소년 순으로, 그리고 실험집단원 수는 10명 이하, 21∼30명, 11∼20명, 31명 이상의 순으로 효과크기가 큰 것으로 나타났다. 국내에서 실시된 정서중심치료 상담프로그램은 현재까지 연구된 변인들 중 불안정애착과 정서조절곤란을 감소시키는 데 특히 효과적이며, 부부대상, 매체기반, 실험집단원 수를 10명 이하로 구성했을 때 더욱 효과적인 것으로 나타났다. 본 연구는 국내 정서중심치료 기반의 상담프로그램 효과성에 대하여 종합적이고 체계적인 이해를 도모하고 정서중심치료 상담프로그램 설계시 고려할 사항들을 제안하였다는 점에 의의가 있다. 연구의 제한점과 후속 연구방향을 논의하였다.

Meta-analysis of the Effects of Cognitive Behavioral Therapy on Adverse Mood of Gastrointestinal Tumor Patients

Meta-analysis of the Effects of Cognitive Behavioral Therapy on Adverse Mood of Gastrointestinal Tumor Patients

Quantifying the effect of Wakefield et al. (1998) on skepticism about MMR vaccine safety in the U.S.

Efforts to trace the rise of childhood vaccine safety concerns in the US often suggest Andrew Wakefield and colleagues' retracted 1998 Lancet study (AW98)-which alleged that the MMR vaccine can cause children to develop autism-as a primary cause of US vaccine skepticism. However, a lack of public opinion data on MMR safety collected before/after AW98's publication obscures whether anecdotal accounts are indicative of a potentially-causal effect. We address this problem using a regression discontinuity framework to study change in monthly MMR injury claims (N = 74,850; from 1990-2019) from the Vaccine Adverse Events Reporting System (VAERS) to proxy concern about vaccine safety. Additionally, we suggest a potential mechanism for the effect of AW98 on vaccine skepticism, via automated sentiment analyses of MMR-related news stories (N = 674; from 1996-2000) in major television and newspaper outlets. AW98 led to an immediate increase of about 70 MMR injury claims cases per month, averaging across six estimation strategies (meta-analytic effect = 70.44 [52.19, 88.75], p < 0.01). Preliminary evidence suggests that the volume of negative media attention to MMR increased in the weeks following AW98's publication, across four estimation strategies (meta-analytic effect = 9.59% [3.66, 15.51], p < 0.01). Vaccine skepticism increased following the publication of AW98, which was potentially made possible by increased negative media coverage of MMR. Childhood vaccine skepticism presents an important challenge to widespread vaccine uptake, and undermines support for pro-vaccine health policies. In addition to advancing our understanding of the previously-obscured origins of US vaccine skepticism, our work cautions that high-profile media attention to inaccurate scientific studies can undermine public confidence in vaccines. We conclude by offering several recommendations that researchers and health communicators might consider to detect and address future threats to vaccine confidence.

Meta-Analytic Methods to Detect Publication Bias in Behavior Science Research.

Publication bias is an issue of great concern across a range of scientific fields. Although less documented in the behavior science fields, there is a need to explore viable methods for evaluating publication bias, in particular for studies based on single-case experimental design logic. Although publication bias is often detected by examining differences between meta-analytic effect sizes for published and grey studies, difficulties identifying the extent of grey studies within a particular research corpus present several challenges. We describe in this article several meta-analytic techniques for examining publication bias when published and grey literature are available as well as alternative meta-analytic techniques when grey literature is inaccessible. Although the majority of these methods have primarily been applied to meta-analyses of group design studies, our aim is to provide preliminary guidance for behavior scientists who might use or adapt these techniques for evaluating publication bias. We provide sample data sets and R scripts to follow along with the statistical analysis in hope that an increased understanding of publication bias and respective techniques will help researchers understand the extent to which it is a problem in behavior science research.

Early Optimistic Effect in Periodontology and Implant Dentistry Trials

Differences in effect estimates between early primary trials included in a meta-analysis and the pooled estimate of meta-analysis might indicate potential novelty bias. The objective of this study was to assess the presence of novelty bias in a sample of studies published in periodontology and implant dentistry. On August 7, 2020, we searched the PubMed database for meta-analyses of clinical studies published between August 2015 and August 2020. Meta-analyses with at least 4 primary studies were selected for assessment. We fitted logistic regression models using trial characteristics as predictors to assess the association between these characteristics and 1) the odds of the first trial’s estimate to be included in the meta-analysis confidence interval (CI) and 2) the odds of overlap between the first trial’s CI and the meta-analysis prediction interval (PI). Ninety-two meta-analyses provided data for assessment. In absolute values, 70% of the meta-analyses have a pooled estimate smaller than the corresponding estimate of the first trial, although there was overlap of the CI of estimates from the first trial and the meta-analysis in 87% of the cases. This is probably due to the small number of trials in most meta-analyses and the subsequently large uncertainty associated with the pooled effect estimate. As the number of trials in the meta-analysis increased, the odds of the treatment effect estimate of the first trial to be included in the meta-analysis CI decreased by 15% for every additional trial (odds ratio, 0.85; 95% CI, 0.73 to 0.96). Meta-analytic effect estimates appear to be more conservative than those from the first trial in the meta-analysis. Our findings show evidence of novelty bias in periodontology and implant dentistry; therefore, clinicians should be aware of the risk of making decisions based on the information reported in new trials because of the risk of exaggerated estimates in these trials.

Meta-analysis of distortions effects on quality of digital images using standard IQA datasets

The research on image quality assessment has been an area of concern for the researchers from last many years. Images, during their life cycle, passes through several phases including acquisition, compression and restoration, for ease of transmission and storage, encryption and decryption for better security. During their processing, the quality of images is affected by many distortions, including compression artifacts, noise, bandwidth loss, etc., that are not present in the original images. The main emphasis of this research work is to analyze the effect of such artifacts on the quality of images. Further, a brief description of available image quality datasets, along with the popular quality evaluation metrics, is also presented. From experimental analysis in the present work, it is observed that when the images are degraded by impurities during their processing phases, then their quality degenerates by a relatively high degree, varying from minimum 1% to maximum of 55% under different sets of distortions, when measured on standard IQA metrics such as MSE, PSNR, PFE, SSIM, etc. This study will motivate the future researchers to have an elaborate quality assessment before employing these images for practical applications like medical sciences, remote sensing, etc.

Virtual charismatic leadership and signaling theory: A prospective meta-analysis in five countries

Drawing upon signaling theory, charismatic leadership tactics (CLTs) have been identified as a trainable set of skills. Although organizations rely on technology-mediated communication, the effects of CLTs have not been examined in a virtual context. Preregistered experiments were conducted in face-to-face (Study 1; n = 121) and virtual settings (Study 2; n = 128) in the United States. In Study 3, we conducted virtual replications in Austria (n = 134), France (n = 137), India (n = 128), and Mexico (n = 124). Combined with past experiments, the meta-analytic effect of CLTs on performance (Cohen’s d = 0.52 in-person, k = 4; Cohen’s d = 0.21 overall, k = 10) and engagement in an extra-role task (Cohen’s d = 0.19 overall; k = 6) indicate large to moderate effects. Yet, for performance in a virtual context Cohen’s d ranged from −0.25 to 0.17 (Cohen’s d = 0.01 overall; k = 6). Study 4 (n = 129) provided mixed support for signaling theory in a virtual context, linking CLTs to some positive evaluations. We conclude with guidance for future research on charismatic leadership and signaling theory.

Does Cross-Race Contact Improve Cross-Race Face Perception? A Meta-Analysis of the Cross-Race Deficit and Contact.

Contact with racial outgroups is thought to reduce the cross-race recognition deficit (CRD), the tendency for people to recognize same-race (i.e., ingroup) faces more accurately than cross-race (i.e., outgroup) faces. In 2001, Meissner and Brigham conducted a meta-analysis in which they examined this question and found a meta-analytic effect of r = -.13. We conduct a new meta-analysis based on 20 years of additional data to update the estimate of this relationship and examine theoretical and methodological moderators of the effect. We find a meta-analytic effect of r = -.15. In line with theoretical predictions, we find some evidence that the magnitude of this relationship is stronger when contact occurs during childhood rather than adulthood. We find no evidence that the relationship differs for measures of holistic/configural processing compared with normal processing. Finally, we find that the magnitude of the relationship depends on the operationalization of contact and that it is strongest when contact is manipulated. We consider recommendations for further research on this topic.

Therapeutic potential of pluripotent stem cell-derived dopaminergic progenitors in Parkinson\u2019s disease: a systematic review protocol

BackgroundParkinson’s disease (PD) is the second most common age-dependent neurodegenerative disease that causes motor and cognitive disabilities. This disease is associated with a loss of dopamine content within the putamen, which stems from the degeneration of dopaminergic (DA) neurons in the substantia nigra pars compacta (SNc). Several approved drugs are available that can effectively treat symptoms of PD. However, long-term medical management is often complicated and does not delay or halt disease progression. Alternatively, cell replacement strategies can address these shortcomings and provide dopamine where it is needed. Although using human pluripotent stem cells (hPSCs) for treatment of PD is a promising alternative, no consensus in the literature pertains to efficacy concerns of hPSC-based therapy for PD. This systematic review aims to investigate the efficacy of primate PSC-derived DA progenitor transplantation to treat PD in preclinical studies.MethodsThis is a systematic review of preclinical studies in animal models of PD. We intend to use the following databases as article sources: MEDLINE (via PubMed), Web of Science, and SCOPUS without any restrictions on language or publication status for all related articles published until the end of April 2021. Two independent reviewers will select the titles and abstracts, extract data from qualifying studies, and assess the risk of bias using the SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE) risk of bias tool and the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES) checklist. Apomorphine-induced rotation test (APO-IR) and amphetamine-induced rotation test (AMP-IR) are defined as the primary outcomes. The standardized mean difference (SMD) by Hedges’ g method (r) and odds ratio (OR) and related 95% confidence interval (CI) will be calculated to determine the size effect of the treatment. The heterogeneity between studies will be calculated by “I2 inconsistency of values and Cochran’s Q statistical test,” where I2 > 50% and/or p < 0.10 suggests high heterogeneity. Meta-analyses of random effects will be run when appropriate.DiscussionThis study will present an overview of preclinical research on PSCs and their therapeutic effects in PD animal models. This systematic review will point out the strengths and limitations of studies in the current literature while encouraging the funding of new studies by public health managers and governmental bodies.

A meta-analysis of ozone effect on tooth bleaching

This systematic review assessed the effectiveness of ozone (O3) in the color change of in-office tooth bleaching in vital teeth (TB) and the sensitivity control. Only randomized controlled clinical trials were included. Seven databases were used as primary search sources, and three additional sources were searched to capture the "grey literature" partially. The JBI tool was used to assess the risk of bias. TB was assessed using the ΔELab color change metric comparing tooth color pre- and post-bleaching. We meta-analyzed the ΔELab estimates per method and calculated the absolute standardized mean difference using random-effect models. The GRADE approach assessed the certainty of the evidence. The ΔELab estimates ranged from 1.28 when the O3 was used alone to 6.93 when combined with hydrogen peroxide (HP). Two studies compared O3 and HP alone, but their TB was similar (SMD = − 0.02; 95%CI: − 0.54; 0.49). The bleaching effectiveness for the combination of O3 + HP compared to HP was similar (SMD = 0.38; 95%CI: − 0.04; 0.81). Thus, based on the available literature, our findings suggest that O3 is not superior to the conventional technique using HP on the change of tooth color. The O3 did not present sensitivity when used alone. When O3 was used in combination with HP, patients reported hypersensitivity only when O3 was applied before HP, i.e., no sensitivity was perceived when O3 was applied after HP.

Reduced alternative insulin dosing in hyperkalemia: A meta-analysis of effects on hypoglycemia and potassium reduction.

Recent studies have identified that reduced alternative intravenous insulin doses, such as 5 units or 0.1 units/kg, may reduce the risk of hypoglycemia compared to standard doses of 10 units in patients treated for hyperkalemia. However, some studies suggest that these alternative doses may reduce the ability to lower serum potassium. This study was performed to determine the impact of alternative insulin dosing on hypoglycemia and potassium reduction in patients with hyperkalemia. Meta-analysis. PubMed/MEDLINE, CENTRAL, Ovid, and ClinicalTrials.gov were searched from inception through November 2020. Patients treated with standard (10 units) or alternative (<10 units) insulin dosing strategies for hyperkalemia. Only studies that evaluated hypoglycemia (serum glucose <70mg/dl), severe hypoglycemia (serum glucose <50mg/dl), and potassium reduction post-treatment were included in the meta-analysis. All articles were assessed for bias using the Cochrane Risk of Bias Assessment Tool and Newcastle-Ottawa scales for randomized prospective trials and retrospective trials, respectively. None. Ten retrospective cohort studies (n=3437) were included and had low- or moderate-risk of bias. Alternative insulin dosing strategies included 5 units, 0.1 units/kg, and <10 units. Alternative dosing had lower pooled odds of hypoglycemia (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.43-0.69, I2 =8%) and severe hypoglycemia (OR 0.41, 95% CI 0.27-0.64, I2 =0%). No difference in potassium reduction was detected (mean difference -0.02mmol/L, 95% CI -0.11-0.07, I2 =53%). Alternative insulin dosing strategies for hyperkalemia management resulted in less hypoglycemia and severe hypoglycemia without compromising potassium reduction compared to standard dose. Prospective studies are needed to confirm these findings.

Digital Health Strategies for Cervical Cancer Control in Low- and Middle-Income Countries: Systematic Review of Current Implementations and Gaps in Research.

BackgroundNearly 90% of deaths due to cervical cancer occur in low- and middle-income countries (LMICs). In recent years, many digital health strategies have been implemented in LMICs to ameliorate patient-, provider-, and health system–level challenges in cervical cancer control. However, there are limited efforts to systematically review the effectiveness and current landscape of digital health strategies for cervical cancer control in LMICs.ObjectiveWe aim to conduct a systematic review of digital health strategies for cervical cancer control in LMICs to assess their effectiveness, describe the range of strategies used, and summarize challenges in their implementation.MethodsA systematic search was conducted to identify publications describing digital health strategies for cervical cancer control in LMICs from 5 academic databases and Google Scholar. The review excluded digital strategies associated with improving vaccination coverage against human papillomavirus. Titles and abstracts were screened, and full texts were reviewed for eligibility. A structured data extraction template was used to summarize the information from the included studies. The risk of bias and data reporting guidelines for mobile health were assessed for each study. A meta-analysis of effectiveness was planned along with a narrative review of digital health strategies, implementation challenges, and opportunities for future research.ResultsIn the 27 included studies, interventions for cervical cancer control focused on secondary prevention (ie, screening and treatment of precancerous lesions) and digital health strategies to facilitate patient education, digital cervicography, health worker training, and data quality. Most of the included studies were conducted in sub-Saharan Africa, with fewer studies in other LMIC settings in Asia or South America. A low risk of bias was found in 2 studies, and a moderate risk of bias was found in 4 studies, while the remaining 21 studies had a high risk of bias. A meta-analysis of effectiveness was not conducted because of insufficient studies with robust study designs and matched outcomes or interventions.ConclusionsCurrent evidence on the effectiveness of digital health strategies for cervical cancer control is limited and, in most cases, is associated with a high risk of bias. Further studies are recommended to expand the investigation of digital health strategies for cervical cancer using robust study designs, explore other LMIC settings with a high burden of cervical cancer (eg, South America), and test a greater diversity of digital strategies.

Why Does Cognitive Training Yield Inconsistent Benefits? A Meta-Analysis of Individual Differences in Baseline Cognitive Abilities and Training Outcomes.

Despite growing interest in improving cognitive abilities across the lifespan through training, the benefits of cognitive training are inconsistent. One powerful contributor may be that individuals arrive at interventions with different baseline levels of the cognitive skill being trained. Some evidence suggests poor performers benefit the most from cognitive training, showing compensation for their weak abilities, while other evidence suggests that high performers benefit most, experiencing a magnification of their abilities. Whether training leads to compensation or magnification effects may depend upon the specific cognitive domain being trained (such as executive function or episodic memory) and the training approach implemented (strategy or process). To clarify the association between individual differences in baseline cognitive ability and training gains as well as potential moderators, we conducted a systematic meta-analysis of the correlation between these two variables. We found evidence of a significant meta-correlation demonstrating a compensatory effect, a negative association between initial ability on a trained cognitive process and training gains. Too few papers met our search criteria across the levels of proposed moderators of cognitive domain and training approach to conduct a reliable investigation of their influence over the meta-analytic effect size. We discuss the implications of a compensatory meta-correlation, potential reasons for the paucity of qualifying papers, and important future directions for better understanding how cognitive trainings work and for whom.