Number Of Meta-analyses Research Articles

Comparison of PTSD prevalence between immigrants and locals with psychotic disorders

IntroductionDue to the global humanitarian crisis, there has been a significant increase in global immigration.(1)The migration process typically involves multiple trauma exposures that are sustained over time(2), which may result in an impact on the mental health of these individuals(3), such as posttraumatic stress disorder(3). A recent meta-analysis estimated that 25% of migrants had PTSD(15), which is significantly higher than the 0.2% to 3.8 percent prevalence data found for the general population(4). In addition, a number of meta-analyses indicate an increased risk of psychosis among immigrants(5). Despite this rise, there is a gap in trauma research in non-refugee immigrants, particularly those with psychotic disorders.ObjectivesTo describe and compare PTSD diagnosis between immigrants and locals recruited from mental health services in Barcelona.MethodsPatients who have presented, according to DSM-V criteria, one or more non-affective psychotic episodes, were recruited in Acute and Chronic inpatients units at Hospital del Mar (Barcelona) from November 2019 to June 2021, leading to a total sample of 199 patients.Demographic characteristics of patients, clinical data and main pharmacological treatment were recorded through a questionnaire. Database information was completed with electronic medical records. Global Assessment of Posttraumatic Stress Questionnaire (EGEP-5) was used as an instrument to assess PTSD diagnosis, main trauma nature and PTSD symptoms. Comparative analysis was performed with IBM SPSS Statistics (Chicago INC) using Chi-Square Test for qualitative variables and t-Student test for continuous variables. Covariate adjustment with demographic and clinical variables was performed by ANOVA test. Study received local ethics committee approval “CEIC” (No. 2019/8398/I).ResultsFrom the total sample of 199 individuals, 98 were immigrants and 98 locals. From the total sample 39 individuals (19.69%) presented PTSD. 32.3% of the immigrants with psychotic disorders presented PTSD compared to 7.1% of the locals with psychotic disorders (F1=19.9, p=0.00). Most traumatic events related to PTSD in immigrants were: “murder of relatives” (33.1%), Physical violence (21.9%) and Terrorism (15.6%) in locals were: “physical violence” (28.6%). Immigrants and locals with psychotic disorders showed similar averages of symptoms, except for avoidance symptoms where locals showed a mean of 5.1 compared to a mean of 3.5 in the immigrant group. Finally, immigrants showed one more functionality affected area by PTSD (5.1) when compared to locals (4) (F7=3.9, p=0.05).ConclusionsAccording to our results there are important differences in PTSD prevalence between immigrants and locals with psychotic disorders. These findings ought to be taken into consideration for programs that are both clinically and sociopolitically tailored to improve assessment and treatment for this population.Disclosure of InterestNone Declared

The vitamin D story – a 2023 update on fractures and falls

Vitamin D is more than just a vitamin – it is a real hormone with great importance for the bone-muscle unit and for many other tissues and biological processes in the human organism. This narrative review is focused on the available evidence for skeletal effects of vitamin D – possible reduction of falls and fractures in elderly people. We follow the natural path of the vitamin D story with the growing interest and hopes followed by some disappointment and then by mere realism. A number of meta-analyses are discussed in an attempt to better describe the available knowledge and the up-to-date consensus on vitamin D. In short, the existing evidence shows a modest effect of vitamin D supplements on fractures and falls, which may be comparable to that of some older antiresorptives. Current consensus statements identified the following subgroups that would benefit most from vitamin D supplements: the elderly, the institutionalized, those with vitamin D insufficiency/deficiency or secondary hyperparathyroidism, those at higher risk of fractures and falls (osteoporosis included). As fractures and falls seem to be dependent from the baseline levels of vitamin D, serum levels should be measured and supplementation should be tailored accordingly (800 – 2000 IU daily). A combination with daily calcium of 600 – 1200 mg is highly recommended to enhance the skeletal effects of vitamin D. The clinician should be aware of the low patients’ adherence with long-term supplements. In conclusion, vitamin D is a cheap and quite effective option to improve bone health with possible beneficial pleiotropic extra-skeletal effects.

Современные представления об ассоциации неалкогольной жировой болезни печени и сердечно-сосудистой патологии

Aim. Based on current literature data, to evaluate the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular diseases (CVD), to consider the pathophysiological mechanisms underlying this relationship, and to indicate methods for reducing cardiometabolic risk in patients with NAFLD. Key points. NAFLD occupies a leading position in the structure of chronic liver diseases, is one of the manifestations of metabolic syndrome and is closely associated with CVD. The relationship between the prevalence of NAFLD and CVD has been established in numerous studies. CVD is significantly more severe in patients with NAFLD. A number of meta-analyses have documented a direct association between NAFLD and cardiovascular mortality. Many pathophysiological mechanisms of development of these two diseases coincide. Some molecular changes that play an important role in NAFLD are also involved in the formation of CVD. Patients with NAFLD often have atherosclerosis, which also underlies the formation of CVD. Conclusion. All modern international and Russian recommendations for the management of patients with NAFLD pay significant attention to the advisability of CVD screening and the need to reduce cardiometabolic risk in patients with NAFLD through lifestyle modification (optimizing diet, weight loss, increasing physical activity), using statin medications, ursodeoxycholic acid and ademetionine. Keywords: non-alcoholic fatty liver disease, liver steatosis, steatohepatitis, cardiovascular diseases, prevalence, risk factors.

Can CD133 Be Regarded as a Prognostic Biomarker in Oncology: Pros and Cons.

The CD133 cell membrane glycoprotein, also termed prominin-1, is expressed on some of the tumor cells of both solid and blood malignancies. The CD133-positive tumor cells were shown to exhibit higher proliferative activity, greater chemo- and radioresistance, and enhanced tumorigenicity compared to their CD133-negative counterparts. For this reason, CD133 is regarded as a potential prognostic biomarker in oncology. The CD133-positive cells are related to the cancer stem cell subpopulation in many types of cancer. Recent studies demonstrated the involvement of CD133 in the regulation of proliferation, autophagy, and apoptosis in cancer cells. There is also evidence of its participation in the epithelial-mesenchymal transition associated with tumor progression. For a number of malignant tumor types, high CD133 expression is associated with poor prognosis, and the prognostic significance of CD133 has been confirmed in a number of meta-analyses. However, some published papers suggest that CD133 has no prognostic significance or even demonstrate a certain correlation between high CD133 levels and a positive prognosis. This review summarizes and discusses the existing evidence for and against the prognostic significance of CD133 in cancer. We also consider possible reasons for conflicting findings from the studies of the clinical significance of CD133.

Copper – a scoping review for Nordic Nutrition Recommendations 2023

Copper functions as a structural component in many proteins involved in energy and iron metabolism, production of neurotransmitters, formation of connective tissue and endogenous antioxidant defence. Several biochemical indices have been suggested and used to assess copper status, but none of these has been found suitable for the detection of marginal copper deficiency or marginal copper toxicity. Copper imbalances have been linked to the pathogenesis of several chronic inflammatory diseases. During the last decade, a number of meta-analyses and systematic reviews have been published shedding light on the association between copper imbalances and some of these pathologies. Most of these meta-analyses are based on case–control studies. All show that blood copper concentrations are higher in cases than in controls, but there is inconclusive evidence to change the recommendations.

How to write an umbrella review? A step-by-step tutorial with tips and tricks.

The number of meta-analyses (MA) and systematic reviews (SR) on various medical issues has increased during the last two decades. The MA and SR results may differ from one another due to a number of factors such as inaccurate or diverse searches through the databases, discrepancies in the extraction process or in statistical analysis, among others. Some results may even contradict one another, resulting in confusion among readers. Umbrella reviews (UR) have allowed the collection of all available data on a medical issue into one concise study, making it the source of evidence-based medical knowledge to the highest degree. Furthermore, UR can resolve those problems by collecting all data and taking into account both MA and SR, making it the superior tool for physicians. Although the pros of UR are clear and the overall popularity of these types of study has increased tremendously, there is no available step-by-step guide on how to conduct one. Therefore, the objective of the present study was to provide researchers with a detailed tutorial on how to conduct an UR. UR represent the next major step in the advancement of evidence-based medicine, with great practical potential for physicians looking for the most up-to-date data on their topic of interest. We hope that our step-by-step guide may be a useful tool for researchers conducting UR in the future.

Not Another Caffeine Effect on Sports Performance Study-Nothing New or More to Do?

The performance-enhancing potential of acute caffeine consumption is firmly established with benefits for many aspects of physical performance and cognitive function summarised in a number of meta-analyses. Despite this, there remains near exponential growth in research articles examining the ergogenic effects of caffeine. Many such studies are confirmatory of well-established ideas, and with a wealth of convincing evidence available, the value of further investigation may be questioned. However, several important knowledge gaps remain. As such, the purpose of this review is to summarise key knowledge gaps regarding the current understanding of the performance-enhancing effect of caffeine and justify their value for future investigation. The review will provide a particular focus on ten research priorities that will aid in the translation of caffeine's ergogenic potential to real-world sporting scenarios. The discussion presented here is therefore essential in guiding the design of future work that will aid in progressing the current understanding of the effects of caffeine as a performance enhancer.

New coronavirus infection (COVID-19) and respiratory diseases / pathological conditions

The respiratory system is the main target of the novel coronavirus infection (COVID19) spread by the SARS-CoV-2 virus. The interim guidelines of the Ministry of Health of the Russian Federation “Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)” (14th version of December 27, 2021) discuss pneumonia in COVID-19 in detail. The issues of the course of other respiratory diseases (chronic obstructive pulmonary disease-COPD, bronchial asthma) are considered in them very briefly. Other diseases and pathological conditions of the respiratory organs are ignored. The federal clinical guidelines Bronchial Asthma, Chronic Obstructive Pulmonary Disease, Community-Acquired Pneumonia in Adults published in 2021 do not discuss the course of these diseases in the context of the COVID-19 pandemic. A search was made for literature on the association of major diseases and pathological conditions of the respiratory organs with the new coronavirus infection COVID-19 in the electronic search engines PubMed and Scopus. The literature sources found indicate that the new coronavirus infection COVID-19 certainly has a specific, often negative, effect on the respiratory system as a whole, and in particular, on certain respiratory diseases and pathological conditions. However, this influence is sometimes ambiguous. Thus, patients with COPD, along with patients with arterial hypertension, diabetes mellitus, and other cardiovascular and cerebrovascular diseases, belong to a vulnerable group of the population during the COVID-19 pandemic, but there was a decrease in the frequency of exacerbations of COPD during the pandemic, especially hospitalizations. due to severe exacerbations. A number of meta-analyses and systematic reviews have shown that the risk of contracting COVID-19 in people with asthma is lower than in people without asthma. There is no association between asthma and a more severe course and worse prognosis of COVID-19. The relationship of diseases/pathological conditions of the respiratory system and COVID-19, therefore, requires further study and clarification.

Intra-articular injections in the treatment of osteoarthritis

Local methods are widely used in the treatment of osteoarthritis (OA) and play a significant role in the complex therapy of this disease. A special place among them belongs to intra-articular (i/a) administration of drugs. The most widely used for this purpose are glucocorticoids (GC) and hyaluronic acid (HA) drugs. When comparing the effectiveness of these drugs, it was shown that during the 1st month, HA had more favorable results, after 3 months the results did not differ significantly, and after 6 months, the effectiveness of HA was higher. Some authors believe that the optimal result can be obtained with the combined use of HA and GC.The efficacy and tolerability of HA drugs in patients with OA have been studied in numerous randomized controlled trials (RCTs), and the data obtained in these studies have been summarized in a number of meta-analyses. At the same time, both in RCTs and in meta-analyses, the results of such treatment were assessed differently. However, when summarizing the materials of various meta-analyses within the framework of a systematic review, it was shown that i/a injections of HA are an effective and safe method of local treatment of OA. However, there are no generally accepted recommendations for the use of HA in the treatment of OA, and the question of their administration in each case is decided individually, taking into account the history, clinical picture, OA phenotype, and tolerability of therapy. The Russian Association of Rheumatologists recommends the use of i/a HA injections in knee OA with synovitis and the use of HA injections to reduce pain and improve joint function.

Reporting Quality in Math Meta-Analyses for Students with or at Risk of Disabilities

Researchers and practitioners alike often look to meta-analyses to identify effective practices to use with students with disabilities. The number of meta-analyses in special education has also expanded in recent years. The purpose of this systematic review is to evaluate the quality of reporting in meta-analyses focused on mathematics interventions for students with or at risk of disabilities. We applied 53 quality indicators (QIs) across eight categories based on recommendations from Talbott et al. to 22 mathematics intervention meta-analyses published between 2000 and 2020. Overall, the meta-analyses met 61% of QIs and results indicated that meta-analyses most frequently met QIs related to providing a clear purpose (95%) and data analysis plan (77%), whereas meta-analyses typically met fewer QIs related to describing participants (39%) and explaining the abstract screening process (48%). We discuss the variation in quality indicator scores within and across the quality categories and provide recommendations for future researchers.

How is organic farming performing agronomically and economically in sub-Saharan Africa?

The potential of organic agriculture and agroecological approaches for improving food security in Africa is a controversial topic in global discussions. While there is a number of meta-analyses on the environmental, agronomic and financial performance of organic farming, most of the underlying data stems from on-station field trials from temperate regions. Data from sub-Sahara Africa in particular, as well as detailed real-farm data is scarce. How organic farming is implemented in sub-Saharan Africa and how it performs in a smallholder context remains poorly understood. We applied a novel observational two-factorial research design, which allowed to evaluate the impacts of i) interventions for introducing organic agriculture and ii) specific organic management practices on 1,645 farms from five case studies in Ghana and Kenya, which we closely monitored for 24 months. Among the farmers who have been exposed to the interventions, we found heterogeneous adoption of organic agriculture principles, depending on the intervention. Furthermore, we found rather passive than active organic management among farmers. Most yields and gross margins under organic management remained at similar levels as the conventional values in four of the case studies. In one case study, however, coffee, maize and macadamia nut yields increased by 127–308% and farm-level gross margins over all analysed crops by 292%. Pooling our data across all case studies, we found significantly higher (+144%) farm-level gross margins on organically managed farms than on conventional farms. This indicates the potential of organic and agroecological approaches if implemented well. Based on our observations, we argue for improving the implementation of organic agriculture projects in settings with smallholder farmers. Limited capacities, lack of appropriate inputs and market access are major agronomic and institutional challenges to be addressed. Furthermore, we argue for supporting a differentiated debate about which types of organic farming are really desirable by classifying approaches to organic farming according to i) their intention to work organically and ii) the degree of following the organic principles. This will support the design and implementation of targeted policy interventions for stimulating sustainability of farming systems and rural development.

Electroconvulsive therapy (ECT) versus sham ECT for depression: do study limitations invalidate the evidence (and mean we should stop using ECT)?

SUMMARYElectroconvulsive therapy (ECT) for depression is a controversial treatment with highly polarised views about the balance between therapeutic benefits and adverse effects. Studies investigating whether ECT is more effective than a placebo treatment started in the 1950s, with the most important randomised controlled trials carried out about four decades ago in which ECT was compared with sham ECT (SECT) involving anaesthesia but no electrically induced seizure. Subsequently the data have been pooled in a number of meta-analyses which have found that ECT is an effective treatment. However, a recent review of the quality of the SECT-controlled studies, and the meta-analyses based on them, concludes that their quality is too poor to allow assessment of the efficacy of ECT and that, given its risks (permanent memory loss and death), the use of ECT should be suspended. This commentary critically discusses the methodology of this review and its conclusions.

COVID-19 meta-analyses: a scoping review and quality assessment.

ABSTRACTObjective:To carry out a scoping review of the meta-analyses published regarding about coronavirus disease 2019 (COVID-19), evaluating their main characteristics, publication trends and methodological quality.Methods:A bibliometric search was performed in PubMed®, Scopus and Web of Science, focusing on meta-analyses about COVID-2019 disease. Bibliometric and descriptive data for the included articles were extracted and the methodological quality of the included meta-analyses was evaluated using A Measurement Tool to Assess Systematic Reviews.Results:A total of 348 meta-analyses were considered eligible. The first meta-analysis about COVID-19 disease was published on February 26, 2020, and the number of meta-analyses has grown rapidly since then. Most of them were published in infectious disease and virology journals. The greatest number come from China, followed by the United States, Italy and the United Kingdom. On average, these meta-analyses included 23 studies and 15,200 participants. Overall quality was remarkably low, and only 8.9% of them could be considered as of high confidence level.Conclusion:Although well-designed meta-analyses about COVID-19 disease have already been published, the majority are of low quality. Thus, all stakeholders playing a role in COVID-19 deseases, including policy makers, researchers, publishers and journals, should prioritize well-designed meta-analyses, performed only when the background information seem suitable, and discouraging those of low quality or that use suboptimal methods.

Mind-Body Interventions for Depressive Symptoms in Chronic Pain: A Systematic Review of Meta-Analyses

BACKGROUND: Psychological comorbidities in chronic pain (CP) are common and contribute to adverse health outcomes and poor quality of life. Evidence-based guidance for the management of depressive symptoms in CP is limited, particularly for mind-body interventions. OBJECTIVES: To investigate the effectiveness of mind-body interventions for the management of depressive symptoms in people with CP. STUDY DESIGN: Systematic review (SR) of SRs. SETTING: SRs with meta-analyses of clinical interventions for the management of depressive symptoms in people with CP. METHODS: This SR was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic searches were performed for MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, the Cochrane Database of Systematic Reviews, and the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports from inception to March 14, 2019. Reference lists and overviews were also hand-searched. SRs of mind-body interventions for CP were included if they conducted a meta-analysis of depression outcomes in people with any CP type not including headache. Two independent reviewers screened, extracted, and evaluated the quality of articles found. Quality was assessed using the AMSTAR 2 criteria and data were summarized narratively with standardized mean differences and 95% confidence intervals of the depression outcome. RESULTS: Eleven SRs with 20 distinct meta-analyses demonstrated a small to moderate beneficial effect for mind-body interventions (effect sizes: -0.05 to -0.63). LIMITATIONS: Depressive symptomatology was a subordinate concern compared with other outcomes. The primary literature base was reasonably broad with 33 primary studies, but small when compared with the number of meta-analyses. CONCLUSIONS: Mind-body interventions show consistent small to moderate effects in reducing depressive symptoms in CP. The literature in this area demonstrates understudy and oversynthesis. There is a need for more clinical trials focusing on people with axial pain, people with comorbid major depressive disorder, and with depression as the primary outcome of interest. Full SR registered on PROSPERO: CRD42019131871. KEY WORDS: Mind-body, meditation, yoga, depression, chronic pain, umbrella review

Wykorzystanie nowego instrumentu do lokalnego pomiaru wpływu prywatyzacji na wyniki przedsiębiorstw

Despite an apparent consensus in the literature that privatisation universally leads to an increase in firm performance, the problem of endogeneity bias is profound and has been emphasised in a number of meta-analyses. We propose a new instrument to address the endogeneity bias and apply it to Polish medium-sized and large firms in the period of 1995 to 2008. We find that improvements in firm performance are not universal; in particular, we find no improvement among manufacturing firms privatised to domestic investors.

Current status of PSMA PET imaging in prostate cancer.

The past decade has witnessed the rising popularity and acceptance of molecular definitions on disease management. Prostate-specific membrane antigen (PSMA), in light of its molecular nature and cytokinetic properties, has rapidly become the target for development of a variety of functional tracers for PET/CT evaluation of prostate cancer. The most commonly used PSMA-binding analog is 68 Ga-labeled PSMA-11, which is now widely applied in both research and clinical settings. Literature data in the recent years have been enriched by a number of meta-analyses and systemic reviews on the evolving role of PSMA PET in primary diagnosis, staging, detection of biochemical recurrence after primary cancer treatment, identification, and significance of oligometastasis, as well as in restaging and treatment monitoring. Being a highly sensitive and reasonably specific molecular tracer, PSMA-binding analogs have a high potential to possess the majority of imaging characteristics required for a variety of management decisions in prostate malignancy.

A Critical Appraisal of a Decade of Left-Main Revascularization Meta-Analyses

Background: Determining the optimal revascularization strategy for patients with left main coronary artery disease (LMCAD) is a compelling topic. After the publication of two new trials, numerous meta-analyses on percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) appeared in the literature. This study set out to review the extent of published meta-analyses on PCI versus CABG in LMCAD, and stipulates the need for “quality over quantity”. Methods: A systematic search in Embase, Medline Ovid and Cochrane databases was performed to identify meta-analyses on PCI versus CABG in LMCAD. Meta-analyses that reported associations between revascularization and clinical outcomes were included. Study outcomes were reported according to descriptive statistics, without pooling study outcomes. Results: Fifty-one meta-analyses were included. Of those, 33 became available after EXCEL and NOBLE trial publication. The composite of major adverse cardiac (and cerebrovascular) events were reported in 41, and 49 reported all-cause mortality. Results varied among meta-analyses, depending on (i) randomized versus observational data, or a combination of both, (ii) methodology and effect-measures to report treatment-differences, (iii) varying sample sizes, and (iv) the year of publication. Conclusions: The number of meta-analyses on PCI versus CABG in patients with LMCAD, is disproportionate and urges the need for quality over quantity. To ensure future high-quality publications, we call on all authors, editors and reviewers to appraise the evidence already available and join forces to conduct individual patient data pooled analyses instead.

Comparison of plate fixation vs. intramedullary fixation for the management of mid-shaft clavicle fractures: A systematic review and meta-analysis of randomised controlled trials.

A number of meta-analyses have compared clinical outcomes following plate vs. intramedullary fixation for midshaft clavicle fractures (MSCF), but with conflicting results. There is a requirement for updated level-1 evidence to guide clinicians managing MSCF. The aim of the present systematic review and meta-analysis was to compare clinical outcomes following plate vs. intramedullary fixation of MSCF. The PubMed, Scopus, BioMed Central, Cochrane Central Register of Controlled Trials and Google Scholar databases were searched for records added until 1st July 2019. A total of 10 randomised controlled trials (RCTs) were included. Shoulder function was assessed using the Constant-Murley Shoulder Outcome questionnaire and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). There was no statistically significant difference in Constant-Murley scores between plate and intramedullary fixation [Mean difference (MD)=0.75; 95% CI: -2.49 to 3.99; P=0.65; I2=85%]. Similarly, there was no statistically significant difference in DASH scores between the two groups (MD=1.55; 95% CI: -1.12 to 4.23; P=0.26; I2=89%). There was no statistically significant difference in complications requiring non-routine surgery between plate and intramedullary fixation [risk ratio (RR)=1.80, 95%CI: 0.80-4.05, P=0.15; I2=0%]. There was an increased risk of complications that did not require non-routine surgery with plate fixation as compared to intramedullary fixation (RR=2.38, 95%CI: 1.22-4.62, P=0.01; I2=70%). Plate fixation was also associated with an increased risk of infection and complications of cosmetic dissatisfaction. The present results indicated no difference in long-term functional outcomes between plate and intramedullary fixation of MSCF. Plate fixation was associated with an increased risk of complications not requiring non-routine surgery. Further high-quality RCTs shall strengthen the evidence on this subject.

The Risk of Myocardial Infarction in Patients with Atrial Fibrillation Taking a Direct Thrombin Inhibitor: Myths and Reality

The purpose of this review is to analyze the results of randomized clinical trials, meta-analyses of cohort and observational studies in real clinical practice on the influence of dabigatran etexilate on the risk of myocardial infarction in patients with atrial fibrillation. A pivotal RE-LY study on dabigatran use in patients with atrial fibrillation did not show statistically significant differences in the frequency of myocardial infarction between any of the doses of dabigatran and warfarin, and the risk of coronary events did not depend on the presence of coronary heart disease or myocardial infarction in the patient's history. Subsequently, a number of meta-analyses have reported an increased risk of myocardial infarction when dabigatran was administered to patients with atrial fibrillation. In general, these studies were characterized by conflicting data, which did not allow to draw any definite conclusions regarding the use of dabigatran in relation to the risk of myocardial infarction. Two FDA cohort observational studies were published in 2014 and 2017, and the former was significantly criticized by experts, and the results of the second study did not provide a definitive answer to the question about the importance of the effect of dabigatran on the development of myocardial infarction in patients with atrial fibrillation. Even more "confusing" the problem arose after the publication of meta-analyses of randomized trials, which showed that the risk of myocardial infarction was increased in patients treated with direct oral anticoagulants compared to patients treated with warfarin. This review provides high quality evidence for the efficacy of dabigatran in preventing myocardial infarction and other vascular complications in patients with atrial fibrillation.

Reporting of financial conflicts of interest in meta-analyses of drug trials published in high-impact medical journals: comparison of results from 2017 to 2018 and 2009

BackgroundA previous study found that 2 of 29 (6.9%) meta-analyses published in high-impact journals in 2009 reported included drug trials’ funding sources, and none reported trial authors’ financial conflicts of interest (FCOIs) or industry employment. It is not known if reporting has improved since 2009. Our objectives were to (1) investigate the extent to which pharmaceutical industry funding and author-industry FCOIs and employment from included drug trials are reported in meta-analyses published in high-impact journals and (2) compare current reporting with results from 2009.MethodsWe searched PubMed (January 2017–October 2018) for systematic reviews with meta-analyses including ≥ 2 randomized controlled trials (RCTs) of patented drugs. We included 3 meta-analyses published January 2017–October 2018 from each of 4 high-impact general medicine journals, high-impact journals from 5 specialty areas, and the Cochrane Database of Systematic Reviews, as in the previous study.ResultsAmong 29 meta-analyses reviewed, 13 of 29 (44.8%) reported the funding source of included trials compared to 2 of 29 (6.9%) in 2009, a difference of 37.9% (95% confidence interval, 15.7 to 56.3%); this included 7 of 11 (63.6%) from general medicine journals, 3 of 15 (20.0%) from specialty medicine journals, and 3 of 3 (100%) Cochrane reviews. Only 2 of 29 meta-analyses (6.9%) reported trial author FCOIs, and none reported trial author-industry employment.Protocol PublicationA protocol was uploaded to the Open Science Framework prior to initiating the study. https://osf.io/8xt5p/LimitationsWe examined only a relatively small number of meta-analyses from selected high-impact journals and compared results to a similarly small sample from an earlier time period.ConclusionsReporting of drug trial sponsorship and author FCOIs in meta-analyses published in high-impact journals has increased since 2009 but is still suboptimal. Standards on reporting of trial funding described in the forthcoming revised PRISMA statement should be adapted and enforced by journals to improve reporting.