Systematic Review Of Characteristics Research Articles

AI-Based Tools in Mathematics Education: A Systematic Review of Characteristics, Applications, and Evaluation Methods

Artificial intelligence has been utilized for enhancement of education. The paper describes the gradual influences of Natural language processing, ChatGPT and Intelligent Tutoring Systems in mathematical education in particular. A systematic review and briefing is targeted for budding researchers in the field of AI based education. A comparison of research with a brief summary is provided along with the analysis of the search. Future scope for the clear understanding and easy implementation of mathematics is aimed with development of the intelligent system with customized solutions to the difficulties faced by the learners of mathematics. The impact of Artificial Intelligence (AI) on the applications in education has been evolving since the past 50+ years. The advent of Intelligent Tutoring Systems has emerged as a rich and important natural environment that deploys and improves AI algorithms. The review carried out shows ITS as an ever growing field for education comes with positive impact on education outcomes, effective increase in learning rates, increase in the learning levels of students and many such benefits. It also has its own challenges in creating authoring environments, making collaborative learning possible, world wide web deployment and creation of virtual reality environments to name a few. In this review paper we focus on the impact of applications that have been developed using NLP, ChatGPT and ITS as education technology.

Covid-19 hotlines, helplines and call centers: a systematic review of characteristics, challenges and lessons learned

BackgroundDuring the Covid-19 pandemic, a number of hotlines/helplines/call centers was implemented to provide remote services and support public health. The objective of this study was to investigate the characteristics, challenges and lessons learned of implementing Covid-19 hotlines/helplines/call centers during the pandemic.MethodsPubMed, Web of Science, Scopus, the Cochrane Library, IEEE Xplore, and ProQuest databases as well as Google Scholar were searched between 1st January 2020 and 31st December 2023 to retrieve relevant articles published in English. The quality and risk of bias of the studies were assessed using the Appraisal tool for Cross-Sectional Studies (AXIS), the Mixed Methods Appraisal Tool (MMAT), and Critical Appraisal Skills Programme (CASP) Checklist.ResultsIn total, 43 out of 1440 articles were included in this study. About half of the hotlines/helplines/call centers were launched in March 2020 (n = 19). Providing psychological support (n = 23), reliable information about Covid-19 (n = 10), healthcare advices about Covid-19 (n = 8), and triage (n = 7) were the most common purposes of implementing these services. The most common challenges included a lack of physical examination, unavailability of hotlines/helplines/call centers at the point of need, and delay in updating Covid-19 information. The most common lessons learned were employing qualified staff, providing proper training, and getting feedback from the callers and operators.ConclusionAccording to the results, most of the Covid-19 hotlines/helplines/call centers were launched in the early months of the pandemic, and about half of them were active seven days a week. Most of the operators were mental health providers and clinicians. The findings show the importance of continuous psychological support during crises, particularly when adequate information about the situation is not available. The challenges experienced by the callers and operators as well as the lessons learned by the service providers also need to be considered for future crises to increase the effectiveness of similar services.

Plastic Surgery Clinical Trials: A Systematic Review of Characteristics, Research Themes, and Predictors of Publication and Discontinuation

Summary: Clinical trials (CTs) are crucial for evidence-based surgical care. Despite growing interest in plastic and reconstructive surgery (PRS) research, the status of PRS CTs remains unknown. We obtained PRS CTs from ClinicalTrials.gov and WHO’s International Clinical Trials Registry Platform (November 2022). Topic modeling identified research themes and machine learning models generated CT-publication pairs. Kaplan-Meier curves visualized CT discontinuation and nonpublication. Of the 4685 PRS CTs identified, 79% were interventional and 81% recruited adults. Most were single-center-led (67%) and academic-funded (77%). Male investigators led 77% of CTs. Female-only patient CTs outnumbered male-only (31% versus 1%). The United States led with 41% of CTs, followed by France, Canada, and China. Industry-funded CTs were higher in the USA, Germany, and Belgium, and academic-funded in France, Canada, and China. PRS CTs clustered into aesthetics (43%), reconstructive (20%), wound healing (8%), peripheral nerve (6%), tumor excision (5%), craniofacial (5%), perioperative pain (5%), and burns (4%). Industry preferred funding aesthetics, whereas academia and industry co-funded wound healing. Publication rates of completed (24%) and terminated (10%) CTs varied by cluster, with perioperative pain CTs exhibiting higher rates. Industry-funded CTs had lower publication rates (hazard ratio: 0.64, 95% confidence interval: 0.5–0.81) and higher discontinuation (hazard ratio: 1.34, confidence interval: 1.06–1.68) driven by sponsors’ decision to terminate prematurely. Global growth in PRS trialome reflects rising interest in evidence-based plastic surgery. Yet, imbalances in participant age, geography, funding source, and trial design influence likelihood of CT discontinuation and publication. Key research gaps include pediatric CTs, accountability in industry-funded research, and multicenter collaborations with underrepresented regions.

The Characteristics and Influencing Factors of Nonsuicidal Self-Injury of Adolescents With Depressive Disorder in China: A Meta-analysis.

This study is a systematic review of characteristics and influencing factors of nonsuicidal self-injury behavior among adolescents with depressive disorder in China. PubMed, CNKI, WanFang Database, and VIP were searched for studies. Meta-analysis was performed using RevMan 5.1 software. Nineteen studies involving 707 subjects were included in the meta-analysis. Age, gender, only child or not, and residence were included in the analysis, of which age ( I2 = 0%, p = 0.42) and residence ( I2 = 0%, p = 0.84) were analyzed by fixed-effects model; gender ( I2 = 75%, p = 0.003) and only child or not ( I2 = 50%, p = 0.140) were analyzed by random-effects model. The evidence shows that, according to the common self-injury mode and location, the nonsuicidal self-injury behavior of young people with depressive disorder aged 15-18 years is paid attention to and guided, so as to achieve early detection and early diagnosis and treatment, and reduce the occurrence of serious harm.

The Eyelid Angiosarcoma: A Systematic Review of Characteristics and Clinical Course.

A systematic search for eyelid angiosarcoma was performed from inception to December 2020 in Medline, EMBASE, and the Cochrane databases. Forty two eyelid angiosarcoma cases in 32 articles were analyzed. Eyelid angiosarcomas showed an incidence peak in the eighth decade of life, and was reported more frequently in Caucasian males. Eyelid angiosarcomas were associated with a mortality rate of 26.2%, a recurrence rate of 14.3%, and a cure rate of 45.2%. Four years event-free survival (EFS) rate was 36.0%, with median EFS of 36 months. Eyelid angiosarcomas with bilateral involvement or metastasis showed higher mortality and recurrence rates than unilateral eyelid invasion cases. In the prognosis analysis according to treatment modalities, the mortality and recurrence rates were the lowest in patients who underwent surgical excision. The 4-year EFS probability in a group with surgical excision was 60.6%, but in a group without surgical excision it was 30.3%. A total of 45.2% of the cases was misdiagnosed and 21.4% of the cases could not be correctly diagnosed with the first biopsy trial. The prognosis for eyelid angiosarcomas was better than that of angiosarcomas invading the face and scalp. Surgical excision was the most important treatment modality; thus, should be considered as the first treatment of choice.

Immune checkpoint inhibitor-related interstitial lung disease in patients with advanced non-small cell lung cancer: systematic review of characteristics, incidence, risk factors, and management.

BackgroundImmune checkpoint inhibitors (ICIs) are widely used in cancers with or without other treatments. Immune-related adverse events (irAEs) have been reported as side effects of ICIs and involve various organs. Pneumonitis, which is also called ICI-related interstitial lung disease (ILD), is one of the life-threatening adverse events. In this report, we reviewed the safety of ICIs and risk factors for ICI-related ILD in non-small cell lung cancer (NSCLC) patients.MethodsDatabases (The National Center for Biotechnology Information, PubMed, Cochrane Library, Google Scholar, and Embase) were searched for the literature on pulmonary adverse events and immunotherapy following PRISMA guidelines. All studies published in English between January 2016 and June 2021 were included.ResultsOne-hundred twenty-five articles were included at final. Pre-existing ILD as well as asthma and chronic obstructive lung disease (COPD) were associated with high risk for the development of ICI-related ILD, however, it did not affect the prognosis. The treatment of ICI-related ILD is different according to the severity grades, which includes discontinuation of ICI, corticosteroids, and for steroid-refractory ILD, other immunosuppressants. Rechallenging of ICI should be carefully considered in selected patients.DiscussionPatients with pre-existing lung disease and poor lung function need more attention for the development of ICI-related ILD. It is necessary to be aware of clinical manifestation of ICI-related ILD with prompt management.

Etiology and clinical characteristics of pediatric non-neoplastic posterior reversible encephalopathy: systematic review.

Background:Although more commonly seen in adult population, posterior reversible encephalopathy syndrome (PRES) can also be observed in pediatric patients. The etiopathogenesis of pediatric PRES is poorly understood, and the available evidence comes mostly from childhood cancer. Analysis of the sociodemographic and clinical characteristics of the different noncancer-related types can improve the understanding of pediatric PRES.Methods:Systematic review of characteristics and outcome of noncancer pediatric PRES. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in relevant publications. Study protocol was registered (Prospero CRD42020165798).Results:We identified 449 cases of noncancer pediatric PRES from 272 studies, median age 10 (newborn to 17 years), 49.9% girls. The 4 most common groups of conditions were renal 165 (36.7%), hematologic 84 (18.7%), autoimmune 64 (14.3%), and cardiovascular 28 (6.2%) disorders. The 4 most prevalent precipitants identified were hypertensive crisis 119 (26.5%), corticosteroids 56 (12.5%), immunosuppression drugs 44 (9.8%), and biologic drugs 14 (3.1%). Clinical presentations included seizures 100 (22.3%), headaches 22 (4.9%), encephalopathy 17 (3.8%), visual disturbances 6 (1.3%), and focal deficit 3 (0.7%). The distribution of lesions was (n = 380): combined anterior/posterior circulation (40.8%), isolated posterior circulation (24.1%), anterior circulation (6.2%), and deep structures (1.6%). Residual neurological deficits occurred in about 1 out 10 cases.Conclusion:Pediatric PRES differs from the adult in etiology, precipitants, and clinical manifestations. Renal diseases predominate, acute raised blood pressure is less frequent, and cortical deficits are rarer. In addition, the proportion of patients with combined anterior/posterior circulation was higher. Permanent neurological sequels can occur.

Immune checkpoint inhibitor induced lichenoid reactions: A systematic review of characteristics and treatment outcomes

To the Editor: The use of immune checkpoint inhibitors (ICIs) as a method of cancer management has increased due to the efficacy; with the increased use of ICIs, there have been increased reports of immune-related adverse events. Lichenoid reactions (LRs) have been reported as specific cutaneous immune-related adverse events of ICIs.1 LRs are uncommon skin rashes that share many features with idiopathic lichen planus.2 This systematic review aimed to summarize reports of ICI-induced LRs, offending drugs, and treatment outcomes.

Erythema Multiforme-Like Contact Dermatitis: A Systematic Review of Characteristics and Treatment Outcomes.

Erythema Multiforme-Like Contact Dermatitis: A Systematic Review of Characteristics and Treatment Outcomes.

Spinal extradural hemangioblastoma: A systematic review of characteristics and outcomes.

Extradural spinal nerve root hemangioblastoma is a rare entity with very few cases reported in the literature. A comprehensive picture of the treatments and outcomes of the same is thus not available. A systematic search was done according to PRISMA guidelines. Search criteria included terms: spinal extradural hemangioblastoma, extradural hemangioblastoma, and spinal root hemangioblastoma. The parameters considered were treatment, motor, and sensory outcome, association with von-Hippel-Lindau (VHL) syndrome. Twenty-two studies (19 full text articles) were available for the review. A total of 39 cases of extradural spinal nerve root hemangioblastoma have been reported. These cases had a median age of 44 years with male predominance (2:1) and up to 48% occur in the thoracic level, similar to our case. Thirty-six percent of patients were associated with VHL syndrome. Surgical resection was the primary modality of treatment with embolization used in selected cases (20%). They had mean follow-up of 23 (±11) months. The prognosis was better than the intradural counterpart with no motor deficit and sensory deficit in only 9%. Preoperative identification of the extradural nature of this pathology and complete excision at the first surgery offers excellent outcomes compared to intradural lesion. Targeted embolization may be used in cases anticipated with high blood loss.

Sleep difficulties in children with Tourette syndrome and chronic tic disorders: a systematic review of characteristics and associated factors.

Sleep difficulties are common in children and young people with Tourette syndrome and chronic tic disorders (TS/CTD). However, it is unclear whether sleep problems can be considered typical of the TS/CTD phenotype or whether they reflect concomitant factors such as individual patient characteristics (e.g. medication use), underlying neurodevelopmental disorders and/or co-occurring psychiatric symptoms. To help address this question, this review systematically explored types and frequency of sleep problems in children and young people with TS/CTD, while also examining the heterogeneity and methodological quality of studies. Psycinfo, Ovid Medline, Embase, and Web of Science databases were searched using a range of terms relating to tics, sleep and co-occurring psychopathology. Studies were considered that included a sample of children with TS/CTD (n > 5) for whom sleep difficulties were measured. Eighteen studies met criteria for inclusion in the review. Findings supported the high prevalence of sleep difficulties in children with TS/CTD, though estimates of sleep difficulties ranged from 9.7% to 80.4%. Twelve studies reported on other factors affecting sleep in this patient group including tic severity, comorbid psychopathological or neurodevelopmental disorders and medication use. Studies varied in terms of methodology, sample characteristics and research quality, but most concluded that children with TS/CTD experienced high levels of sleep difficulties with children with co-occurring anxiety most at risk. The current review highlights the need for further empirical investigation of sleep in children with TS/CTS, with a view to informing understanding and clinical management.

“How are running shoes assessed? A systematic review of characteristics and measurement tools used to describe running footwear”

ABSTRACTBackground: Many footwear characteristics are argued as risk factors for running related injuries (RRI). Several footwear assessment tools are available; however, their use in studies of RRI is unknown. Objective: This systematic review evaluated the characteristics and methods of assessing footwear in studies of RRI. Design: Five online databases were searched for studies on adult runners, in running style footwear, who experienced running-related pain or injury. The methodological quality of included articles was independently assessed by two raters using a modified Downs and Black checklist. Study and participant characteristics, footwear assessment tools used, and footwear characteristics reported were extracted for qualitative synthesis. Results: Twenty-four articles were included in the review. Low risk of bias was determined for 11 (44%) of the included studies. Twenty-eight different footwear characteristics were grouped into four categories: nomenclature, measurements, qualitative features, and subjective features. Fifteen different methods for assessing the 28 footwear characteristics were reported among the included studies. Only three methods were described previously, as valid and reliable. Conclusion: Differences in assessing footwear may mask the link between footwear characteristics and injury risk. Systematic footwear assessments and nomenclature are needed to evaluate the effects of footwear characteristics on RRI.

91IS THERE A ROLE FOR AN ORTHOGERIATRIC MODEL OF CARE IN THE MANAGEMENT OF VERTEBRAL FRAGILITY FRACTURES IN HOSPITAL

Introduction: Orthogeriatric care has led to improved outcomes in the management of patients admitted to hospital with hip fractures. Such an interprofessional multidisciplinary collaboration ensured that the complex needs of older people with hip fractures are met. This thesis considered the role of an orthogeriatric model of care for patients in hospital with vertebral fragility fractures. To support such a care model, certain conditions had to be met. The number of patients admitted to hospital warrant such a service, these patients have complex care needs, their outcomes poor and that hospital care had to be delivered by healthcare professionals with specific knowledge and skills. Method: A multi-method study was conducted which synthesised findings from a systematic review of characteristics and outcomes of patients admitted to hospital with vertebral fragility fractures, an observational study of patients requiring hospital treatment, and a modified-Delphi consensus study to determine how these patients should be managed in hospital. Results: The annual incidence of hospital admission for the UK was estimated at 6 per 10,000/year in patients over the age of 50 years. Those admitted were in severe pain, especially during mobilisation which restricted their daily living. These patients were older, mostly in their ninth decade of life, reported a high prevalence of frailty, multimorbidity and cognitive impairment. In addition to treating the acute fracture, their care in hospital involved managing their concomitant medical diagnosis, falls risk, bone health and rehabilitation requirements. This required input from healthcare professionals with medical, surgical, nursing and therapy background. After an average of 2 weeks in hospital, up to half did not return to their usual residence but required an increase in care, either temporary or permanent. One-third at 6 months after hospital discharge remained in pain. Many do not return to their pre-fracture level of function. One-year mortality can be as high as 27%. Worse outcomes were associated with increasing age and comorbidities. Clinicians with responsibility for managing patients with vertebral fragility fractures in hospital agreed that a coordinated multidisciplinary approach was required. Discussion: Those admitted to hospital with vertebral fragility fractures are vulnerable to the adverse effects of their fracture and hospitalisation. A systematic organised service, i.e. orthogeriatric care for these patients can address their care needs. Conclusion: There is a role for an orthogeriatric model of care for patients admitted to hospital with vertebral fragility fractures. The next phase is to evaluate the feasibility in delivering such a service and gauge the resources required for it.

Pharmacoeconomics Evaluations of Oral Anticancer Agents: Systematic Review of Characteristics, Methodological Trends, and Reporting Quality

To review literature characteristics, describe methodological trends, and assess the reporting quality of the economic evaluations of oral anticancer drugs (OACDs). The review included comparative economic evaluations of OACDs. The search was conducted via PubMed, Embase, EconLit, and Economic Evaluation Database, and studies till December 2017 were included. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, literature inclusion and data extraction were performed in duplicate by separate investigators. Outcome measures were literature characteristics, gaps and methodological trends, and reporting quality using the Consolidated Health Economic Evaluation Reporting Standards checklist. Data were summarized on the basis of methodological themes of interest. Descriptive statistics and tabulations were used for result presentation. Out of 241 found articles, 21 were included. There is a recent increasing interest in the economics of OACDs, whereby the cost per quality-adjusted life-year, via cost-utility analysis, is the most used for decision making. Most of the studies were from the payer perspective, and the primary sources of data were clinical trials, expert panels, and medical charts. The dominance status (higher effect, lower cost) was a commonly reported outcome. Decision-analytic modeling was used in most of the studies, mostly including Markov modeling. Studies were highly heterogeneous in methodological aspects, and the included studies did not meet most of the reporting quality criteria. High heterogeneity in methods in studies may limit the robustness and transferability of results, potentially misleading decision makers toward wrong decisions on OACDs. The transferability and generalizability of results are further limited by a "less than ideal" adherence to current reporting standards.

Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications

PurposePosttraumatic arthritis (PTA) may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty (THA) in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. MethodsPubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords “acetabular”, “fracture”, “arthroplasty”, and “post traumatic arthritis” published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies. ResultsWith 1830 studies were screened and data from 10 studies with 448 patients were included in this review. The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27–74 months. Mean follow-up times ranged from 4 to 20 years. The mean Harris hip scores (HHS) improved from 41.5 pre-operatively, to 87.6 post-operatively. The most prevalent postoperative complications were heterotopic ossification (28%–63%), implant loosening (1%–24%), and infection (0%–16%). The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%. ConclusionDespite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture (including soft tissue scarring, existing hardware, and acetabular bone loss) and the relatively high complication rates, THA in patients with PTA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients.

The Use of Traditional Media for Public Communication about Medicines: A Systematic Review of Characteristics and Outcomes

ABSTRACTA systematic review was conducted to identify, appraise, and synthesize data from original research investigating the use of traditional media for public communication about medicines. Databases were searched for studies conducting quantitative or qualitative analyses between the years 2007 and 2017. Data extraction and assessment of the quality of the resulting studies was conducted by one reviewer and checked for accuracy by a second reviewer. A total of 57 studies met the inclusion criteria. Studies were grouped as follows: “newspapers and other print media” (n = 42), “television” (n = 9), and “radio and a combination of media” (n = 6). Content analysis (n = 34) was the most frequent research design, followed by surveys or interviews (n = 14) and randomized controlled trials (RCTs) (n = 9). Advertising, public awareness, and health administration were the most common themes, and the medicines most analyzed were vaccines, particularly human papillomavirus (HPV) and influenza. Studies conducted in the United States were the most frequent, followed by other high-income countries such as Canada and the United Kingdom. The lack of consistent studies of the effects of media campaigns stresses the importance of the use of standardized research methodologies. Theoretical and practical implications of the findings for further research are discussed.

Phaseolus vulgaris lectins: A systematic review of characteristics and health implications

ABSTRACTLegume lectins are carbohydrate-binding proteins of non-immune origin. Significant amounts of lectins have been found in Phaseolus vulgaris beans as far back as in the last century; however, many questions about their potential biological roles still remain obscure. Studies have shown that lectins are anti-nutritional factors that can cause intestinal disorders. Owing to their ability to act as toxic allergens and hemagglutinins, the Phaseolus vulgaris lectins are of grave concern for human health and safety. Nonetheless, their potential beneficial health effects, such as anti-cancer, anti-human immunodeficiency virus (anti-HIV), anti-microbial infection, preventing mucosal atrophy, reducing type 2 diabetes and obesity, promoting nutrients absorption and targeting drugs, are of immense interest. The significance of Phaseolus vulgaris lectins in biological researches and the potential biomedical applications have placed tremendous emphasis on the development of purification strategies to obtain the protein in pure and stable forms. These purification strategies entail considerations such as effects of proteolysis, heating, gamma radiation, and high-hydrostatic-pressure that can have crucial outcomes in either eliminating or improving bioactivities of the lectins. Thus, up-to-date research findings of Phaseolus vulgaris lectins on different aspects such as anti-nutritional and health impacts, purification strategies and novel processing trends, are systematically reviewed.

Hepatoblastoma in an 11-year-old

Rationale:Hepatoblastoma is a rare malignancy. Approximately 100 cases are diagnosed yearly in the United States. The highest incidence occurs in infants and in children younger than 5 years. Cases involving patients older than 5 years are very rare. We describe the case of a patient who was diagnosed with hepatoblastoma at an atypical age of presentation for this type of malignancy. We also performed Ovid MEDLINE search for hepatoblastoma and epidemiology reports occurring in children between the ages of 5 and 18 years. In this article we review the epidemiology and summarize case reports published between 1997 and 2012 of patients with hepatoblastoma, who were older than 5 years.Patient concerns and diagnosis:Our patient is an 11 year old boy with stage IV hepatoblastoma with lung and omental metastases at diagnosis.Interventions:The patient received 7 cycles of chemotherapy following the treatment plan of COG protocol AHEP 0731, off study. He also had tumor resection and omentectomy and achieved complete remission.Outcomes:He later had disease recurrence and after undergoing treatment with different modalities, ultimately died of his disease. Review of SEER program data shows that the incidence of hepatoblastoma in children above the age of 5 years is too infrequent to be calculated. Literature review revealed 13 cases of patients diagnosed at age older than 5 years. Most cases were published due to unusual associations and/or complications. There are no obvious unifying characteristics for these cases, although there may be a slight male preponderance and many patients in this selected series presented with elevated Alpha-fetoprotein.Lessons:The reported case is rare, given the very low incidence of hepatoblastoma outside of infancy. A systematic review of characteristics and outcomes for patients older than 5 years who are enrolled in cooperative group hepatoblastoma trials may reveal important information about the epidemiology and tumor biology in this rare patient population.

Outcomes of hepatitis C screening programs targeted at risk groups hidden in the general population: a systematic review.

BackgroundEffective screening programs are urgently needed to provide undiagnosed hepatitis C virus (HCV)-infected individuals with therapy. This systematic review of characteristics and outcomes of screening programs for HCV focuses on strategies to identify HCV risk groups hidden in the general population.MethodsWe conducted a comprehensive search of MEDLINE and EMBASE databases for articles published between 1991–2010, including studies that screened the general population using either a newly developed (nonintegrated) screening program or one integrated in existing health care facilities. Look-back studies, prevalence studies, and programs targeting high-risk groups in care (e.g., current drug users) were excluded.ResultsAfter reviewing 7052 studies, we identified 67 screening programs: 24 nonintegrated; 41 programs integrated in a variety of health care facilities (e.g., general practitioner); and 2 programs with both integrated and nonintegrated strategies. Together, these programs identified approximately 25,700 HCV-infected individuals. In general, higher HCV prevalence was found in programs in countries with intermediate to high HCV prevalence, in psychiatric clinics, and in programs that used a prescreening selection based on HCV risk factors. Only 6 programs used a comparison group for evaluation purposes, and 1 program used theory about effective promotion for screening. Comparison of the programs and their effectiveness was hampered by lack of reported data on program characteristics, clinical follow-up, and type of diagnostic test.ConclusionsA prescreening selection based on risk factors can increase the efficiency of screening in low-prevalence populations, and we need programs with comparison groups to evaluate effectiveness. Also, program characteristics such as type of diagnostic test, screening uptake, and clinical outcomes should be reported systematically.

988 OUTCOMES OF HEPATITIS C SCREENING PROGRAMS TARGETED AT RISK GROUPS HIDDEN IN THE GENERAL POPULATION: A SYSTEMATIC REVIEW

Background: Effective screening programs are urgently needed to provide undiagnosed hepatitis C virus (HCV)-infected individuals with therapy. This systematic review of characteristics and outcomes of screening programs for HCV focuses on strategies to identify HCV risk groups hidden in the general population. Methods: We conducted a comprehensive search of MEDLINE and EMBASE databases for articles published between 1991–2010, including studies that screened the general population using either a newly developed (nonintegrated) screening program or one integrated in existing health care facilities. Look-back studies, prevalence studies, and programs targeting high-risk groups in care (e.g., current drug users) were excluded. Results: After reviewing 7052 studies, we identified 67 screening programs: 24 nonintegrated; 41 programs integrated in a variety of health care facilities (e.g., general practitioner); and 2 programs with both integrated and nonintegrated strategies. Together, these programs identified approximately 25,700 HCV-infected individuals. In general, higher HCV prevalence was found in programs in countries with intermediate to high HCV prevalence, in psychiatric clinics, and in programs that used a prescreening selection based on HCV risk factors. Only 6 programs used a comparison group for evaluation purposes, and 1 program used theory about effective promotion for screening. Comparison of the programs and their effectiveness was hampered by lack of reported data on program characteristics, clinical follow-up, and type of diagnostic test. Conclusions: A prescreening selection based on risk factors can increase the efficiency of screening in low-prevalence populations, and we need programs with comparison groups to evaluate effectiveness. Also, program characteristics such as type of diagnostic test, screening uptake, and clinical outcomes should be reported systematically.