Systematic Review Of Effectiveness Research Articles

Recommendations on self-management interventions for adults living with obesity: COMPAR-EU project.

Self-management interventions (SMIs) may improve disease management in adults living with obesity. We formulated evidence-based recommendations for SMIs within the context of the COMPAR-EU project. The multidisciplinary panel selected critical outcomes based on the COMPAR-EU core outcome set and established decision thresholds for each outcome. Recommendations were informed by systematic reviews of effects, cost-effectiveness, and a contextual assessment. To assess the certainty of the evidence and formulate the recommendations, we used the GRADE approach guidance. Overall, SMIs were deemed to have a small impact, but the absence of harmful effects and potential cumulative benefits indicated a favourable balance of effects, despite low certainty. SMIs showed variations in structure, intensity, and resource utilisation, but overall are likely to be cost-effective. Adapting SMIs to local contexts would enhance equity, acceptability, and feasibility, considering patients' values, and availability of resources and teamwork. Consequently, the panel made conditional recommendations favouring SMIs over usual care. The rigorous and explicit recommendations demonstrated the effectiveness of SMIs for adults living with obesity. However, the gaps in the literature influenced the panel to make only conditional recommendations in favour of SMIs. Further research is needed to strengthen the evidence base and improve recommendations' certainty and applicability.

Mechanical marvels: robots in carotid artery stenting - a systematic review of effectiveness in neuroendovascular interventions

Aim: Carotid artery disease, or carotid stenosis, is a critical medical condition carrying the risk of stroke and fatality. The underlying pathology involves the accumulation of atheromatous plaques, leading to luminal constriction and disrupted blood flow. Endovascular interventions, such as carotid artery stenting (CAS), aim to restore vessel patency. Robotic assistance in CAS surgeries is rapidly evolving globally, offering precision and fatigue-free capabilities. Despite growing interest, a dedicated systematic review on robotic applications in CAS is notably absent. Methods: Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search strategy involving five databases. Data extraction encompassed study origin, patient demographics, procedural details, procedure times, complications, fluoroscopy, and radiation parameters. Results: Over 199 articles were identified from five databases. Seven studies meeting inclusion criteria were analyzed. The predominant robotic system, CorPath GRX, demonstrated advantages such as remote operation, precision, and compatibility with various catheter sizes. Magellan Robotic System, employed in one study, showcased remote-controlled capabilities. These studies involved a total of 44 patients undergoing carotid artery stenosis procedures with robotic assistance. Reported complications included access site conversion, Angio-Seal device failure, and residual stenosis. Mean operation time varied from 34 to 85 min. Conclusions: The integration of robotic assistance in carotid interventions, as demonstrated by the CorPath GRX and Magellan Robotic System, holds significant promise in improving the precision and safety of CAS procedures. However, the limited number of studies, the high risk of bias, and the need for further research and standardization highlight the evolving nature of this technology.

CO48 A Systematic Review of Effectiveness and Safety of Acupuncture on Suicidal Behavior

CO48 A Systematic Review of Effectiveness and Safety of Acupuncture on Suicidal Behavior

Interventions to improve oral health and related health behaviours of substance use, smoking, and diet in people with severe and multiple disadvantage: a systematic review of effectiveness and cost-effectiveness

BackgroundHomelessness overlapping with substance use and offending is described as severe and multiple disadvantage (SMD). People experiencing SMD have poor oral health along with high levels of related behaviours such as substance use, smoking, and poor diet. Existing evidence largely describes the prevalence of oral health problems, substance use, and smoking in SMD groups. Little is known about interventions that can address these conditions in SMD groups. We aimed to review the effectiveness and cost-effectiveness of interventions on oral health and related health behaviours in adults experiencing SMD. MethodsFor this systematic review, we searched bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, EBSCO, Scopus) and grey literature for papers published from inception to February 2023. Two researchers independently reviewed the searches. Randomised controlled trials (RCTs), comparative studies and economic evaluations were included. Risk of bias was assessed. Population included adults experiencing SMD (including homelessness and substance use or repeat offending). Outcomes included oral health, and related behaviours (substance use, smoking, poor diet). Results were narratively synthesised. This review was registered with PROSPERO, CRD42020202416. FindingsThe review included 38 studies (published between 1991 and 2023), with 34 reporting effectiveness. These studies comprised of 23 RCTs and 11 quasi-experimental studies conducted in the USA (25 studies), Canada (seven studies), France (one study), and Spain (one study). The interventions involving multiple components, such as housing services with substance use and mental health support, effectively reduced substance use in SMD groups; these were mostly individual-level interventions. However, these studies had short follow-up periods and high attrition rates. Only one study addressed oral health outcomes, none focused on diet, and three RCTs covered smoking, with one intervention showing smoking abstinence at 4 weeks. Some limited evidence suggested cost-effectiveness of substance use interventions. InterpretationThis review found that integrating services such as housing with other health-care services together could be effective in improving health behaviours, especially substance use among SMD groups. More evidence is needed specifically on oral health, smoking, and diet-related interventions. The generalisability of findings of this review is limited to high-income countries and shorter-term outcomes. FundingNational Institute for Health and Care Research (NIHR) Policy Research Programme.

Educational strategies used in master's and doctoral nursing education: A scoping review.

Advanced practice nurses and future nursing researchers must be adequately educated with the best available evidence. However, we know little about educational strategies and their characteristics used explicitly to educate advanced practice nurses and future researchers. A scoping review was used to map the latest educational strategies used in master's and doctoral nursing education between 2011 and 2021. Components of educational strategies were extracted based on the Guideline for Reporting Evidence-Based Practice Educational Interventions and Teaching and the Saskatchewan Education Department Framework of Professional Practice. The New World Kirkpatrick Model was used to categorize the associated learning outcomes. A narrative description approach was used to synthesize the findings. A total of 56 studies were included. Several information was missing regarding the theoretical foundations of the educational strategies. A total of 158 educational strategies were identified. Individual work (e.g., homework) was the most popular educational strategy. Most studies assessed learning outcomes related to reactions (e.g., satisfaction) or learning (e.g., knowledge). More studies should be done using interactive instruction or multimodal approaches, while the authors should better describe intervention components. A systematic review of effectiveness needs to be conducted to evaluate the best educational strategies in the master's and doctoral nursing education.

(058) Does Ecstasy Have Treatment Potential in Female Sexual Dysfunction? A Systematic Review of Effects on the Female Sexual Response Cycle

Abstract Introduction Female sexual dysfunction (FSD) is a highly prevalent and distressing condition, yet limited treatment modalities have been established and incorporated into clinical practice to address this condition. 3,4-Methylenedioxy-methamphetamine (MDMA, ‘Ecstasy’ or ‘Molly’) is a psychostimulant affecting central serotonin, dopamine, and norepinephrine neurotransmission. These same neurotransmitters play important roles in sexual function which suggests that MDMA has potential to be utilized as a novel treatment strategy for FSD. Objective The purpose of this systematic review is to evaluate effects of MDMA on different domains of female sexual response cycle. Methods We conducted a systematic review on the effects of MDMA on the various domains of the female sexual response cycle. PubMed, MEDLINE, and EMBASE were queried, and results were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search terms, including “MDMA” or “ecstasy” in combination with “desire,” “arousal”, “lubrication”, “orgasm”, “pleasure”, “libido,” were utilized. Inclusion criteria for this review were: MDMA was used by study subjects, sexual outcomes in at least one domain of female sexual cycle were described and measured, and the manuscript was written in English between January 2000 to June 2022. Case reports and studies that did not address conditions of interest were excluded from analysis. Results We identified a total of 175 studies. Of these, six studies including 155 women met our inclusion and exclusion criteria. Four of the six studies, including one randomized control study, reported increased sexual desire with MDMA use. Arousal and lubrication were improved in three of four studies but were not affected based on one randomized control study. Orgasm after using MDMA was delayed or difficult to reach, but more intense and pleasurable if achieved. Conclusions This systematic review demonstrates the need for further investigation of the effect of MDMA on different domains of the female sexual response cycle. While effect on orgasm and desire is more certain based on the available data, there is conflicting evidence about MDMA enhancing sexual arousal. MDMA is illicit and unregulated recreational drug, our findings should be interpreted with caution. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Abbvie, Coloplast, Sprout Pharmaceuticals.

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis.

Exploring the effect of case management in homelessness per components: A systematic review of effectiveness and implementation, with meta-analysis and thematic synthesis.

Investigating the role of friendship interventions on the mental health outcomes of adolescents: a scoping review of range and a systematic review of effectiveness

Investigating the role of friendship interventions on the mental health outcomes of adolescents: a scoping review of range and a systematic review of effectiveness

Review: Crisis responses for children and young people - a systematic review of effectiveness, experiences and service organisation (CAMH-Crisis).

In England, one in six children aged 5-19 has a probable diagnosable mental health disorder. This is a major public health problem, with multiple agencies adopting varying approaches to care delivery for children and young people (CYP) in crisis. To examine the organisation of crisis services across education, health, social care and voluntary sectors; the experiences and perceptions of CYP, families and staff; the effectiveness of current approaches to care and the goals of crisis intervention. A systematic review of all relevant English language evidence regarding the provision and receipt of crisis support for CYP aged 5-25 (PROSPERO-CRD42019160134). Seventeen databases were searched from 1995 to 2021 and relevant UK-only grey literature was identified. Critical appraisal was conducted using appropriate design specific appraisal tools. A narrative approach to synthesis was conducted. In total, 138 reports (48 reports covering 42 primary research studies; 36 reports covering 39 descriptive accounts of the organisation services and 54 UK-only grey literature reports) were included. The evidence suggests that crisis services were organised as follows: triage/assessment-only, digitally mediated support approaches, and intervention approaches and models. When looking at experiences of crisis care, four themes were identified: (a) barriers and facilitators to seeking and accessing appropriate support; (b) what children and young people want from crisis services; (c) children's, young people's and families' experiences of crisis services; and (d) service provision. In determining effectiveness, the findings are summarised by type of service and were generated from single heterogenous studies. The goals of crisis services were identified. Despite a lack of high-quality international studies, findings suggest that support prior to reaching crisis point is important. From this work, various aspects of crisis care have been identified that can be incorporated into existing services across education, health, social care and the voluntary sector.

Quantification of blood loss for the diagnosis of postpartum hemorrhage: a systematic review and meta-analysis.

to compare the effectiveness of different diagnostic methods to estimate postpartum blood volume loss. a systematic review of effectiveness according to PRISMA and JBI Protocol. Searches in PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science and CINAHL, with descriptor "Postpartum Hemorrhage" associated with keyword "Quantification of Blood Loss". Tabulated extracted data, presented in metasynthesis and meta-analysis was applied to quantitative data. To assess risk of bias, JBI Appraisal Tools were applied. fourteen studies were included, published between 2006 and 2021. Quantification of loss by any method was superior to visual estimation and is highly recommended, however the studies' high heterogeneity did not allow estimating this association. the studies' high heterogeneity, with a probable margin of error given the uncontrolled factors, indicates the need for further studies, however quantification proved to be effective in relation to visual estimate. PROSPERO registration CRD 42021234486.

Women Infertility: A Systematic Review of Effects and Causes

Women Infertility: A Systematic Review of Effects and Causes

Hyperbaric oxygen in children with cerebral palsy: A systematic review of effectiveness and safety

To report current evidence regarding the effectiveness of hyperbaric oxygen therapy (HBOT) on the impairments presented by children with cerebral palsy (CP), and its safety. PUBMED, The Cochrane Library, Google Scholar, and the Undersea and Hyperbaric Medical Society database were searched by two reviewers. Methodological quality was graded independently by 2 reviewers using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the modified Downs and Black (m-DB) evaluation tool for non RCTs. A meta-analysis was performed where applicable for RCTs. Five RCTs were identified. Four had a high level of evidence. Seven other studies were observational studies of low quality. All RCTs used 100% O2, 1.5 to 1.75 ATA, as the treatment intervention. Pressurized air was the control intervention in 3 RCTs, and physical therapy in 2. In all but one RCTs, similar improvements were observed regarding motor and/or cognitive functions, in the HBOT and control groups. Adverse events were mostly of mild severity, the most common being middle ear barotrauma (up to 50% of children). There is high-level evidence that HBOT is ineffective in improving motor and cognitive functions, in children with CP. There is moderate-level evidence that HBOT is associated with a higher rate of adverse events than pressurized air in children.

Histone deacetylase inhibitor use as a radiosensitizer in solid organ malignancies: a systematic review protocol.

The objective of this review is to evaluate the efficacy and adverse effects of histone deacetylase inhibitors (HDACi) in combination with radiotherapy for the treatment of solid organ malignancies. Histone deacetylase inhibitors are a diverse class of drugs that have shown promise as novel anti-cancer therapeutics via epigenetic modification and radiosensitization of neoplastic cells. The aim of HDACi in combination with radiotherapy is to reduce radiation dosage requirements, improve radiotherapy efficacy, and reduce treatment side effects. This review will consider studies utilizing HDACi in conjunction with radiotherapy in adult patients with solid organ malignancy. Sources to be included in this review include experimental and quasi-experimental study designs, analytical studies, and descriptive observational studies. A systematic review of effectiveness will be conducted in accordance with JBI methodology. A detailed search will be conducted via MEDLINE (Ovid), Embase (Ovid), and Scopus. A search of the Cochrane Central Register of Controlled Trials, the International Clinical Trials Registry Platform, and ClinicalTrials.gov will also be performed for relevant trials. Inclusion and exclusion criteria will be utilized to select studies, and papers selected for retrieval will be assessed for methodological validity using the JBI critical appraisal instruments. Evidence will be extracted from eligible studies and summarized using quantitative methods, where possible, including meta-analysis and assessment of heterogeneity. Where statistical pooling is not possible, the findings will be presented in diagrammatic or tabular form accompanied by a narrative summary. PROSPERO CRD42021293005.

Restrictions and their reporting in systematic reviews of effectiveness: an observational study

BackgroundRestrictions in systematic reviews (SRs) can lead to bias and may affect conclusions. Therefore, it is important to report whether and which restrictions were used. This study aims to examine the use of restrictions regarding language, publication period, and study type, as well as the transparency of reporting in SRs of effectiveness.MethodsA retrospective observational study was conducted with a random sample of 535 SRs of effectiveness indexed in PubMed between 2000 and 2019. The use of restrictions and their reporting were analysed using descriptive statistics.ResultsOf the total 535 SRs included, four out of every ten (41.3%) lacked information on at least one of the three restrictions considered (language, publication period, or study type). Overall, 14.6% of SRs did not provide information on restrictions regarding publication period, 19.1% regarding study type, and 18.3% regarding language. Of all included SRs, language was restricted in 46.4%, and in more than half of the SRs with restricted language (130/248), it was unclear whether the restriction was applied during either the search or the screening process, or both. The restrictions were justified for publication period in 22.2% of the respective SRs (33/149), study type in 6.5% (28/433), and language in 3.2% (8/248). Differences in reporting were found between countries as well as between Cochrane and non-Cochrane reviews.ConclusionsThis study suggests that there is a lack of transparency in reporting on restrictions in SRs. Authors as well as editors and reviewers should be encouraged to improve the reporting and justification of restrictions to increase the transparency of SRs.

Systematic review of effectiveness and quality assessment of patient education materials and decision aids for breathlessness

BackgroundAround 10% of adults suffer from clinically significant breathlessness. High quality and actionable patient education materials (PEMs) and patient decision aids (PDAs) have an important role for shared decision making and patient self-management.ObjectiveTo systematically assess the effectiveness of patient education materials (PEMs) and patient decision aids (PDAs) on clinical outcomes. Secondly, to assess the quality of PEMs and PDAs for breathlessness that are accessible online.MethodsA systematic review of PEM or PDA intervention for breathlessness published between 1 January 2010 and November 2020 was conducted. An environmental scan and quality assessment of publicly available PEMs and PDAs was also conducted.ResultsOut of 2985 records, five studies were eligible for inclusion in this systematic review. Results of two randomised controlled trials suggest potential effectiveness of PEMs to improve patient reported outcomes and reduce healthcare utilization. In the environmental scan, 88 materials were included. Minimum reading age for most was high (Grade 10) and PEMs scored an average of 87% for understandability and 67% for actionability. Based on the DISCERN tool only 10 were classified as high quality.ConclusionThere is a paucity of evidence on the effectiveness of PEMs and PDAs for improvement in breathlessness. There is a need to develop higher quality PEMs for breathlessness.

Content, Structure and Delivery Characteristics of Yoga Interventions for Managing Rheumatoid Arthritis: A Systematic Review Protocol.

The global burden of rheumatoid arthritis among adults is rising. Yoga might be a potential solution for managing rheumatoid arthritis. This systematic review aims to synthesise the content, structure and delivery characteristics of effective yoga interventions for managing rheumatoid arthritis. The JBI methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed. PRISMA for systematic review protocols (PRISMA-P) was used to write the protocol. Randomised controlled trials assessing the effectiveness of yoga interventions for managing rheumatoid arthritis in adults will be included in this review. We aim to search the following databases to find published and unpublished studies: ABIM, AMED, AYUSH Research Portal, CAM-QUEST, CINAHL, CENTRAL, EMBASE, MEDLINE, PeDro, PsycInfo, SPORTDiscus, TRIP, Web of Science, DART-Europe-e-theses portal, EthOS, OpenGrey and ProQuest Dissertations and Theses. No date or language restrictions will be applied. A narrative synthesis will be conducted. Meta-regression will be conducted to explore the statistical evidence for which components (content, structure and delivery characteristics) of yoga interventions are effective.

Content, Structure and Delivery Characteristics of Yoga Interventions for the Management of Osteoarthritis: A Systematic Review Protocol.

The global burden of osteoarthritis among adults is rising. Yoga might be a potential solution for the management of osteoarthritis. This systematic review aims to synthesise the content, structure and delivery characteristics of effective yoga interventions for the management of osteoarthritis. The JBI methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed. Randomised controlled trials (RCTs) assessing the effectiveness of yoga interventions for the management of osteoarthritis in adults will be included in this review. We aim to search the following databases to find published and unpublished studies: MEDLINE, EMBASE, CINAHL, PsycInfo, SPORTDiscus, AMED, Web of Science, CENTRAL, TRIP, AYUSH Research Portal, ABIM, CAM-QUEST, PeDro, OpenGrey, EthOS, ProQuest Dissertations and Theses and DART-Europe-e-theses portal. No date or language restrictions will be applied. A narrative synthesis will be conducted with the help of tables. A meta-regression will be conducted to explore the statistical evidence for which the components (content, structure and delivery characteristics) of yoga interventions are effective.

Medical Gas Therapy for Tissue, Organ, and CNS Protection: A Systematic Review of Effects, Mechanisms, and Challenges (Adv. Sci. 13/2022)

Medical Gas Therapy The frontispiece exhibits an artistic view of the history (≈1550s BC–2020s AD) for medical gas therapy development. In article number 2104136 by Ross D. Zafonte, Yang D. Teng, and co-workers, the cytoprotection mechanisms, data qualities, and challenges of gas agents are systematically reviewed. Whereas gas molecules protected cells in safe dosages, validating their therapeutic targets remained an urgent demand. Review and image design: Y.D. Teng. Image artwork: R. Dennison and Y.D. Teng.

P289 The effectiveness of interventions to reduce psychological distress in patients with autoimmune rheumatic conditions: a systematic review of effectiveness

Abstract Background/Aims Autoimmune rheumatic conditions are multisystem chronic disorders associated with increased psychological distress. Consequences include poor medication adherence and high levels of disease activity. Psychological interventions may reduce distress and change health behaviours. We aimed to determine the effectiveness of interventions for psychological distress in patients with autoimmune rheumatic conditions. Methods This was a systematic review of effectiveness which included randomised controlled trials of psychological interventions in adults with autoimmune rheumatic conditions. We searched MEDLINE, BNI, CINAHL, EMBASE, EMCARE, PsycINFO, NICE Evidence and The Cochrane Library. Two reviewers screened titles and abstracts and assessed the methodological quality of the included studies using Cochrane Risk of Bias 2 tool. Data were extracted by one reviewer and checked by a second. In each study, the effectiveness data were determined by extracting the reported means (and standard deviation) for each group and calculating the standardised mean differences using RevMan 5.4 software (The Cochrane Collaboration, 2020). The data on primary outcomes (anxiety and depression) are reported here. Results The search identified 96 studies. The process of screening and assessing for eligibility resulted in 20 studies for inclusion. Of these, one study had an overall low risk of bias and 19 had ‘some concerns’, mainly due to inadequate blinding and no information on pre-specified analysis plan. Only eight studies reported the effects on anxiety and 10 studies reported on depression. These studies included 919 patients in total. Most interventions were based on cognitive behavioural therapy and the context of delivery ranged from face-to-face individualised treatment to online group therapy. They often included education on topics such as stress and fatigue. Interventions often trained participants to develop skills in relaxation, problem-solving, and thought reframing. Goal setting and action planning were common to help participants make behaviour changes and apply their learning. Table 1 summarises disease group, type of intervention, comparator, outcome measure, and effects. Conclusion Conclusion: Most interventions were effective in reducing anxiety and depression in autoimmune rheumatic conditions. However, given the clinical heterogeneity and ‘some concerns’ about the included quality of studies, more work is needed to understand the mechanisms of the intervention effectiveness. Disclosure J. Hulley-Mills: None. C. Sliverthorne: None. B. Jones: None. J. Hooper: None. J. Robson: None. E. Dures: None. J. Daniels: None. M. Thompson: None. M. Ndosi: None.

Medical Gas Therapy for Tissue, Organ, and CNS Protection: A Systematic Review of Effects, Mechanisms, and Challenges.

Gaseous molecules have been increasingly explored for therapeutic development. Here, following an analytical background introduction, a systematic review of medical gas research is presented, focusing on tissue protections, mechanisms, data tangibility, and translational challenges. The pharmacological efficacies of carbon monoxide (CO) and xenon (Xe) are further examined with emphasis on intracellular messengers associated with cytoprotection and functional improvement for the CNS, heart, retina, liver, kidneys, lungs, etc. Overall, the outcome supports the hypothesis that readily deliverable “biological gas” (CO, H2, H2S, NO, O2, O3, and N2O) or “noble gas” (He, Ar, and Xe) treatment may preserve cells against common pathologies by regulating oxidative, inflammatory, apoptotic, survival, and/or repair processes. Specifically, CO, in safe dosages, elicits neurorestoration via igniting sGC/cGMP/MAPK signaling and crosstalk between HO‐CO, HIF‐1α/VEGF, and NOS pathways. Xe rescues neurons through NMDA antagonism and PI3K/Akt/HIF‐1α/ERK activation. Primary findings also reveal that the need to utilize cutting‐edge molecular and genetic tactics to validate mechanistic targets and optimize outcome consistency remains urgent; the number of neurotherapeutic investigations is limited, without published results from large in vivo models. Lastly, the broad‐spectrum, concurrent multimodal homeostatic actions of medical gases may represent a novel pharmaceutical approach to treating critical organ failure and neurotrauma.