Systematic Review Of Effectiveness Research Articles

Mindfulness Meditation–Based Interventions in Parents of Autistic Children: a Systematic Review of Effects on Children

Mindfulness Meditation–Based Interventions in Parents of Autistic Children: a Systematic Review of Effects on Children

Rapid health technology assessment to inform policy: a case study with respiratory syncytial virus

Abstract Background Respiratory syncytial virus (RSV) can cause severe acute respiratory tract infection in infants and older adults. However, until recently, no immunisation interventions were available to reduce the burden of RSV disease in the general population. New health technologies have now been authorised in Europe for infants (a long-acting monoclonal antibody (nirsevimab) and a maternal vaccine (RSVpreF)), and two vaccines for adults aged ≥60 years (RSVPreF3 and RSVpreF). A rapid health technology assessment (HTA) was requested by the Irish Department of Health to support an interim decision on RSV immunisation. Methods The rapid HTA commenced in January 2024, and comprised description of technology, a summary of international practice, national and international epidemiology and burden of disease, and a costing analysis. The summary of international practice (including underpinning evidence) was undertaken rather than a systematic review of effectiveness and safety due to the rapidly changing evidence base and short timeline within which information was required. Results While new recommendations regarding immunisation against RSV are emerging internationally in response to recently authorised technologies, implementation and funding strategies are not currently widespread. Compared with a full HTA, a rapid HTA enabled an efficient and flexible approach to producing a high quality evidence synthesis to inform a temporary policy decision, taking approximately 6 months to complete rather than 12 months or longer. A full HTA is planned to inform long-term decision-making on this topic, but would not have been feasible to inform an interim decision. Conclusions This rapid HTA will inform a temporary decision on immunisation policy for a single RSV season in Ireland. Conducting a rapid HTA prior to a full HTA has enabled timely decision-making, with implications for Ireland’s national healthcare system and people at risk of severe RSV-related disease. Key messages • Innovations in immunisation against RSV are leading to changes in policy across Europe. • Rapid HTA can support timely, evidence-based public health decision-making in a fast-evolving field.

The revised JBI critical appraisal tool for the assessment of risk of bias for cohort studies.

Cohort studies are a robust analytical observational study design that explore the difference between two different cohorts on an outcome, differentiated by their exposure status. Despite being observational in nature, they are often included in systematic reviews of effectiveness, particularly when randomized controlled trials are limited or not feasible. Like all studies included in a systematic review, cohort studies must undergo a critical appraisal process to assess the extent to which a study has considered potential bias in its design, conduct, or analysis. Critical appraisal tools facilitate this evaluation. This paper introduces the revised critical appraisal tool for cohort studies, completed by the JBI Effectiveness Methodology Group (EMG), who are currently revising the suite of JBI critical appraisal tools for quantitative study designs. The revised tool responds to updates in methodological guidance from the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group and reporting guidance from PRISMA 2020, providing a robust framework for evaluating risk of bias in a cohort study. Transparent and rigorous assessment using this tool will assist reviewers in understanding the validity and relevance of the results and conclusions drawn from a systematic review that includes cohort studies. This may contribute to better evidence-based decision-making in health care. This paper discusses the key changes made to the tool, justifications for these changes, and provides practical guidance on how this tool should be interpreted and applied by systematic reviewers.

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.

Robot-Assisted Eye Surgery: A Systematic Review of Effectiveness, Safety, and Practicality in Clinical Settings.

Surgical innovation in ophthalmology is impeded by the physiological limits of human motion, and robotic assistance may facilitate an expansion of the surgical repertoire. We conducted a systematic review to identify ophthalmic procedures in which robotic systems have been trialled, evaluate their performance, and explore future directions for research and development of robotic techniques. The Cochrane Library, Embase, MEDLINE, Scopus, and Web of Science were searched. Screening adhered to five criteria: (1) English language; (2) primary research article; (3) human patients; (4) ophthalmological surgery; and (5) robot-assisted surgery. Quality assessment was conducted with Joanna Briggs Institute Tools for Critical Appraisal. The study protocol was registered prospectively (PROSPERO ID CRD42023449793). Twelve studies were included. In comparative studies, there was no difference in the occurrence of ocular harms in robot-assisted procedures and conventional surgery. However, robotic assistance did not demonstrate consistent benefits over manual surgery in terms of effectiveness or practicality, likely reflecting the learning curve associated with these systems. Single studies indicated the potential of robotic assistance to improve the consistency of subretinal drug infusion and efficiency of instrument manipulation in vitreoretinal surgery. Proof-of-concept studies have demonstrated the potential of robotic assistance to facilitate procedures otherwise infeasible or impractical, and may broaden access to surgery. However, robot-assisted surgery has not yet demonstrated any significant benefits over standard surgical practice. Improving the speed and reducing perioperative requirements of robot-assisted surgery are particular priorities for research and innovation to improve the practicality of these novel techniques. This systematic review summarizes the potential and limitations of robotic systems for assisting eye surgery and outlines what is required for these systems to benefit patients and surgeons.

A Systematic Review of Effects on ACL Injury of Soccer Shoe Outsoles, Soccer Playing Field Surfaces, and Outsole–Surface Interface

Soccer is a sport with a high incidence of injuries. The most common injury occurs when the anterior cruciate ligament of the knee has undergone a sprain, strain, or partial or total rupture. Besides fitness factors (e.g., proprioception, balance and strength capabilities), a principal cause of ACL injuries is sport shoes and playing surfaces. Especially with the emergence of artificial surfaces (rubbers, turfs, concrete, asphalt, red turf), the ACL injuries dramatically increase. The cost of ACL injuries is high both in terms of career termination and in social and economic costs. Thus, it is necessary to understand the impact of sport shoes and playing surfaces on the ACL and how it can be mitigated. The present literature review followed the PRISMA methodology to identify the major biomechanical factors influencing the behavior of surfaces and shoes in relation to the ACL damage. Fifty-eight papers were identified. After reviewing the mechanism of injuries, we identified several distinct factors: type of outsole and mechanical arrangement of the outsoles; shear forces; characteristics of artificial turf surfaces; effect of weather on artificial surface aging and change in mechanical characteristics; outsole/ground interface; and the frictional, tractional and rotational forces in the pathogenesis of ACL injuries in soccer.

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.

A systematic review of effectiveness and safety of some herbal compounds as treatment for primary insomnia

Introduction Sleep related disorders affect around 30% of people all over the world, and evidence shows that 10% require therapeutic intervention. Insomnia represents the most common disturbance of sleep, defined as the experience of poor sleep for at least 1 month. Most of primary insomnia can be prevented by a proper lifestyle and sleep hygiene rules. Regardless, hypnotic drugs and widely prescribed, and most times, long-term used, which is not recommended because of its negative side effects.ObjectivesReview the scientific evidence about effectiveness of plant extracts for insomnia, natural products with practically no side-effects, and thus be possible to reduce or even avoid the use of hypnotic drugs.MethodsThe Medline database through the Pubmed search engine was used with the following keywords: “insomnia” and “herbal compounds”.ResultsValerian activity on sleep disturbances has been attributed to the presence of isovaleric acids and valepotriates with reported calming action and GABA reuptake inhibition with sedative effects. Considering the data presented in the literature, despite controversial and conflicting, several studies showed that valerian (160-600mg/day) improved sleep quality and reduced sleep latency and duration; also valerian seems more effective for chronic insomnia than acute episodes.Hop has different properties: calming, sleep inducing, gastric secretion stimulating and spasmolytic.Increasing GABAergic activity seems to be the main mechanism of action, thus inhibiting the central nervous system and also has demonstrated binding affinities to some of the melatonin and serotonin receptor. It’s sedative characteristics have been confirmed in a clinical trial in association with valerian, where sleep latency and quality were improved. However, monotherapy studies showed no relevant effectiveness in sleep.Kava Kava plant showed promising results, in rats and humans, with decrease sleep latency, better sleep quality and recuperation after sleep. However, raised concern about its potential of hepatotoxicity.There is also promising evidence of the lavender efficacy for sleep disorders in a wide variety of populations and diseases, it was actually mentioned to be as effective as lorazepam in adults with anxiety and sleeping problems. With studies with dose of 80mg it was observed a reduction in sleep awakenings, sleep duration and overall sleep quality and anxiety.Conclusions There is a clear preference from the patient to natural compounds, and with almost nonexistent side effects, some herbal derivates are showed to have positive effectiveness in mild insomnia, but nonetheless much more studies on this field are needed.Disclosure of InterestNone Declared

Remote Palliative Care: A Systematic Review of Effectiveness, Accessibility, and Patient Satisfaction

Remote Palliative Care: A Systematic Review of Effectiveness, Accessibility, and Patient Satisfaction

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

Occupational health and safety regulatory interventions to improve the work environment: An evidence and gap map of effectiveness studies.

Unsafe and unhealthy working conditions lead to injuries and financial losses across the globe, resulting in a need for research into effective work environment interventions. The objective of this evidence and gap map (EGM) is to provide an overview of existing systematic reviews and primary studies examining the effects of occupational health and safety regulatory interventions. Relevant studies are identified through searches in published and unpublished literature performed up to January 2023. The population for this EGM is workers above the age of 15 and their workplaces within the OECD. We include randomised controlled trials, non-randomised studies with a comparison of two or more groups of participants, and systematic reviews of effects. The map has been populated based on information about interventions and outcomes, study design, OECD country, and publication status. We have performed critical appraisal of included systematic reviews using an adjusted version of the AMSTAR-2 tool. The included studies for this report consist of six systematic reviews, 28 primary effect studies, and three on-going studies. The interactive map shows that the largest cluster of studies is located in the inspection activity domain, while the sickness absence outcome domain and the intervention categories for training initiatives and formulation of regulatory standards are only scarcely populated. Additionally, the AMSTAR-appraisal suggests a lack of rigorous systematic reviews and meta-analyses. More research in the form of primary studies and rigorous systematic reviews is needed to provide stakeholders with better guidance as to what constitutes the most efficient regulatory approaches to improve the work environment.

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.