Systematic Review Search Research Articles

Ethics in the professional practice of imaging specialists

Introduction: During professional practice, it is absolutely necessary that ethics and Imaging complement each other as fundamental sciences. Objective: Describe the role of ethics in Imaging for the proper development of professional practice. Methods: In June and July of 2023, an electronic search for publications and systematic literature reviews was conducted using Google Scholar and the electronic databases PubMed, Medline, and SciELO. The following descriptors were used: "ethics and medical ethics", "Imaging", and "ethics and Imaging". A total of 56 sources were reviewed in the databases mentioned above. Out of these, 31 bibliographic references were used.Results: Imaging specialists, like other healthcare professionals, must adhere to ethical duties that include respecting privacy, maintaining privileged communication, confidentiality, and obtaining informed consent. Professionals in the field often face ethical conflicts during their practice. Therefore, it is crucial that they are technically and scientifically prepared to handle such situations. This is especially important when dealing with medical-legal imaging and the ethical dilemmas that may arise. It is essential to pay close attention to the indication of imaging studies, particularly when they do not provide any benefit to the patient. Conclusions: Imaging specialists who are involved in patient care must adhere to ethical standards governing the practice of the profession

Measuring general mental health in early-mid adolescence: Asystematic meta-review of content and psychometrics.

Adolescent mental health is a major concern and brief general self-report measures can facilitate insight into intervention response and epidemiology via large samples. However, measures' relative content and psychometrics are unclear. A systematic search of systematic reviews was conducted to identify relevant measures. We searched PsycINFO, MEDLINE, EMBASE, COSMIN, Web of Science, and Google Scholar. Theoretical domains were described, and item content was coded and analysed, including via the Jaccard index to determine measure similarity. Psychometric properties were extracted and rated using the COSMIN system. We identified 22 measures from 19 reviews, which considered general mental health (GMH) (positive and negative aspects together), life satisfaction, quality of life (mental health subscales only), symptoms, and wellbeing. Measures were often classified inconsistently within domains at the review level. Only 25 unique indicators were found and several indicators were found across the majority of measures and domains. Most measure pairs had low Jaccard indexes, but 6.06% of measure pairs had >50% similarity (most across two domains). Measures consistently tapped mostly emotional content but tended to show thematic heterogeneity (included more than one of emotional, cognitive, behavioural, physical and social themes). Psychometric quality was generally low. Brief adolescent GMH measures have not been developed to sufficient standards, likely limiting robust inferences. Researchers and practitioners should attend carefully to specific items included, particularly when deploying multiple measures. Key considerations, more promising measures, and future directions are highlighted. PROSPERO registration: CRD42020184350 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020184350.

The Role of Salivary C-Reactive Protein in Systemic and Oral Disorders: A Systematic Review.

Background: Blood sampling is expensive, time-consuming, invasive, and requires technical facilities, which can be replaced by more convenient samples such as saliva. C-reactive protein (CRP) is a widely used biomarker in the management of many disorders and plasma CRP (pCRP) is suggested to be replaced by salivary CRP (sCRP). This study aimed to systematically review all available literature on the sCRP levels in systemic and oral disorders and how sCRP and pCRP levels correlate among these patients and healthy individuals. Methods: In this systematic review, a PubMed, Embase, Scopus, and Google Scholar search was conducted on October-2021 to identify all research investigating sCRP levels in systemic and oral disorders. Results: A total of 130 publications were analyzed in the review. Most of the studies reported that sCRP and pCRP levels are correlated, and sCRP is a reliable alternative for pCRP level for the diagnosis and management of medical conditions. sCRP has been measured in many different medical and oral disorders and significantly correlated with disease activity in most cases. Conclusion: Salivary CRP is a good alternative for Plasma CRP levels in most cases.

Virtual clinic in pregnancy and postpartum healthcare: A systematic review.

To monitor the health status of pregnant women moment by moment, new technologies in the field of telemedicine can be used, such as virtual visits and virtual clinics. During the COVID-19 pandemic, by using these technologies, useful and satisfactory services have been provided to pregnant mothers. The aim of this study is to specify the applications, features, and infrastructure of a comprehensive virtual clinic in the field of gynecological and pregnancy care. A systematic review search was conducted through the scientific databases from February 2013 to February 2022 using Scopus, Web of Science, and PubMed. Furthermore, manual searches in Google Scholar and the reference lists of included studies were carried out. In this systematic review we included 16 articles that reported experiences in virtual clinics in pregnancy and postpartum healthcare. The involved studies were experimental, cohort, and cross-sectional studies. The target group users were pregnant or women who gave birth and families of neonatal. The application of virtual clinics was for the visit, consultation, monitoring, follow-up, and home care virtually. Highly satisfaction scores of caregivers after virtual visits and consultation were reported. There were some challenges during virtual visits and consultation; the most important challenge was a poor internet connection. The reviewed studies show promising outcomes according to patient and provider satisfaction. We predict that telehealth will become a growingly significant part of gynecological care in the future.

Expert searchers identified time, team, technology and tension as challenges when carrying out supplementary searches for systematic reviews: A thematic network analysis.

Systematic reviews require detailed planning of complex processes which can present logistical challenges. Understanding these logistical challenges can help with planning and execution of tasks OBJECTIVES: To describe the perspectives of expert searchers on the main logistical challenges when carrying out supplementary searches for systematic reviews, in particular, forward citation searching and web searching. Qualitative interviews were undertaken with 15 experts on searching for studies for systematic reviews (e.g. information specialists) working in health and social care research settings. Interviews were undertaken by video-call between September 2020 and June 2021. Data analysis used thematic network analysis. We identified three logistical challenges of using forward citation searching and web searching which were organised under the global theme of 'tension': time, team and technology. Several subthemes were identified which supported the organising themes, including allocating time, justifying time and keeping to time; reviewer expectations and contact with review teams; and access to resources and reference management. Forward citation searching and web searching are logistically challenging search methods for a systematic review. An understanding of these challenges should encourage expert searchers and review teams to maintain open channels of communication, which should also facilitate improved working relationships.

PP27 Reusing And Adapting Health Technology Assessments (HTAs): An Example From The COVID-19 Time

IntroductionHealth technology assessment (HTA) reports are complex technical documents that address multiple aspects of the incorporation of a technology into the health care system applying complicated methodologies coming from different disciplines. The purpose of HTA is to support decision-makers and these should have an adequate level of training to fully understand these assessments. However, most HTA education programs and courses are intended for HTA doers and there is a lack of practical guidance training aimed at preparing health managers or policy makers in HTA. The objective is to describe an HTA training program developed for decision-makers of the three levels (health care administration, hospital management and clinical practice).MethodsRolling Collaborative Review (RCR) 01 of convalescent plasma was identified and selected because it complied with our Population Intervention Comparator Outcome Design Question. The EUnetHTA HTA adaptation Toolkit was used to check the relevance (about research question); reliability (quality of the report) and transferability (application of information to the target setting). Additional considerations regarding the local context were examined. A panel of four professionals and one patient was formed to rate the importance of the outcomes and to carry out the external reviewResultsAccording to the toolkit, information on RCR01 Convalescent Plasma could be adopted for the safety and effectiveness domains. The technical characteristics and current use domains were adapted and extended. It was considered of interest to include the domains of organization and ethics. The organizational aspects were answered through the information retrieved in a search for systematic reviews and guides, and with the collaboration of experts. The ethics domain was answered through a specific literature search on ethical issues related to COVID-19 and transfusions.ConclusionsThe use of the EUnetHTA Toolkit has been helpful in supporting the adaptation process. The adoption of the effectiveness and safety domains from already developed HTA assessments is an efficient way to provide useful information for the decision-making process. However, contextual elements should be included in the adaptation process to ensure a complete framework for the decision.

OP31 Assessment Of AI Supported Health Technologies - How To Move Forward?

IntroductionArtificial intelligence (AI)-supported technologies are rapidly developing and have the potential to improve healthcare quality at reduced cost. However, few examples exist of successfully deployed AI-technologies in a real-world context that have been adequately assessed. Therefore, the objective of this research is to: (i) identify existing health technology assessment (HTA) methods developed or adapted to assess AI-supported health technologies, (ii) identify new assessment topics or domains relevant for AI-technology uptake, and (iii) take the first step in developing a framework applicable for new challenges that emerge with the introduction of AI.MethodsA systematic literature review of studies describing methods or frameworks to assess AI-supported health technologies was performed on PubMed from January 2010 until February 2021. Furthermore, a web page search of international HTA agencies and international organizations such as the World Health Organization, Organziation for Economic and Co-ordination and Development, and the European Commission was performed to identify important aspects to consider when implementing and assessing AI technologies.ResultsNo assessment frameworks for AI technologies were identified from the systematic literature review or web page searches of international HTA agencies. Reports from international organizations highlight limitations or inability of most AI technologies to ‘explain’ their decision-making process (black box issue), leading to lack of trust in the technology that affects its adoption. It is recommended to put more emphasis on assessing transparency and ‘explainability’ of the AI solution as well as aspects of safety, ethical, legal, and social issues related to implementation and the development/training phase of the AI technology.ConclusionsThe results from this study uncover key gaps in frameworks posed for performing a systematic and holistic assessment of AI in a real-world context of health care. However, valuable information on relevant assessment aspects for AI-supported technologies have been identified.The results will form the basis for the development of a framework to assist decision-makers in assessing AI-supported technologies in a holistic manner for a responsible deployment – the HTA AI Framework.

MSR107 Can Artificial Intelligence (AI) Be Used to Improve the Efficiency of Title and Abstract Citation Screening?

Literature searches for systematic reviews (SRs) often return a large number of studies for reviewers to screen. We developed an AI-assisted human-in-the-loop screening tool leveraging named-entity recognition, a natural language-processing method. The tool identifies and highlights biomedical concepts and prespecified keywords to filter text and to guide reviewers toward relevant text in the title and abstract. We hypothesized that highlighted keywords and concepts may reduce the time taken to decide which references to include or to exclude. We aimed to evaluate the time spent and accuracy of AI assisted screening using the tool compared with unassisted screening in Excel.

PP20 Effectiveness And Safety Of Autogenic Training As A Treatment For Medical Conditions

IntroductionAutogenic training consists of reaching a state of deep relaxation through mental representations of physical sensations in different parts of the body. It is a promising technique for improving the psychological well-being of people with chronic diseases, but there are no clinical practice guidelines recommending the use of autogenic training in this population. The aim of this work was to identify, critically evaluate, and synthesize the available evidence on the safety and effectiveness of autogenic training in the prevention and treatment of medical conditions.MethodsWe conducted a systematic search for systematic reviews and randomized controlled trials (RCTs) in MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials. The selection and assessment of risk of bias of the included studies was carried out independently by two reviewers.ResultsA total of 2,420 references were identified after eliminating duplicates. Of these, 141 were selected for reading the full text, and 13 systematic reviews and 18 RCTs were included. Compared with no intervention or delayed treatment, autogenic training significantly reduced levels of anxiety and depression as well as some physical symptoms (e.g., headaches and atopic dermatitis).ConclusionsAutogenic training could be useful for improving the psychological well-being and physical symptoms of patients with chronic health conditions and as an additional element in multicomponent intervention programs. However, these conclusions are not definitive due to the low number of studies available for each health condition and their high or unclear risk of bias.

Alzheimer disease clinical trials in low and middle income countries: A call for globalization of clinical trials

AbstractBackgroundIn the absence of clinically meaningful disease‐modifying treatments, the number of adults with dementia worldwide is projected to more than triple. Much of this increase will occur in low and middle‐income countries (LMICs); by 2050, 68% of adults living with dementia will be in LMICs. However, there is a gross under‐representation of LMICs in historical and contemporary AD clinical trial platforms.MethodsWe aimed to determine the global distribution of dementia clinical trials and identify existing barriers for conducting AD clinical trials in LMICs. Our primary data sources to identify trial distribution in LMICs included ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform. Data analysis included number of clinical trials per country, regional distribution, funding source, study phase (1, 1/2, 2, 2/3, or 3), and annual growth rate by region relative to population density. An additional systematic review search and expert consensus was conducted to identify barriers for conducting clinical trials in LMICs.ResultAmong 1737 dementia interventional trials, only 17.2% have been or are conducted in LMIC (figure 1). LMICs trial sites participated/conducted 23.6% and 10.9% of phase 3 and phase 1 trials, respectively. We identified several limitations for trial implementation including lack of financial resources, low industry presence, regulatory obstacles and operational barriers, especially related to resources in neuroimaging. Two successful international trials platforms (Dominantly Inherited Alzheimer Network‐Trials Unit [DIAN‐TU] and Worldwide FINGERS) have been able to expand into Latin American countries creating a regional network for trial implementation.ConclusionAlthough LMICs bear the greatest burden of AD in the world, substantial development of clinical trial platforms to address this inequity is lacking. Ongoing LMICs regional trial platforms (e.g., DIAN‐TU and LatAm‐FINGERS) may shed light on alternative strategies to overcome existing barriers and highlight the need for a more thoughtful approach to increase diverse representation in AD clinical trials and expand access to LMIC.

Narrative Review on the Effects of Oat and Sprouted Oat Components on Blood Pressure.

Hypertension (HTN) is a major risk factor for cardiovascular disease (CVD) and cognitive decline. Elevations in blood pressure (BP) leading to HTN can be found in young adults with increased prevalence as people age. Oats are known to decrease CVD risk via an established effect of β-glucan on the attenuation of blood cholesterol. Many past studies on CVD and oats have also reported a decrease in BP; however, a thorough assessment of oats and BP has not been conducted. Moreover, oats deliver several beneficial dietary components with putative beneficial effects on BP or endothelial function, such as β-glucan, γ-amino butyric acid (GABA), and phytochemicals such as avenanthramides. We conducted a comprehensive search for systematic reviews, meta-analyses, and clinical intervention studies on oats and BP and identified 18 randomized controlled trials (RCTs) and three meta-analyses that supported the role of oats in decreasing BP. Emerging data also suggest oat consumption may reduce the use of anti-hypertensive medications. The majority of these studies utilized whole oats or oat bran, which include a vast array of oat bioactives. Therefore, we also extensively reviewed the literature on these bioactives and their putative effect on BP-relevant mechanisms. The data suggest several oat components, such as GABA, as well as the delivery of high-quality plant protein and fermentable prebiotic fiber, may contribute to the anti-HTN effect of oats. In particular, GABA is enhanced in oat sprouts, which suggests this food may be particularly beneficial for healthy BP management.

Remote mental health care interventions during the COVID-19 pandemic: An umbrella review

Mitigating the COVID-19 related disruptions in mental health care services is crucial in a time of increased mental health disorders. Numerous reviews have been conducted on the process of implementing technology-based mental health care during the pandemic. The research question of this umbrella review was to examine what the impact of COVID-19 was on access and delivery of mental health services and how mental health services have changed during the pandemic. A systematic search for systematic reviews and meta-analyses was conducted up to August 12, 2022, and 38 systematic reviews were identified. Main disruptions during COVID-19 were reduced access to outpatient mental health care and reduced admissions and earlier discharge from inpatient care. In response, synchronous telemental health tools such as videoconferencing were used to provide remote care similar to pre-COVID care, and to a lesser extent asynchronous virtual mental health tools such as apps. Implementation of synchronous tools were facilitated by time-efficiency and flexibility during the pandemic but there was a lack of accessibility for specific vulnerable populations. Main barriers among practitioners and patients to use digital mental health tools were poor technological literacy, particularly when preexisting inequalities existed, and beliefs about reduced therapeutic alliance particularly in case of severe mental disorders. Absence of organizational support for technological implementation of digital mental health interventions due to inadequate IT infrastructure, lack of funding, as well as lack of privacy and safety, challenged implementation during COVID-19. Reviews were of low to moderate quality, covered heterogeneously designed primary studies and lacked findings of implementation in low- and middle-income countries. These gaps in the evidence were particularly prevalent in studies conducted early in the pandemic. This umbrella review shows that during the COVID-19 pandemic, practitioners and mental health care institutions mainly used synchronous telemental health tools, and to a lesser degree asynchronous tools to enable continued access to mental health care for patients. Numerous barriers to these tools were identified, and call for further improvements. In addition, more high quality research into comparative effectiveness and working mechanisms may improve scalability of mental health care in general and in future infectious disease outbreaks.

Neuroblastic tumors and neurofibromatosis type 1: A retrospective multicenter study in Italy and systematic review of the literature.

Neuroblastic tumors (NBTs) are the most common extra-cranial solid tumors of childhood. Neurofibromatosis type 1 (NF1) is the most common neurocutaneous disorder with a predisposition to tumors. The co-occurrence of NBTs in the setting of NF1 has been occasionally reported, suggesting a non-casual association and likely configuring a spectrum of neural crest-derived disorders. To explore the occurrence of NBTs within NF1 and to report on its natural history, therapeutic strategies, and outcomes in an Italian cohort of children with NF1 and in the literature. Study (a): a retrospective analysis of questionnaire-based data [years 1979-2017] derived from the databases of the Italian Registry for Neuroblastoma (RINB) of the Italian Society of Pediatric Onco-Haematology (AIEOP); and Study (b): a systematic review search on NF1/NB co-occurrence. Study (a) identified eight children with NBTs, 0.2% of patients registered in the RINB, fulfilling the diagnostic criteria for NF1. The primary site of NBTs was abdominal in six patients. The NBTs were neuroblastoma (NB) in five patients, ganglioneuroblastoma (GNB) in one, patient, and ganglioneuroma (GN) in two. Metastatic diffusion occurred in three out of eight children. MYCN gene testing, performed in the tumors of five patients, resulted not-amplified. The major features of NF1 included the following: NF1 family history in four patients, café-au-lait spots in all, freckling in six, Lisch nodules in three, and neurofibromas in three. With regard to the outcome, four children survived three of these for the progression of NB and one for a second tumor. Study (b) identified 12 patients with NF1/NB from the years 1966-2017, and the median age at diagnosis was 27 months (range = 0-168 months). The primary site of NB was thoracic. The prevalent histotype was NB in nine patients, GNB in two, and GN in one. Eight/nine NBs were metastatic. The MYCN gene was amplified in the only studied case. The NF1 features included NF1 family history in seven patients; the major NF1 features were café-au-lait spots in nine patients, freckling in one, Lisch nodules in none, and neurofibromas in six. The outcome was good for only two children, while eight children died of neuroblastoma, at a median age of 49.5 months (range = 2.4-174 months), with a median survival time of 21.75 months after diagnosis. To our knowledge, this represents the first systematic study on the occurrence of NBTs in NF1. This confirms that NBs are rare per se in the setting of NF1 (0.2% of all NBs) and even if compared to the overall frequency of malignancies in NF1 (i.e., 14.7%). The male:female ratio in study (a) (0.6) was different from what was recorded in study (b) (1.5) and in line with the overall increased frequency of malignancies in females with NF1. The median ages at diagnosis of NB in either study (a) or (b) were concordant with what occurred in the NB population. In study (a) versus study (b), the frequency of metastatic diffusion was lower, likely indicating less awareness on work-ups for malignancies in old NF1 series in the literature. The outcome was much better in study (a) than in study (b), indicating that multidisciplinary treatment for NB is highly recommended.

A review about the putative mechanisms of action of electroconvulsive therapy in schizophrenia in human research

Electroconvulsive therapy (ECT) has multiple uses in psychiatry, but its mechanisms of action (MA) in patients with schizophrenia (PS) are poorly understood. We synthesize and discuss the available evidence in this regard. We conducted a search for primary human studies and systematic reviews searching MA of ECT in PS published in PubMed/Medline, SciELO, PsycInfo, and the Cochrane Library, including 24 articles. Genetic findings are scarce and inconsistent. At the molecular level, the dopaminergic and GABAergic role stands out. The increase in brain derived neurotrophic factor (BDNF) after ECT, is a predictor of positive clinical outcomes, while the change in N-acetyl aspartate levels would demonstrate a neuroprotective role for ECT. This intervention would improve inflammatory and oxidative parameters, thereby resulting in a symptomatic improvement. ECT is associated with an increase in functional connectivity in the thalamus, right putamen, prefrontal cortex and left precuneus, structures that play a role in the neural default mode network. A decrease in connectivity between the thalamus and the sensory cortex and an enhanced functional connectivity of the right thalamus to right putamen along with a clinical improvement have been reported after ECT. Moreover a volumetric increase in hippocampus and insula has been reported after ECT. These changes could be associated with the biochemical pathophysiology of schizophrenia. Most of the included studies are observational or quasi-experimental, with small sample sizes. However, they show simultaneous changes at different neurobiological levels, with a pathophysiological and clinical correlation. We propose that the research on ECT should be carried out from neurobiological dimensions, but with a clinical perspective.

The Ethical Triage and Management Guidelines of the Entrapped and Mangled Extremity in Resource Scarce Environments: A Systematic Literature Review

Background/Introduction:While there are accepted triage and treatment guidelines for the entrapped and mangled extremity in civilian and military resource rich environments, there are none for resource-scarce environments.Objectives:A PRISMA systematic literature review was performed to elucidate the current triage and treatment of the entrapped and mangled extremity to understand the factors that contribute to the decision to amputate, or not amputate, and to extract data to develop clinical guidelines.Method/Description:A lead researcher followed the PRISMA systematic literature review search strategy inclusion and exclusion criteria.A first reviewer was randomly assigned sources. One of the two lead researchers was the second reviewer. Each determined the Level of Evidence (LOE) and Quality of Evidence (QE) from each source.Results/Outcomes:Five-hundred ninety-seven (597) records were screened. Fifty-eight (58) articles were entered into the final study. There was one study determined to be LOE-1, 29 LOE-2, and 28 LOE-3 with 15 determined to achieve QE-1, 37 QE-2, and six QE-3.Data extracted included relevant information to develop clinical guidelines to include physiologic parameters, injury patterns or procedures, imaging, rehabilitation, ethics, and the informed consent process.Conclusion:This systematic literature review showed that there is a lack of studies producing strong evidence to support the triage and treatment of an entrapped or mangled extremity in resource-scarce environments. A Delphi method study is suggested to adapt and modify available evidence extracted to create clinical guidelines in the resource-scarce environment.

Interventions to prevent HIV and Hepatitis C among people who inject drugs: Latest evidence of effectiveness from a systematic review (2011 to 2020).

Hepatitis C virus (HCV) and HIV remain prevalent among people who inject drugs (PWID) and transmission is usually associated with injecting risk behaviour (IRB). We update a 2011 review of reviews (RoR) to assess the latest evidence on the effectiveness of harm reduction interventions - drug treatment (including opioid agonist therapy [OAT]), needle and syringe programmes (NSP) and other interventions - in the prevention of HCV and HIV transmission, and related measures of infection risk (IRB and injecting frequency [IF]), among PWID. We undertook an initial search for systematic reviews (i.e. an Overview of Reviews [OoR]) and subsequent systematic searches for primary studies where required. Where there was sufficient evidence based on synthesis of multiple robust studies for an intervention effect in the 2011 RoR, new evidence was not sought. Medline, CINAHL, The Cochrane Library, EMBASE, PsycINFO and Web of Science were searched (2011-2020). Two reviewers screened papers, extracted data, and graded reviews/studies. We classified evidence as 'sufficient', 'tentative', 'insufficient', or 'no evidence'. We screened 8513 reviews and 7133 studies, with 27 and 61 identified as relevant, respectively. The level of evidence increased since the 2011 RoR and is now 'sufficient' for OAT (regarding all outcomes), NSP (for reducing HIV transmission and IRB), and combination OAT/NSP (for reducing HCV transmission). There is also now sufficient evidence for in-prison OAT, psychosocial interventions, pharmacy-based NSP and provision of sterile drug preparation equipment for reducing IRB. There is now a strong body of empirical evidence for the effectiveness of OAT and NSP, alone and in combination, in reducing IRB, and HCV and HIV transmission. However, there is still a relative lack of evidence for other interventions, including heroin-assisted treatment, pharmacological treatment for stimulant dependence, contingency management, technology-based interventions, low dead space syringes and drug consumption rooms on HCV or HIV risk.

Sex-Specific Differences in Patients With Psoriatic Arthritis: A Systematic Review.

A systematic review of published literature was conducted to collate evidence on sex-specific differences in clinical characteristics, disease activity, and patient-reported outcomes (PROs) in psoriatic arthritis (PsA), including response to treatment. Searches of MEDLINE, Embase, and the Cochrane Database of Systematic Reviews were performed in November 2020 for observational studies of adults with PsA reporting outcomes by sex (published from January 1, 2015, to November 13, 2020). In addition, hand searches of systematic literature reviews and (network) metaanalysis bibliographies were performed. Searches of ClinicalTrials.gov and congress abstracts from the European Alliance of Associations for Rheumatology, the American College of Rheumatology (ACR), and the American Academy of Dermatology (2019-2020) were also carried out. Eligible studies with 100 or more patients prespecified a comparison by sex and reported clinical characteristics and/or disease activity. Data extracted included patient characteristics, study design, baseline clinical characteristics, and disease activity results, including PROs. Database searching yielded 3283 unique records; 31 publications of 27 unique studies were included. The review found generally higher rates of peripheral disease in women, including higher tender joint counts. There was some evidence of more axial disease in men, plus greater skin disease burden. There were consistently no differences in Dermatology Life Quality Index scores, though across other PROs, women had worse scores, including pain and fatigue. Women had poorer responses to treatment, indicated by outcome measures such as ACR responses and minimal disease activity. This review indicates that important differences exist between the sexes in PsA. However, the limited evidence for this conclusion underlines the need for additional research in this area.

Working Together: How Academic Librarians Can Help Researchers Prepare for a Grey Literature Search for Systematic Reviews Involving Minoritized Populations

As evidence synthesis methodologies, particularly systematic reviews (SRs), continue to gain popularity across social science research disciplines, faculty requests for librarian assistance with literature searchers are also increasing. A critical component of a well-developed systematic review is a robust grey literature search. Grey literature provides access to research outside of traditional publishing streams, such as conference proceedings, government reports, or project reports, and thus is especially important when research involves specific populations who are historically underrepresented in empirical research, such as minoritized populations. While SRs follow well established guidelines for searching and reporting results from published literature, the same level of transparency for grey literature is frequently absent. Based on experiences from a recent SR involving a minoritized population, this article presents recommendations to facilitate discussions between librarians and researchers about preparing for the inclusion of grey literature if the SR is conducted on a minoritized population. Statement of significanceThis article provides academic librarians with an overview of the benefits and challenges of conducting a grey literature search as well as a framework to use in collaboration with faculty researchers to guide discussions about including a grey literature search in their SR. The conversation framework, informed by lessons learned, may serve as a guide for other librarians to use when assisting faculty and research groups with preparations regarding the inclusion of grey literature.

Sexual and reproductive health aspects in women with polycystic ovary syndrome: An integrative review.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women worldwide, affecting their sexual and reproductive health (SRH). This integrative review aimed to identify SRH aspects in women with PCOS by consolidating the findings from previous studies. The present integrative review was conducted through an electronic systematic review search of 1052 manuscripts published from April 2000 to March 2020 using PubMed, SCOPUS, Web of Science, Embase, Google Scholar, MEDLINE, Science Direct, Ovid, and the Cochrane Library. After at least 2 researchers evaluated the articles based on the inclusion and exclusion criteria, 27 papers were accepted. The data were analyzed by thematic analysis. 9 main themes of SRH were obtained: 1) the impact of PCOS-related complications on reproductive health; 2) the lifelong effect of PCOS on reproductive patterns; 3) PCOS and adverse reproductive and pregnancy outcomes; 4) women's need for understanding complications; 5) the financial burden of the disease; 6) women's life experiences and quality of life; 7) sexual disorders; 8) psychological concerns and issues; and 9) femininity feelings and roles. We were able to identify and categorize various aspects of SRH needs for women with PCOS. These categories can facilitate a more comprehensive assessment of SRH, including previously neglected areas. We suggest that these aspects should be considered in the health plans of women with PCOS.

Why COVID-19 modelling of progression and prevention fails to translate to the real-world.

Mathematical models were used widely to inform policy during the COVID pandemic. However, there is a poor understanding of their limitations and how they influence decision-making. We used systematic review search methods to find early modelling studies that determined the reproduction number and analysed its use and application to interventions and policy in the UK. Up to March 2020, we found 42 reproduction number estimates (39 based on Chinese data: R0 range 2.1–6.47). Several biases affect the quality of modelling studies that are infrequently discussed, and many factors contribute to significant differences in the results of individual studies that go beyond chance. The sources of effect estimates incorporated into mathematical models are unclear. There is often a lack of a relationship between transmission estimates and the timing of imposed restrictions, which is further affected by the lag in reporting. Modelling studies lack basic evidence-based methods that aid their quality assessment, reporting and critical appraisal. If used judiciously, models may be helpful, especially if they openly present the uncertainties and use sensitivity analyses extensively, which need to consider and explicitly discuss the limitations of the evidence. However, until the methodological and ethical issues are resolved, predictive models should be used cautiously.