Systematic Reviews最新文献

Background: Meta-epidemiological research plays a vital role in providing empirical evidence needed to develop methodological manuals and tools, but the reporting quality has not been comprehensively assessed, and the influence of reporting guidelines remains unclear. The current study aims to evaluate the reporting quality of meta-epidemiological studies, assess the impact of reporting guidelines, and identify factors influencing reporting quality.

Methods: We searched PubMed and Embase for meta-epidemiological studies. The reporting quality of these studies was assessed for adherence to established reporting guidelines. Two researchers independently screened the studies and assessed the quality of the included studies. Time-series segmented linear regression was used to evaluate changes in reporting quality over time, while beta-regression analysis was performed to identify factors significantly associated with reporting quality.

Results: We initially identified 1720 articles, of which 125 meta-epidemiological studies met the inclusion criteria. Of these, 65 (52%) had low reporting quality, 60 (48%) had moderate quality, and none achieved high quality. Of the 24 items derived from established reporting guidelines, 4 had poor adherence, 13 had moderate adherence, and 7 had high adherences. High journal impact factor (≥ 10) (OR = 1.42, 95% CI: 1.13, 1.80; P = 0.003) and protocol registration (OR = 1.70, 95% CI: 1.30, 2.22; P < 0.001) were significantly associated with better reporting quality. The publication of the reporting guideline did not significantly increase the mean reporting quality score (- 0.53, 95% CI: - 3.37, 2.31; P = 0.67) or the trend (- 0.38, 95% CI: - 1.02, 0.26; P = 0.20).

Conclusions: Our analysis showed suboptimal reporting quality in meta-epidemiological studies, with no improvement post-2017 guidelines. This potential shortcoming could hinder stakeholders' ability to draw reliable conclusions from these studies. While preregistration could reduce reporting bias, its adoption remains low. Registration platforms could consider creating tailored types for meta-epidemiological research, and journals need to adopt more proactive measures to enforce reporting standards.

Background: People living with advanced, non-malignant chronic conditions often have extensive and complex care needs. Informal or family caregivers often provide the care and support needed by those with advanced chronic conditions at home. These informal caregivers experience many challenges associated with their caring role, which can impact their own wellbeing. Whilst there is growing evidence around the impact on carers, guidance on support for informal caregivers of patients with advanced, non-malignant, chronic conditions is lacking, with little evidence available on effective psychosocial carer interventions. This systematic review explored existing interventions for caregivers of those with advanced, non-malignant, chronic illness, in order to assess the effectiveness of these interventions in improving psychosocial outcomes.

Methods: Electronic databases, Medline, CINAHL, EMBASE, and PsycINFO, were searched up to the end of March 2023. Studies meeting the inclusion criteria, focusing on interventions to improve psychosocial outcomes, such as depression, anxiety, quality of life, and caregiver burden, in this cohort of caregivers were included. Data were extracted regarding study setting, design, methods, intervention components, and outcomes. Risk of bias and quality assessment were conducted.

Results: A total of 5281 articles were screened, ultimately identifying 12 studies for inclusion, reported in 13 publications. A narrative synthesis revealed mixed results. Psychosocial interventions resulted in more significant improvements in psychosocial outcomes than psychoeducational or support interventions, with interventions for carer-patient dyads also reflecting more positive outcomes for caregivers. Evidence-based interventions, guided by an appropriate theoretical model, were reportedly more effective in improving caregiver outcomes. Differences in outcomes were related to intervention development, design, delivery, and outcome assessment.

Conclusions: This review, to our knowledge, is the first to explore the effectiveness of interventions in improving psychosocial outcomes for caregivers of those with advanced, non-malignant, chronic conditions. The review highlights the need for more robust, sufficiently powered, high-quality trials of evidence-based interventions for caregivers of people with advanced chronic illness. Optimal intervention duration and frequency of sessions are unclear and need further exploration.

Background: Home-based chemotherapy (HBC) has emerged as a standard option for treating various types of cancer, primarily to decrease the waiting time for treatment. As HBC gains more recognition, ongoing research is delving into the experiences of patients with cancer who receive chemotherapy in a home setting or chemotherapy closer to home. Understanding these experiences is vital for the use of chemotherapy delivery outside the traditional hospital environments. This review aims to synthesize and critically appraise qualitative studies that investigate the experience and perspectives of patients with cancer who received parenteral chemotherapy administration in home settings. Findings will be used to develop evidence-based policies to support home-based care models.

Methods: This review will follow JBI methods for systematic reviews of qualitative evidence. The databases for searching will include MEDLINE (PubMed), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), ProQuest Health and Medical Collection, two Chinese databases, CNKI and Wanfang, and one Thai database, ThaiJO. Studies published in English, Chinese, and Thai will be considered for inclusion. Two reviewers will independently undertake study selection, data extraction, and critical appraisal of the methodological quality of studies. The synthesized findings will be assessed using the ConQual approach.

Discussion: The synthesis of qualitative studies on this topic will provide insights into the nuanced and varied experiences of patients receiving chemotherapy within the comfort of their homes. The review will also provide evidence-based recommendations to policymakers and healthcare administrators, to support the implementation of HBC for patients.

Systematic review registration: Systematic review registration: PROSPERO CRD42024500476.

Background: Gastric intestinal metaplasia (GIM) is a precancerous lesion that increases the risk of gastric cancer. Several preliminary studies have examined the prevalence of GIM. The present systematic review and meta-analysis were conducted aimed estimating the global prevalence of GIM.

Methods: The present systematic review and meta-analysis was conducted based on the PRISMA reporting guidelines in the range of 1988-2022. Articles related to the purpose of the study were obtained from Embase, PubMed, Scopus, Web of Science (WOS), MagIran, SID databases, and Google Scholar search engine using relevant and validated keywords in MeSH/Emtree. Inclusion criteria were observational articles, access to the full text of the article, and articles that reported prevalence. Heterogeneity among studies was examined using the I² index. The random effects model was used in this review due to the high heterogeneity between the results of the studies. Data were statistically analyzed using the Comprehensive Meta-Analysis (CMA) software.

Results: In the initial search, 4946 studies were found, of which 20 articles with a sample size of 57,263 met all the criteria for inclusion in the study. The global prevalence of GIM was 17.5% (95% confidence interval: 14.6-20.8%). The highest percentage of prevalence of GIM belonged to American continent with 18.6% (95% confidence interval: 13.8-24.6%) and patients with gastroesophageal reflux with 22.9% (95% confidence interval: 9.9-44.6%).

Conclusion: The results of this study showed that the prevalence of GIM in the world is high and needs further investigation. Therefore, it is recommended to be given more attention by experts, officials, and health policymakers.

Background: Postoperative pneumonia is a common but serious complication in patients with lung cancer. This meta-analysis aims to evaluate the effect of respiratory exercise on reducing postoperative pneumonia in patients with lung cancer and to provide a reliable basis for clinical treatment and nursing of patients with lung cancer.

Methods: Two reviewers searched PubMed, Embase, Web of Science, Cochrane Library, China Knowledge Network, Wanfang, and Weipu databases. We searched for the randomized controlled trials (RCTs) published in Chinese or English on the breathing exercises in patients with lung cancer up to January 30, 2024. The quality of the literature was evaluated with the Cochrane Risk of Bias Tool 2 (ROB 2). RevMan 5.3 software was used for meta-analysis.

Results: Eleven RCTs with 1429 patients with lung cancer were included, and 710 patients received breathing exercises. The meta-analysis results showed that breathing exercises could significantly reduce the incidence of postoperative pneumonia [RR = 0.35, 95%CI (0.25, 0.51)], improve the FEV1 [MD =  - 0.49, 95%CI (- 0.73, - 0.24)], FVC [MD =  - 0.59, 95%CI (- 0.83, - 0.35)] in patients with lung cancer (all P < 0.05). There were significant differences in the incidence of pneumonia for patients undergoing breathing exercises with single exercise time ≥ 15 min (RR = 0.37, 95%CI 0.24 ~ 0.62), breathing exercises for 1 week (RR = 0.29, 95%CI 0.16 ~ 0.55) or for 2 weeks (RR = 0.48, 95%CI 0.28 ~ 0.85) and breathing exercises > 4 times (RR = 0.36, 95%CI 0.23 ~ 0.57) per day (all P < 0.05).

Conclusion: Breathing exercises have shown the capacity to augment pulmonary function in patients with lung cancer, concurrently mitigating the risk of postoperative pneumonia.

Aim: To provide an overview of the various influencing factors related to the positive aspects of caring for dementia patients by family caregivers.

Design: A systematic mixed studies review.

Methods: The Preferred Reporting Items for Systematic Reviews guided this protocol as reported. Peer-reviewed studies published in English from 1997 to the present will be searched via information sources, gray literature, and the following databases: Web of Science, PsycINFO, PubMed, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials. Eligible trials will also be retrieved from ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. This will be a mixed studies review. The Mixed Method Appraisal Tool will be used for the mixed-method studies. The Newcastle-Ottawa Scale for case-control and cohort studies and the JBI quality scale for cross-sectional and interventional (i.e., randomized or quasi-experimental) studies will be consulted. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research will be used for the qualitative studies. All the data will be extricated with JBI data extraction tools. The convergent synthesis method will be used in the review.

Discussion: This systematic review will synthesize and analyze the factors that influence the positive aspects of caring for dementia patients by family caregivers.

Conclusion: The findings will help decision-makers to adopt more appropriate and effective interventions for caregivers of people with dementia.

Patient or public contributions: This review protocol will ascertain the factors affecting the mediation of and path to improved caregiving, explore the factors' action mechanisms, and examine the controlling factors to design a more targeted intervention program to improve caregiving, thus improving dementia patients' outcomes and care. Contributions of the findings will include evidence of strategies that address ongoing dementia caregiving issues and the identification of areas for future research.

Background: Fibrin sealants are increasingly used in head and neck surgery to aid hemostasis, but individual studies lack conclusive evidence. This systematic review investigates their effectiveness compared to placebo or usual care in head and neck surgery.

Methods: Studies comparing fibrin sealant to placebo or usual care in patients 18 years or older who have undergone soft tissue surgery of the head and neck with drain placement were included. Primary outcomes include wound complications and time to surgical drain removal postoperatively. Secondary outcomes include length of hospital stay, drain volume output, surgical management of hematoma, blood transfusion rates, and adverse reactions. Electronic databases were searched on October 2023 for randomized controlled and quasi-experimental studies. Studies underwent independent screening, review, and appraisal by two reviewers using JBI appraisal tools. Certainty was assessed with GRADE, and meta-analysis was conducted using JBI SUMARI, presenting effect sizes as relative risk ratios or mean differences with 95% confidence intervals.

Results: Fourteen studies were included examining 904 patients. The fibrin sealant group exhibited reduced postoperative wound complications (hematoma, seroma, wound dehiscence, wound infection) (RR = 0.64, 95% CI = 0.45-0.92), shorter drain removal times (MD =  - 0.49 days, 95% CI =  - 0.68 to - 0.29), decreased drain output (MD =  - 16.52 mL, 95% CI =  - 18.56 to - 14.52), and shorter hospital stay (MD =  - 0.84 days, 95% CI =  - 1.11 to - 0.57) compared to controls. There was no statistically significant difference on the rate of intervention for postoperative hematoma and the rate of adverse reactions.

Discussion: Evidence demonstrates with low certainty that fibrin sealant use is associated with a modest reduction in the rate of wound complications, drain duration, and length of stay, and a small reduction in drain volume output. Methodological weaknesses and clinical heterogeneity limit these findings. Further research should focus on enhancing methodological quality and exploring the cost-effectiveness of fibrin sealant use in surgery.

Systematic review registration: CRD42023412820.

Funding: Nil.