JBI database of systematic reviews and implementation reports最新文献

Objective: The objective of the systematic review is to summarize the incidence, prevalence, risk factors and health consequences of polypharmacy in adults in South Asia.

Introduction: Several studies have been conducted in South Asia on the incidence, prevalence, risk factors and health consequences of polypharmacy in adults. Until now, no systematic review has been conducted on this topic.

Inclusion criteria: Related epidemiological studies conducted on adults (aged 18 years and over) and residing in any country within South Asia (i.e. Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka) will be eligible for inclusion.

Methods: MEDLINE, Embase, CINAHL, PsycINFO, BNI, Web of Science, Scopus and AMED databases will be searched to identify published studies. The search for unpublished studies will be undertaken in EThOS, OpenGrey and ProQuest Dissertations and Theses. Databases will be searched from their inception dates and no language restrictions will be applied. The JBI systematic review methodology will be followed to conduct the review. Data synthesis will be conducted using narrative synthesis and meta-analyses, where appropriate.

Objective: The objective of this review is to evaluate the effectiveness of serial focused ultrasound of the lungs (FLUS) and/or inferior vena cava (IVC) compared to standard care for monitoring patients with acute dyspnea.

Introduction: Acute dyspnea is one of the most common complaints reported by patients in hospital emergency departments, and has high in-hospital mortality rates. The current methods of monitoring patients with acute dyspnea lack both sensitivity and specificity. Point-of-care FLUS and IVC is a promising monitoring tool, but an overview of the existing evidence is absent.

Inclusion criteria: This review will include studies of adult patients admitted to hospital with acute dyspnea that is examined via FLUS, IVC or both a minimum of twice during hospitalization compared to standard care.

Methods: The following electronic databases will be searched: PubMed, Cochrane, Embase, Scopus, Web of Science and Google Scholar. Gray literature will be sought in OpenGrey and ProQuest. The search is limited to articles written in English, Danish, Swedish, Norwegian and German. Articles published before 2003 will be excluded from the search and duplicates will be removed. Two independent reviewers will screen and critically appraise the included studies and perform the data extraction. If possible, data will be synthesized with statistical meta-analysis; otherwise, data will be presented in narrative form.

Systematic review registration number: PROSPERO CRD42018116608.

Objective: The objective of the systematic review is to explore adult patients' experiences using electronic personal health records (e-PHRs) for chronic non-communicable disease self-management.

Introduction: Self-management is a key component of chronic disease management. One of the strategies to support self-management in patients with chronic disease is the use of e-PHRs. Electronic personal health records offer patients the opportunity to actively engage with their own health information, promote continuity of care and collaboration through disease tracking, and provide patients and providers with an ongoing connection. To adopt e-PHRs and maximize any benefits for chronic disease management, they should align with patients' values and preferences.

Inclusion criteria: The review will include qualitative studies that explore the experiences of adult patients (aged 18 years and over) with a chronic non-communicable disease who have used e-PHR for the self-management of their condition. This review will consider studies conducted in any setting or country.

Methods: The systematic review will be conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence, with meta-aggregation as the method of synthesis. Published studies will be searched in CINAHL, PubMed, PsycINFO, Embase and Scopus. Gray literature will also be considered. Critical appraisal and data extraction will be conducted using the appropriate JBI tools. Extracted data will be aggregated and analyzed to produce a set of synthesized findings that can be used to develop evidence-informed recommendations for the use of e-PHRs in chronic disease self-management.

Systematic review registration number: PROSPERO CRD42019133301.

Objective: The objective of this review is to conduct comprehensive appraisal and synthesis of evidence on risk factors for hypertensive crisis and, specifically, hypertensive emergencies among adult patients with hypertension.

Introduction: Hypertensive crisis is the most extreme form of poorly controlled hypertension that may lead to acute target organ damage (hypertensive emergency). Hypertensive crisis is associated with increased mortality, high utilization of health care and escalated healthcare costs.

Inclusion criteria: This review will include epidemiological studies with participants over 18 years old with diagnosis of hypertension. The review will exclude pediatric, pregnant and postpartum patients. The review will consider studies that explore risk factors for hypertensive crisis, defined as an acute elevation of blood pressure equal or above 180/110 mmHg.

Methods: The search strategy aims to find both published and unpublished studies. The databases to be searched will include MEDLINE (Ovid), Embase, Cochrane Database of Systematic Reviews and Web of Science. Following the search, all identified studies will be screened against the inclusion criteria. Selected studies will be critically appraised for methodological quality. Data on exposures and outcomes will be extracted from papers included in the review. Quantitative data, where possible, will be pooled in meta-analysis. Effect sizes expressed as odds ratio and their 95% confidence intervals will be calculated. Heterogeneity of studies will be assessed statistically. Subgroup analysis to determine the association of risk factors with hypertensive emergencies will be conducted, if possible. Where statistical pooling is not possible, the findings will be presented in a narrative form.

Systematic review registration number: PROSPERO CRD42019140093.

Objective: The objective of this review was to assess the association between quality indicators used to evaluate individual colonoscopist performance and subsequent interval colorectal cancers (CRCs) in patients participating in bowel cancer screening programs.

Introduction: Colorectal cancer is a leading cause of cancer death. Bowel cancer screening has been shown to reduce CRC mortality and morbidity, and has therefore been introduced in many countries. Endoscopy societies have developed quality assurance guidelines and guidelines on quality indicators for screening colonoscopies. These quality indicators need to be validated against a relevant outcome to assess their value.

Inclusion criteria: We included studies on screening colonoscopies conducted on participants in a bowel cancer screening program, regardless of comorbidity. Studies on procedures performed on patients with known CRC, hereditary nonpolyposis colorectal cancer or familial adenomatous polyposis were excluded. We also included studies evaluating the quality indicators of withdrawal time (WT), cecal intubation rate (CIR) and adenoma detection rate (ADR). The search did not reveal any studies evaluating the quality indicators polyp retrieval rate and incomplete adenoma resection/incomplete polyp resection. Only studies with interval CRC as an outcome were included (i.e. CRC diagnosed after a negative screening colonoscopy, but before the next recommended examination date).

Methods: Published studies were searched in: MEDLINE, Embase, Web of Science and CINAHL. Unpublished studies were searched in: OpenGrey and Grey Literature Report. The sources were searched from 1980 to2018. Data were extracted using the JBI critical appraisal checklist for analytical cross sectional studies. A meta-analysis was conducted based on three of the colonoscopist dependent quality indicators: WT, CIR and ADR.

Results: Seven prospective and retrospective cohort studies were included out of 2373 papers identified after duplicates were removed. The included studies were on bowel cancer screening programs with colonoscopy as the primary screening tool, resulting in the inclusion of a total of 616,390 screening colonoscopies performed by 1431 colonoscopists and 2319 subsequent interval CRCs. Six studies were assessed as high-quality studies, and one study was of low quality. The meta-analysis on WT revealed a 61% lower risk of interval CRC among the patients if the mean WT per colonoscopist was >6 minutes as compared to a mean WT of <6 minutes (RR: 0.39 [95% CI: 0.23 - 0.66]). The meta-analysis on CIR revealed a 31% lower risk of interval CRC among the patients if the CIR per colonoscopist was ≥90% as compared to a CIR of <85% (RR: 0.69 [95% CI: 0.56 - 0.83]). One of two meta-analyses on the individual colonoscopist ADR suggested that this should be 15-19%, as compared to an ADR <10% (RR: 0.77

Objective: This scoping review aims to map primary care models designed to support adults with long-term conditions. The review will analyze the following in relation to the models identified: characteristics, impact reported, implications for practice and outcome measures.

Introduction: Robust solutions to support individuals with long-term conditions need to be established in order to increase health service capacity and provide cost-effective solutions while, most importantly, ensuring they receive the best services to live meaningful and productive lives.

Inclusion criteria: The concept to be mapped is primary care models used to support adults living with long-term conditions. This may also encompass services not solely designed for people with long-term conditions; however, they will be services that may be the first port of call for this group. Operational a priori criteria have been designed to assist with distinguishing appropriate literature.

Methods: Due to the nature of the scoping review, literature from a range of published and unpublished sources will be utilized from 1995 to 2019. Databases to be searched will include: MEDLINE, Embase, PsycINFO, HMIC, CINAHL, Cochrane Database of Systematic Reviews and Web of Science. Appropriate gray literature will be searched, alongside hand searching selected primary care journals, conference abstracts and professional and government bodies. Articles will be restricted to English. Titles and abstracts will be screened by two independent reviewers for assessment against the inclusion criteria. Charting of the data will include details about the population, concept, context, study methods and key findings relevant to the review objective.

Objective: The objective of this systematic review is to synthesize and present the best available evidence on community perceptions and practices relating to trachoma in Africa.

Introduction: Globally, trachoma is the leading cause of blindness and is responsible for about 1.4% of all cases of blindness. The African continent is the worst affected, with about 1.9 million cases of trichiasis (61%). While interventions are currently being implemented to combat the disease in Africa, very little is known by decision makers about community perceptions and practices relating to trachoma, which may hinder successful implementation.

Inclusion criteria: Studies with participants, regardless of their health status, gender, religion and ethnicity, aged 14 and over conducted in any African country, will be considered. Studies on Africans, conducted out of the continent and those involving healthcare professionals, will not be included in this review.

Methods: Qualitative studies, published in English from 1996 onwards. will be considered. Databases to be searched will include, but not be limited to: PubMed, CINAHL, Embase and PsycINFO. Study selection, critical appraisal and data extraction will be conducted by two independent reviewers, using the appropriate JBI methodology and any disagreement will be resolved by discussion or with a third reviewer. Qualitative findings will be synthesized using the appropriate JBI methodology, following the meta-aggregation approach. Where textual pooling is not possible, the findings will be presented in narrative form. The ConQual approach will be used to grade synthesized findings, and these will be presented in a Summary of Findings.

Objective: This review aims to investigate and compare the effectiveness of endoscopic drainage techniques against external drainage techniques for the treatment of orbital and subperiosteal abscesses as a complication of rhinosinusitis.

Introduction: Transnasal endoscopic drainage and external drainage techniques have been used in the management of subperiosteal orbital abscesses secondary to rhinosinusitis. Each of these approaches has its own advantages and disadvantages, with extensive literature describing each technique separately. However, there is a lack of guidance in the studies on assessing and comparing the safety, effectiveness and suitability of these techniques. This review aims to compare the effectiveness of these techniques based on measuring outcomes in the literature such as: length of postoperative hospital stay, rate of revision surgery and complication rates.

Inclusion criteria: Eligible studies will include people of all ages diagnosed with subperiosteal abscess, orbital abscess or cavernous sinus thrombosis (Chandler stages III-V) secondary to rhinosinusitis disease, who have also undergone drainage via either an endoscopic approach, external approach or combined surgical approach.

Methods: A comprehensive search of both published and unpublished literature will be performed to uncover studies meeting the inclusion criteria. Reference lists of studies included in final analyses will also be manually searched and subject matter experts contacted to investigate other sources of literature. Two reviewers will screen studies and a third reviewer will resolve disagreements. Studies will, where possible, be pooled in statistical meta-analysis with heterogeneity of data being assessed using the standard Chi-squared and I tests.

Objective: The objective of this systematic review is to explore the experiences of caregivers and healthcare workers regarding the management of pneumonia in children younger than five years in low-and lower middle-income countries.

Introduction: Pneumonia is a major cause of mortality among children younger than five years. A large percentage of these deaths occur in low-and lower-middle income countries. These deaths can be averted if the disease is recognized early and prompt medical care is sought. The ability of caregivers to detect early symptoms of pneumonia and seek prompt medical care is critical. The ability of healthcare workers to correctly diagnose and initiate early and effective treatment is also key to preventing pneumonia-related deaths.

Inclusion criteria: This systematic review will consider qualitative studies that explored the experiences of caregivers and healthcare workers regarding the management of pneumonia in children younger than five years in low- and lower middle-income countries. The term "caregivers" primarily refers to family members, whereas the term "healthcare workers" can include nurses, doctors, community and lay healthcare workers. Only studies published in English will be included, with no date restrictions.

Methods: The systematic review will use the JBI systematic review approach for qualitative studies, with meta-aggregation as the method of synthesis. The search for published studies will be undertaken in PubMed, Embase, Scopus and CINAHL. Gray literature will also be considered. Critical appraisal and data extraction will be conducted using the appropriate JBI tools. Following synthesis, recommendations for clinical practice and areas for future research will be identified.