Category Archives: Meta-analyses – Systematic Reviews

In 2004, the Office of the Assistant Deputy Under Secretary for Health for Policy and Planning estimated that the total number of Veterans with dementia would be as high as 563,758 in FY 2010. The behavioral symptoms that are associated with dementia, such as agitation/aggression,wandering, and sleep disturbances, are associated with increased caregiver burden, decreased quality of life for the patient, and increased healthcare costs. It is estimated that behavioral symptoms occur in as many as 90 percent of people …

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For chronic migraine, onabotulinumtoxin A reduced migraine attacks but increased the risk of adverse effects and treatment discontinuation due to adverse effects. For episodic migraine, approved drugs are effective but increase risk of adverse effects and treatment discontinuation due to adverse effects. Some off-label beta blockers and angiotensin inhibiting drugs are effective without bothersome harms and therefore offer the best benefits-to-harms ratio. We could not determine the long-term (i.e., trials of more than 3 months’ duration), preventive benefits and adherence …

Few studies have evaluated interventions to address one or more CVD risk factors in patients with SMI. Comparative effectiveness studies are needed to test multimodal strategies, agents known to be effective in non-SMI populations, and antipsychotic-management strategies.

The objective of this methods project was to determine whether PFS is an outcome related to psychological well-being or QOL. It focused on the relationship between PFS, an outcome, and other outcomes of importance to patients. In contrast to a traditional comparison of interventions, the variable of interest, PFS, is somewhat problematic, because the presence or absence of progression can only be observed, precluding the ability to design a prospective randomized clinical trial. Defining the relationship between PFS and QOL …

Intimate partner violence (IPV) is a form of trauma that can result in significant mental health distress for victims. Rates of clinical depression and posttraumatic stress disorder are higher among abused versus non-abused women, particularly if victims have experienced other lifetime trauma. While there are numerous interventions designed to reduce trauma induced mental health symptoms, most were originally developed to address events that have occurred in the past (e.g., combat, childhood sexual abuse). Many IPV survivors are still under threat …

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The growing incidence of chronic diseases has, in part, contributed to increased political and societal pressures to ensure public funds are allocated to the provision of services with known effectiveness. In other words, there is a call to action to ensure the programs and services implemented across Canada in population and public health are effective, and that they will result in improved health outcomes for Canadians. There is some evidence to suggest that current practices related to the promotion of …

Conclusions Most authors of Cochrane reviews who searched for unpublished data received useful information, primarily from trialists. Our response rate was low and the authors who did not respond were probably less likely to have searched for unpublished data. Manufacturers and regulatory agencies were uncommon sources of unpublished data.

The growing incidence of chronic diseases has, in part, contributed to increased political and societal pressures to ensure public funds are allocated to the provision of services with known effectiveness. In other words, there is a call to action to ensure the programs and services implemented across Canada in population and public health are effective, and that they will result in improved health outcomes for Canadians. There is some evidence to suggest that current practices related to the promotion of …

Conclusions Using cancer trial publications alone to assess risk of bias could be unreliable; thus, reviewers should be cautious about using them as a basis for trial inclusion, particularly for those trials assessed as unclear risk. Supplementary information from trialists should be sought to enable appropriate assessments and potentially reduce or overcome some risks of bias. Furthermore, guidance should ensure clarity on what constitutes risk of bias, particularly for the more subjective domains.

Aims: Sub-Saharan Africa is disproportionately affected by HIV/AIDS, and growing evidence suggests that alcohol consumption is a co-occurring problem in the region. We conducted a meta-analysis on studies of alcohol use and HIV infection in sub-Saharan Africa in order to assess associations, evaluate heterogeneity in the literature, identify susceptible subgroups, and suggest avenues for future research. Design: We performed a systematic review, including published review articles and electronic database searches, and identified 35 studies on alcohol use and HIV. Setting …

Conclusions Treatment effect estimates differed within meta-analyses solely based on trial sample size, with stronger effect estimates seen in small to moderately sized trials than in the largest trials.

Continue reading here:  Withdrawal versus continuation of chronic antipsychotic drugs for behavioural and psychological symptoms in older people with dementia

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Aim: To systematically review research outlining the effects of price and taxation on alcohol consumption, alcohol-related harms, and drinking initiation in low- and middle-income countries (LMIC). Design: The systematic review and meta-analyses were conducted according to internationally standardized protocols (Preferred Reporting Items for Systematic Review and Meta-Analysis; PRISMA). Data were collected up to June 2011 by searching the peer-reviewed article databases MEDLINE, EMBASE, PsycINFO, and EconLit, along with the World Health Organization’s gray literature Database of Abstracts of Reviews of …

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The social determinants of health search identified 31 high quality reviews, 17 of which reported on outcomes relevant to this review. Outcomes reported on most frequently included: health care utilization (N=10), mental health (N=9), physical health (N=6), and behavioural problems (N=6). The participants studied ranged from the general population with low literacy to adults with mental disorders and homeless persons, as well as children, adults, and health professionals. The interventions evaluated can be classified into the following categories: improving health, …

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Atypical antipsychotic medications for the adjunctive treatment of depression are efficacious in reducing observer-rated depressive symptoms, but clinicians should interpret these findings cautiously in light of (1) the small-to-moderate-sized benefits, (2) the lack of benefit with regards to quality of life or functional impairment, and (3) the abundant evidence of potential treatment-related harm.

Findings Twenty-six articles met the inclusion criteria: 5 involved voluntary self-regulation; 8, labelling alone; 4, labelling and voluntary limits; 5, local bans and 4, national bans. Overall, the TFA content of food decreased with all types of policy intervention. In general, saturated fat levels increased or decreased, depending on the product type, and total fat content remained stable. National and local bans were most effective at eliminating TFAs from the food supply, whereas mandatory TFA labelling and voluntary TFA limits …

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Originally from:  Physical rehabilitation for older people in long-term care

Source:   Personalised risk communication for informed decision making about taking screening tests

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