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18261. Treatment of depression: newer pharmacotherapies

improved as assessed by a global assessment method), total discontinuation rates, and rates of discontinuation due to adverse events. Secondary outcomes were health-related quality-of-life, functional status and suicide. Uncommon, serious adverse effects were investigated. How were decisions on the relevance of primary studies made? Two or more independent reviewers identified the trials for inclusion in the review. Assessment of study quality The validity of studies included in the review was assessed (...) that assumed that all drop-outs gained no treatment benefit. A sensitivity analysis was based on an end point method, whereby the denominator for the risk ratio was the number of participants who completed follow-up or whose last observation was carried forward. Methods of synthesis How were the studies combined? Within the review, studies were grouped by type of comparison and type of depression. Where studies were conceptually homogeneous, quantitative analyses were performed using an empirical Bayes

1999 DARE.

18262. Program factors and treatment outcomes in drug dependence treatment: an examination using meta-analysis

, and studies of impaired professionals and employee assistance programmes. Participants included in the review Studies that involved adults (aged at least 18 years) or in which adults constituted at least 80% of the sample were eligible for inclusion. Outcomes assessed in the review Studies that quantitatively assessed outcomes such as drug use, employment and criminal behaviour were eligible for inclusion. The actual outcomes assessed in the primary studies were not reported. How were decisions (...) on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the reviewers performed the selection. Assessment of study quality A formal assessment of validity was not undertaken. Aspects relating to the validity of single-group studies were mentioned briefly in the text. Data extraction One of seven trained masters or doctoral-level students extracted and coded the following data: study context; study methodology; subject characteristics

2000 DARE.

18263. The effects of physical therapy in Parkinson's disease: a research synthesis

was 8 years. Outcomes assessed in the review Studies that evaluated the effect of Parkinson's disease were eligible for inclusion. The review assessed ADL, walking speed, stride length and neurological signs. How were decisions on the relevance of primary studies made? The authors did not state how the papers were selected for the review, or how many reviewers performed the selection. Assessment of study quality Validity was assessed on the basis of the following criteria: method of randomisation (...) of a third reviewer where required. The reviewers were not blinded to the authors, institution or journal. Inter-rater agreement on the validity scores was estimated. Data extraction One reviewer extracted the data. Methods of synthesis How were the studies combined? Hedge's 'g' summary effect size (SES) and 95% confidence interval (CI) was calculated for each outcome, using a fixed-effect model where no statistical heterogeneity was found and a random-effects model where significant heterogeneity

2001 DARE.

18264. Propfol versus methohexital for electroconvulsive therapy: a meta-analysis

opening. How were decisions on the relevance of primary studies made? The retrieved reports were screened for relevance by one author. Assessment of study quality The methodological validity of the included studies was assessed using the 3-item, 5-point Oxford score as described by Jadad et al. (see Other Publications of Related Interest no.1). All authors independently scored all the included trials for methodological validity, and any disagreements were resolved by consensus. Data extraction (...) The data were extracted from the included studies by one author, with the other two authors assessing the adequacy of the data extraction process. Data were extracted on the patients' characteristics, the propofol and methohexital regimens, any concomitant drugs, and the end points of interest. Methods of synthesis How were the studies combined? Narrative and quantitative syntheses were undertaken. The weighted mean differences were calculated for continuous data (duration of seizures and duration

2001 DARE.

18265. A lack of evidence of superiority of propofol versus midazolam for sedation in mechanically ventilated critically ill patients: a qualitative and quantitative systematic review

hypertriglyceridaemia and arterial hypotension; the length of ICU stay; mortality; and cost estimations. A clinically relevant hypertriglyceride level was defined as at least a doubling of the normal values as reported in the individual trial. Arterial hypotension was defined as a systolic blood-pressure of less than 90 mmHg, or the need for an intervention. The depth of sedation was assessed in sixteen trials using the Ramsay scale. How were decisions on the relevance of primary studies made? One author screened (...) from the crossover RCT were reported as if they had come from a parallel group trial, and the data were used assuming the lack of any carryover effect. An intention to treat analysis could not be performed because most of the trials only reported the number of analysed patients. Methods of synthesis How were the studies combined? The weighted mean differences (WMD) and 95% confidence intervals (CIs) were calculated for the continuous data. The pooled relative risk (RR), 95% CI and the number-needed

2001 DARE.

18266. Feasibility and effectiveness of treatments for post-stroke depression in elderly inpatients: systematic review

activities of daily living and function, frequency of contraindications, and unacceptable side-effects that required the treatment to be discontinued. How were decisions on the relevance of primary studies made? The articles were screened by one reviewer, based on the title and/or abstract. A final decision for inclusion was made independently by two reviewers against the inclusion criteria for the review. Assessment of study quality The criteria used to assess the validity of the RCTs were randomisation (...) discrepancies were resolved by consensus or a third reviewer. Methods of synthesis How were the studies combined? The studies were tabulated by type of treatment and discussed and compared in the narrative. No formal pooling occurred; this was possibly due to the small number of studies with useable data. The methods for assessing publication bias were not discussed. Studies were discussed within each of the four types of interventions (heterocyclic drugs, with or without SSRIs, psychostimulants, or ECT

2001 DARE.

18267. Octreotide for acute esophageal variceal bleeding: a meta-analysis

of bleeding were eligible. The following primary outcomes were assessed: overall mortality (from any cause); sustained control of bleeding (absence of re-bleeding as defined in each study); any complication (excluding post-sclerotherapy ulcerations); and major complications. How were decisions on the relevance of primary studies made? All identified article titles and available abstracts were reviewed. The authors do not state how many of the reviewers performed the selection. Assessment of study quality (...) recent publications were used. For trials with multiple interventions, comparisons of octreotide with placebo were used. Methods of synthesis How were the studies combined? Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using the fixed-effect Mantel-Haenszel method. Intention-to-treat analyses were performed for all studies together and by considering three major alternative interventions. These were vasoactive agents (vasopressin or terlipressin); immediate and follow

2001 DARE.

18268. Antidepressants and anticonvulsants for diabetic neuropathy and postherpetic neuralgia: a quantitative systematic review

. These values depended on the type of measurement scale used and the number of points on the scale. The outcomes were assessed using the self-reported global scale, visual analogue scale, categorical pain relief scale, and neuropathy scale. Adverse effects were classified as minor if they were reported by a patient who continued with the medication and completed the trial. A major adverse effect was one that caused the patient to withdraw from the study. How were decisions on the relevance of primary (...) studies made? The authors do not state how the papers were selected for the review, or how many of the reviewers performed the selection. Assessment of study quality Validity was assessed using the 3-item, 5-point scale of Jadad et al. (see Other Publications of Related Interest no.1). The authors do not state how the papers were assessed for validity, or how many of the reviewers performed the validity assessment. Data extraction The authors do not state how the data were extracted for the review

2000 DARE.

18269. Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials

(range: 8 to 73) for the hypertensive participants. Outcomes assessed in the review Systolic and diastolic blood-pressure, and urinary sodium excretion were assessed. How were decisions on the relevance of primary studies made? The titles and abstracts were assessed for simple relevance criteria by two independent observers, in order to exclude obviously irrelevant citations. The methods section of articles included after this stage were blinded for title, authors, journal, abstract and results (...) . The authors do not state how the papers were assessed for validity, or how many of the authors performed the validity assessment. Data extraction The data extraction were carried out independently by two observers using a customised form. Any discrepancies in the data extraction were identified and resolved by consensus. Methods of synthesis How were the studies combined? A quantitative synthesis was undertaken. Both fixed-effect and random-effects estimates were calculated; analyses were weighted

1996 DARE.

18270. A meta-analytic evaluation of the polymerase chain reaction for the diagnosis of HIV infection in infants

the sensitivity and specificity of PCR were eligible for inclusion in the review. How were decisions on the relevance of primary studies made? Two independent investigators assessed the studies for relevance using defined inclusion criteria. Assessment of study quality Studies were assessed on the basis of the following: the adequacy of PCR; the adequacy of the reference test; the consistency in applying the reference test; whether PCR was interpreted blinded to other test results and clinical information (...) of study initiation and publication, location of study and author affiliations. The sensitivity and specificity were calculated based on the number of participants rather than the number of samples. The results were stratified according to participant age: studies of patients aged 30 days or younger, and studies of patients aged older than 30 days or all ages. Methods of synthesis How were the studies combined? The estimates of sensitivity and specificity were combined in a summary receiver operating

1996 DARE.

18271. Patient outcomes following tricompartmental total knee replacement: a meta-analysis

in the review Patients undergoing initial knee replacement were included. The weighted mean age across all studies was 65 years and 71.17% of enrolled patients were women. Outcomes assessed in the review Pain, function and range of motion, as measured by a global knee-rating scale (GKRS), mortality, complications (overall and thromboembolism) and revisions. How were decisions on the relevance of primary studies made? A multistaged assessment was performed by two of the study investigators. It is not stated (...) . Data extraction The data were extracted by one of the 3 research assistants or one of the 3 study investigators. There is no mention of this process being checked for accuracy. Data were extracted so as to enable 'patients' to be used as the unit of analysis, except for post-operative complications where 'knees' were used. Methods of synthesis How were the studies combined? Tricompartmental prostheses were classified according to the manner in which the cruciate and collateral ligaments were

1994 DARE.

18272. Effect of calcium supplementation on pregnancy-induced hypertension and preeclampsia: a meta-analysis of randomized controlled trials

in the review Incidence of pre-eclampsia and hypertension (systolic and diastolic blood-pressure). For a subgroup of studies, outcomes included pre-term delivery, intra-uterine growth retardation and Caesarean section. How were decisions on the relevance of primary studies made? The titles and abstracts (if available) from the searches were printed in duplicate. Two reviewers independently examined the lists. Studies randomising pregnant women to treatment or control, measuring blood-pressure and following (...) ' agreement ranged between 0.86 and 1.0. Data extraction Data were abstracted in duplicate and differences were resolved by consensus. Primary authors of studies were contacted for additional information. Full details are presented in the companian review (see Other Publications of Related Interest no. 1). Methods of synthesis How were the studies combined? The data were summarised in fixed-effect and random-effects models, combined with summary tables of individual studies. How were differences between

1996 DARE.

18273. Drug-related falls in the older adult

in the review). Older people, both hospitalised and in community-dwellings, were included. Outcomes assessed in the review The outcome assessed was drug-related falls. How were decisions on the relevance of primary studies made? One reviewer summarised the studies in a table. Assessment of study quality Validity was assessed by study design, statistical precision, bias, confounding and generalisability. Three reviewers assessed the validity of each paper independently. Consensus was reached by discussion (...) at several meetings. Data extraction One reviewer summarised the studies in tabular format. Methods of synthesis How were the studies combined? The studies were combined in a narrative review. How were differences between studies investigated? The studies were grouped according to the drugs used. Results of the review Two RCTs (461 patients), 6 cohort studies (2,705 patients) and 5 case-control studies (749 cases versus 681 controls). Psychotropics and psychoactive medications: included studies were

1996 DARE.

18274. A meta-analysis of the effectiveness of occupational therapy for older persons

in spasticity, reduction in hypertonus, feeding responses, hygienic skills, improved attitude and mental functioning, depression and self-esteem. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection. Assessment of study quality The authors do not report the criteria used to assess validity, or how the validity assessment was performed. Data extraction One author coded all study (...) design variables and two authors independently calculated the appropriate effect size estimates. Methods of synthesis How were the studies combined? Separate effect size estimates were generated for each relevant outcome measure within each study. Then, separately within each study, the mean of all corresponding effect size estimates was calculated and used as the primary unit of analysis. In addition, within each study, a single effect size estimate specific to each represented outcome variable

1996 DARE.

18275. A critical appraisal of positioning infants in the neonatal intensive care unit

Physiological outcomes including at least one cardiopulmonary or growth parameter, and developmental outcomes including either neurobehavioural or neuromotor parameters and head shape. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection. Studies had to include prematurely born infants who were on a positioning programme while in the neonatal intensive care unit. Assessment (...) of study quality The studies were evaluated using Sackett's five levels of evidence and three grades of recommendations (e.g. level 1, large randomised trials; level 2, small randomised trials; level 3, non-randomised trials with concurrent cohort comparison; level 4, non-randomised trials with historical cohort comparison; level 5, case studies with no controls). The authors do not state how the papers were assessed for validity, or how many of the authors performed the validity assessment. Data

1995 DARE.

18276. Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis

fish oil supplementation. Participants included in the review Patients with rheumatoid arthritis (n=408) were included. Outcomes assessed in the review The use of at least one of: tender joint count, swollen joint count, morning stiffness, grip strength, patient/physician global assessment or visual analogue scale. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection (...) of study. The treatment and control groups were also blotted out and randomly designated by letters. Data extraction The authors do not state how the data were extracted for the review, or how many of the authors performed the data extraction. Data were collected on demographic and outcome variables. For the reanalysis of primary data, the same variables were abstracted for individual patients (data were available for 395 participants). Methods of synthesis How were the studies combined? For each

1995 DARE.

18277. A meta-analysis of intervention effectiveness for symptom management in oncology nursing research

of disease are discussed in the review. Outcomes assessed in the review The main outcomes assessed in the meta-analysis were the differences in the intervention effectiveness between the experimental and control groups for the following symptoms: nausea and vomiting, pain, anxiety, alopecia, infection, oral assessment, shivering duration, healing time and quality of life. How were decisions on the relevance of primary studies made? Periodic reliability testing was performed throughout the selection phase (...) as a measure of difference between the experimental and control groups. taking sample size into account. A Binomial Effect Size Display (BED) was calculated for the intervention success rate for each study. Methods of synthesis How were the studies combined? Results from the individual studies were combined using a weighted (for sample size) average d between the experimental and control group for the outcome selected, with 95% confidence intervals (CIs). How were differences between studies investigated

1994 DARE.

18278. A meta-analysis of somatostatin versus vasopressin in the management of acute esophageal variceal hemorrhage

as clinical absence of continued bleeding within 6-12 hours); sustained control of bleeding (24-72 hours); adverse drug effects leading to discontinuation of treatment and all cause mortality. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection. Assessment of study quality Quality of the trials were evaluated on the basis of investigator blindness; well-defined study population (...) on aspects of quality. Data extraction Two reviewers independently abstracted data regarding the number of patients in both treatment groups and the number with each outcome. Methods of synthesis How were the studies combined? Summary points estimations of effect were computed using precision-based weighted averages of stratum-specific relative risk (RR), with the weights derived from the reciprocals of the variances. 95% confidence intervals (CI) were calculated by the Taylor series method (see Other

1995 DARE.

18279. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials

was assessed. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection. Assessment of study quality The authors do not state that they assessed validity. Data extraction Individual patient data were obtained directly from trialists. All data were checked for internal consistency, and against the trial protocol and published reports. Each trial was analysed individually and sent (...) to the trialists for verification. Methods of synthesis How were the studies combined? The data were combined to calculate the individual and overall pooled hazard ratios (HRs) using the fixed-effect model. The analysis was undertaken on an intention to treat basis. The absolute survival differences were also calculated. Subgroup analysis was undertaken to look for differences due to stage, age, sex, histological cell type and performance status. How were differences between studies investigated? Tests

1995 DARE.

18280. Exercise rehabilitation programs for the treatment of claudication pain: a meta-analysis

Participants with claudication pain were included. The mean age was 62.8 years (range: 57.9 to 68). Outcomes assessed in the review Claudication pain was assessed using a treadmill test before and after an exercise programme. Studies were excluded if mean or individual times or distances walked to the onset of pain and to the maximal claudication pain were not reported. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how (...) many of the authors performed the selection. Assessment of study quality The authors do not state that they assessed validity. Data extraction The data were independently extracted by the principal investigator and a research assistant. Neither reader was masked to the identity of the authors or to the institution, but the research assistant was masked as to the purpose of the study. Methods of synthesis How were the studies combined? Inverse-variance averages of the within study treatment effects

1995 DARE.

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