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201. Evaluating Tele-ICU Implementation Based on Observed and Predicted ICU Mortality: A Systematic Review and Meta-Analysis

Evaluating Tele-ICU Implementation Based on Observed and Predicted ICU Mortality: A Systematic Review and Meta-Analysis Past studies have examined numerous components of tele-ICU care to decipher which elements increase patient and institutional benefit. These factors include review of the patient chart within 1 hour, frequent collaborative data reviews, mechanisms for rapid laboratory/alert review, and interdisciplinary rounds. Previous meta-analyses have found an overall ICU mortality benefit (...) implementing tele-ICU, however, subgroup analyses found few differences. The purpose of this systematic review and meta-analysis was to explore the effect of tele-ICU implementation with regard to ICU mortality and explore subgroup differences via observed and predicted mortality.We searched PubMed, Cochrane Library, Embase, and European Society of Intensive Care Medicine for articles related to tele-ICU from inception to September 18, 2018.We included all trials meeting inclusion criteria which looked

2019 EvidenceUpdates

202. Effectiveness of school-based self-management interventions for asthma among children and adolescents: findings from a Cochrane systematic review and meta-analysis

Effectiveness of school-based self-management interventions for asthma among children and adolescents: findings from a Cochrane systematic review and meta-analysis The evidence that teaching self-management techniques to children and young people with asthma in schools is effective has not, to date, been the subject of systematic review.We conducted a systematic review of intervention studies. Studies were eligible if they employed a randomised parallel-group design and were published (...) in reducing levels of hospitalisations (standardised mean differences [SMD] -0.19, 95% CI -0.35 to -0.04; studies=6). A meta-analysis of three studies suggest that the intervention approach could reduce the number of days of restricted activity (SMD -0.30, 95% CI -0.41 to -0.18; studies=3). However, there was uncertainty as to whether school-based self-management interventions impacted on reducing absences from school.Self-management interventions for children with asthma delivered in schools reduce

2019 EvidenceUpdates

203. Comparing Automated Office Blood Pressure Readings With Other Methods of Blood Pressure Measurement for Identifying Patients With Possible Hypertension: A Systematic Review and Meta-analysis

Comparing Automated Office Blood Pressure Readings With Other Methods of Blood Pressure Measurement for Identifying Patients With Possible Hypertension: A Systematic Review and Meta-analysis Automated office blood pressure (AOBP) measurement involves recording several blood pressure (BP) readings using a fully automated oscillometric sphygmomanometer with the patient resting alone in a quiet place. Although several studies have shown AOBP measurement to be more accurate than routine office BP (...) measurement and not subject to a "white coat effect," the cumulative evidence has not yet been systematically reviewed.To perform a systematic review and meta-analysis to examine the association between AOBP and office BP readings measured in routine clinical practice and in research studies, and ambulatory BP recorded during awake hours, as the latter is a standard for predicting future cardiovascular events.The MEDLINE, Embase, and Cochrane Library were searched from 2003 to April 25, 2018.Studies

2019 EvidenceUpdates

204. Impact of the Advanced Practice Provider in Adult Critical Care: A Systematic Review and Meta-Analysis

Impact of the Advanced Practice Provider in Adult Critical Care: A Systematic Review and Meta-Analysis To evaluate the effects on quality and efficiency of implementation of the advanced practice provider in critical care.PubMed, Embase, The Cochrane Library, and CINAHL were used to extract articles regarding advanced practice providers in critical care.Articles were selected when reporting a comparison between advanced practice providers and physician resident/fellows regarding the outcome (...) measures of mortality, length of stay, or specific tasks. Descriptive studies without comparison were excluded. The methodological quality of the included studies was rated using the Newcastle-Ottawa scale. The agreement between the reviewers was assessed with Cohen's kappa. A meta-analysis was constructed on mortality and length of stay.One-hundred fifty-six studies were assessed by full text. Thirty comparative cohort studies were selected and analyzed. These compared advanced practice providers

2019 EvidenceUpdates

205. Cerclage for women with twin pregnancies: a systematic review and meta-analysis

Cerclage for women with twin pregnancies: a systematic review and meta-analysis This study was conducted to estimate whether cerclage could extend the prolongation of pregnancy, reduce the risk of preterm birth, and improve perinatal outcomes in women with twin pregnancies.We included randomized controlled trials and cohort studies comparing the efficacy of cerclage with no cerclage for women with twin pregnancies.The following databases were searched for all published studies that compared (...) % confidence interval, 0.20-0.85; P=.030; I2=80%), and <24 weeks of gestation (risk ratio, 0.35; 95% confidence interval, 0.18-0.67; P=.001; I2=24%), and improvement of perinatal outcomes compared with those in the control group. However, for twin pregnancies with a normal cervical length (eg, cerclage for an indication for women with a history of preterm birth or twin alone), the efficacy of cerclage placement was less certain because of the limited data.Our metaanalysis indicates that cerclage placement

2019 EvidenceUpdates

206. Robot-assisted therapy for balance function rehabilitation after stroke: A systematic review and meta-analysis

Robot-assisted therapy for balance function rehabilitation after stroke: A systematic review and meta-analysis To identify the rehabilitative effects of robot-assisted therapy on balance function among stroke patients.A systematic review and meta-analysis of randomized controlled trials.Thirteen electronic databases were systematically searched from inception to March 2018: Web of Science, PubMed, EMBase, The Cochrane Library, Science Direct, CINAHL, MEDLINE, AMED, Physiotherapy Evidence (...) size was evaluated by mean difference with corresponding 95% confidence intervals. Methodological quality and risk bias evaluation for each included study followed the quality appraisal criteria for randomized controlled trials that were recommended by Cochrane Handbook. Meta-analysis was conducted by utilizing Review Manager 5.3, a Cochrane Collaboration tool. Data was synthesized with descriptive analysis instead of meta-analysis where comparisons were not possible to be conducted with a meta

2019 EvidenceUpdates

207. Programmed Death-1 or Programmed Death Ligand-1 Blockade in Patients with Platinum-resistant Metastatic Urothelial Cancer: A Systematic Review and Meta-analysis

Programmed Death-1 or Programmed Death Ligand-1 Blockade in Patients with Platinum-resistant Metastatic Urothelial Cancer: A Systematic Review and Meta-analysis Several anti-programmed death-1 (anti-PD-1) and anti-programmed death ligand-1 (anti-PD-L1) antibodies have been approved by regulatory authorities for treatment of platinum-resistant metastatic urothelial cancer (mUC). The impact of these therapies on survival, and comparability of PD-1 versus PD-L1 blockade are unknown.To determine (...) individual time-to-event data from published Kaplan-Meier curves. The RMST with 95% confidence interval (CIs) was calculated.From 836 references, six clinical trials were included. Survival data were reconstructed for 1315 and 736 patients treated with PD-1/PD-L1 inhibitors and chemotherapy, respectively. The RMSTs with PD-1/PD-L1 blockade up to 12 and 18mo of follow-up were 7.8mo (95% CI 7.6, 8.1) and 10mo (95% CI 9.7, 10.5), respectively. A network meta-analysis of two randomized trials revealed

2019 EvidenceUpdates

208. Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis

Pain Neuroscience Education for Adults With Chronic Musculoskeletal Pain: A Mixed-Methods Systematic Review and Meta-Analysis Chronic musculoskeletal pain (CMP) is an urgent global public health concern. Pain neuroscience education (PNE) is an intervention used in the management of CMP aiming to reconceptualize an individual's understanding of their pain as less threatening. This mixed-methods review undertook a segregated synthesis of quantitative and qualitative studies to investigate

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2019 EvidenceUpdates

209. Efficacy and safety of alirocumab and evolocumab: a systematic review and meta-analysis of randomized controlled trials

Efficacy and safety of alirocumab and evolocumab: a systematic review and meta-analysis of randomized controlled trials The effect of low-density lipoprotein cholesterol-lowering therapy with alirocumab or evolocumab on individual clinical efficacy and safety endpoints remains unclear. We aimed to evaluate the efficacy and safety of alirocumab and evolocumab in patients with dyslipidaemia or atherosclerotic cardiovascular disease.We performed a review of randomized controlled trials (RCTs

2019 EvidenceUpdates

210. Systematic review and meta-analysis of experimental studies: In-hospital mobilization for patients admitted for medical treatment

Systematic review and meta-analysis of experimental studies: In-hospital mobilization for patients admitted for medical treatment To determine the impact of strategies to promote mobilization on physical function in hospitalized adults with medical conditions.Slow progress is noted on the promotion of mobilization during hospitalization for adult patients admitted for medical conditions. This may reflect the limited evidence on the evaluation of the impact of progressive mobilization activities (...) on clinical endpoints in adult patients throughout hospitalization.A systematic review and meta-analysis of published randomized controlled trials in any language.The literature search was performed in the MEDLINE, CINAHL online, HealthStar, EMBASE, the Cochrane Library Controlled Trials Registry and LILACS databases (January 2000-February 2017).Two authors independently identified randomized trials meeting inclusion criteria, assessed their quality and extracted relevant data. Outcomes assessed were

2019 EvidenceUpdates

211. Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Perioperative Probiotics or Synbiotics in Adults Undergoing Elective Abdominal Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials To define the impact of perioperative treatment with probiotics or synbiotics on postoperative outcome in patients undergoing abdominal surgery.Postoperative surgical infection accounts for a third of all cases of sepsis, and is a leading cause of morbidity and mortality. Probiotics, prebiotics, and synbiotics (preparations that combine

2019 EvidenceUpdates

212. Psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities: A systematic review and meta-analysis

Psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities: A systematic review and meta-analysis To evaluate the effectiveness of psychological interventions in reducing stress, depression and anxiety among parents of children and adolescents with developmental disabilities.A systematic review and a meta-analysis.Seven electronic databases (CINAHL, CENTRAL, EMBASE, ProQuest Dissertation and Theses, PsycINFO (...) , PubMed and Scopus) were searched from each database's point of inception to December 2018.Quality appraisal was conducted using the Cochrane Risk of Bias Tool. Data were analysed using Review Manager 5.3. The overall quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation system.A total of 18 studies were included in this review. Eleven studies were involved in a meta-analysis and the remaining seven studies were summarized narratively. The meta

2019 EvidenceUpdates

213. Perioperative Fluid Restriction in Abdominal Surgery: A Systematic Review and Meta-analysis

Perioperative Fluid Restriction in Abdominal Surgery: A Systematic Review and Meta-analysis Perioperative fluid management is a critical component in patients undergoing abdominal surgery. However, the benefit of restricted fluid regimen remains inconclusive. This systematic review aimed to explore potential factors causing these inconsistent findings.The literature searches were performed in three databases including PubMed, Embase, and the Cochrane library until August 30, 2018. Only (...) randomized, controlled trials comparing the effect of restricted versus liberal regimen in abdominal surgery were included. The primary outcome was total postoperative complications. Subgroup analysis was performed according to between-group weight increase difference (≥ 2 kg and < 2 kg) and fluid intake ratio (≥ 1.8 and < 1.8).Sixteen studies were finally included in this meta-analysis. The benefit of the restricted regimen in reducing postoperative complication was only significant in the subgroup

2019 EvidenceUpdates

214. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data

Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data The benefits and risks of testosterone treatment for women with diminished sexual wellbeing remain controversial. We did a systematic review and meta-analysis to assess potential benefits and risks of testosterone for women.We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science for blinded, randomised controlled trials (...) of testosterone treatment of at least 12 weeks' duration completed between Jan 1, 1990, and Dec 10, 2018. We also searched drug registration applications to the European Medicine Agency and the US Food and Drug Administration to identify any unpublished data. Primary outcomes were the effects of testosterone on sexual function, cardiometabolic variables, cognitive measures, and musculoskeletal health. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO), number

2019 EvidenceUpdates

215. The role of anticoagulation in venous thromboembolism primary prophylaxis in patients with malignancy: A systematic review and meta-analysis of randomized controlled trials

The role of anticoagulation in venous thromboembolism primary prophylaxis in patients with malignancy: A systematic review and meta-analysis of randomized controlled trials Venous thromboembolism (VTE) is a common cause of morbidity and mortality among patients with cancer. As such, we conducted a meta-analysis of randomized controlled trials (RCTs) that evaluated anticoagulants as primary prophylaxis against VTE in cancer patients.Pubmed/MEDLINE, Embase, and the Cochrane Library were screened

2019 EvidenceUpdates

216. Neonatal, infant, and childhood growth following metformin versus insulin treatment for gestational diabetes: A systematic review and meta-analysis

Neonatal, infant, and childhood growth following metformin versus insulin treatment for gestational diabetes: A systematic review and meta-analysis Metformin is increasingly offered as an acceptable and economic alternative to insulin for treatment of gestational diabetes mellitus (GDM) in many countries. However, the impact of maternal metformin treatment on the trajectory of fetal, infant, and childhood growth is unknown.PubMed, Ovid Embase, Medline, Web of Science, ClinicalTrials.gov (...) with oral glucose-lowering agents other than insulin. Two reviewers independently assessed articles for eligibility and risk of bias, and conflicts were resolved by a third reviewer. Outcome measures were parameters of fetal, infant, and childhood growth, including weight, height, BMI, and body composition. In total, 28 studies (n = 3,976 participants) met eligibility criteria and were included in the meta-analysis. No studies reported fetal growth parameters; 19 studies (n = 3,723 neonates) reported

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2019 EvidenceUpdates

217. Total Neoadjuvant Therapy in Rectal Cancer: A Systematic Review and Meta-analysis of Treatment Outcomes

Total Neoadjuvant Therapy in Rectal Cancer: A Systematic Review and Meta-analysis of Treatment Outcomes The addition of induction chemotherapy to concomitant neoadjuvant chemoradiation in locally advanced rectal cancer could increase pathological downstaging and act on occult micrometastatic disease, leading ultimately to a better outcome. A systematic review was carried out of the existing literature on the treatment outcomes of total neoadjuvant therapy (TNT) on locally advanced rectal cancer

2019 EvidenceUpdates

218. Pharmacologic and Nonpharmacologic Treatments for Urinary Incontinence in Women: A Systematic Review and Network Meta-analysis of Clinical Outcomes. (PubMed)

Pharmacologic and Nonpharmacologic Treatments for Urinary Incontinence in Women: A Systematic Review and Network Meta-analysis of Clinical Outcomes. Urinary incontinence (UI), a common malady in women, most often is classified as stress, urgency, or mixed.To compare the effectiveness of pharmacologic and nonpharmacologic interventions to improve or cure stress, urgency, or mixed UI in nonpregnant women.MEDLINE, Cochrane Central Register of Controlled Trials (Wiley), Cochrane Database (...) of Systematic Reviews (Wiley), EMBASE (Elsevier), CINAHL (EBSCO), and PsycINFO (American Psychological Association) from inception through 10 August 2018.84 randomized trials that evaluated 14 categories of interventions and reported categorical cure or improvement outcomes.1 researcher extracted study characteristics, results, and study-level risk of bias, with verification by another independent researcher. The research team collaborated to assess strength of evidence (SoE) across studies.84 studies

2019 Annals of Internal Medicine

219. Efficacy and Safety of Patient-controlled Analgesia Compared With Epidural Analgesia After Open Hepatic Resection: A Systematic Review and Meta-analysis

Efficacy and Safety of Patient-controlled Analgesia Compared With Epidural Analgesia After Open Hepatic Resection: A Systematic Review and Meta-analysis To compare the efficacy and safety of patient-controlled analgesia (PCA) to epidural analgesia in adults undergoing open hepatic resection.Effective pain management in patients undergoing open hepatic resection is often achieved with epidural analgesia. However, associated risks have prompted investigation of alternative analgesic methods (...) in this patient population.A comprehensive systematic literature review via Medline, Embase, and the Cochrane databases from inception until December 2, 2017 was conducted, followed by meta-analysis. Abstract and full-text screening, data extraction, and quality assessment were conducted by 2 investigators. Odds ratios (OR), mean differences (MD), and 95% confidence intervals were calculated using RevMan 5.3.Four randomized controlled trials with 278 patients were identified. All studies compared the use

2019 EvidenceUpdates

220. The Efficacy and Safety of Inpatient Rehabilitation Compared With Home Discharge After Hip or Knee Arthroplasty: A Meta-Analysis and Systematic Review

The Efficacy and Safety of Inpatient Rehabilitation Compared With Home Discharge After Hip or Knee Arthroplasty: A Meta-Analysis and Systematic Review Total hip and knee arthroplasties (THKAs) are successful procedures in managing end-stage arthritis when nonoperative treatments fail. The immediate postoperative period is an important time for the body to recuperate and rehabilitate. Studies have shown that early intensive rehabilitation can enhance recovery. Rehabilitation can be provided (...) as inpatient rehabilitation (IR) or discharge with home rehabilitation. These options have been studied, but literature on the efficacy and safety of IR compared to home discharge is scarce, and evidence is not well established. This meta-analysis aims to compare the efficacy and safety of IR to home discharge with rehabilitation after THKA.A multidatabase search was performed according to PRISMA guidelines. Data from studies assessing the efficacy and safety of IR and home as discharge destinations after

2019 EvidenceUpdates

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