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101. Systematic review and meta-analysis of acute type B thoracic aortic dissection, open, or endovascular repair

Systematic review and meta-analysis of acute type B thoracic aortic dissection, open, or endovascular repair The purpose of this study was to compare perioperative and mortality outcomes of endovascular aortic repair against open repair in acute type B thoracic aortic dissection.A comprehensive search was undertaken among the four major databases (PubMed, Embase, Scopus, and Ovid) to identify all published data comparing open vs endovascular repair in management of acute type B aortic

2019 EvidenceUpdates

102. The renoprotective effects of sodium-glucose cotransporter 2 inhibitors versus placebo in patients with type 2 diabetes with or without prevalent kidney disease: A systematic review and meta-analysis

The renoprotective effects of sodium-glucose cotransporter 2 inhibitors versus placebo in patients with type 2 diabetes with or without prevalent kidney disease: A systematic review and meta-analysis We undertook a systematic review and meta-analysis to assess the efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT2is) concerning kidney outcomes in patients with type 2 diabetes mellitus (T2DM), with or without prevalent kidney disease.PubMed, Web of science, Embase

2019 EvidenceUpdates

103. Comparative effectiveness and harms of long-acting insulins for type 1 and type 2 diabetes: A systematic review and meta-analysis

Comparative effectiveness and harms of long-acting insulins for type 1 and type 2 diabetes: A systematic review and meta-analysis To review evidence comparing benefits and harms of long-acting insulins in patients with type 1 and 2 diabetes.MEDLINE and two Cochrane databases were searched during February 2018. Two authors selected studies meeting inclusion criteria and assessed their quality. Comparative studies of adult or paediatric patients with diabetes treated with insulin degludec (...) , detemir or glargine were included. Meta-analysis was used to combine results of similar studies, and the I2 statistic calculated to assess statistical heterogeneity.Of 2534 citations reviewed, 70 studies met the inclusion criteria. No statistically significant differences in HbA1c were seen between any two insulins or formulations. Hypoglycaemia was less probable with degludec than with glargine, including nocturnal hypoglycaemia in type 1 (rate ratio 0.68, 95% CI 0.56-0.81) and type 2 diabetes (rate

2019 EvidenceUpdates

104. Double sequential external defibrillation for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and meta-analysis

Double sequential external defibrillation for refractory ventricular fibrillation out-of-hospital cardiac arrest: A systematic review and meta-analysis Double sequential external defibrillation (DSED) is a novel intervention which has shown potential in the management of refractory ventricular fibrillation (VF). This review aims to identify the literature surrounding the use of DSED in out-of-hospital refractory VF and assess whether this intervention improves survival outcomes.The databases (...) differed across studies. Over half of cases were witnessed cardiac arrests (58.7%, n = 293) and bystander CPR was initiated in 53.3% (n = 266) of cases. In the meta-analysis, DSED had no effect on survival to hospital discharge (OR 0.69, 95% CI: 0.30, 1.60), event survival (OR 0.98, CI: 0.59, 1.62) or ROSC (OR 0.86, 95% CI: 0.49-1.48).The effectiveness of DSED remains unclear. Further well-designed prospective studies are needed to determine whether DSED has a role in the treatment of refractory

2019 EvidenceUpdates

105. Comparative efficacy and acceptability of psychosocial interventions for individuals with cocaine and amphetamine addiction: A systematic review and network meta-analysis

Comparative efficacy and acceptability of psychosocial interventions for individuals with cocaine and amphetamine addiction: A systematic review and network meta-analysis Clinical guidelines recommend psychosocial interventions for cocaine and/or amphetamine addiction as first-line treatment, but it is still unclear which intervention, if any, should be offered first. We aimed to estimate the comparative effectiveness of all available psychosocial interventions (alone or in combination (...) cause) at the end of treatment, but we also measured the acute (12 weeks) and long-term (longest duration of study follow-up) effects of the interventions and the longest duration of abstinence. Odds ratios (ORs) and standardised mean differences were estimated using pairwise and network meta-analysis with random effects. The risk of bias of the included studies was assessed with the Cochrane tool, and the strength of evidence with the Grading of Recommendations Assessment, Development

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2019 EvidenceUpdates

106. Results of simultaneous bilateral carotid artery stenting: A systematic review and meta-analysis

Results of simultaneous bilateral carotid artery stenting: A systematic review and meta-analysis Although staged procedures to treat bilateral carotid artery stenosis are mainstream, a growing number of articles on simultaneous bilateral carotid artery stenting (SBCAS) have been published. Thus, this meta-analysis was performed to evaluate the efficacy and safety of SBCAS.The PubMed and Embase databases were searched to identify all studies reporting SBCAS from January 1, 2000, to October 1 (...) , 2017. Patients' characteristics, comorbidities, technical success, deaths, and complications were collected and analyzed. Forest plots were drawn with either a random-effects model or fixed-effects model according to their heterogeneities. Publication biases were tested by funnel plots and linear regression test.Overall, 333 patients with bilateral carotid stenosis in 10 retrospective studies were enrolled in this meta-analysis. The mean age was 67.4 years; 75% of the patients were male, and 85.6

2019 EvidenceUpdates

107. The effects of incretin-based therapies on beta-cell function and insulin resistance in type 2 diabetes: A systematic review and network meta-analysis combining 360 trials

The effects of incretin-based therapies on beta-cell function and insulin resistance in type 2 diabetes: A systematic review and network meta-analysis combining 360 trials To evaluate the comparative effects of incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), on β-cell function and insulin resistance in patients with type 2 diabetes mellitus (T2DM).Medline, Embase, the Cochrane Library (...) and www.clinicaltrials.gov were searched for randomized controlled trials (RCTs) with a duration of at least 4 weeks. Network meta-analysis was performed, followed by subgroup analysis and meta-regression. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to assess the quality of evidence. Outcomes of interest include homeostasis model assessment for β cell function (HOMA-β) and insulin resistance (HOMA-IR), fasting C-peptide and fasting plasma glucose (FPG). Weighted mean

2019 EvidenceUpdates

108. Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis

Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis Although corticosteroids are widely used for adults with sepsis, both the overall benefit and potential risks remain unclear.To conduct a systematic review and meta-analysis of the efficacy and safety of corticosteroids in patients with sepsis.MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception until March 20, 2018 (...) reviewers completed citation screening, data abstraction, and risk assessment.Twenty-eight-day mortality.This meta-analysis included 37 RCTs (N = 9564 patients). Eleven trials were rated as low risk of bias. Corticosteroid use was associated with reduced 28-day mortality (RR, 0.90; 95% CI, 0.82-0.98; I2 = 27%) and intensive care unit (ICU) mortality (RR, 0.85; 95% CI, 0.77-0.94; I2 = 0%) and in-hospital mortality (RR, 0.88; 95% CI, 0.79-0.99; I2 = 38%). Corticosteroids were significantly associated

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2019 EvidenceUpdates

109. Comparison of Functional Outcomes of Computer-Assisted vs Conventional Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of High-Quality, Prospective Studies

Comparison of Functional Outcomes of Computer-Assisted vs Conventional Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of High-Quality, Prospective Studies Computer-assisted navigation system (CAS) in total knee arthroplasty (TKA) has been shown to improve mechanical alignment and prosthesis positioning as compared to conventional TKA. However, the evidence with regard to whether CAS-TKA has better patient function over conventional TKA is not clear. This systematic review (...) and meta-analysis compares functional outcomes of CAS vs conventional TKA at longer follow-up periods.This study was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, Embase, gray literature, and clinicaltrials.gov were searched up to April 30, 2018. All prospective original studies (only level 1 and 2) that compared functional outcomes of CAS-TKA vs conventional TKA, with minimum 2-year follow-up, were included. The research

2019 EvidenceUpdates

110. Clinical Outcomes and Complications of the Surgical Implant Generation Network (SIGN) Intramedullary Nail: A Systematic Review and Meta-Analysis

Clinical Outcomes and Complications of the Surgical Implant Generation Network (SIGN) Intramedullary Nail: A Systematic Review and Meta-Analysis This study is a systematic review and meta-analysis of the clinical outcomes and pooled complication rate of femoral, tibial, and humeral fracture fixation using SIGN nails. We aimed at comparing the pooled rate of adverse events based on the country of study origin, acute versus delayed fracture fixation, and length of follow-up.We searched PubMed

2019 EvidenceUpdates

111. Effect of Resveratrol on Blood Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Effect of Resveratrol on Blood Lipid Levels in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis Few studies have considered the effect of resveratrol on blood lipid levels, and the results of these studies are inconsistent. In this study, the first meta-analysis on the effect of resveratrol on blood lipid levels in patients with type 2 diabetes was conducted.This study used keywords such as type 2 diabetes, total cholesterol, triglyceride (TG), high-density lipoprotein, low

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2019 EvidenceUpdates

112. Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis

Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis Long-term exercise benefits on prevalent adverse events in older populations, such as falls, fractures, or hospitalizations, are not yet established or known.To systematically review and investigate the association of long-term exercise interventions (≥1 year) with the risk of falls, injurious falls, multiple falls, fractures (...) participants), and mortality (29 RTCs; 11 441 participants). Sensitivity analyses provided similar findings, except the fixed-effect meta-analysis for the risk of fracture, which showed a significant effect favoring exercisers (RR, 0.84; 95% CI, 0.70-1.00; P = .047). Meta-regressions on mortality and falls suggest that 2 to 3 times per week would be the optimal exercise frequency.Long-term exercise is associated with a reduction in falls, injurious falls, and probably fractures in older adults, including

2019 EvidenceUpdates

113. A systematic review and meta-analysis of early outcomes after endovascular versus open repair of thoracoabdominal aortic aneurysms

A systematic review and meta-analysis of early outcomes after endovascular versus open repair of thoracoabdominal aortic aneurysms The objective of this study was to compare the early results of endovascular vs open thoracoabdominal aortic aneurysm (TAAA) repair.MEDLINE and Embase were searched for studies from January 2006 to March 2018 that compared endovascular vs open repair of TAAA using branched or fenestrated endografts. Data were subjected to a meta-analysis using a random-effects model

2019 EvidenceUpdates

114. Effectiveness of Exercise Interventions for Pain Reduction in People With Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Effectiveness of Exercise Interventions for Pain Reduction in People With Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials To systematically review the evidence of the effect of exercise compared with passive control on pain in people with multiple sclerosis.Five electronic databases were searched for randomized controlled trials published up to March 2017 that recruited people with multiple sclerosis where exercise was the intervention and pain (...) was an outcome (PROSPERO registration number CRD42017060489).A random-effects meta-analysis was conducted to estimate the standardized mean difference of the effect of exercise on pain between treatment and control groups. We assessed risk of bias, fitted meta-regression models to explore heterogeneity between studies, and assessed small study effects.Ten studies met the inclusion criteria (total sample size=389), and all studies were at high risk of bias. We found that exercise interventions were associated

2019 EvidenceUpdates

115. Micropapillary Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-analysis of Disease Characteristics and Treatment Outcomes

Micropapillary Urothelial Carcinoma of the Bladder: A Systematic Review and Meta-analysis of Disease Characteristics and Treatment Outcomes The optimal treatment of urothelial bladder cancer (UBC) with micropapillary (MP) variant histology is not clear.To review the current literature on disease characteristics and treatment outcomes of MP UBC.A systematic search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook (...) for Systematic Reviews of Interventions. The primary end points were recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS).We identified 758 reports comprising a total of 3154 patients, of which 28 and 15 articles were selected for qualitative and quantitative analysis, respectively. In patients with T1 MP UBC, the 5-yr CSS rates for early radical cystectomy (RC) ranged from 81% to 100%, while they were between 60% and 85% for transurethral resection of the bladder

2019 EvidenceUpdates

116. Should Viscous Fiber Supplements Be Considered in Diabetes Control? Results From a Systematic Review and Meta-analysis of Randomized Controlled Trials

Should Viscous Fiber Supplements Be Considered in Diabetes Control? Results From a Systematic Review and Meta-analysis of Randomized Controlled Trials Evidence from randomized controlled trials (RCTs) suggests that viscous dietary fiber may offer beneficial effects on glycemic control and, thus, an improved cardiovascular disease risk profile. Our purpose was to conduct a systematic review and meta-analysis of RCTs to synthesize the therapeutic effect of viscous fiber supplementation

2019 EvidenceUpdates

117. Effectiveness of Supervised Home-Based Exercise Therapy Compared to a Control Intervention on Functions, Activities, and Participation in Older Patients After Hip Fracture: A Systematic Review and Meta-analysis

Effectiveness of Supervised Home-Based Exercise Therapy Compared to a Control Intervention on Functions, Activities, and Participation in Older Patients After Hip Fracture: A Systematic Review and Meta-analysis The aim of this review was to investigate whether supervised home-based exercise therapy after hospitalization is more effective on improving functions, activities, and participation in older patients after hip fracture than a control intervention (including usual care). Furthermore, we

2019 EvidenceUpdates

118. Endoscopic versus open microvascular decompression for trigeminal neuralgia: a systematic review and comparative meta-analysis

Endoscopic versus open microvascular decompression for trigeminal neuralgia: a systematic review and comparative meta-analysis OBJECTIVEMicrovascular decompression (MVD) is commonly used in the treatment of trigeminal neuralgia (TN) with positive clinical outcomes. Fully endoscopic MVD (E-MVD) has been proposed as an effective minimally invasive alternative, but a comparative review of the two approaches has not been conducted. The authors performed a meta-analysis of studies, comparing patient (...) outcome rates and complications for the open versus the endoscopic technique.METHODSThe PubMed/MEDLINE and Ovid databases were searched for studies published from database inception to 2017. The search terms used included, but were not limited to, "open microvascular decompression," "microvascular decompression for trigeminal neuralgia," and "endoscopic decompression for trigeminal neuralgia." Criteria for inclusion of studies in the meta-analysis were established as follows: adult patients, clinical

2019 EvidenceUpdates

119. Therapeutic hypothermia for mild neonatal encephalopathy: a systematic review and meta-analysis

Therapeutic hypothermia for mild neonatal encephalopathy: a systematic review and meta-analysis To examine if therapeutic hypothermia reduces the composite outcome of death, moderate or severe disability at 18 months or more after mild neonatal encephalopathy (NE).MEDLINE, Cochrane database, Scopus and ISI Web of Knowledge databases, using 'hypoxic ischaemic encephalopathy', 'newborn' and 'hypothermia', and 'clinical trials' as medical subject headings and terms. Manual search of the reference (...) lists of all eligible articles and major review articles and additional data from the corresponding authors of selected articles.Randomised and quasirandomised controlled trials comparing therapeutic hypothermia with usual care.Safety and efficacy data extracted independently by two reviewers and analysed.We included the data on 117 babies with mild NE inadvertently recruited to five cooling trials (two whole-body cooling and three selective head cooling) of moderate and severe NE, in the meta

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2019 EvidenceUpdates

120. Long-term outcomes of mechanical versus biological aortic valve prosthesis: Systematic review and meta-analysis

Long-term outcomes of mechanical versus biological aortic valve prosthesis: Systematic review and meta-analysis In recent years, the use of surgically implanted biological aortic valves has been favored over mechanical prosthesis in patients between 50 and 70 years of age. However, outcomes on long-term survival are contradictory. The objective of this study was to determine if patients with mechanical valves have worse long-term survival than patients with biological prostheses.We (...) systematically searched published studies that: (1) were propensity score-matched or randomized controlled trials; (2) provided survival data with a minimum follow-up of 5 years; and (3) included patients older than 50 and younger than 70 years of age. Review articles, case reports, and editorials were excluded. We conducted a meta-analysis on the basis of 2 types of analysis. A reconstruction of the database of each study to simulate a patient-level meta-analysis was performed. Log rank test of Kaplan-Meier

2019 EvidenceUpdates

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