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- Fusar-Poli, P, et al.
(författare)
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Ten simple rules for conducting umbrella reviews
- 2018
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Ingår i: Evidence-based mental health. - : BMJ. - 1468-960X .- 1362-0347. ; 21:3, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Evidence syntheses such as systematic reviews and meta-analyses provide a rigorous and transparent knowledge base for translating clinical research into decisions, and thus they represent the basic unit of knowledge in medicine. Umbrella reviews are reviews of previously published systematic reviews or meta-analyses. Therefore, they represent one of the highest levels of evidence synthesis currently available, and are becoming increasingly influential in biomedical literature. However, practical guidance on how to conduct umbrella reviews is relatively limited.MethodsWe present a critical educational review of published umbrella reviews, focusing on the essential practical steps required to produce robust umbrella reviews in the medical field.ResultsThe current manuscript discusses 10 key points to consider for conducting robust umbrella reviews. The points are: ensure that the umbrella review is really needed, prespecify the protocol, clearly define the variables of interest, estimate a common effect size, report the heterogeneity and potential biases, perform a stratification of the evidence, conduct sensitivity analyses, report transparent results, use appropriate software and acknowledge the limitations. We illustrate these points through recent examples from umbrella reviews and suggest specific practical recommendations.ConclusionsThe current manuscript provides a practical guidance for conducting umbrella reviews in medical areas. Researchers, clinicians and policy makers might use the key points illustrated here to inform the planning, conduction and reporting of umbrella reviews in medicine.
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- Garcia-Olive, I, et al.
(författare)
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Effect of Air Pollution on Exacerbations of Bronchiectasis in Badalona, Spain, 2008-2016
- 2018
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Ingår i: Respiration. - : S. Karger AG. - 1423-0356 .- 0025-7931. ; 96:2, s. 111-116
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Introduction:</i></b> Air pollution has been widely associated with respiratory diseases. Nevertheless, the association between air pollution and exacerbations of bronchiectasis has been less studied. <b><i>Objective:</i></b> To analyze the effect of air pollution on exacerbations of bronchiectasis. <b><i>Methods:</i></b> This was a retrospective observational study conducted in<i></i> Badalona. The number of daily hospital admissions and emergency room visits related to exacerbation of bronchiectasis (ICD-9 code 494.1) between 2008 and 2016 was obtained. We used simple Poisson regressions to test the effects of daily mean temperature, SO<sub>2</sub>, NO<sub>2</sub>, CO, and PM<sub>10</sub> levels on bronchiectasis-related emergencies and hospitalizations on the same day and 1–4 days after. All <i>p</i> values were corrected for multiple comparisons. <b><i>Results:</i></b> SO<sub>2</sub> was significantly associated with an increase in the number of hospitalizations (lags 0, 1, 2, and 3). None of these associations remained significant after correcting for multiple comparisons. The number of emergency room visits was associated with higher levels of SO<sub>2</sub> (lags 0–4). After correcting for multiple comparisons, the association between emergency room visits and SO<sub>2</sub> levels was statistically significant for lag 0 (<i>p</i> = 0.043), lag 1 (<i>p</i> = 0.018), and lag 3 (<i>p</i> = 0.050). <b><i>Conclusions:</i></b> The number of emergency room visits for exacerbation of bronchiectasis is associated with higher levels of SO<sub>2</sub>.
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| 128. |
- Gardoki-Souto, I, et al.
(författare)
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Prevalence and Characterization of Psychological Trauma in Patients with Fibromyalgia: A Cross-Sectional Study
- 2022
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Ingår i: Pain research & management. - : Hindawi Limited. - 1918-1523 .- 1203-6765. ; 2022, s. 2114451-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Preliminary evidence suggests that psychological trauma, especially childhood trauma, is a risk factor for the onset of fibromyalgia (FM). Objective. The main objective of this study consisted of evaluating the prevalence and detailed characteristics of psychological trauma in a sample of patients with FM, the chronology of trauma across the lifespan, and its clinical symptoms. We also calculated whether childhood trauma could predict the relationship with different clinical variables. Method. Eighty-eight females underwent an interview to assess sociodemographic data, psychiatric comorbidities, level of pain, FM impact, clinical symptoms of anxiety, depression, insomnia, quality of life, and psychological trauma. Results. The majority of participants (71.5%) met the diagnostic criteria for current post-traumatic stress disorder (PTSD). Participants reported having suffered traumatic events throughout their lifespan, especially in childhood and early adolescence, in the form of emotional abuse, emotional neglect, sexual abuse, and physical abuse. Traumatic events predict both poor quality of life and a level of pain in adulthood. All patients showed clinically relevant levels of anxiety, depression, insomnia, suicidal thoughts, and pain, as well as somatic comorbidities and poor quality of life. Pain levels predicted anxiety, depression, dissociation, and insomnia symptoms. 84% of the sample suffered one or more traumatic events prior to the onset of pain. Conclusions. Our data highlight the clinical complexity of patients with FM and the role of childhood trauma in the onset and maintenance of FM, as well as the high comorbidity between anxiety, depression, somatic symptoms, and FM. Our data also supports FM patients experiencing further retraumatization as they age, with an extremely high prevalence of current PTSD in our sample. These findings underscore the need for multidisciplinary programs for FM patients to address their physical pain and their psychiatric and somatic conditions, pay special attention to the assessment of psychological trauma, and provide trauma-focused interventions. Trial registration: ClinicalTrials.gov NCT04476316. Registered on July 20th, 2020.
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| 129. |
- Gosling, CJ, et al.
(författare)
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metaumbrella: the first comprehensive suite to perform data analysis in umbrella reviews with stratification of the evidence
- 2023
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Ingår i: BMJ mental health. - : BMJ. - 2755-9734. ; 26:1
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Tidskriftsartikel (refereegranskat)abstract
- Umbrella reviews are a new form of literature review that summarises the strength and/or quality of the evidence from all systematic reviews and meta-analyses conducted on a broad topic. This type of review thus provides an exhaustive examination of a vast body of information, providing the highest synthesis of knowledge. A critical strength of umbrella reviews is recalculating the meta-analytic estimates within a uniform framework to allow a consistent evidence stratification. To our best knowledge, there is no comprehensive package or software to conduct umbrella reviews.MethodsThe R package metaumbrella accomplishes this aim by building on three core functions that (1) automatically perform all required calculations in an umbrella review (including but not limited to pairwise meta-analyses), (2) stratify evidence according to various classification criteria and (3) generate a visual representation of the results. In addition, this package allows flexible inputs for each review or meta-analysis analysed (eg, means plus SD, or effect size estimate and CI) and customisation (eg, stratification criteria following Ioannidis, algorithmic GRADE or personalised classification).ResultsThe R package metaumbrella thus provides the first comprehensive range of facilities to perform umbrella reviews with stratification of the evidence.ConclusionTo facilitate the use of this package, even for researchers unfamiliar with R, we also provide a JAMOVI module and an open-access, browser-based graphical interface that allow use of the core functions of the package with a few mouse clicks.
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