Systematic reviews
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Review Meta Analysis
Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis.
Although health care providers utilize classically described signs and symptoms to diagnose tension pneumothorax, available literature sources differ in their descriptions of its clinical manifestations. Moreover, while the clinical manifestations of tension pneumothorax have been suggested to differ among subjects of varying respiratory status, it remains unknown if these differences are supported by clinical evidence. Thus, the primary objective of this study is to systematically describe and contrast the clinical manifestations of tension pneumothorax among patients receiving positive pressure ventilation versus those who are breathing unassisted. ⋯ This study will compile the world literature on tension pneumothorax and provide the first systematic description of the clinical manifestations of the disorder according to presenting patient respiratory status. It will also demonstrate a series of methods that may be used to address difficulties likely to be encountered during the conduct of a meta-analysis of data contained in published case reports and series. PROSPERO registration number: CRD42013005826.
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Review Meta Analysis
Collaborative care for the treatment of comorbid depression and coronary heart disease: a systematic review and meta-analysis protocol.
Depression and coronary heart disease (CHD) are frequently comorbid and portend higher morbidity, mortality and poorer quality of life. Prior systematic reviews of depression treatment randomized controlled trials (RCTs) in the population with CHD have not assessed the efficacy of collaborative care. This systematic review aims to bring together the contemporary research on the effectiveness of collaborative care interventions for depression in comorbid CHD populations. ⋯ PROSPERO CRD42014013653.
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Review Meta Analysis
Prescription opioid misuse and its relation to injection drug use and hepatitis C virus infection: protocol for a systematic review and meta-analysis.
The production, prescription, and consumption of opioid analgesics to treat non-cancer pain have increased dramatically in the USA in the past decade. As a result, misuse of these opioids has increased; overdose and transition to riskier forms of drug use have also emerged. Research points to a trend in transition to drug injection among those misusing prescription opioids, where clusters of acute hepatitis C virus (HCV) infection are now being reported. This systematic review and meta-analysis aims to synthesize the prevalence of prescription opioid misuse in the USA and examine the rate of transition to injection drug use and incident HCV in these new people who inject drugs (PWID). ⋯ PROSPERO CRD42014008870.
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Review Meta Analysis
Does intravenous contrast-enhanced computed tomography cause acute kidney injury? Protocol of a systematic review of the evidence.
Contrast-induced acute kidney injury is a common cause of iatrogenic acute kidney injury (AKI). Most of the published estimates of AKI after contrast use originate from the cardiac catheterization literature despite contrast-enhanced computed tomography (CT) scans being the more common setting for contrast use. This systematic review aims to summarize the current evidence about (1)the risk of AKI following intravenous (IV) contrast-enhanced CT scans and(2) the risk of clinical outcomes (i.e. death, hospitalization and need for renal replacement therapy) due to IV contrast-enhanced CT scans. ⋯ PROSPERO CRD42013003799.
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Categorizing an inherently continuous predictor in prognostic analyses raises several critical methodological issues: dependence of the statistical significance on the number and position of the chosen cut-point(s), loss of statistical power, and faulty interpretation of the results if a non-linear association is incorrectly assumed to be linear. This also applies to a therapeutic context where investigators of randomized clinical trials (RCTs) are interested in interactions between treatment assignment and one or more continuous predictors. ⋯ This project will be the first meta-analysis to combine continuous treatment effect functions derived by the MFPI procedure separately in each of several RCTs. Such an approach requires individual patient data (IPD). They are available from an earlier IPD meta-analysis using different methods for analysis. This new analysis strategy allows assessing whether treatment effects interact with continuous baseline patient characteristics and avoids categorization-based subgroup analyses. These interaction analyses of the present study will be exploratory in nature. However, they may help to foster future research using the MFPI approach to improve interaction analyses of continuous predictors in RCTs and IPD meta-analyses. This study is registered in PROSPERO (CRD42012003129).