摘要 :
To compare the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs), including salicylate, for the treatment of osteoarthritis (OA).PubMed, Embase, Cochrane Library and Web of Science were searched from 19...
展开
To compare the efficacy and safety of topical non-steroidal anti-inflammatory drugs (NSAIDs), including salicylate, for the treatment of osteoarthritis (OA).PubMed, Embase, Cochrane Library and Web of Science were searched from 1966 to January 2017. Randomised controlled trials (RCTs) comparing topical NSAIDs with placebo or each other in patients with OA and observational studies comparing topical NSAIDs with no treatment or each other irrespective of disease were included. Two investigators identified studies and independently extracted data. Bayesian network and conventional meta-analyses were conducted. The primary outcomes were pain relief for RCTs and risk of adverse effects (AEs) for observational studies.43 studies, comprising 36 RCTs (7 900 patients with OA) and seven observational studies (218?074 participants), were included. Overall, topical NSAIDs were superior to placebo for relieving pain (standardised mean difference (SMD)=?0.30, 95%?CI ?0.40 to –0.20) and improving function (SMD=?0.35, 95%?CI ?0.45 to –0.24) in OA. Of all topical NSAIDs, diclofenac patches were most effective for OA pain (SMD=?0.81, 95%?CI ?1.12 to –0.52) and piroxicam was most effective for functional improvement (SMD=?1.04, 95%?CI ?1.60 to –0.48) compared with placebo. Although salicylate gel was associated with higher withdrawal rates due to AEs, the remaining topical NSAIDs were not associated with any increased local or systemic AEs.Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population. However, confirmation of the cardiovascular safety of topical NSAIDs still warrants further observational study.
收起
摘要 :
In their comment, Jeffery et al., make several criticisms of our meta-analysis (Biederman & Harpole 2012). Specifically, they argued that we (i) failed to provide a 'thorough assessment of all the different socioeconomic, biophysical, and ecological components from a systems analysis perspective'; (ii) that we did not assess all of the potential effects of biochar; and (iii) our conclusions were 'beyond what can be robustly concluded...
展开
In their comment, Jeffery et al., make several criticisms of our meta-analysis (Biederman & Harpole 2012). Specifically, they argued that we (i) failed to provide a 'thorough assessment of all the different socioeconomic, biophysical, and ecological components from a systems analysis perspective'; (ii) that we did not assess all of the potential effects of biochar; and (iii) our conclusions were 'beyond what can be robustly concluded based on the data presented in the article'. We address these criticisms below. Furthermore, Jeffery et al. correctly state that we failed to address their 2011 meta-analysis in our study. Unfortunately, the timing of our literature searches missed this contribution. As we now have the opportunity to compare these two analyses, we find that the primary difference in our findings appears to be the result of several problematic decisions made by Jeffery et al. in their analysis that caused them to underestimate biochar's mean effect with exaggerated confidence. A comparison of these methods and their consequences is also provided below.
收起
摘要 :Objective. To combine evidence from randomized controlled trials to assess the effect of Fe-fortified foods on mean Hb concentration in children (<10 years). Design. We conducted a meta-analysis of randomized, controlled, Fe-fortified feeding trials that evaluated Hb concentration. The weighted mean difference was calculated for net changes in Hb by using random-effects models. Meta-regression and covariate analyses were performed to explore the influence of confounders on the net pooled effect. Setting. Trials were identified through a systematic search of PubMed, the Cochrane Library and secondary references. Subjects. Eighteen studies covering 5142 participants were identified. The duration of feeding of fortified foods ranged from 6 to 12 months in these studies. Results. Eighteen studies were included and evaluated in the meta-analysis. The overall pooled estimate of Hb concentration showed a significant increase in the fortification group compared with the control group (weighted mean difference = 5.09 g/l; 95 % CI 3.23, 6.95 g/l; I 2 = 90 %, tau 2 = 18.37, P< 0.0001). Meta-regression analysis indicated that duration of feeding was positively related to the effect size (regression coefficient = 0.368; 95 % CI 0.005, 0.731; P< 0.05). The net pooled effect size after removing the confounders was 4.74 (95 % CI 3.08, 6.40) g/l. Conclusions. We observed an association between intake of Fe-fortified foods and Hb concentration in children aged <10 years. Fe-fortified foods could be an effective strategy for reducing Fe-deficiency anaemia in children...
展开
Objective. To combine evidence from randomized controlled trials to assess the effect of Fe-fortified foods on mean Hb concentration in children (<10 years). Design. We conducted a meta-analysis of randomized, controlled, Fe-fortified feeding trials that evaluated Hb concentration. The weighted mean difference was calculated for net changes in Hb by using random-effects models. Meta-regression and covariate analyses were performed to explore the influence of confounders on the net pooled effect. Setting. Trials were identified through a systematic search of PubMed, the Cochrane Library and secondary references. Subjects. Eighteen studies covering 5142 participants were identified. The duration of feeding of fortified foods ranged from 6 to 12 months in these studies. Results. Eighteen studies were included and evaluated in the meta-analysis. The overall pooled estimate of Hb concentration showed a significant increase in the fortification group compared with the control group (weighted mean difference = 5.09 g/l; 95 % CI 3.23, 6.95 g/l; I 2 = 90 %, tau 2 = 18.37, P< 0.0001). Meta-regression analysis indicated that duration of feeding was positively related to the effect size (regression coefficient = 0.368; 95 % CI 0.005, 0.731; P< 0.05). The net pooled effect size after removing the confounders was 4.74 (95 % CI 3.08, 6.40) g/l. Conclusions. We observed an association between intake of Fe-fortified foods and Hb concentration in children aged <10 years. Fe-fortified foods could be an effective strategy for reducing Fe-deficiency anaemia in children
收起
摘要 :
Early meta-analyses in management research sought primarily to resolve seemingly conflicting findings by estimating a relationship's population-level effect size. Since then, management researchers have adopted increasingly sophis...
展开
Early meta-analyses in management research sought primarily to resolve seemingly conflicting findings by estimating a relationship's population-level effect size. Since then, management researchers have adopted increasingly sophisticated approaches that permit new theorizing, testing and comparing sophisticated models, and identifying boundary conditions. We summarize three of these approaches - i.e., qualitative meta-analysis (QMA), meta-analytic structural equation modeling (MASEM), and meta-analytic regression analysis (MARA) - along with the special issue papers that adopt each approach. We conclude by raising three unresolved controversies that we believe deserve more attention and by offering our thoughts about how to maximize a meta-analytic study's chances for publication and impact.
收起
摘要 :
Prior to quantitative analyses, meta-analysts often explore descriptive characteristics of effect sizes. A graphic is proposed that treats effect sizes as fuzzy numbers. This plot can provide meta-analysts with such information su...
展开
Prior to quantitative analyses, meta-analysts often explore descriptive characteristics of effect sizes. A graphic is proposed that treats effect sizes as fuzzy numbers. This plot can provide meta-analysts with such information such as heterogeneity of effects, precision of estimates, possible clusters, and existence of outliers.
收起
摘要 :
Meta-analyses of data from human studies are invaluable resources in the life sciences and the methods to conduct these are well documented. Similarly there are a number of benefits in conducting meta-analyses on data from animal ...
展开
Meta-analyses of data from human studies are invaluable resources in the life sciences and the methods to conduct these are well documented. Similarly there are a number of benefits in conducting meta-analyses on data from animal studies; they can be used to inform clinical trial design, or to try and explain discrepancies between preclinical and clinical trial results. However there are inherit differences between animal and human studies and so applying the same techniques for the meta-analysis of preclinical data is not straightforward. For example preclinical studies are frequently small and there is often substantial heterogeneity between studies. This may have an impact on both the method of calculating an effect size and the method of pooling data. Here we describe a practical guide for the meta-analysis of data from animal studies including methods used to explore sources of heterogeneity.
收起
摘要 :
Systematic reviews and meta-analyses are powerful tools for summarizing existing literature and combining evidence from multiple studies. These methods employ complex searches, statistical techniques, and presentation techniques w...
展开
Systematic reviews and meta-analyses are powerful tools for summarizing existing literature and combining evidence from multiple studies. These methods employ complex searches, statistical techniques, and presentation techniques with which the clinical audience may not be very familiar. This review article aims to familiarize the clinical audience with the various techniques employed to conduct a high-quality systematic review and meta-analysis.
收起
摘要 :
Abstract Objective To evaluate the clinically relevant POPF rate between Pancreatogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). To evaluate the confounding factors affecting meta-analytic res...
展开
Abstract Objective To evaluate the clinically relevant POPF rate between Pancreatogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). To evaluate the confounding factors affecting meta-analytic results. Methods A systematic literature search of randomized clinical trials (RCTs) comparing PG to PJ with an International Study Group of Pancreatic Fistula (ISGPF) definition of postoperative pancreatic fistula (POPF). Risk difference (RD) and number needed to treat or harm (NNT and NNH) were used. Fixed and random-effect models were applied. Impact of confounding covariates on the meta-analytic results was evaluated using meta-regression analysis, reporting β coefficient?±?standard error (SE). Results Seven RCTs were identified involving 1184 patients: 603?PG and 581?PJ. RD in the fixed model of clinically relevant POPFs suggested that PG was superior to PJ (RD-0.07; 95% CI:??0.11 to??0.03) with an NNT of 14 (95% CI: 9 to 33). In random model, PG was not superior to PJ (RD-0.06; 95% CI:??0.13 to 0.01) with an NNT of 17 and a possibility of harm in some cases (NNH?=?100). Meta-regression suggested that the increase in the proportion of “soft pancreas” in the PG arm corresponded to a more positive value of RD (β?=?0.47?±?0.19; P value: 0.045?±?0.003). Conclusion A PG could be slightly superior to PJ in the prevention of clinically relevant POPF. The presence of high risk pancreatic remnant remains the main limitation of PG.
收起
摘要 :AbstractObjectiveTo evaluate the clinically relevant POPF rate between Pancreatogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). To evaluate the confounding factors affecting meta-analytic resul...
展开AbstractObjectiveTo evaluate the clinically relevant POPF rate between Pancreatogastrostomy (PG) and pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD). To evaluate the confounding factors affecting meta-analytic results.MethodsA systematic literature search of randomized clinical trials (RCTs) comparing PG to PJ with an International Study Group of Pancreatic Fistula (ISGPF) definition of postoperative pancreatic fistula (POPF). Risk difference (RD) and number needed to treat or harm (NNT and NNH) were used. Fixed and random-effect models were applied. Impact of confounding covariates on the meta-analytic results was evaluated using meta-regression analysis, reporting β coefficient?±?standard error (SE).ResultsSeven RCTs were identified involving 1184 patients: 603?PG and 581?PJ. RD in the fixed model of clinically relevant POPFs suggested that PG was superior to PJ (RD-0.07; 95% CI:??0.11 to??0.03) with an NNT of 14 (95% CI: 9 to 33). In random model, PG was not superior to PJ (RD-0.06; 95% CI:??0.13 to 0.01) with an NNT of 17 and a possibility of harm in some cases (NNH?=?100). Meta-regression suggested that the increase in the proportion of “soft pancreas” in the PG arm corresponded to a more positive value of RD (β?=?0.47?±?0.19; P value: 0.045?±?0.003).ConclusionA PG could be slightly superior to PJ in the prevention of clinically relevant POPF. The presence of high risk pancreatic remnant remains the main limitation of PG.]]>
收起
原文获取