Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement

Identifying psychosocial interventions that improve both physical and mental health in patients with diabetes: a systematic review and meta-analysis

OBJECTIVE

Patients with diabetes suffer high rates of mental health problems, and this combination is associated with poor outcomes. Although effective treatments exist for both diabetes and mental health problems, delivering services for physical and mental health problems separately ignores their interaction and may be inefficient. This systematic review sought to identify psychosocial interventions that could improve both the physical and mental health of patients with diabetes.

RESEARCH DESIGN AND METHODS

Studies were identified from the following databases: CENTRAL, MEDLINE, Excerpta Medica (EMBASE), Psychinfo, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The review included randomized controlled trials in patients with type 1 and type 2 diabetes who received psychosocial interventions and where both mental health and physical health outcomes were reported. Data were extracted on study quality, the content and process of interventions, and outcomes.

RESULTS

Eighty-five eligible comparisons were identified, of which 49 reported sufficient data for analysis. Psychosocial interventions modestly improved A1C (standardized mean difference -0.29 [95% CI -0.37 to -0.21]) and mental health outcomes (-0.16 [-0.25 to -0.07]). However, there was a limited association between the effects on A1C and mental health, and no intervention characteristics predicted benefit on both outcomes.

CONCLUSIONS

Managing physical and mental health in long-term conditions are increasingly important. The review did not identify types of interventions that consistently provide benefits for both physical and mental health. Developing such interventions remains an important challenge. The findings have implications for understanding the interaction between physical and mental health problems and for the coordination of care.

CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials

The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.

To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.

CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials

The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.

Guidance for developers of health research reporting guidelines

David Moher and colleagues from the EQUATOR network offer guidance and recommended steps for developing health research reporting guidelines.

Face masks to prevent transmission of influenza virus: a systematic review

Influenza viruses circulate around the world every year. From time to time new strains emerge and cause global pandemics. Many national and international health agencies recommended the use of face masks during the 2009 influenza A (H1N1) pandemic. We reviewed the English-language literature on this subject to inform public health preparedness. There is some evidence to support the wearing of masks or respirators during illness to protect others, and public health emphasis on mask wearing during illness may help to reduce influenza virus transmission. There are fewer data to support the use of masks or respirators to prevent becoming infected. Further studies in controlled settings and studies of natural infections in healthcare and community settings are required to better define the effectiveness of face masks and respirators in preventing influenza virus transmission.

The effectiveness of reproductive surgery in the treatment of female infertility: facts, views and vision

BACKGROUND

The role of reproductive surgery is declining due to the widespread availability of assisted reproductive technology, but an evidence-based fundament for this decline is lacking. We therefore performed a systematic review of the literature.

METHODS

We searched MEDLINE, EMBASE and the Cochrane Library for randomised trials evaluating laparoscopic or hysteroscopic interventions in subfertile women, studying pregnancy or live birth rates. We present an overview of the results and quality of the detected studies.

RESULTS

The methodological quality of the 63 detected studies was mediocre. The laparoscopic treatment of minimal/ mild endometriosis might increase the pregnancy rate but the two major studies report conflicting results. Excision of the endometriotic cyst wall increases the spontaneous conception rate (RR 2.8, 95% CI 1.4-5.5). Laparoscopic ovarian drilling results at least in equal pregnancy rates as gonadotropin treatment (RR 1.0, 95% CI 0.83-1.2) but decreases the multiple pregnancy rate (RR 0.16, 95% CI 0.04-0.58). Laparoscopic tubal surgery for hydrosalpinx prior to IVF increases the pregnancy rate (RR 1.9, 95% CI 1.4-2.7). Removal of polyps prior to IUI increases the pregnancy rate (RR 2.2, 95% CI 1.6-3.1). Myomectomy for submucosal fibroids results in higher pregnancy rates (RR 2.2, 95% CI 1.6-2.9). The removal of intramural/ subserosal fibroids shows a beneficial trend, albeit not statistically significant (RR 1.2, 95% CI 0.75-1.9). Hysteroscopy in patients with recurrent IVF failure increases the pregnancy rates even in the absence of pathology (RR 1.6, 95% CI 1.3-1.9).

CONCLUSIONS

Although the limited evidence indicates a positive role for some surgical reproductive interventions, we should be very cautious in providing guidelines for clinical practice in reproductive surgery since more research is needed.

Surgical endodontic treatment under magnification has high success rates

DATA SOURCES

Medline, Embase and reference lists of identified articles were used to find relevant publications; searches were limited to English language.

STUDY SELECTION

Randomised control trials (RCT) or prospective case series of surgical endodontic treatments performed by a modern technique using magnification, root-end resection with minimal or no bevel, retrograde cavity preparation with ultrasonic tips, and retrograde root canal filling where the lesion was located at the periapical area, with a minimum of 1-year followup and outcomes assessed according to the Rud¹ or Molven² criteria, were included. Studies that did not use a modern surgical approach, involved teeth with apico-marginal defects, periodontal disease, root fractures and root perforations or undergoing repeat surgery were excluded, as were those with less than 1-year followup and with outcomes not evaluated using the Rud¹ or Molven² criteria.

DATA EXTRACTION AND SYNTHESIS

Studies were reviewed and data extracted independently by three observers, with disagreements resolved by discussion. Studies included were combined to estimate the pooled successes and 95% confidence intervals (CI), where success was considered to be complete healing or incomplete healing, by using generalised linear models, assuming a binomial (proportion) distribution.

RESULTS

Eleven studies (six RCT and five prospective case series) met the criteria. The pooled proportion of treatments deemed to be a success (complete healing and incomplete healing) was found to be 91.6% (95% CI, 85.9-95.1%). The pooled proportion deemed to be failures was found to be 4.7% (95% CI, 2.24-9.50%). The remainder were categorised as of uncertain healing (3.7%).

CONCLUSIONS

Surgical endodontic treatment carried out using a modern technique carries predictable outcomes. Additional large-scale prospective clinical studies are needed to evaluate further predictors of success and failure.

Older people's and relatives' experiences in acute care settings: systematic review and synthesis of qualitative studies

OBJECTIVE

To explore older people's and their relatives' views on and experiences of acute health care.

DESIGN

Systematic procedures were used for study selection and data extraction and analysis. A comparative thematic approach to synthesis was taken with a number of features adopted from the literature on meta-ethnography.

DATA SOURCES

Worldwide grey and published literature written in English between January 1999 and June 2008 identified from databases: CINAHL, Medline, British Nursing Index, EMBASE Psychiatry, International Bibliography of the Social Sciences, PsychINFO, and AgeInfo.

REVIEW METHODS

We conducted a systematic review and synthesis of qualitative studies describing older patients' and/or their relatives' experiences of care in acute hospital settings. 42 primary studies and 1 systematic review met the inclusion criteria.

RESULTS

A number of themes emerged. The quality of technical care is often taken for granted by older patients, and good or bad experiences are described more in terms of relational aspects of care. Older patients in hospital may feel worthless, fearful or not in control of what happens, especially if they have impaired cognition, or communication difficulties. Three key features of care consistently mediated these negative feelings and were linked to more positive experiences: "creating communities: connect with me", "maintaining identity: see who I am" and "sharing decision-making: include me".

CONCLUSION

These findings highlight the perspectives of older people and their relatives on the delivery of personalized and dignified care in acute settings. They lend support to previous calls for relationship-centred approaches to care and provide a useful experience-based framework for practice for those involved in care for older people.

Sexual dysfunction, erectile impotence and obstructive azoospermia in respiratory disease. Relevance of lung-mediated regulation of prostaglandins

Background

Acute diverticulitis (AD) presents a unique diagnostic and therapeutic challenge for general surgeons. This collaborative project between EAES and SAGES aimed to summarize recent evidence and draw statements of recommendation to guide our members on comprehensive AD management.

Methods

Systematic reviews of the literature were conducted across six AD topics by an international steering group including experts from both societies. Topics encompassed the epidemiology, diagnosis, management of non-complicated and complicated AD as well as emergency and elective operative AD management. Consensus statements and recommendations were generated, and the quality of the evidence and recommendation strength rated with the GRADE system. Modified Delphi methodology was used to reach consensus among experts prior to surveying the EAES and SAGES membership on the recommendations and likelihood to impact their practice. Results were presented at both EAES and SAGES annual meetings with live re-voting carried out for recommendations with < 70% agreement.

Results

A total of 51 consensus statements and 41 recommendations across all six topics were agreed upon by the experts and submitted for members’ online voting. Based on 1004 complete surveys and over 300 live votes at the SAGES and EAES Diverticulitis Consensus Conference (DCC), consensus was achieved for 97.6% (40/41) of recommendations with 92% (38/41) agreement on the likelihood that these recommendations would change practice if not already applied. Areas of persistent disagreement included the selective use of imaging to guide AD diagnosis, recommendations against antibiotics in non-complicated AD, and routine colonic evaluation after resolution of non-complicated diverticulitis.

Conclusion

This joint EAES and SAGES consensus conference updates clinicians on the current evidence and provides a set of recommendations that can guide clinical AD management practice.

Electronic supplementary material

The online version of this article (10.1007/s00464-019-06882-z) contains supplementary material, which is available to authorized users.