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Best Evidence Synthesis (best + evidence_synthesis)
Selected AbstractsInterventions to improve recall of medical information in cancer patients: a systematic review of the literaturePSYCHO-ONCOLOGY, Issue 9 2008Nienke van der Meulen Abstract This systematic review investigates which interventions are effective to improve recall of medical information in cancer patients. A literature research was done in PubMed, PsychINFO, CINAHL and Cochrane Library, following the guidelines of the Cochrane Collaboration. The methodological quality of selected studies was assessed independently by two reviewers. The results were synthesized with a Best Evidence Synthesis. Of initially 5173 found publications, 10 met all selection criteria. The results indicate that an audiotape of the patients' own consultation has added value upon oral information only. However, providing patients with a general audiotape does not improve recall of information and might even inhibit patients' recall. Furthermore, there is scientific evidence, although limited, that the use of a question prompt sheet (QPS) has a positive effect on recall of information, provided that the physician actively endorses this sheet. No evidence was found for an effect of providing patients with a summary letter of the consultation on recall, although research on this subject is scarce. In conclusion, the review suggests that interventions that are tailored to the individual cancer patient, such as an audiotape of the consultation or a QPS, are most effective. Further research needs to be done to establish robust results. Copyright © 2007 John Wiley & Sons, Ltd. [source] Review: A systematic review of prospective studies on attention problems and academic achievementACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010T. J. C. Polderman Polderman TJC, Boomsma DI, Bartels M, Verhulst FC, Huizink AC. A systematic review of prospective studies on attention problems and academic achievement. Objective:, Our aim was to provide an overview of prospective studies that have addressed the association between attention problems (AP, i.e. symptoms of hyperactivity and inattentiveness) and academic achievement (AA). Method:, We conducted a systematic search in the literature. Normal population studies and clinical studies were included. The methodological quality of each study was evaluated by objective criteria. A best evidence synthesis was used to determine the strengths of the association. Results:, Sixteen studies were included. We found convincing evidence for a negative association between AP and AA. After controlling for intelligence, comorbidity, and socioeconomic status (SES), the association between the hyperactive symptoms of AP and AA was non-significant in two studies. Conclusion:, Children with AP are at risk for lower AA and subsequent adverse outcomes later in life. Interventions in affected children should focus on their behavioural and educational development. [source] Prognostic factors for the progression of Parkinson's disease: A systematic review,MOVEMENT DISORDERS, Issue 13 2007Bart Post MD Abstract The purpose of this systematic review is to summarize studies that describe the course of Parkinson's disease (PD) and to identify factors that predict change in motor impairment, disability, and quality of life. A literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science limited to the English, French, German, Spanish, and Dutch language. Reports were selected if the study involved subjects with PD, the outcome measures described impairment, disability, or quality of life and follow-up was at least 6 months. All included studies were scored for methodological quality. Data were extracted and summarized in a best evidence synthesis. We screened 1,535 titles and abstracts, of which 27 fulfilled our inclusion criteria. A meta-analysis to quantitatively aggregate progression scores of motor impairment and disability was not possible because of the wide variety of outcome measures used and the heterogeneous study populations. Limited evidence is found for lower UPDRS-ME at baseline, dementia and SE < 70% as prognostic factors for future motor impairment. There is strong evidence for higher age at onset and higher PIGD-score; and limited evidence for higher bradykinesia-score, non-tremor dominant subtype, symmetrical disease at baseline, and depression as prognostic factors for progression of disability. Prognostic factors were identified for impairment and disability. The literature on prognosis in PD is not fulfilling the high methodological standards applied nowadays. There is a need for prospective cohorts of PD patients assembled at a common early point in the disease with long time follow-up. © 2007 Movement Disorder Society [source] Immunotherapy in children and adolescents with allergic rhinoconjunctivitis: a systematic reviewPEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 3 2008Esther Röder Allergen-specific immunotherapy is one of the cornerstones of allergic rhinoconjunctivitis treatment. Since the development of non-invasive administration forms with better safety profiles, there is an increasing tendency to prescribe immunotherapy in youngsters. However, no overview is available on the efficacy of immunotherapy in all its different administration forms in youngsters. Therefore, we systematically reviewed randomized controlled trials (RCTs) to evaluate the effect of immunotherapy with inhalant allergens on symptoms and medication use in children and adolescents with allergic rhinoconjunctivitis. Medline, EMBASE, the Cochrane Controlled Clinical Trials Register and reference lists of recent reviews and published trials were searched. RCTs including youngsters aged 0,18 yr with allergic rhinoconjunctivitis and comparing immunotherapy with placebo, symptomatic treatment or a different administration form of immunotherapy were included. Primary outcome measures were rhinoconjunctivitis symptom and/or medication scores. Methodological quality was assessed using the validated Delphi list. A method of best evidence synthesis, a rating system with levels of evidence based on the overall quality and the outcome of the trials, was used to assess efficacy. Six subcutaneous (SCIT), four nasal (LNIT), seven oral (OIT) and 11 sublingual (SLIT) immunotherapy trials, comprising 1619 youngsters, were included. Only 39% of the trials were of high methodological quality. For the SCIT and OIT subgroups the level of evidence for efficacy was conflicting. Moderate evidence of effect was found for LNIT. Analysis of the SLIT subgroup showed no evidence of effect. The evidence for the perennial and seasonal allergen trials within the subgroups varied from moderate evidence of effect to no evidence of effect. In conclusion, there is at present insufficient evidence that immunotherapy in any administration form has a positive effect on symptoms and/or medication use in children and adolescents with allergic rhinoconjunctivitis. [source] Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measuresCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2009Article first published online: 6 APR 200 Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures . PijpersM. A. M., TabbersM. M., BenningaM. A. & BergerM. Y. ( 2009 ) Archives of Disease in Childhood , 94 , 117 , 131 . DOI: 10.1136/adc.2007.127233 . Introduction Constipation is a common complaint in children and early intervention with oral laxatives may improve complete resolution of functional constipation. However, most treatment guidelines are based on reviews of the literature that do not incorporate a quality assessment of the studies. Objective To investigate and summarize the quantity and quality of the current evidence for the effect of laxatives and dietary measures on functional childhood constipation. Methods The Medline and Embase databases were searched to identify studies evaluating the effect of a medicamentous treatment or dietary intervention on functional constipation. Methodological quality was assessed using a validated list of criteria. Data were statistically pooled, and in case of clinical heterogeneity results were summarized according to a best evidence synthesis. Results Of the 736 studies found, 28 met the inclusion criteria. In total 10 studies were of high quality. The included studies were clinically and statistically heterogeneous in design. Most laxatives were not compared with placebo. Compared with all other laxatives, polyethylene glycol (PEG) achieved more treatment success (pooled relative risk: 1.47; 95% CI 1.23 to 1.76). Lactulose was less than or equally effective in increasing the defecation frequency compared with all other laxatives investigated. There was no difference in effect on defecation frequency between fibre and placebo (weighted standardized mean difference 0.35 bowel movements per week in favour of fibre, 95% CI 0.04 to 0.74). Conclusion Insufficient evidence exists supporting that laxative treatment is better than placebo in children with constipation. Compared with all other laxatives, PEG achieved more treatment success, but results on defecation frequency were conflicting. Based on the results of this review, we can give no recommendations to support one laxative over the other for childhood constipation. [source] | ||||||||||