Tag: systematic

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Exposure to Community Violence and Physical Health Outcomes in Youth: A Systematic Review.

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Exposure to Community Violence and Physical Health Outcomes in Youth: A Systematic Review.

J Pediatr Psychol. 2016 Oct 28;:

Authors: Wright AW, Austin M, Booth C, Kliewer W

Abstract
OBJECTIVE?: To systematically review the evidence for associations between exposure to community violence and physical health outcomes in children and adolescents. METHODS?: A thorough search of multiple online databases and careful consideration of inclusion and exclusion criteria yielded a final 28 studies for detailed review. In addition to review of findings, studies were rated on overall quality based on study design. RESULTS?: Seven categories of physical health outcomes emerged, including asthma/respiratory health, cardiovascular health, immune functioning, hypothalamic-pituitary-adrenal axis functioning, sleep problems, weight, and a general health category. There were mixed findings across these categories. Evidence for a positive association between community violence exposure and health problems was strongest in the cardiovascular health and sleep categories. CONCLUSION?: There is reason to believe that community violence exposure has an effect on some areas of physical health. Additional well-designed research that focuses on mechanisms as well as outcomes is warranted.

PMID: 27794530 [PubMed – as supplied by publisher]

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A systematic review of predictive models for asthma development in children.

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A systematic review of predictive models for asthma development in children.

BMC Med Inform Decis Mak. 2015;15(1):99

Authors: Luo G, Nkoy FL, Stone BL, Schmick D, Johnson MD

Abstract
BACKGROUND: Asthma is the most common pediatric chronic disease affecting 9.6 % of American children. Delay in asthma diagnosis is prevalent, resulting in suboptimal asthma management. To help avoid delay in asthma diagnosis and advance asthma prevention research, researchers have proposed various models to predict asthma development in children. This paper reviews these models.
METHODS: A systematic review was conducted through searching in PubMed, EMBASE, CINAHL, Scopus, the Cochrane Library, the ACM Digital Library, IEEE Xplore, and OpenGrey up to June 3, 2015. The literature on predictive models for asthma development in children was retrieved, with search results limited to human subjects and children (birth to 18 years). Two independent reviewers screened the literature, performed data extraction, and assessed article quality.
RESULTS: The literature search returned 13,101 references in total. After manual review, 32 of these references were determined to be relevant and are discussed in the paper. We identify several limitations of existing predictive models for asthma development in children, and provide preliminary thoughts on how to address these limitations.
CONCLUSIONS: Existing predictive models for asthma development in children have inadequate accuracy. Efforts to improve these models’ performance are needed, but are limited by a lack of a gold standard for asthma development in children.

PMID: 26615519 [PubMed – in process]

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Volatile organic compounds in asthma diagnosis: a systematic review and meta-analysis.

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Volatile organic compounds in asthma diagnosis: a systematic review and meta-analysis.

Allergy. 2015 Oct 17;

Authors: Cavaleiro Rufo J, Madureira J, Oliveira Fernandes E, Moreira A

Abstract
We aimed to assess the value and classification rate of exhaled volatile organic compounds (VOCs) in asthma diagnosis. A PRISMA oriented systematic search for published studies regarding exhaled VOCs in asthma diagnosis was conducted based on pre-defined criteria. Studies presenting sensitivity and specificity values for the test were included in the meta-analysis. Pooled diagnosis odds ratios (DOR), area under the curve (AUC) and positive and negative likelihood ratios (LR) for exhaled VOC profiles were calculated; and publication bias, threshold effect and heterogeneity were estimated. Eighteen studies were selected for the qualitative analysis and 6 met the criteria for inclusion in the quantitative analysis. Mean (95%CI) pooled DOR, positive and negative LR were 49.3 (15.9 to 153.3), 5.86 (3.07 to 11.21) and 0.16 (0.10 to 0.26), respectively. The AUC value was 0.94. Only 3 of the 18 reviewed studies performed an external validation of the model using a different dataset. The results from the revised studies suggest that exhaled VOCs are promising biomarkers for asthma diagnosis and that several compounds, mainly alkanes, may be significantly associated with asthma inflammation. However, there are still various constraints associated with standardization and externally validated studies are needed to introduce exhaled VOCs profiling in a clinical scenario. This article is protected by copyright. All rights reserved.

PMID: 26476125 [PubMed – as supplied by publisher]

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Leukotriene-Receptor Antagonists Versus Placebo in the Treatment of Asthma in Adults and Adolescents: A Systematic Review and Meta-Analysis.

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Leukotriene-Receptor Antagonists Versus Placebo in the Treatment of Asthma in Adults and Adolescents: A Systematic Review and Meta-Analysis.

Ann Intern Med. 2015 Sep 22;

Authors: Miligkos M, Bannuru RR, Alkofide H, Kher SR, Schmid CH, Balk EM

Abstract
Background: Leukotriene-receptor antagonists (LTRAs) are recommended as an alternative treatment in patients with mild asthma, but their effect compared with placebo is unclear.
Purpose: To determine the benefits and harms of LTRAs as monotherapy or in combination with inhaled corticosteroids compared with placebo in adults and adolescents with asthma.
Data Sources: MEDLINE and the Cochrane Central Register of Controlled Trials from inception through June 2015.
Study Selection: Peer-reviewed, English-language, randomized, controlled trials in patients with asthma that reported the effect of LTRAs versus placebo on measures of asthma control.
Data Extraction: Three researchers extracted data on study population, interventions, outcome measures, and adverse events. One researcher assessed risk of bias.
Data Synthesis: Of the 2008 abstracts that were screened, 50 trials met eligibility criteria. Random-effects meta-analyses of 6 trials of LTRA monotherapy showed that LTRAs reduced the risk for an exacerbation (summary risk ratio [RR], 0.60 [95% CI, 0.44 to 0.81]). In 4 trials of LTRAs as add-on therapy to inhaled corticosteroids, the summary RR for exacerbation was 0.80 (CI, 0.60 to 1.07). Leukotriene-receptor antagonists either as monotherapy or add-on therapy to inhaled corticosteroids increased FEV1, whereas FEV1 percentage of predicted values was only improved in trials of LTRA monotherapy. Adverse event rates were similar in the intervention and comparator groups.
Limitation: Variation in definitions and reporting of outcomes, high risk of bias in some studies, heterogeneity of findings, possible selective outcome reporting bias, and inability to assess the effect of asthma severity on summary estimates.
Conclusion: Leukotriene-receptor antagonists as monotherapy improved asthma control compared with placebo, but which patients are most likely to respond to treatment with LTRAs remains unclear.
Primary Funding Source: National Institutes of Health.

PMID: 26390230 [PubMed – as supplied by publisher]

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The evolution of mobile apps for asthma: an updated systematic assessment of … – BMC Blogs Network

The evolution of mobile apps for asthma: an updated systematic assessment of …
BMC Blogs Network
Background Interest in mobile apps that support long-term conditions such as asthma is matched by recognition of the importance of the quality and safety of apps intended for patient use. We assessed how changes over a 2-year period affected the …

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Complex interventions reduce use of urgent healthcare in adults with asthma: Systematic review with meta-regression.

Complex interventions reduce use of urgent healthcare in adults with asthma: Systematic review with meta-regression.

Respir Med. 2014 Nov 15;

Authors: Blakemore A, Dickens C, Anderson R, Tomenson B, Woodcock A, Guthrie E

Abstract
INTRODUCTION: Asthma accounts for considerable healthcare expenditure, a large proportion of which is attributable to use of expensive urgent healthcare. This review examines the characteristics of complex interventions that reduce urgent healthcare use in adults with asthma.
METHOD: Electronic searches of MEDLINE, EMBASE, PSYCINFO, CINAHL, the British Nursing Library and the Cochrane library, from inception to January 2013 were conducted. Studies were eligible for inclusion if they: i) included adults with asthma ii) assessed the efficacy of a complex intervention using randomised controlled trial design, and iii) included a measure of urgent healthcare utilisation at follow-up. Data on participants recruited, methods, characteristics of complex interventions and the effects of the intervention on urgent healthcare use were extracted.
RESULTS: 33 independent studies were identified resulting in 39 comparisons altogether. Pooled effects indicated that interventions were associated with a reduction in urgent healthcare use (OR = 0.79, 95% CI = 0.67, 0.94). When study effects were grouped according to the components of the interventions used, significant effects were seen for interventions that included general education (OR = 0.77, 95% CI = 0.64, 0.91), skills training (OR = 0.64, 95% CI = 0.48, 0.86) and relapse prevention (OR = 0.75, 95% CI = 0.57, 0.98). In multivariate meta-regression analysis, only skills training remained significant.
CONCLUSIONS: Complex interventions reduced the use of urgent healthcare in adults with asthma by 21%. Those complex interventions including skills training, education and relapse prevention may be particularly effective in reducing the use of urgent healthcare in adults with asthma.

PMID: 25433953 [PubMed – as supplied by publisher]

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Corticosteroid Drugs Used For Asthma Suppress Growth – Systematic Reviews – Science 2.0


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Corticosteroid Drugs Used For Asthma Suppress Growth – Systematic Reviews
Science 2.0
They are the most effective drugs for controlling asthma and clearly reduce asthma deaths, hospital visits and the number and severity of exacerbations, and improve quality of life. Worldwide, seven ICS drugs are currently available: beclomethasone, …

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An estimate of asthma prevalence in Africa: a systematic analysis.

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An estimate of asthma prevalence in Africa: a systematic analysis.

Croat Med J. 2013 Dec 28;54(6):519-31

Authors: Adeloye D, Chan KY, Rudan I, Campbell H

Abstract
Aim. To estimate and compare asthma prevalence in Africa in 1990, 2000, and 2010 in order to provide information that will help inform the planning of the public health response to the disease. Methods. We conducted a systematic search of Medline, EMBASE, and Global Health for studies on asthma published between 1990 and 2012. We included cross-sectional population based studies providing numerical estimates on the prevalence of asthma. We calculated weighted mean prevalence and applied an epidemiological model linking age with the prevalence of asthma. The UN population figures for Africa for 1990, 2000, and 2010 were used to estimate the cases of asthma, each for the respective year. Results. Our search returned 790 studies. We retained 45 studies that met our selection criteria. In Africa in 1990, we estimated 34.1 million asthma cases (12.1%; 95% confidence interval [CI] 7.2-16.9) among children <15 years, 64.9 million (11.8%; 95% CI 7.9-15.8) among people aged <45 years, and 74.4 million (11.7%; 95% CI 8.2-15.3) in the total population. In 2000, we estimated 41.3 million cases (12.9%; 95% CI 8.7-17.0) among children <15 years, 82.4 million (12.5%; 95% CI 5.9-19.1) among people aged <45 years, and 94.8 million (12.0%; 95% CI 5.0-18.8) in the total population. This increased to 49.7 million (13.9%; 95% CI 9.6-18.3) among children <15 years, 102.9 million (13.8%; 95% CI 6.2-21.4) among people aged <45 years, and 119.3 million (12.8%; 95% CI 8.2-17.1) in the total population in 2010. There were no significant differences between asthma prevalence in studies which ascertained cases by written and video questionnaires. Crude prevalences of asthma were, however, consistently higher among urban than rural dwellers. Conclusion. Our findings suggest an increasing prevalence of asthma in Africa over the past two decades. Due to the paucity of data, we believe that the true prevalence of asthma may still be under-estimated. There is a need for national governments in Africa to consider the implications of this increasing disease burden and to investigate the relative importance of underlying risk factors such as rising urbanization and population aging in their policy and health planning responses to this challenge.

PMID: 24382846 [PubMed – in process]

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Association of CD14 -260 (-159) C>T and asthma: a systematic review and meta … – 7thSpace Interactive (press release)

Association of CD14 -260 (-159) C>T and asthma: a systematic review and meta …
7thSpace Interactive (press release)
Asthma is a phenotypically diverse disease with genetic susceptibility. A single nucleotide polymorphism (SNP) in the CD14 gene at position -260 (also known as -159) C>T has been inconsistently associated with asthma. The aim of this study was to …

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