Systematic Reviews

Diagnostic accuracy of serological tests for dermatitis herpetiformis: systematic review and Bayesian meta-analysis
Ocagli H, Berti G, Canova C, Szekely S, Piaserico S, Zingone F and Baldi I
The diagnosis of Dermatitis Herpetiformis (DH) relies on both clinical and serological tests. Accurate diagnostic tools are critical for effective management. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of serological tests for DH, focusing on the impact of gluten-free diet (GFD) status on test performance, using Direct Immunofluorescence (DIF) as the reference standard.
Assessment of the utility and performance of SORMAS in low- and middle-income countries: a scoping review protocol
Danso SA, Aku FY, Newton S, Quentin W and Opoku D
The Surveillance Outbreak Response Management and Analysis System (SORMAS) is an open source digital tool created to enhance real time surveillance and outbreak response especially in resource poor settings like low- and middle-income countries (LMICs). Even though the tool has been deployed in several countries, there is no comprehensive review of the available research reporting its implementation and the evidence on utility and performance as experienced by countries. This review aims to systematically map out available evidence to assess the utility and performance of SORMAS across LMICs systematically.
The relationship between auditory steady-state response and behavioural audiometry in hearing estimation for infants: a meta-analysis
Huang X, Kluk K and Perugia E
Auditory Steady-State Response (ASSR) allows the identification of infants with hearing loss and consequently early intervention. Therefore, it is important to assess the accuracy of ASSR for determining hearing thresholds in infants. This study aimed to systematically review the threshold differences between air-conducted ASSR and behavioural audiometry (BA) in infants.
Medication-related problems and contributing factors in patients with cardiovascular disorders in Ethiopia: a systematic review and meta-analysis
Gobezie MY, Tesfaye NA, Demessie MB, Andualem A, Wendie TF and Hassen M
Cardiovascular diseases (CVDs) are a leading cause of mortality and disability globally. In Ethiopia, the management of CVDs faces significant challenges, particularly in addressing medication-related problems (MRPs). This systematic review and meta-analysis aims to assess the prevalence of MRPs among CVD patients in Ethiopia.
Factors influencing early detection of lung cancer in patients in low- and middle-income countries: a scoping review protocol
Nene S, Hlongwa M, Hlongwana K and Dlamini S
Cancer is a leading cause of mortality globally. It is increasingly becoming a public health concern in sub-Saharan Africa (SSA) and a major societal and economic problem worldwide. Approximately three quarters of all cancer-related deaths occur in low- and middle-income countries (LMICs), with lung cancer being the most frequently diagnosed cancer in 2022. Given the poor health outcomes associated with late diagnosis, early detection for lung cancer should be prioritised to rekindle hope for improved health outcomes. This is a scoping review protocol paper aimed at mapping evidence on factors influencing early identification of lung cancer in patients in low- and middle-income countries.
From theory to practice in training health researchers in patient and public involvement: a scoping review protocol
Jesus C, Regalado ICR, Monteiro KS, Magalhães AG, de Carvalho Chagas PS, Faria CDCM, Córdova VV, Álvarez-Aguado I, Namisango E, Morris C and Longo E
Patient and public involvement (PPI) aims to increase the relevance and impact of research by ensuring that outcomes align with the real needs of those involved. In PPI, the public actively participates in all stages of research, which has been shown to improve research quality, empower participants, and enrich researchers' understanding of patients' and the public's lived experiences. However, implementing PPI poses a challenge for many researchers, making training essential as it provides the necessary skills to incorporate PPI meaningfully into their projects. Thus, this review aims to map existing PPI training programs in health research, identifying effective strategies that can be replicated, thereby contributing to the improvement of health research practices.
Impact of multicomponent physical exercise and high-intensity interval training on osteoporosis in postmenopausal women: protocol for a systematic review and network meta-analysis of randomized controlled trials
Monteiro AM, Schneider A, Encarnação S, Forte P, Barbosa T and Martín DP
Osteoporosis is a progressive degenerative bone condition leading to increased fracture risk. Therefore, osteoporosis acknowledges around 200 million cases, with about 70% of the cases occurring in postmenopausal women. Medicaments are often suggested to treat osteoporotic conditions, but physical exercise also plays an essential role. The current literature highlights multicomponent training (MCT) and high-intensity and high-impact exercises as physical exercise interventions that positively affect postmenopausal women's bone health. Furthermore, there is prior evidence of systematic reviews about the positive effects of both methods on the bone health of this population. Despite this prior evidence, no systematic reviews with metanalytic methods compare the effectiveness of the two interventions.
Beyond global trueness and precision: evaluating the clinical suitability of automated brachial cuff blood pressure measurements in acute care-a protocol for systematic review and meta-analysis of aggregated and individual participant data
Dauvergne JE, Lakhal K and Boulain T
Invasive intra-arterial blood pressure (IABP) monitoring using an arterial catheter carries both risks and practical limitations. Noninvasive blood pressure (NIBP) monitoring using the widely adopted oscillometric automated brachial cuff is performed in nearly all patients in acute care settings at some point, yet its reliability remains in question. Conventional statistical approaches to assessing the global trueness (bias) and precision (standard deviation, SD) of NIBP compared to IABP may not fully capture the risk of harm posed by NIBP's measurement errors to patients, nor its ability to detect blood pressure (BP) values above or below critical thresholds. Moreover, risk factors for poor performance of NIBP warrant further investigation. We will perform a meta-analysis using individual participant data (IPD) to evaluate the clinical suitability of NIBP in acute care settings.
Neuroimaging in pediatric language development and disorders: a scoping review protocol
Ning R and Washington KN
Infancy and early childhood represent critical periods for language development, as well as for the diagnosis and intervention of language disorders. Neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI) and magnetoencephalography (MEG), have revolutionized our understanding of the brain's role in language development and disorders. These techniques provide detailed insights into the neural mechanisms underlying language acquisition and the deviations associated with language disorders. However, there is a notable lack of comprehensive literature reviews on the application of neuroimaging techniques in studying pediatric language development and disorders, particularly in children under eight years old in the field of speech-language pathology. This gap in the literature hinders the ability to form a cohesive understanding of the current state of research and its clinical implications, i.e., garnering an understanding of the contributions of these technological tools in understanding language development and disorders.
Prediction of sentinel lymph node status in patients with early breast cancer using breast imaging as an alternative to surgical staging-a systematic review and meta-analysis
Rejmer C, Hjärtström M, Bendahl PO, Dihge L, Skarping I, Zhang D, Dustler M and Rydén L
Prediction models for sentinel lymph node (SLN) status could potentially substitute surgical axillary staging in patients with early breast cancer. Several imaging modalities have been used with various feature extraction and selection approaches. This systematic review and meta-analysis aimed to evaluate prediction models for SLN status based on breast imaging in patients with early breast cancer to summarize the current evidence and to identify areas requiring additional research.
Evaluating the use and adaptation of implicit attitude measures in older adults: a scoping review protocol
Vinnikova A and Yang Q
The ongoing demographic shift toward an aging global population has significant implications for the design and application of psychological research tools. Among these, implicit attitude measures-used to assess automatic, unconscious evaluations-pose particular challenges when applied to older adults. Although such measures are widely used in psychological and health-related research, they were primarily developed and validated with younger populations. Age-related cognitive and sensory changes may interfere with task performance and compromise the validity of these tools, yet little is known about how such issues have been addressed or adapted for in empirical studies.
What is the effect of commercial food and non-alcoholic beverage marketing on the dietary intake of children and adolescents? Protocol for systematic review and meta-analysis with an equity lens
Chen QJ, Mozaffari H, Ananthapavan J, Smith BT, Wong GWK and Jessri M
Previous reviews have shown that food and beverage marketing increases dietary intake among children. However, no updated review has been conducted since the COVID-19 pandemic. Furthermore, limited evidence exists on how this effect varies by sociodemographic factors and marketing media. The proposed study aims to assess and quantify the effect of food and beverage marketing exposure on children's dietary intake and to examine variations based on age, sex, ethnicity, socioeconomic position, and marketing medium.
Effectiveness of inspiratory muscle training and multicomponent physical training in patients with post-COVID conditions: a systematic review and meta-analysis
da Costa Correia A, Ribeiro F, Amorim FF, Giusti PR, Peccin MS and Imoto AM
There is evidence that fatigue and dyspnea are among the most frequently reported symptoms of post-COVID condition. Therefore, several studies have investigated respiratory muscle or global peripheral muscle training as strategies to manage those symptoms. Despite evidence of potential benefits, conflicting results persist due to the heterogeneity of rehabilitation protocols and assessment tools. Thereby, the objective of this systematic review was to evaluate the effectiveness of inspiratory muscle training and multicomponent physical training in adults with dyspnea and fatigue for at least 12 weeks after COVID-19.
Coping with copper: a bibliometric analysis of copper's role in cancer pathogenesis and treatment
Chen C, Su Q, Zi M, Duan Y and Zhang Z
This bibliometric analysis on copper's role in cancer pathogenesis and treatment, spanning from 2014 to 2024, provides a comprehensive overview of current trends and emerging research areas. It highlights China's dominance in research output and identifies a seminal 2022 study by Tsvetkov Peter as the most cited, cementing its importance in the field. Central keywords such as "DNA damage," "trace elements," and "oxidative stress" reflect the critical roles copper plays in cancer biology. As the field continues to evolve, key areas of focus for future studies are expected to include copper homeostasis, the roles of cuproptosis and ferroptosis, and the development of cancer prognosis models based on cuproptosis. This analysis offers valuable insights for advancing both scientific inquiry and clinical applications in this area.
The cortical mechanisms underlying the analgesic effects of repetitive transcranial magnetic stimulation: protocol for a systematic review and meta-analysis
Chowdhury NS, Cheng D, Chang WJ, Hesam-Shariati N, Quide Y, da Cunha PHM, da Silva Lapa JD, Kubota GT, Dos Santos KDA, Coelho DN, de Andrade DC and Gustin S
Repetitive transcranial magnetic stimulation (rTMS) is a promising, safe, and non-invasive treatment for pain. However, there is no clear understanding of the cortical mechanisms underlying the analgesic effect of rTMS. One theory is that rTMS-induced analgesia is associated with alterations in corticomotor and cortical excitability, assessed using single-pulse TMS and TMS-electroencephalography (TMS-EEG), respectively. The aim of this systematic review and meta-analysis will be to synthesise the available literature to determine the following: (1) the effect of rTMS on corticospinal and cortical excitability across experimental pain and acute and chronic clinical pain conditions; (2) whether changes in cortical/corticospinal excitability correlate with changes in pain outcomes for these pain types following rTMS.
Effectiveness of photobiomodulation therapy for ophthalmic diseases: protocol for a systematic review and meta-analysis of disease-specific and shared physiological outcomes
Choy S, Chun JM, Seok JW, Park SR and Kim JD
Photobiomodulation therapy (PBMT)-a noninvasive therapeutic strategy-employs low-level red or near-infrared light to regulate cellular bioenergetics, reduce oxidative stress, and modulate inflammation. It has demonstrated therapeutic potential for several ophthalmic diseases, including age-related macular degeneration, diabetic retinopathy, glaucoma, retinitis pigmentosa, and dry eye disease. However, the clinical evidence remains fragmented due to heterogeneity in study designs, treatment parameters, and outcome measures. Moreover, existing reviews are largely confined to single diseases. Robust, prespecified assessments that standardize disease-specific endpoints and only explore shared physiological measures across conditions remain scarce.
The role of physical activity and exercise in gynecologic cancer care: protocol for an umbrella review
Witwaranukool P, Kynoch K and Fernandez R
Gynecologic cancers are associated with long-term physical and psychological challenges. Physical activity (PA) and exercise are increasingly recognized as important components of cancer care. However, no umbrella review has synthesized evidence across gynecologic cancers. This review aims to evaluate the effectiveness of PA and exercise in improving health outcomes.
Gastrocsoleus lengthening in combination with tibialis anterior tendon shortening for equinus deformity in children with cerebral palsy: a systematic review
Modi D, Gould D, Ye K, Graham K and Rutz E
Equinus is the most common deformity in cerebral palsy, and gastrocsoleus lengthening (GSL) is the most common surgical intervention in children with cerebral palsy (CwCP). GSL is a dose-dependent surgical concept carried out with consideration of the severity of equinus contracture, aimed at addressing this problem during the stance phase of gait. The addition of the novel procedure, tibialis anterior tendon shortening (TATS), may offer benefit in correcting the swing phase problem by addressing foot drop due to the agonist/antagonist relationship with gastrocsoleus. Given the small sample sizes and mixed results presented by current literature, our study aimed to collate the available evidence in order to review the effectiveness and safety of the addition of TATS to the GSL procedure for CwCP with equinus deformity.
Inconsistency was more prevalent than reported: an empirical study of 57 networks with multiple treatments using the node-splitting approach and a novel interpretation index
Spineli LM
Inconsistency has been reported to be ubiquitous in network meta-analysis. However, this evidence is based on statistical tests for inconsistency with well-documented power limitations. A novel interpretation index was developed that is founded on the Kullback-Leibler divergence measure and warrants a semi-objective decision about the extent of inconsistency as acceptably low or material when statistical tests are underpowered. The prevalence of local inconsistency was investigated using the synergy of the Bayesian node-splitting approach with the newly proposed interpretation index. The results were also contrasted with inferences drawn from the 'standard decision-making approach' about the presence of inconsistency.
Interventions to improve help seeking for older adults living in the community with mental illness: a mixed methods review protocol
Prindiville P, Bhar S, Nedeljkovic M and Schofield P
Mental health illnesses are prevalent for older adults. Despite the effectiveness of treatments for improving mental health, the uptake is low. Interventions that target barriers to mental health help seeking lead to improved treatment uptake in adults and younger populations. However, the effects, characteristics, and experience of these interventions for older adults remain unclear. The first aim of this mixed methods review is to explore the effects of interventions for improving help seeking in community dwelling older adults with mental health difficulties. The secondary aims are to describe the characteristics, feasibility and acceptability of these interventions to interest-holders.
Conversational agent-based interventions for lifestyle behavior modification in older adults: a systematic review
Zhang Q, Wong AKC and Hui V
The global rise in population aging and the increasing burden of non-communicable diseases demand scalable, cost-effective strategies to support healthy aging. Conversational agent-based interventions, which deliver personalized guidance through interactive dialogue, offer a promising yet underexplored approach to promoting lifestyle behavior change among older adults. Thus, the purpose of this study is to systematically review the characteristics, acceptability, and effectiveness of conversational agent-based interventions for lifestyle behavior modification in older adults, and to identify key design and research considerations for advancing this emerging field.