Communication technologies to improve HPV vaccination initiation and completion: A systematic review

ObjectivesThis systematic review examines the effectiveness of communication technology interventions on HPV vaccination initiation and completion.MethodsA comprehensive search strategy was used to identify existing randomized controlled trials testing the impact of computer-, mobile- or internet-based interventions on receipt of any dose of the HPV vaccine. Twelve relevant studies were identified with a total of 38,945 participants.ResultsThe interventions were delivered using several different methods, including electronic health record (i.e. recall/reminder) prompts, text messaging, automated phone calls, interactive computer videos, and email. Vaccine initiation and completion was greater for technology-based studies relative to their control conditions.ConclusionThere is evidence that interventions utilizing communication technologies as their sole or primary mode for HPV vaccination intervention delivery may increase vaccination coverage.Practice implicationsCommunication technologies hold much promise for the future of HPV vaccination efforts, especially initiatives in practice-based settings.     

Previsit Multidomain Psychosocial Screening Tools for Adolescents and Young Adults: A Systematic Review

Adolescence and young adulthood constitute a period when exploratory behaviors can evolve into risky behaviors. Most causes of adolescent ill health are preventable; therefore, it is a priority to detect them early before they turn into health problems. Previsit multidomain psychosocial screening tools are used by professionals to detect and prioritize potentially problematic issues. In conjunction with appropriate clinician training, these tools have improved clinician screening rates in several areas of adolescent health. This article reviews existing multidomain previsit psychosocial screening tools developed in the 21st century and describes their characteristics using a systematic methodology.We reviewed 10,623 records to identify 15 different tools in use since 2000 and described their characteristics. Results show that all tools were developed in high-income countries. The tools provide sufficient coverage of many psychosocial domains relevant to young people's health. However, some psychosocial domains such as screen use and strengths are seldomly addressed. Furthermore, the tools rarely focus on young adults as a target population. Future research should assess the effectiveness, acceptability, and psychometric properties of validated psychosocial screening tools and examine how to expand their use in low- and middle-income countries.     

Modified Broström repair with suture tape augmentation for lateral ankle instability: A systematic review

BackgroundThere is increasing interest in augmentation of modified Broström repairs for lateral ankle instability with a prosthetic reconstruction using suture tape internal bracing. The aim of this study was to investigate if suture tape augmentation resulted in improved clinical and radiological outcomes compared to a standard modified Broström repair alone.MethodsA systematic review following PRISMA guidelines was undertaken. All clinical studies published in Medline, Embase, Pubmed and the Cochrane Library Database from inception until January 2020 reporting on the use of suture tape augmentation to a modified Broström repair for lateral ankle instability.Results78 studies were identified of which 10 (assessing 333 patients) met the criteria for inclusion. Mean follow up was 24.8 months (range 6–52 months). All studies showed a statistically significant improvement across multiple clinical outcome measures post-surgery in both suture tape augmentation and modified Broström groups, however there were no statistically significant inter-group differences.Pooled results suggested there may be a reduction in recurrence of instability with suture tape augmentation when compared to modified Broström repair alone (p < 0.05). Overall quality of evidence was moderate to poor with limited data to support use of suture tape augmentation.ConclusionClinical and radiographic outcomes using a suture tape internal bracing for lateral ankle instability are excellent, and are equivalent to standard treatment across multiple clinical and radiographic assessment measures. There is minimal evidence to suggest functional outcomes are better, or recurrence rates are lower than modified Broström repair alone.PROSPERO REGISTRYCRD42020169876.Level of evidenceII.     

国内学者眼科领域系统评价和Meta分析在SCI期刊的发表情况

目的 统计分析目前国内学者在SCI期刊发表的眼科领域系统评价和Meta分析论文情况，为今后发表此类研究提供参考。设计 描述性研究。研究对象 在PubMed、EMBASE及Cochrane library三大数据库中收录的所有眼科领域的系统评价和Meta分析论文。方法 系统检索PubMed、EMBASE及Cochrane library三大数据库。检索时，限定研究对象为人类，语言为英语，检索时间截止到2017年1月30日。通过阅读标题、摘要及全文，排除重复及不相关研究，将最终符合条件的研究按作者来源、发表年限、疾病类型等进行归类分析。主要指标 作者来源、发表年限、疾病类型。 结果 三大数据库共检索到10 551条题录（PubMed 4214，EMBASE 6155，Cochrane library 182）。排除重复及不相关研究后，最终符合条件的系统评价和Meta分析442篇。此类研究最早发表于2004年，按年发表量排名，前三名分别是：2015（100篇，22.62%）、2014（91篇，20.59%）、2016（90篇，20.36%）。共有来自52个城市的作者参与发表过此类研究，前三名城市分别是：上海（95篇，21.49%）、北京（45篇，10.18%）、广州（38篇，8.60%）。共有126种杂志发表此类研究，前三名杂志分别是：PLoS One (79篇，17.87%)、Molecular Vision（16篇，3.62%）、BMC Ophthalmology（15篇，3.39%）。研究内容以视网膜疾病最多，前三名疾病分别是：视网膜疾病（168篇，38.01%）、青光眼（95篇，21.49%）、屈光手术（47篇，10.63%）。定性系统评价17篇（3.85%），Meta分析425篇（96.15%）。在Meta分析中干预性研究177篇，观察性研究248篇，后者以基因相关研究（137篇）、危险因素（84篇）为主。结论 国内学者在眼科领域系统评价发表量逐年增多，作者主要集中于国内大城市，尤其是上海和北京，研究热点主要是视网膜疾病、青光眼，非干预性研究发表量已超越干预性研究，其中以基因相关研究及危险因素研究为主。     

No-shows in appointment scheduling – a systematic literature review

No-show appointments significantly impact the functioning of healthcare institutions, and much research has been performed to uncover and analyze the factors that influence no-show behavior. In spite of the growing body of literature on this issue, no synthesis of the state-of-the-art is presently available and no systematic literature review (SLR) exists that encompasses all medical specialties. This paper provides a SLR of no-shows in appointment scheduling in which the characteristics of existing studies are analyzed, results regarding which factors have a higher impact on missed appointment rates are synthetized, and comparisons with previous findings are performed. A total of 727 articles and review papers were retrieved from the Scopus database (which includes MEDLINE), 105 of which were selected for identification and analysis. The results indicate that the average no-show rate is of the order of 23%, being highest in the African continent (43.0%) and lowest in Oceania (13.2%). Our analysis also identified patient characteristics that were more frequently associated with no-show behavior: adults of younger age; lower socioeconomic status; place of residence is distant from the clinic; no private insurance. Furthermore, the most commonly reported significant determinants of no-show were high lead time and prior no-show history.     

如何运用系统评价结果进行临床实践

循证医学实践需要高质量证据。系统评价/Meta分析通过立题、检索文献、筛选文献、评价文献质量、收集资料、分析资料、解释结果、更新原有评价等严格系统的制作过程,确保研究结果和结论的真实性和可靠性,因此被公认为论证强度最高的证据。然而临床医生在将其具体应用于临床实践之前还需考虑该系统评价结果是否适用于你的患者,是否包含了所有可能的重要结果,其干预措施对患者的诊治益处在临床上是否重要,对患者是否利大于弊,此外,还需要考虑所需治疗费用以及患者的价值取向。循证医学临床实践因需要而产生,同时它也因为真实性、患者的个体化以及疾病的复杂性而不断更新。也正是因为它的缺陷性和不完美性,循证临床实践才具有更广阔的发展空间。     

Squamous cell carcinoma of the pancreas: A systematic review and pooled survival analysis

The diagnosis and treatment of squamous cell carcinoma of the pancreas pose dilemmas in the clinical practice. The present study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible articles were sought in MEDLINE up to 30th April 2016. A pooled Cox regression analysis was performed to evaluate factors potentially associated with overall survival (OS) and relapse-free survival (RFS). Fifty-four cases of pure squamous cell pancreatic carcinomas were identified in total. The mean age was 61.9 years, and most patients were males (61.1%). The median OS was 7 months. Resectability (p = 0.003) and more recent publication year (p < 0.001) were associated with better OS, as was low/intermediate tumour grade (p = 0.032) with RFS. Despite its poor prognosis, survival rates of pancreatic squamous cell carcinoma seem improved during the recent years; resectability and low/intermediate grade emerged as favourable prognostic factors. Collaborative epidemiological studies are deemed necessary to further validate the results stemming from the published case reports of this rare entity.