A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy

Objective: Summarizing the evidence on the effects of pre- and postoperative exercise and psychosocial rehabilitation interventions on patient-reported outcomes (PROs) and physical fitness in bladder cancer patients undergoing radical cystectomy. Data sources: The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Web of Science and the Physiotherapy Evidence Database were searched independently by two authors from inception until 10 November 2017. Cited references of the studies and citing references retrieved via Web of Science were also checked. Review methods: Randomized controlled trials (RCTs) and non-randomized studies assessing effects of exercise and psychosocial interventions in bladder cancer patients undergoing radical cystectomy were eligible. Primary outcome measures were PROs and physical fitness. Risk of bias was assessed using the Cochrane Collaboration tool and the Newcastle-Ottawa Scale. Results: Five RCTs (three exercise and two psychosocial studies) and one non-randomized psychosocial study comprising 317 bladder cancer patients were included. Timing of the intervention was preoperative (n=2), postoperative (n=2) or both pre- and postoperative (n=2). Positive effects of exercise were found for physical fitness (n=3), some health-related quality-of-life (HRQoL) domains (n=2), personal activities in daily living (n=1) and muscle strength (n=1). Psychosocial interventions showed positive effects on anxiety (n=1), fatigue (n=1), depression (n=1), HRQoL (n=1) and posttraumatic growth (n=1). Quality assessment showed most shortcomings with sample sizes and strong heterogeneity was observed between studies. Conclusion: The evidence relating to the effects of exercise in bladder cancer is very limited and is even less for psychosocial interventions

Guidance for systematic reviews in journal author instructions: findings and recommendations for editorial teams

Introduction: Systematic reviews play a crucial role in informing clinical decision‐making, policy formulation, and evidence‐based practice. However, despite the existence of well‐established guidelines, inadequately executed and reported systematic reviews continue to be published. These highly cited reviews not only pose a threat to the credibility of science but also have substantial implications for medical decision‐making. This study aims to evaluate and recommend improvements to the author instructions of biomedical and health journals concerning the conducting and reporting of systematic reviews. Methods: A sample of 168 journals was selected based on systematic reviews published between 2020 and 2021, taking into account their Altmetric attention score, citation impact, and mentions in Altmetric Explorer. Author instructions were downloaded, and data extraction was carried out using a standardized web form.Two reviewers independently extracted data, and discrepancies were resolved by a third reviewer. The findings were presented using descriptive statistics, and recommendations for editorial teams were formulated. The protocol is registered with the Open Science Framework Registries (osf. io/bym8d). Results: One‐third of the journals lack tailored guidance for systematic reviews, as demonstrated by the absence of references to conducting or reporting guidelines,protocol registration, data sharing, and the involvement of an information specialist.Half of the author instructions do not include a dedicated section on systematic reviews, hampering the findability of tailored information. The involvement of information specialists is seldom acknowledged. Ultimately, the absence of an update date in most author instructions raises concerns about the incorporation of the most recent developments and tools for systematic reviews.Conclusion: Journals that make substantial contributions to synthesizing evidence in biomedicine and health are missing an opportunity to provide clear guidance within their author instructions regarding the conducting and reporting of reliable systematic reviews. This not only fails to inform future authors but also potentially compromises the quality of this frequently published research type. Furthermore,there is a need for greater recognition of the added value of information specialists to the systematic review and publishing processes. This article provides recommendations drawn from the study's observations, aiming to help editorial teams enhance author instructions and, consequently, potentially assisting systematic reviewers in improving the quality of their reviews

A comprehensive catalogue of EQ-5D scores in chronic disease : results of a systematic review

Purpose: Chronic diseases are associated with impaired health-related quality of life (HRQoL) outcomes. Comparison of HRQoL outcomes between different diseases and with the general population is of major importance to health economists, epidemiologists, clinicians, and policy makers. The aim of this systematic literature review was to develop a catalogue with EQ-5D scores in chronic non-communicable diseases, and to compare these scores with reference values from the general population. Methods: MEDLINE, Embase, and Web of Science were systematically searched independently by two reviewers. Studies were included if they reported mean EQ-5D index values for the adult population and if these scores were compared with the general population. The QualSyst tool for quantitative research was used for quality appraisal. Results: Two hundred and seven articles met the inclusion criteria. An extensive catalogue summarizes the EQ-5D scores in a wide variety of chronic diseases. Mean EQ-5D index values ranged between - 0.20 and 1. Lower EQ-5D scores are reported in chronic diseases compared to the general population, specifically in neurological disorders. Most of the diseases demonstrate a substantial disutility, although a minority of diseases have equal or even higher index scores than the general population. Conclusion: A comprehensive, international catalogue has been developed to provide EQ-5D index scores for diverse chronic diseases compared with reference values based on the available literature. The catalogue gives a clear overview of the existing EQ-5D scores and can be rapidly accessed by researchers worldwide for different applications such as health economic evaluations, decision making, resource allocation, and other policy objectives. Future studies should focus on unexamined diseases and specific patient groups to expand the evidence base on HRQoL in chronic diseases

Influence of health interventions on quality of life in seriously ill children at the end of life : a systematic review protocol

Background: Seriously ill children suffer from numerous symptoms at the end of their lives, including pain, anxiety, and restricted communication. There are currently no comprehensive overviews of which health interventions have proven benefits and which have proven detrimental effects on the quality of life of children in an end-of-life context. In order to identify potential quality indicators to eventually improve care, a systematic review of available evidence is needed. The aim of the current systematic review will be to make an overview of the influence of health interventions on associated outcomes related to quality of life at the end of life in seriously ill children. Methods: A systematic search will be conducted in MEDLINE, Embase, CENTRAL, CINAHL, and Web of Science. We will include quantitative empirical designs looking into the influence of a health intervention on (proxies of) quality of life at the end of life in seriously ill children. Three independent authors will review titles and abstracts and screen full texts against eligibility criteria. One reviewer will carry out full data extraction and quality assessment, and a 20% random sample will be extracted and assessed by two independent reviewers. We will use the QualSyst Tool for assessment of the quality of the included studies (QualSyst Tool) for quality assessment; overall strength of the body of evidence will be assessed using the Grading of Recommendations Assessment Development, and Evaluation (GRADE) approach. An overview table of health interventions will be discussed through narrative synthesis. Should sufficient homogeneous publications arise, we will perform meta-analyses with a random-effects model. Our protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist for study protocols. Discussion: As part of a larger project, we will use the results of this review to identify a first set of quality indicators for the care for children at the end of life. Reviewing the current span of evidence and identifying research gaps will uncover future research priorities into the care for children at the end of life

Magnetic resonance imaging for forensic age estimation in living children and young adults : a systematic review

Background The use of magnetic resonance imaging (MRI) in forensic age estimation has been explored extensively during the past decade. Objective To synthesize the available MRI data for forensic age estimation in living children and young adults, and to provide a comprehensive overview that can guide age estimation practice and future research. Materials and Methods MEDLINE, Embase and Web of Science were searched. Additionally, cited and citing articles and study registers were searched. Two authors independently selected articles, conducted data extraction, and assessed risk of bias. Study populations including living subjects up to 30 years were considered. Results Fifty-five studies were included in qualitative analysis and 33 in quantitative analysis. Most studies suffered from bias, including relatively small European (Caucasian) populations, varying MR-approaches and varying staging techniques. Therefore, pooling of the age distribution data was not appropriate. Reproducibility of staging was remarkably lower in clavicles than in any other anatomical structure. Age estimation performance was in line with the gold standard, which uses radiographs, with mean absolute errors ranging from 0.85 to 2.0 years. The proportion of correctly classified minors ranged from 65% to 91%. Multi-factorial age estimation performed better than based on a single anatomical site. Conclusion More multi-factorial age estimation studies are necessary, together with studies testing if the MRI data can safely be pooled. The current review results can guide future studies, help medical professionals to decide on the preferred approach for specific cases, and help judicial professionals to interpret the evidential value of age estimation results

Differential online exposure to extremist content and political violence: testing the relative strength of social learning and competing perspectives

The present study applies Social Learning (Differential Association) Theory to the explanation of political violence, focusing on exposure to extremist content through new social media (NSM) and controlling for key variables derived from rival theories. Data are gathered using (a) a paper-and-pencil study among high school students, and (b) a web survey targeting youths between 16 and 24 years old. A total of 6020 respondents form the dataset. Binary logistic regression is used to analyze the data. Results show that even when controlling for background variables, strain variables, personality characteristics, moral values, and peer influences, the statistical association between measures of extremism through NSM (ENSM) and self-reported political violence remains significant and fairly constant. The most persistent effects are found for those measures where individuals actively seek out extremist content on the Internet, as opposed to passive and accidental encounters using NSM. Furthermore, offline differential associations with racist and delinquent peers are also strongly and directly related to self-reported political violence, as are some mechanisms from rival perspectives. This indicates that political violence can only partially be explained by social learning and suggests that the impact of ENSM is mediated by real-world associations and that the offline world has to be taken into account