Dataset Information

The acute and long-term management of anaphylaxis: protocol for a systematic review.

ABSTRACT:

Background

The European Academy of Allergy and Clinical Immunology is in the process of developing its Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management and impact on quality of life, which will be used to inform clinical recommendations.The aims of this systematic review will be to assess the effectiveness of interventions for the acute management of anaphylaxis, and pharmacological and non-pharmacological approaches for the long-term management of anaphylaxis.

Methods

A highly sensitive search strategy has been developed, and validated study design filters will be applied to retrieve all articles pertaining to the management of anaphylaxis from electronic bibliographic databases. We will systematically review the literature on the acute management of anaphylaxis by assessing the effectiveness of epinephrine, H1-antihistamines (versus placebo), systemic glucocorticosteroids, methylxanthines or any other treatments for the emergency management of people experiencing anaphylaxis. The main interventions that have been studied in the context of long-term management are anaphylaxis management plans and allergen-specific immunotherapy.

Discussion

There is at present little in the way of robust evidence to guide decisions on the acute and/or long-term management of anaphylaxis. Given the risk of death and the considerable morbidity associated with anaphylaxis these evidence gaps need to be filled wherever possible; this systematic review will make a start in this area.

SUBMITTER: Dhami S

PROVIDER: S-EPMC3626654 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature

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Publications

The acute and long-term management of anaphylaxis: protocol for a systematic review.

Dhami Sangeeta S Panesar Sukhmeet S SS Rader Tamara T Muraro Antonella A Roberts Graham G Worm Margitta M Sheikh Aziz A

Clinical and translational allergy 20130410 1

<h4>Background</h4>The European Academy of Allergy and Clinical Immunology is in the process of developing its Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management and impact on quality of life, which will be used to inform clinical recommendations.The aim ...[more]

PMID: 23575342

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Project description:BackgroundAllergic reactions to plant and animal derived food allergens can have serious consequences for sufferers and their families. The associated social, emotional and financial costs make it a priority to understand the best ways of managing such immune-mediated hypersensitivity responses. Conceptually, there are two main approaches to managing food allergy: those targeting immediate symptoms and those aiming to support long-term management of the condition. The European Academy of Allergy and Clinical Immunology is developing guidelines about what constitutes an effective treatment for food allergies. As part of the guidelines development process, a systematic review is planned to examine published research about the management of food allergy in adults and children.MethodsSeven bibliographic databases were searched from their inception to September 30, 2012 for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-and-after studies and interrupted time series. Experts were consulted for additional studies. There were no language or geographic restrictions. Studies were critically appraised using the Critical Appraisal Skills Program and Cochrane EPOC Risk of Bias tools. Only studies where people had a diagnosis of food allergy or reported a history of food allergy were included. This means that many studies of conditions that may be caused by food allergy are omitted, because only research in people with an explicit diagnosis or history was eligible.DiscussionMany initiatives have been tested to treat the immediate symptoms of food allergy (acute management) and to deal with longer lasting symptoms or induce tolerability to potential allergens (long-term management). The best management strategies for people with food allergy are likely to depend on the type of allergy, symptom manifestations and age. There is a real need to increase the amount of high quality research devoted to treatment strategies for food allergy. Food allergy can be debilitating and is affecting an increasing number of children and adults. With such little known about how to effectively manage the condition and its manifestations, this appears a priority for future research.

Project description:IntroductionPeople experiencing homelessness are at increased risk of, and have poorer outcomes from, a range of physical long-term conditions (LTCs). It is increasingly recognised that interventions targeting people who are homeless should be tailored to the specific needs of this population. This systematic review aims to identify, describe and appraise trials of interventions that aim to manage physical LTCs in homeless adults and are delivered by healthcare professionals.Methods and analysisSeven electronic databases (Medline, EMBASE, Cochrane Central Register of Controlled Trials, Assia, Scopus, PsycINFO and CINAHL) will be searched from 1960 (or inception) to October 2016 and supplemented by forward citation searching, handsearching of reference lists and searching grey literature. Two reviewers will independently review titles, abstract and full-texts using DistillerSR software. Inclusion criteria include (1) homeless adults with any physical LTC, (2) interventions delivered by a healthcare professional (any professional trained to provide any form of healthcare, but excluding social workers and professionals without health-related training), (3) comparison with usual care or an alternative intervention, (4) report outcomes such as healthcare usage, physical and psychological health or well-being or cost-effectiveness, (5) randomised controlled trials, non-randomised controlled trials, controlled before-after studies. Quality will be assessed using the Cochrane EPOC Risk of Bias Tool. A meta-analysis will be performed if sufficient data are identified; however, we anticipate a narrative synthesis will be performed.Ethics and disseminationThis review will synthesise existing evidence for interventions delivered by healthcare professionals to manage physical LTCs in adults who are homeless. The findings will inform the development of future interventions and research aiming to improve the management of LTCs for people experiencing homelessness. Ethical approval will not be required for this systematic review as it does not contain individual patient data. We will disseminate the results of this systematic review via conference presentations, healthcare professional networks, social media and peer-reviewed publication.Trial registration numberPROSPERO registration number: CRD42016046183.

Project description:BackgroundAlthough there are many wearable devices available to help people lose weight and decrease the rising prevalence of obesity, the effectiveness of these devices in long-term weight management has not been established.ObjectiveThis study aimed to systematically review the literature on using wearable technology for long-term weight loss in overweight and obese adults.MethodsWe searched the following databases: Medical Literature Analysis and Retrieval System Online, EMBASE, Compendex, ScienceDirect, Cochrane Central, and Scopus. The inclusion criteria were studies that took measurements for a period of ?1 year (long-term) and had adult participants with a BMI >24. A total of 2 reviewers screened titles and abstracts and assessed the selected full-text papers for eligibility. The risk of bias assessment was performed using the following tools appropriate for different study types: the Cochrane risk of bias tool, Risk Of Bias In Nonrandomized Studies-of Interventions, A MeaSurement Tool to Assess systematic Reviews, and 6 questions to trigger critical thinking. The results of the studies have been provided in a narrative summary.ResultsWe included five intervention studies: four randomized controlled trials and one nonrandomized study. In addition, we used insights from six systematic reviews, four commentary papers, and a dissertation. The interventions delivered by wearable devices did not show a benefit over comparator interventions, but overweight and obese participants still lost weight over time. The included intervention studies were likely to suffer from bias. Significant variances in objectives, methods, and results of included studies prevented meta-analysis.ConclusionsThis review showed some evidence that wearable devices can improve long-term physical activity and weight loss outcomes, but there was not enough evidence to show a benefit over the comparator methods. A major issue is the challenge of separating the effect of decreasing use of wearable devices over time from the effect of the wearable devices on the outcomes. Consistency in study methods is needed in future long-term studies on the use of wearable devices for weight loss.Trial registrationPROSPERO CRD42018096932; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=96932.

Project description:BackgroundOsteoporosis is the fourth most common chronic disease worldwide. The adoption of preventative measures and effective self-management interventions can help improve bone health. Mobile health (mHealth) technologies can play a key role in the care and self-management of patients with osteoporosis.ObjectiveThis study presents a systematic review and meta-analysis of the currently available mHealth apps targeting osteoporosis self-management, aiming to determine the current status, gaps, and challenges that future research could address, as well as propose appropriate recommendations.MethodsA systematic review of all English articles was conducted, in addition to a survey of all apps available in iOS and Android app stores as of May 2021. A comprehensive literature search (2010 to May 2021) of PubMed, Scopus, EBSCO, Web of Science, and IEEE Xplore was conducted. Articles were included if they described apps dedicated to or useful for osteoporosis (targeting self-management, nutrition, physical activity, and risk assessment) delivered on smartphone devices for adults aged ≥18 years. Of the 32 articles, a random effects meta-analysis was performed on 13 (41%) studies of randomized controlled trials, whereas the 19 (59%) remaining studies were only included in the narrative synthesis as they did not provide enough data.ResultsIn total, 3906 unique articles were identified. Of these 3906 articles, 32 (0.81%) articles met the inclusion criteria and were reviewed in depth. The 32 studies comprised 14,235 participants, of whom, on average, 69.5% (n=9893) were female, with a mean age of 49.8 (SD 17.8) years. The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth-supported interventions resulted in a significant reduction in pain (Hedges g -1.09, 95% CI -1.68 to -0.45) and disability (Hedges g -0.77, 95% CI -1.59 to 0.05). The posttreatment effect of the digital intervention was significant for physical function (Hedges g 2.54, 95% CI -4.08 to 4.08) but nonsignificant for well-being (Hedges g 0.17, 95% CI -1.84 to 2.17), physical activity (Hedges g 0.09, 95% CI -0.59 to 0.50), anxiety (Hedges g -0.29, 95% CI -6.11 to 5.53), fatigue (Hedges g -0.34, 95% CI -5.84 to 5.16), calcium (Hedges g -0.05, 95% CI -0.59 to 0.50), vitamin D intake (Hedges g 0.10, 95% CI -4.05 to 4.26), and trabecular score (Hedges g 0.06, 95% CI -1.00 to 1.12).ConclusionsOsteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be valuable tools for patients and health professionals. However, most of the apps that are currently available lack clinically validated evidence of their efficacy and focus on a limited number of symptoms. A more holistic and personalized approach within a cocreation design ecosystem is needed.Trial registrationPROSPERO 2021 CRD42021269399; https://tinyurl.com/2sw454a9.

Project description:IntroductionDengue is among the most important mosquito-borne diseases, with more than half of the world's population at risk of infection in dengue endemic countries. Environmental management, which includes any activities that involve environmental modification, environmental manipulation and changes to human behaviour have been used to mitigate the risk of dengue transmission. In this protocol, we will integrate the data from various sources to assess the overall effect of environmental management on the incidence of dengue and other entomological indices.Methods and analysesWe will conduct a systematic review of intervention that assess the effect of environmental management on the incidence of dengue and/or entomological indices. We will include any studies that include intervention through environmental management for dengue control, involving environmental modification, environmental manipulation and changes to human behaviour. A comprehensive search will be performed in electronic databases PUBMED, CENTRAL, SCOPUS, Web of Science and relevant research websites such as PROPSERO, WHO ICTRP and ClinicalTrials.gov to identify studies that meet our inclusion criteria. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic reviews and Meta-Analysis. Titles, abstract, keywords for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using quality assessment tool for studies with diverse design and Cochrane risk of bias tool. The characteristics of the selected articles will be described based on the study design, types of intervention and outcomes of the study in various countries. These include the types of environmental management intervention methods and the effectiveness of the intervention in reducing dengue cases or incidence and impact on entomological indices.Ethics and disseminationWe will register this systematic review with the National Medical Research Register, Ministry of Health Malaysia. This protocol also had been registered with the PROSPERO. No ethical approval is necessary, as there will be no collection of primary data. The results will be disseminated though a peer-reviewed publication and conference presentation.Trial registration numberCRD42018092189.

Dataset Information

The acute and long-term management of anaphylaxis: protocol for a systematic review.

Background

Methods

Discussion

Publications

The acute and long-term management of anaphylaxis: protocol for a systematic review.

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