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Use of Systematic Review and Meta-Analysis in Environmental Health Epidemiology: a Systematic Review and Comparison with Guidelines.

ABSTRACT: Systematic review (SR) and meta-analysis (MA) have potential to contribute substantially to environmental health (EH) risk assessment and policy-making, provided study questions are clear and methods sound. We undertook a systematic review of the published epidemiological literature for studies using both SR and MA examining associations between chronic low-dose chemical exposures and adverse health outcomes in general populations and compared actual methods and reporting with a checklist based on available published guidelines. We identified 48 EH SRMAs meeting these criteria. Associations were mainly positive and statistically significant, often involving large populations. A majority of studies followed most general SRMA guidance, although we identified weaknesses in problem formulation, study search, selection and data extraction, and integrating policy implications. Fewer studies followed EH-specific SRMA recommendations, particularly regarding exposure heterogeneity and other risks of bias. Development and adoption of EH-specific SRMA guidelines would contribute to strengthening these tools for public health decision-making.

SUBMITTER: Sheehan MC

PROVIDER: S-EPMC4513215 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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Use of Systematic Review and Meta-Analysis in Environmental Health Epidemiology: a Systematic Review and Comparison with Guidelines.

Sheehan Mary C MC Lam Juleen J

Current environmental health reports 20150901 3

Systematic review (SR) and meta-analysis (MA) have potential to contribute substantially to environmental health (EH) risk assessment and policy-making, provided study questions are clear and methods sound. We undertook a systematic review of the published epidemiological literature for studies using both SR and MA examining associations between chronic low-dose chemical exposures and adverse health outcomes in general populations and compared actual methods and reporting with a checklist based ...[more]

PMID: 26231504

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Project description:BackgroundInternational estimates suggest around a third of students arrives at university with symptoms indicative of a common mental disorder, many in late adolescence at a developmentally high-risk period for the emergence of mental disorder. Universities, as settings, represent an opportunity to contribute to the improvement of population mental health. We sought to understand what is known about the management of student mental health, and asked: (1) What proportion of students use mental health services when experiencing psychological distress? (2) Does use by students differ across health service types?MethodsA systematic review was conducted following PRISMA guidelines using a Context, Condition, Population framework (CoCoPop) with a protocol preregistered on Prospero (CRD42021238273). Electronic database searches in Medline, Embase, PsycINFO, ERIC and CINAHL Plus, key authors were contacted, citation searches were conducted, and the reference list of the WHO World Mental Health International College Student Initiative (WMH-ICS) was searched. Data extraction was performed using a pre-defined framework, and quality appraisal using the Joanna Briggs Institute tool. Data were synthesised narratively and meta-analyses at both the study and estimate level.Results7789 records were identified through the search strategies, with a total of 44 studies meeting inclusion criteria. The majority of included studies from the USA (n = 36), with remaining studies from Bangladesh, Brazil, Canada, China, Ethiopia and Italy. Overall, studies contained 123 estimates of mental health service use associated with a heterogeneous range of services, taking highly variable numbers of students across a variety of settings.DiscussionThis is the first systematic quantitative survey of student mental health service use. The empirical literature to date is very limited in terms of a small number of international studies outside of the USA; studies of how services link together, and of student access. The significant variation we found in the proportions of students using services within and between studies across different settings and populations suggests the current services described in the literature are not meeting the needs of all students.

Project description:BackgroundUnderstanding the epidemiology of substance use disorders (SUDs) and mental health disorders (MHDs) among forced migrants from the Middle East and North Africa and Türkiye (MENAT) region is of utmost importance given their distinct challenges and vulnerabilities. Existing research on the topic is substantial; however, comprehensive systematic reviews are limited. We aim to conduct a systematic literature review to bridge this gap, providing a thorough understanding of SUDs and MHDs epidemiology among this population.MethodsThe systematic review will include original, peer-reviewed research articles published in English or Arabic between 2013 and 2023. It will encompass qualitative, quantitative, and mixed-methods studies focusing on SUDs and/or MHDs among forced migrants from the MENAT region. A Medline (via Ovid) search strategy was developed and will be translated into databases of EMBASE (via Ovid), Web of Science Core Collection (as licensed at Yale), and CINAHL. Risk of Bias in the included studies will be assessed using the Joanna Briggs Institute (JBI) checklist for observational studies and the Cochrane Risk of Bias (ROB) 2 tool for intervention studies. Meta-analysis using random-effects models will be conducted and subgroup analyses based on studies' data will be performed. The systematic review will be conducted based on the framework introduced by the Joanna Briggs Institute. Additionally, the PRISMA-P extension for systematic reviews was used to report the present protocol. The present systematic review protocol has been registered with PROSPERO, an international prospective register of systematic reviews. The review's registration ID is CRD42021286882.DiscussionThe systematic review aims to explore, identify and synthesize the evidence to reveal the epidemiology of SU and/or MH of forced migrants of the MENAT region as described in this protocol. In sum, the review will provide evidence to fill the gap in the literature and help the stakeholders, policymakers, and health providers to expand current knowledge of the prevalence and risk factors of SU and/or MH in humanitarian settings.

Project description:ImportanceIn the US and the United Kingdom, cocaine use is the second leading cause of illicit drug overdose death. Psychosocial treatments for cocaine use disorder are limited, and no pharmacotherapy is approved for use in the US or Europe.ObjectiveTo compare treatments for active cocaine use among adults.Data sourcesPubMed and the Cochrane Database of Systematic Reviews were searched for clinical trials published between December 31, 1995, and December 31, 2017.Study selectionThis meta-analysis was registered on Covidence.org (study 8731) on December 31, 2015. Clinical trials were included if they (1) had the term cocaine in the article title; (2) were published between December 31, 1995, and December 31, 2017; (3) were written in English; (4) enrolled outpatients 18 years or older with active cocaine use at baseline; and (5) reported treatment group size, treatment duration, retention rates, and urinalysis results for the presence of cocaine metabolites. A study was excluded if (1) more than 25% of participants were not active cocaine users or more than 80% of participants had negative test results for the presence of cocaine metabolites at baseline and (2) it reported only pooled urinalysis results indicating the presence of multiple substances and did not report the specific proportion of positive test results for cocaine metabolites. Multiple reviewers reached criteria consensus. Of 831 records screened, 157 studies (18.9%) met selection criteria and were included in the analysis.Data extraction and synthesisThis study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Search results were imported from PubMed XML into Covidence.org then Microsoft Excel. Data extraction was completed in 2 iterations to ensure fidelity. Analyses included a multilevel random-effects model, a multilevel mixed-effects meta-regression model, and sensitivity analyses. Treatments were clustered into 11 categories (psychotherapy, contingency management programs, placebo, opioids, psychostimulants, anticonvulsants, dopamine agonists, antidepressants, antipsychotics, miscellaneous medications, and other therapies). Missing data were imputed using multiple imputation by chained equations. The significance threshold for all analyses was P = .05. Data were analyzed using the metafor and mice packages in R software, version 3.3.2 (R Foundation for Statistical Computing). Data were analyzed from January 1, 2018, to February 28, 2021.Main outcomes and measuresThe primary outcome was the intention-to-treat logarithm of the odds ratio (OR) of having a negative urinalysis result for the presence of cocaine metabolites at the end of each treatment period compared with baseline. The hypothesis, which was formulated after data collection, was that no treatment category would have a significant association with objective reductions in cocaine use.ResultsA total of 157 studies comprising 402 treatment groups and 15 842 participants were included. Excluding other therapies, the largest treatment groups across all studies were psychotherapy (mean [SD] number of participants, 40.04 [36.88]) and contingency management programs (mean [SD] number of participants, 37.51 [25.51]). Only contingency management programs were significantly associated with an increased likelihood of having a negative test result for the presence of cocaine (OR, 2.13; 95% CI, 1.62-2.80), and this association remained significant in all sensitivity analyses.Conclusions and relevanceIn this meta-analysis, contingency management programs were associated with reductions in cocaine use among adults. Research efforts and policies that align with this treatment modality may benefit those who actively use cocaine and attenuate societal burdens.

Project description:Hepatitis C virus (HCV) morbidity appears to be high in Mongolia. Yet, the scale and nature of the infection burden is not well-understood. Our study's objective is to systematically review and synthetize all available epidemiological data on HCV antibody (Ab) prevalence, ribonucleic acid (RNA) prevalence, incidence, risk factors to HCV exposure, and circulating HCV genotypes/subtypes among different at-risk populations. Additionally, we aim to estimate national population-level HCV-Ab prevalence and the number of HCV chronically infected individuals in the population of Mongolia.Our systematic review will be reported based on the items outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2009) statement. All reports with primary data collected from surveillance or observational studies on Mongolian populations will be eligible for inclusion if the study sample size is greater than 25. Included reports need to present studies that use biological assay for HCV-Ab ascertainment. We will consider three primary outcomes of interest: HCV-Ab incidence, HCV-Ab prevalence, and HCV genotypes/subtypes among different at-risk populations. In addition, two secondary outcomes of interests will be also collected: HCV RNA prevalence, and unadjusted and/or adjusted statistically significant risk factors for HCV exposure (p value ≤0.05). In order to identify relevant reports, we will search PubMed, Embase, and Index Medicus for the Southeast Asian region. Additionally, we will search Mongolian scientific and medical journals not indexed in PubMed or Embase and the archives of Mongolian local conferences. Lastly, the literature search will be supplemented by checking references of the included reports and identified reviews. We will use broad search criteria with no language or time restrictions. Meta-analyses will estimate pooled HCV-Ab prevalence (by at-risk population, sex, age group, and period), and pooled RNA prevalence among HCV-Ab positive individuals in the general population. Age-adjustment of estimates will be conducted.The proposed systematic review and meta-analysis will produce a comprehensive synthesis of HCV epidemiology in Mongolia. The study will provide empirical evidence to inform health policy decision-making, resource allocation, and planning and implementation of relevant public health interventions.We have not registered with PROSPERO.

Project description:BACKGROUND:Globally, complications of preterm birth are among the most common cause of neonatal mortality. In Ethiopia, the neonatal mortality reduction is not worthy of attention. Hence, this study reviewed the prevalence of preterm birth and factors associated with preterm birth in Ethiopia. METHODS:The review protocol of this study has been registered in PROSPERO (CRD42017077356). The PRISMA guideline was followed for this review. Studies that assessed the prevalence and/or associated factors of preterm birth in Ethiopia and published from Jan 01, 2009 to Dec 31, 2019 were considered. Studies were searched from the PubMed and Science Direct among medical electronic databases and Google Scholar. Random-effects model was used for detected heterogeneity among studies. Publication bias and sensitivity analysis were assessed. Pooled estimates with its 95% confidence interval were reported using forest plots. The quality of evidence from the review was assessed using GRADE approach. RESULTS:Twenty-two studies involving a total of 12,279 participants were included. The overall pooled prevalence of preterm birth in Ethiopia was 10.48% (95% CI: 7.98-12.99). Pooled odds ratio showed rural residence (AOR?=?2.34, 95% CI: 1.35-4.05), being anemic (AOR?=?2.59, 95% CI: 1.85-3.64), <?4 antenatal care visits (AOR?=?2.34, 95%CI: 1.73-3.33), pregnancy induced hypertension (AOR?=?3.49, 95% CI: 2.45-4.97), prelabor rapture of membrane (AOR?=?4.42, 95% CI: 2.28-8.57), antepartum hemorrhage (AOR?=?5.02, 95% CI: 2.90-8.68), multiple pregnancies (AOR?=?3.89, 95% CI: 2.52-5.99), past adverse birth outcomes (AOR?=?3.24, 95% CI: 2.53-4.15) and chronic illness (AOR?=?4.89, 95%CI: 3.12-7.66) were associated with increased likelihood of preterm birth. Further, support during pregnancy was associated with reduced occurrence of preterm birth. CONCLUSION:The pooled national level prevalence of preterm birth in Ethiopia is high. Socio demographic, nutritional, health care, obstetric and gynecologic, chronic illness and medical conditions, behavioral and lifestyle factors are the major associated factors of preterm birth in Ethiopia. This evidence is graded as low grade. Thus, efforts should be intensified to address reported risk factors to relieve the burden of preterm birth in the study setting, Ethiopia.

Dataset Information

Use of Systematic Review and Meta-Analysis in Environmental Health Epidemiology: a Systematic Review and Comparison with Guidelines.

Publications

Use of Systematic Review and Meta-Analysis in Environmental Health Epidemiology: a Systematic Review and Comparison with Guidelines.

Similar Datasets

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