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Biomedical subjects

Mark Petticrew

Publications and source records attributed to Mark Petticrew.

24 records · Page 2Linked to original sources

New roads and human health: a systematic review.

We sought to synthesize evidence of the health effects of construction of new roads by systematically reviewing observational studies of such effects. We included and critically appraised 32 studies. The review suggested that out-of-town bypasses decrease injuries on main roads through or around towns, although more robust evidence is needed on effects on secondary roads. New major urban roads have statistically insignificant effects on injury incidence. New major roads between towns decrease injuries. Out-of-town bypasses reduce disturbance and community severance in towns but increase them elsewhere. Major urban roads increase disturbance and severance. More robust research is needed in this area, particularly regarding effects of new roads on respiratory health, mental health, access to health services, and physical activity.

Accidents, Traffic↗

Influence of psychological coping on survival and recurrence in people with cancer: systematic review.

OBJECTIVE: To summarise the evidence on the effect of psychological coping styles (including fighting spirit, helplessness/hopelessness, denial, and avoidance) on survival and recurrence in patients with cancer. DESIGN: Systematic review of published and unpublished prospective observational studies. MAIN OUTCOMES MEASURES: Survival from or recurrence of cancer. RESULTS: 26 studies investigated the association between psychological coping styles and survival from cancer, and 11 studies investigated recurrence. Most of the studies that investigated fighting spirit (10 studies) or helplessness/hopelessness (12 studies) found no significant associations with survival or recurrence. The evidence that other coping styles play an important part was also weak. Positive findings tended to be confined to small or methodologically flawed studies; lack of adjustment for potential confounding variables was common. Positive conclusions seemed to be more commonly reported by smaller studies, indicating potential publication bias. CONCLUSION: There is little consistent evidence that psychological coping styles play an important part in survival from or recurrence of cancer. People with cancer should not feel pressured into adopting particular coping styles to improve survival or reduce the risk of recurrence.

Adaptation, Psychological↗

Effectiveness of interventions to prevent sexually transmitted infections and human immunodeficiency virus in heterosexual men: a systematic review.

Our objective was to review systematically studies of interventions to prevent transmission of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) in heterosexual men. Of 1157 studies identified through database and hand searching, 27 met our inclusion criteria. Most interventions targeted specific groups of men (eg, those attending STI clinics) rather than general populations. Few were conducted with men alone, and most focused on behavioral and social psychological rather than morbidity outcomes. Of 8 interventions designed to reduce STI incidence (including HIV), 5 were successful, 2 were unsuccessful, and 1 had equivocal results. Of the 5 successful interventions, 1 was carried out in the workplace, 1 in the military, and 3 in STI clinics.They included on-site individual counseling and HIV testing, mass communications regarding risk reduction, and multiple-component motivation and skills education in STI clinics. More high-quality research into the effectiveness of interventions targeting heterosexual men is needed, especially methodologically sound trials to evaluate effects on morbidity.

Attitude to Health↗

Rational decision-making in mental health: the role of systematic reviews.

BACKGROUND: "Systematic reviews" have come to be recognized as the most rigorous method of summarizing confusing and often contradictory primary research in a transparent and reproducible manner. Their greatest impact has been in the summarization of epidemiological literature - particularly that relating to clinical effectiveness. Systematic reviews also have a potential to inform rational decision-making in healthcare policy and to form a component of economic evaluation. AIMS OF THE STUDY: This article aims to introduce the rationale behind systematic reviews and, using examples from mental health, to introduce the strengths and limitations of systematic reviews, particularly in informing mental health policy and economic evaluation. METHODS: Examples are selected from recent controversies surrounding the introduction of new psychiatric drugs (anti-depressants and anti-schizophrenia drugs) and methods of delivering psychiatric care in the community (case management and assertive community treatment). The potential for systematic reviews to (i) produce best estimates of clinical efficacy and effectiveness, (ii) aid economic evaluation and policy decision-making and (iii) highlight gaps in the primary research knowledge base are discussed. Lastly examples are selected from outside mental health to show how systematic reviews have a potential to be explicitly used in economic and health policy evaluation. RESULTS: Systematic reviews produce the best estimates of clinical efficacy, which can form an important component of economic evaluation. Importantly, serious methodological flaws and areas of uncertainty in the primary research literature are identified within an explicit framework. Summary indices of clinical effectiveness can be produced, but it is difficult to produce such summary indices of cost effectiveness by pooling economic data from primary studies. Modelling is commonly used in economic and policy evaluation. Here, systematic reviews can provide the best estimates of effectiveness and, importantly, highlight areas of uncertainty that can be used in "sensitivity analysis". DISCUSSION: Systematic reviews are an important recent methodological advance, the potential for which has only begun to be realized in mental health. This use of systematic reviews is probably most advanced in producing critical summaries of clinical effectiveness data. Systematic reviews cannot produce valid and believable conclusions when the primary research literature is of poor quality. An important function of systematic reviews will be in highlighting this poor quality research which is of little use in mental health decision making. IMPLICATIONS FOR HEALTH PROVISION: Health care provision should be both clinically and cost effective. Systematic reviews are a key component in ensuring that this goal is achieved. IMPLICATIONS FOR HEALTH POLICIES: Systematic reviews have potential to inform health policy. Examples presented show that health policy is often made without due consideration of the research evidence. Systematic reviews can provide robust and believable answers, which can help inform rational decision-making. Importantly, systematic reviews can highlight the need for important primary research and can inform the design of this research such that it provides answers that will help in forming healthcare policy. IMPLICATIONS FOR FURTHER RESEARCH: Systematic reviews should precede costly (and often unnecessary) primary research. Many areas of health policy and practice have yet to be evaluated using systematic review methodology. Methods for the summarization of economic data are methodologically complex and deserve further research

Journal Article↗