Biomedical subjects

Michael P Major

Publications and source records attributed to Michael P Major.

4 recordsLinked to original sources

PubMed2006

Assessment of lateral cephalometric diagnosis of adenoid hypertrophy and posterior upper airway obstruction: a systematic review.

INTRODUCTION: Our objective was to evaluate the capability of lateral cephalograms in diagnosing hypertrophied adenoids and obstructed posterior nasopharyngeal airways. METHODS: A systematic review of the literature by using several electronic databases (Cochrane Library, Medline, Medline in progress, PubMed, Web of Science, Embase, and Lilacs) was performed with the help of a senior health-sciences librarian. The electronic search was followed up with hand searches. After applying our inclusion-exclusion criteria, the search yielded 11 articles that were then scored based on their methodological validity. RESULTS: Lateral cephalograms performed reasonably well in evaluating adenoid size; both quantitative measures of adenoid area and subjective grading of adenoid size on lateral cephalograms had reasonable correlations to actual adenoid size (range of r, 0.60 to 0.88). However, evidence suggested that cephalograms were less ideal for evaluating the size of the posterior nasopharyngeal airway. The diagnostic difference is likely because the adenoid is a simpler 3-dimensional structure than the nasopharynx; therefore, it loses less information when compressed into 2 dimensions by the radiograph. CONCLUSIONS: Being used as a screening tool to determine the need for more rigorous ENT follow-up appears to be the greatest utility of lateral cephalograms. Because no consensus could be reached on what are the most useful landmarks, we recommend that clinicians look for multiple deviant measures of adenoid size rather than one definitive quantification.

Adenoids↗

PubMed2006

Search and selection methodology of systematic reviews in orthodontics (2000-2004).

INTRODUCTION: More systematic reviews related to orthodontic topics are published each year, although little has been done to evaluate their search and selection methodologies. METHODS: Systematic reviews related to orthodontics published between January 1, 2000, and December 31, 2004, were searched for their use of multiple electronic databases and secondary searches. The search and selection methods of identified systematic reviews were evaluated against the Cochrane Handbook's guidelines. RESULTS: Sixteen orthodontic systematic reviews were identified in this period. The percentage of reviews documenting and using each criterion of article searching has changed over the last 5 years, with no recognizable directional trend. On average, most systematic reviews documented their electronic search terms (88%) and inclusion-exclusion criteria (100%), and used secondary searching (75%). Many still failed to search more than MEDLINE (56%), failed to document the database names and search dates (37%), failed to document the search strategy (62%), did not use several reviewers for selecting studies (75%), and did not include all languages (81%). CONCLUSIONS: The methodology of systematic reviews in orthodontics is still limited, with key methodological components frequently absent or not appropriately described.

Databases, Bibliographic↗

PubMed2006

Soft tissue changes with fixed functional appliances in Class II division 1.

OBJECTIVE: To evaluate facial soft tissue changes after the use of fixed functional appliances in Class II division 1 malocclusion cases using a systematic review of the literature. MATERIALS AND METHODS: Several electronic databases (PubMed, Medline, Medline In-Process & Other Non-Indexed Citations, Cochrane Database, Embase, Web of Sciences, and Lilacs) were searched with the help of a senior Health Sciences librarian. Abstracts that appeared to fulfill the initial selection criteria were selected by consensus. The original articles were then retrieved. Their references were also hand-searched for possible missing articles. Clinical trials assessing facial soft tissue changes with the use of fixed functional appliances without any surgical intervention or syndromic characteristics were considered. A comparable untreated control group was required to factor out normal growth changes. Four articles using Herbst and one using Jasper Jumper fulfilled the selection criteria. An individual analysis of these articles was made and some methodological flaws were identified. RESULTS: Although fixed functional appliances produce some significant statistical changes in the soft tissue profile, the magnitude of the changes may not be perceived as clinically significant. CONCLUSIONS: The conclusions from this systematic review should be considered with caution because only a secondary level of evidence was found. Long-term double-blinded prospective randomized clinical trials are needed. Three-dimensional quantification of the soft tissue changes is required to overcome current limitations in our understanding of the soft tissue changes obtained with the use of fixed functional appliances.

Activator Appliances↗

PubMed2006

An evaluation of search and selection methods used in dental systematic reviews published in English.

BACKGROUND: Increasing numbers of systematic reviews are published each year, though little has been done to evaluate their search and selection methodology. METHODS: The authors searched dental systematic reviews published between Jan. 1, 2000, and July 14, 2005, for descriptions of how researchers used multiple electronic databases and secondary searches. They evaluated search and selection methods of identified systematic reviews against the guidelines found in the 2005 Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: The authors identified 220 unique dental systematic reviews. They found that all aspects of search and selection methodology had improved. In 2005, most systematic reviews documented database names and search dates (90 percent), electronic search terms (95 percent) and inclusion-exclusion criteria (95 percent), and most employed secondary searching (100 percent). Many still failed to search more than MEDLINE (20 percent), document the search strategy (20 percent), use multiple reviewers for selecting studies (25 percent) and include all languages (39 percent). CONCLUSIONS AND CLINICAL IMPLICATIONS: Systematic review methodology is improving, though key components frequently are absent. Reviews should be read critically and in consideration of the methodological flaws.

Databases, Bibliographic↗