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At least 775 records · Page 43Linked to original sources
PubMed1999

Radiologic staging in patients with endometrial cancer: a meta-analysis.

PURPOSE: To apply a meta-analysis to compare the utility of computed tomography (CT), ultrasonography (US), and magnetic resonance (MR) imaging in staging endometrial cancer. MATERIALS AND METHODS: Data were obtained from a MEDLINE literature search and from manual reviews of article bibliographies. Articles were selected that included results in patients with proved endometrial cancer and imaging-histopathologic correlation and that presented data that allowed calculation of contingency tables. Data for the imaging evaluation of myometrial and cervical invasion were abstracted independently by two authors. Data on year of publication, International Federation of Gynecology and Obstetrics (FIGO) stage distribution, and methodologic quality were also collected. A subgroup analysis was performed to compare contrast medium-enhanced MR imaging with nonenhanced MR imaging, US, and CT. RESULTS: Six studies met the inclusion criteria for CT; 16, for US; and 25, for MR imaging. Summary receiver operating characteristic analysis showed no significant differences in the overall performance of CT, US, and MR imaging. In the assessment of myometrial invasion, however, contrast-enhanced MR imaging performed significantly better than did nonenhanced MR imaging or US (P < .002) and demonstrated a trend toward better results, as compared with CT. The lack of data on the assessment of cervical invasion at CT or US prevented meta-analytic comparison with data obtained at MR imaging. Results were not influenced by year of publication, FIGO stage distribution, or methodologic quality. CONCLUSION: Although US, CT, or MR imaging can be used in the pretreatment evaluation of endometrial cancer, contrast-enhanced MR imaging offers "one-stop" examination with the highest efficacy.

Endometrial Neoplasms↗
PubMed2026

Joint association of sedentary behaviour and physical activity with cardiovascular disease: a systematic review and meta-analysis.

This systematic review and meta-analysis of cohort studies aimed to synthesize existing evidence on the joint association of physical activity (PA) and sedentary behaviour (SB) with cardiovascular disease (CVD) risk among adults. We searched PubMed, EMBASE, and Cochrane for English studies published between January 2010 and February 2025 that examined the joint association of PA and SB (fatal and non-fatal) CVD among adults and pooled their results through meta-analyses using study-level data. Using findings from 17 studies, the pooled effect size for the lowest PA + highest SB group was 1.78 (95% CI: 1.59-2.00), suggesting increased risk for CVD compared with the reference group (i.e. highest PA + lowest SB). Compared with the same reference group, we found an increased risk for CVD in the lowest PA + lowest SB (HR = 1.25, 95% CI: 1.12-1.40) and the highest PA + highest SB (HR = 1.16, 95% CI: 1.06-1.27) groups. Subgroup analyses according to domains or types of PA and SB exposure, outcome measures, and exposure measurement method revealed a similar pattern. In conclusion, individuals with the lowest PA combined with the highest SB may experience an increased risk for CVD events compared with those with the highest PA and lowest SB. There was also an increased risk for individuals with a combination of either low PA + low SB and high PA + high SB, albeit to a lesser extent. Although substantial study-level heterogeneity exists, the results highlight the potential value of considering both behaviours jointly in relation to CVD risk.

Humans↗
PubMed2004

Effects of caffeine ingestion on exercise testing: a meta-analysis.

This study used the meta-analytic approach to examine the effects of caffeine ingestion on exercise testing. Forty double-blind studies with 76 effect sizes (ES) met the inclusion criteria. The type of exercise test was classified as endurance, graded, or short-term. In comparison with placebo, caffeine improved test outcome by 12.3 % (95 % CI, 9.1 to 15.4), which was equivalent to an overall ES of 0.41 (95 % CI, 0.31 to 0.51). Endurance exercise significantly improved test outcome (P < 0.05) more than either graded or short-term exercise. When exercise protocol was examined, time-to-exhaustion (Tlim) protocols had a significantly greater (P < 0.05) ES than either the graded or the non-Tlim protocol(s). The results from this meta-analysis confirm the ergogenic effects of caffeine, particularly for endurance testing that use Tlim protocols.

Adult↗
PubMed2004

Diabetes mellitus and risk of prostate cancer: a meta-analysis.

AIMS/HYPOTHESIS: The association of diabetes mellitus with prostate cancer has been controversial. This study examines the strength of this association by conducting a detailed meta-analysis of the studies published in peer-reviewed literature on the subject. METHODS: A comprehensive search for articles published up to 2003 was performed, reviews of each study were conducted and data were abstracted. Prior to meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) was calculated using the random- and the fixed-effects models. Subgroup and sensitivity analyses were also performed. RESULTS: We included 14 studies, published between 1971 and 2002, in the meta-analysis (five case-control studies, nine cohort studies). We found no evidence of publication bias ( p=0.89) or heterogeneity among the studies ( p=0.38). The association of diabetes with prostate cancer was statistically significant, both on the basis of a random-effects model (RR=0.91, 95% CI: 0.86 to 0.96), and on the basis of a fixed-effects model (RR=0.91, 95% CI: 0.88 to 0.94). When the analysis was stratified into subgroups according to study design, the association was inverse in both cohort and case-control studies, but only in the former was it statistically significant. The sensitivity analysis strengthened our confidence in the validity of this association. CONCLUSIONS/INTERPRETATION: Our meta-analysis findings provide strong evidence that people with diabetes have a significant decrease in risk of developing prostate cancer. There is biological evidence to support this association.

Adult↗
PubMed2007

An evaluation of bivariate random-effects meta-analysis for the joint synthesis of two correlated outcomes.

Often multiple outcomes are of interest in each study identified by a systematic review, and in this situation a separate univariate meta-analysis is usually applied to synthesize the evidence for each outcome independently; an alternative approach is a single multivariate meta-analysis model that utilizes any correlation between outcomes and obtains all the pooled estimates jointly. Surprisingly, multivariate meta-analysis is rarely considered in practice, so in this paper we illustrate the benefits and limitations of the approach to provide helpful insight for practitioners. We compare a bivariate random-effects meta-analysis (BRMA) to two independent univariate random-effects meta-analyses (URMA), and show how and why a BRMA is able to 'borrow strength' across outcomes. Then, on application to two examples in healthcare, we show: (i) given complete data for both outcomes in each study, BRMA is likely to produce individual pooled estimates with very similar standard errors to those from URMA; (ii) given some studies where one of the outcomes is missing at random, the 'borrowing of strength' is likely to allow BRMA to produce individual pooled estimates with noticeably smaller standard errors than those from URMA; (iii) for either complete data or missing data, BRMA will produce a more appropriate standard error of the pooled difference between outcomes as it incorporates their correlation, which is not possible using URMA; and (iv) despite its advantages, BRMA may often not be possible due to the difficulty in obtaining the within-study correlations required to fit the model. Bivariate meta-regression and further research priorities are also discussed.

Analysis of Variance↗
PubMedDate not supplied

[HLA and chronic alcoholic pancreatitis. A meta-analysis].

The authors made a meta-analysis of nine important works about the possible relationship of IILA and chronic alcoholic pancreatitis. They concluded that there are actually three types more prevalent: A1, B13 and B18.

Adolescent↗
PubMed1997

[Treatment of chronic cardiac insufficiency with coenzyme Q10, results of meta-analysis in controlled clinical trials].

Meta-analysis applied to eight controlled clinical trials of coenzyme Q10 (CoQ10)-treatment of congestive heart failure revealed a significant improvement a several important cardiac parameters such as ejection fraction (EF), stroke volume (SV), cardiac output (CO), cardiac index (CI) and end diastolic volume index (EDVI). Concerning the improvement in SV and CO the average patient in the CoQ10 group had a higher score than respectively 76% and 73% of the patients in the placebo group. The improvement in CO and SV was also significant when considering of homogeneity. Additional controlled clinical trials seem justified which may strengthen the power of the meta-analyses. However, based on available results, it can not be excluded that CoQ10 may have a future role a adjunctive therapy in a dosage of 100-200 mg/day in the treatment of chronic congestive heart failure.

Antioxidants↗
PubMed2000

Genetic epidemiology of major depression: review and meta-analysis.

OBJECTIVE: The authors conducted a meta-analysis of relevant data from primary studies of the genetic epidemiology of major depression. METHOD: The authors searched MEDLINE and the reference lists of previous review articles to identify relevant primary studies. On the basis of a review of family, adoption, and twin studies that met specific inclusion criteria, the authors derived quantitative summary statistics. RESULTS: Five family studies met the inclusion criteria. The odds ratios for proband (subjects with major depression or comparison subjects) versus first-degree relative status (affected or unaffected with major depression) were homogeneous across the five studies (Mantel-Haenszel odds ratio=2.84, 95% CI=2.31-3.49). No adoption study met the inclusion criteria, but the results of two of the three reports were consistent with genetic influences on liability to major depression. Five twin studies met the inclusion criteria, and their statistical summation suggested that familial aggregation was due to additive genetic effects (point estimate of heritability of liability=37%, 95% CI=31%-42%), with a minimal contribution of environmental effects common to siblings (point estimate=0%, 95% CI=0%-5%), and substantial individual-specific environmental effects/measurement error (point estimate=63%, 95% CI=58%-67%). The literature suggests that recurrence best predicts the familial aggregation of major depression. CONCLUSIONS: Major depression is a familial disorder, and its familiality mostly or entirely results from genetic influences. Environmental influences specific to an individual are also etiologically significant. Major depression is a complex disorder that does not result from either genetic or environmental influences alone but rather from both. These findings are notably consistent across samples and methods and are likely to be generally applicable.

Adoption↗
PubMed2004

Are wound healing disturbances and length of hospital stay reduced with minimally invasive vein harvest? A meta-analysis.

Minimally invasive great saphenous vein harvest for coronary artery bypass grafting aims to reduce post-operative leg-wound related morbidity. In a meta-analysis of randomised trials we have shown leg wound infection rates to be significantly lower in patients undergoing minimally invasive harvest. This study aims to use meta-analysis to compare the two techniques with regards to non-infective wound healing disturbances (NIWHD) (wound drainage, haematoma, dehiscence, necrosis, need for surgical debridement, and seroma formation). A meta-analysis of all studies published between 1995 and 2002 reporting a comparison between the two techniques was performed. Primary outcomes of interest were the six wound healing disturbances mentioned above and length of hospital stay. Heterogeneity was assessed using graphical exploration and sensitivity analysis with subgroup analysis. Twenty-seven studies published between 1997 and 2002 matched our selection criteria, with a combined total of 4953 subjects, of which 2442(49%) underwent minimally invasive harvest and 2511(51%) underwent conventional surgery. When considering only randomised studies, the total number of non-infective wound disturbances was lower in minimally invasive (4%) as compared to the conventional (13%) group (random effect OR 0.24, CI 0.16-0.38). Similar results were found when only fully matched studies were considered. The absolute risk reduction when comparing the two techniques was calculated to be 0.10, which translates to a number of patients needed to treat of 10. Length of stay was significantly reduced in the minimally invasive group in comparison to the conventional group (random effect weighted mean difference of -1.04, CI -1.92 to -0.16). Our results suggest that NIWHD all reduced with minimally invasive harvest techniques. Despite the limitations of this meta-analysis, we feel we have once again illustrated an important link between minimally invasive great saphenous vein harvest and improved tissue healing when compared to conventional open surgery. This has the potential to reduce wound-related morbidity, infection, post-operative pain, length of hospital stay, and re-admission rate.

Coronary Artery Bypass↗
PubMed1999

Occupational exposure to diesel exhaust and lung cancer: a meta-analysis.

OBJECTIVES: We undertook a meta-analysis of epidemiological studies investigating the relationship between occupational diesel exhaust exposure and lung cancer. METHODS: Thirty of 47 studies initially identified as potentially relevant met specified inclusion criteria. We extracted or calculated 39 independent estimates of relative risk and derived pooled estimates of risk for all studies and for numerous study subsets by using a random-effects model. We also examined interstudy heterogeneity by using linear metaregressions. RESULTS: There was substantial heterogeneity in the pooled risk estimates for all studies combined and for most subsets. Several factors consistent with higher study quality, however, contributed to increased pooled estimates of risk and lower heterogeneity, including (1) adjustment for confounding by cigarette smoking and other covariates, (2) having a lower likelihood of selection bias, and (3) having increased study power. CONCLUSION: This analysis provides quantitative support for prior qualitative reviews that have ascribed an etiologic role to occupational diesel exhaust exposure in lung cancer induction. Among study populations most likely to have had substantial exposure to diesel exhaust, the pooled smoking-adjusted relative risk was 1.47 (95% confidence interval = 1.29, 1.67).

Data Interpretation, Statistical↗
PubMed2002

[Acupuncture for back pain: meta-analysis of randomised controlled trials and an update with data from the most recent studies].

BACKGROUND: Acupuncture is commonly used to treat back pain. A meta-analysis of clinical trials of acupuncture for this condition came to a positive conclusion whilst a qualitative review was negative. AIM: To compare our meta-analysis of trials of acupuncture for the treatment of back pain with a qualitative review and the most recent studies on the subject. METHODS: A systematic literature search was conducted to retrieve all randomised controlled trials of any form of acupuncture for any type of back pain in humans. The adequacy of the acupuncture was assessed by consulting six experienced acupuncturists. The main outcome measure for the meta-analysis was numbers of subjects who where improved at the end of treatment. These data are discussed in relation to the qualitative review and the most recent studies. RESULTS: Twelve studies were included of which nine presented data suitable for meta-analysis. The odds ratio of improvement with acupuncture compared with control intervention was 2.30 (95% confidence interval 1.28 to 4.13). For sham-controlled, evaluator-blinded studies, the odds ratio was 1.37 (95% confidence interval, 0.84-2.25). The results from the majority of the most recent studies also support the effectiveness of acupuncture in the treatment of back pain. CONCLUSIONS: Collectively, these data imply that acupuncture is superior to various control interventions, although there is insufficient evidence to state whether it is superior to placebo.

Acupuncture Analgesia↗
PubMedDate not supplied

Quality of life in cardiac patient research: a meta-analysis.

This article reports a meta-analysis of 84 studies of quality of life (QOL) in cardiac patient populations published in the 5-year period 1987-1991. Selected methodologies and substantive characteristics of the studies are described. An overall effect size of .31 indicated a small but significant positive effect of pharmacologic, mechanical, surgical, nursing, or other treatment on QOL. No negative effect of treatment was found for any cardiovascular diagnostic category. Homogeneity analysis revealed eight potential moderators of the overall effect size: quality of study, gender of sample, time dimension, sampling method, intervention, marital status of subjects, quality-of-life dimension measured, and sample size.

Aged↗
PubMed2006

Correlation of sperm DNA damage with IVF and ICSI outcomes: a systematic review and meta-analysis.

PURPOSE: To assess the effects of sperm DNA damage, as determined by the TUNEL assay and the SCSA respectively, on the outcomes of IVF/ICSI treatment. METHODS: A Medline search (from Jan 1978 to Apr 2006) was performed, together with a manual search of the bibliographies of retrieved original papers and review articles. 8 articles met all inclusion/exclusion criteria, of which, 5 used the TUNEL assay and the other 3 used the SCSA. All these articles were included in separate meta-analysis. The meta-analysis was conducted using the RevMan software with fixed-effect model or random-effects model. RESULTS: As for articles using the TUNEL assay, the pooled results of IVF outcomes indicated that the clinical pregnancy rate (RR 0.68, 95% CI 0.54 to 0.85, P = 0.006), but not the fertilization rate (RR 0.79, 95% CI 0.54 to 1.16, P = 0.23) decreased significantly for patients with high degree of sperm DNA damage compared with those with low degree of sperm DNA damage. RRs of the ICSI outcomes indicated that there was no significant difference in either fertilization rate (RR 1.03, 95% CI 0.89 to1.18, P = 0.70) or clinical pregnancy rate (RR 0.76, 95% CI 0.55 to 1.04, P = 0.09) between these two groups. As for the SCSA papers, the pooled results showed no significant effects of sperm DNA damage on the clinical pregnancy rate after IVF (RR 0.58, 95% CI 0.25 to 1.31, P = 0.19) or ICSI (RR 1.18, 95% CI 0.81 to 1.74, P = 0.38). CONCLUSION(S): Our meta-analysis indicates that sperm DNA damage, as assessed by the TUNEL assay, significantly decreases only the chance of IVF clinical pregnancy, but not that of either IVF fertilization or ICSI fertilization or ICSI clinical pregnancy. Besides, our results also reveal that sperm DNA damage, when assessed by the SCSA, has no significant effect on the chance of clinical pregnancy after IVF or ICSI treatment.

DNA Damage↗
PubMed2007

Data exploration in meta-analysis with smooth latent distributions.

Meta-analysis with discrete outcomes is interpreted as the estimation (in one or two dimensions) of a non-parametric smooth latent distribution of event probabilities (or rates). A simple but efficient EM algorithm is presented. A fine grid is used and fast smoothing is done by penalized least squares. Data exploration is the primary goal, but the estimated distribution can also be used to compute useful statistics of treatment effects.

Algorithms↗
PubMed2002

Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis.

The purpose of this meta-analysis is to review studies investigating the efficacy of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients and to find out whether patient characteristics influence the efficacy of IMT. A systematic literature search was performed using the Medline and Embase databases. On the basis of a methodological framework, a critical review was performed and summary effect-sizes were calculated by applying fixed and random effects models. Both IMT alone and IMT as adjunct to general exercise reconditioning significantly increased inspiratory muscle strength and endurance. A significant effect was found for dyspnoea at rest and during exercise. Improved functional exercise capacity tended to be an additional effect of IMT alone and as an adjunct to general exercise reconditioning, but this trend did not reach statistical significance. No significant correlations were found for training effects with patient characteristics. However, subgroup analysis in IMT plus exercise training revealed that patients with inspiratory muscle weakness improved significantly more compared to patients without inspiratory muscle weakness. From this review it is concluded that inspiratory muscle training is an important addition to a pulmonary rehabilitation programme directed at chronic obstructive pulmonary disease patients with inspiratory muscle weakness. The effect on exercise performance is still to be determined.

Breathing Exercises↗
PubMed2003

Dopamine D3 receptor gene Ser9Gly variant and schizophrenia: association study and meta-analysis.

OBJECTIVE: To further evaluate the controversial putative association between a Ser9Gly variant in the first exon of the dopamine D3 receptor gene (DRD3) and schizophrenia. METHODS: Swedish patients with schizophrenia ( n=156) and control subjects ( n=463) were assessed for the DRD3 Ser9Gly variant. Meta-analyses including previous and the present Swedish case-control results were performed. RESULTS: No significant difference between the Swedish patients and controls were found, but there was an association between DRD3 Ser9Gly Ser/Ser and homozygous genotypes and response to anti-psychotic drugs. This finding was supported by an incomplete meta-analysis. In a meta-analysis of all case-control studies comprising 8761 subjects the association between DRD3 Ser9Gly homozygosity and schizophrenia ( =4.96, degree of freedom=1, p <0.05, odds ratio=1.10, 95% confidence interval=1.01-1.20) persisted. However, the previously proposed association between the Ser/Ser genotype and schizophrenia was not significant (chi2 =2.71, degree of freedom=1, p>0.05, odds ratio=1.08, 95% confidence interval=0.99-1.17). CONCLUSIONS: Whereas the present Swedish case-control analysis did not yield any evidence for association with the diagnosis, the present meta-analysis suggests that the DRD3 gene confer susceptibility to schizophrenia. Reasons for the discrepancies between prior studies are discussed.

Amino Acid Substitution↗
PubMed2004

Does the cause of obstructive azoospermia affect the outcome of intracytoplasmic sperm injection: a meta-analysis.

OBJECTIVE: To define whether the outcome of intracytoplasmic sperm injection (ICSI) using sperm surgically retrieved from men with obstructive azoospermia (OA) depends on the cause of obstruction. PATIENTS AND METHODS: We first analysed our data and then used a meta-analysis of published data (including ours) to compare the outcome of ICSI in OA, classified in terms of congenital and acquired causes. The present study comprised 82 couples who underwent 127 ICSI cycles using surgically retrieved sperm. The cause was classified as congenital bilateral absence of vas deferens (CBAVD, in 20), after vasectomy (56), infective/inflammatory (21), noninfective (24) and ejaculatory (five). Five reports (687 cycles) including the present were identified as suitable for meta-analysis. RESULTS: Analysis of the present data showed that fertilization and live-birth rates were highest in men with a previous vasectomy and no infective cause (vasectomy 51% and 23%; not infective 53% and 29%, respectively) and lowest in men with infective or inflammatory causes. There was no difference in outcome if the sperm was fresh or frozen, or whether epididymal or testicular. Meta-analysis comparing congenital (CBAVD) and acquired causes showed a significantly increased fertilization rate (95% confidence interval, 0.84-1) with acquired causes. Meta-analysis of the three papers reporting delivery outcome showed no difference in live-birth rate but a significantly higher miscarriage rate in the congenital group (relative risk 2.67). CONCLUSION: In ICSI cycles in men with OA the cause appears to influence the outcome, but outcome is not affected by whether the retrieved sperm is fresh, frozen, epididymal or testicular. The meta-analysis suggested a higher fertilization rate and lower miscarriage rate in acquired causes of OA.

Adult↗