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Results for “Meta- analysis”

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PubMed2006

Effect of hepatitis B immunisation in newborn infants of mothers positive for hepatitis B surface antigen: systematic review and meta-analysis.

OBJECTIVE: To evaluate the effects of hepatitis B vaccine and immunoglobulin in newborn infants of mothers positive for hepatitis B surface antigen. DESIGN: Systematic review and meta-analysis of randomised clinical trials. DATA SOURCES: Electronic databases and hand searches. REVIEW METHODS: Randomised clinical trials were assessed for methodological quality. Meta-analysis was undertaken on three outcomes: the relative risks of hepatitis B occurrence, antibody levels to hepatitis B surface antigen, and adverse events. RESULTS: 29 randomised clinical trials were identified, five of which were considered high quality. Only three trials reported inclusion of mothers negative for hepatitis B e antigen. Compared with placebo or no intervention, vaccination reduced the occurrence of hepatitis B (relative risk 0.28, 95% confidence interval 0.20 to 0.40; four trials). No significant difference in hepatitis B occurrence was found between recombinant vaccine and plasma derived vaccine (1.00, 0.71 to 1.42; four trials) and between high dose versus low dose vaccine (plasma derived vaccine 0.97, 0.55 to 1.68, three trials; recombinant vaccine 0.78, 0.31 to 1.94, one trial). Compared with placebo or no intervention, hepatitis B immunoglobulin or the combination of plasma derived vaccine and hepatitis B immunoglobulin reduced hepatitis B occurrence (immunoglobulin 0.50, 0.41 to 0.60, one trial; vaccine and immunoglobulin 0.08, 0.03 to 0.17, three trials). Compared with vaccine alone, vaccine plus hepatitis B immunoglobulin reduced hepatitis B occurrence (0.54, 0.41 to 0.73; 10 trials). Hepatitis B vaccine and hepatitis B immunoglobulin seem safe, but few trials reported adverse events. CONCLUSION: Hepatitis B vaccine, hepatitis B immunoglobulin, and vaccine plus immunoglobulin prevent hepatitis B occurrence in newborn infants of mothers positive for hepatitis B surface antigen.

Combined Modality Therapy↗

PubMed1989

Decision rules for selecting effect sizes in meta-analysis: a review and reanalysis of psychotherapy outcome studies.

This study deals with some of the judgmental factors involved in selecting effect sizes from within the studies that enter a meta-analysis. Particular attention is paid to the conceptual redundancy rule that Smith, Glass, and Miller (1980) used in their study of the effectiveness of psychotherapy for deciding which effect sizes should and should not be counted in determining an overall effect size. Data from a random sample of 25 studies from Smith et al.'s (1980) population of psychotherapy outcome studies were first recoded and then reanalyzed meta-analytically. Using the conceptual redundancy rule, three coders independently coded effect sizes and identified more than twice as many of them per study as did Smith et al. Moreover, the treatment effect estimates associated with this larger sample of effects ranged between .30 and .50, about half the size claimed by Smith et al. Analyses of other rules for selecting effect sizes showed that average effect estimates also varied with these rules. Such results indicate that the average effect estimates derived from meta-analyses may depend heavily on judgmental factors that enter into how effect sizes are selected within each of the individual studies considered relevant to a meta-analysis.

Humans↗

PubMed2005

Leisure-time physical activity and lung cancer: a meta-analysis.

OBJECTIVE: Several studies have evaluated the relationship between physical activity and lung cancer. To summarize and review these studies, we conducted a meta-analysis of all relevant reports published from 1966 through October 2003. METHOD: Adjusted odds ratios (ORs) from the original studies were pooled by the inverse of their variance, and all pooled estimates were accompanied by an assessment of heterogeneity across investigations. Test for linear trend across activity categories (low, moderate, high) were applied. RESULTS: The combined ORs were 0.87 (95 confidence interval=0.79-0.95) for moderate leisure-time physical activity (LPA) and 0.70 (0.62-0.79) for high activity (p trend = 0.00). This inverse association occurred for both sexes, although it was somewhat stronger for women. No evidence of publication bias was found. Several studies were able to adjust for smoking, but none adjusted for possible confounding from previous malignant respiratory disease. Our simulations suggest that this condition is unlikely to entirely explain the inverse association. CONCLUSION: The findings of this meta-analysis indicate that higher levels of LPA protect against lung cancer. The inverse association is possible remains confounded by inadequately controlled smoking patterns. However on the whole, confounding seems an unlikely explanation for the findings of individual studies on non-smokers.

Adult↗

PubMed2005

Efficacy of lifestyle education to prevent type 2 diabetes: a meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the efficacy of lifestyle education for preventing type 2 diabetes in individuals at high risk by meta-analysis of randomized controlled trials, as assessed by incidence and a reduced level of plasma glucose 2 h after a 75-g oral glucose load (2-h plasma glucose). RESEARCH DESIGN AND METHODS: Through an electronic search, 123 studies were identified. A literature search identified eight studies that met strict inclusion criterion of meta-analysis for 2-h plasma glucose and five studies for the incidence of diabetes. All were randomized controlled trials of > or =6 months with lifestyle education that included a dietary intervention. Subjects were adults diagnosed as being at high risk for type 2 diabetes. The difference in mean reduction of 2-h plasma glucose from baseline to the 1-year follow-up and relative risk (RR) of the incidence of diabetes in the lifestyle education group versus the control group were assessed. Overall estimates were calculated using a random-effects model. Those estimates were confirmed by several models, and the possibility of selection bias was examined using a funnel plot. RESULTS: Lifestyle education intervention reduced 2-h plasma glucose by 0.84 mmol/l (95% CI 0.39-1.29) compared with the control group. The 1-year incidence of diabetes was reduced by approximately 50% (RR 0.55, 95% CI 0.44-0.69) compared with the control group. Results were stable and little changed if data were analyzed by subgroups or other statistical models. Funnel plots revealed no selection bias. CONCLUSIONS: Lifestyle education was effective for reducing both 2-h plasma glucose and RR in high-risk individuals and may be a useful tool in preventing diabetes.

Adult↗

PubMed1997

Burnout in psychiatric nursing: a meta-analysis of related variables.

The purpose of this study was to describe the relative strengths of a number of variables on burnout among psychiatric nurses. A meta-analysis of correlations revealed that burnout was negatively associated with job satisfaction, staff support and involvement with the organization and positively associated with role conflict. The results of the meta-analysis were in line with results of other studies in which different populations were investigated. Therefore, the findings as such are not specific to psychiatric nurses. Based on the literature, three typical risk factors of burnout among psychiatric nurses were found: the patient group the nurse works with, such as patients who are aggressive and suicidal; the inequity in the exchange process between nurses and patients; and the unrealistic expectations of nurses of the patients' potential for rehabilitation.

Burnout, Professional↗

PubMed1988

A method for meta-analysis of epidemiological studies.

This article presents a stepwise approach for conducting a meta-analysis of epidemiological studies based on proposed guidelines. This systematic method is recommended for practitioners evaluating epidemiological studies in the literature to arrive at an overall quantitative estimate of the impact of a treatment. Bendectin is used as an illustrative example. Meta-analysts should establish a priori the purpose of the analysis and a complete protocol. This protocol should be adhered to, and all steps performed should be recorded in detail. To aid in developing such a protocol, we present methods the researcher can use to perform each of 22 steps in six major areas. The illustrative meta-analysis confirmed previous traditional narrative literature reviews that Bendectin is not related to teratogenic outcomes in humans. The overall summary odds ratio was 1.01 (chi 2 = 0.05, p = 0.815) with a 95 percent confidence interval of 0.66-1.55. When the studies were separated according to study type, the summary odds ratio for cohort studies was 0.95 with a 95 percent confidence interval of 0.62-1.45. For case-control studies, the summary odds ratio was 1.27 with a 95 percent confidence interval of 0.83-1.94. The corresponding chi-square values were not statistically significant at the p = 0.05 level.

Antiemetics↗

PubMed2004

Meta-analysis of randomized trials of percutaneous transluminal coronary angioplasty versus atherectomy, cutting balloon atherotomy, or laser angioplasty.

OBJECTIVES: We conducted a systematic overview (meta-analysis) of randomized trials of balloon angioplasty versus coronary atherectomy, laser angioplasty, or cutting balloon atherotomy to evaluate the effects of plaque modification during percutaneous coronary intervention. BACKGROUND: Several mechanical approaches have been developed that ablate or section atheromatous plaque during percutaneous coronary interventions to optimize acute results, minimize intimal injury, and reduce complications and restenosis. METHODS: Sixteen trials (9,222 patients) constitute the randomized controlled experience with atherectomy, laser, or atherotomy versus balloon angioplasty with or without coronary stenting. Each trial tested the hypothesis that ablative therapy would result in better clinical or angiographic results than balloon dilation alone. RESULTS: Short-term death rates (<31 days) were not improved by the use of ablative procedures (0.3% vs. 0.4%, odds ratio [OR] 0.94 [95% confidence interval 0.46 to 1.92]), but periprocedural myocardial infarctions (4.4% vs. 2.5%, OR 1.83 [95% CI 1.43 to 2.34]) and major adverse cardiac events (5.1% vs. 3.3%, OR 1.54 [95% CI 1.25 to 1.89]) were increased. Angiographic restenosis rates (6,958 patients) were not improved with the ablative devices (38.9% vs. 37.4%, OR 1.06 [95% CI 0.97 to 1.17]). No reduction in revascularization rates (25.2% vs. 24.5%, OR 1.04 [95% CI 0.94 to 1.14]) or cumulative adverse cardiac events rates up to one year after treatment were seen with ablative devices (27.8% vs. 26.1%, OR 1.09 [95% CI 0.99 to 1.20]). CONCLUSIONS: The combined experience from randomized trials suggests that ablative devices failed to achieve predefined clinical and angiographic outcomes. This meta-analysis does not support the hypothesis that routine ablation or sectioning of atheromatous tissue is beneficial during percutaneous coronary interventions.

Angioplasty, Balloon, Coronary↗

PubMed2004

Hippocampal volume and depression: a meta-analysis of MRI studies.

OBJECTIVE: Several studies have found reduced hippocampal volume in patients with unipolar depression, but discrepancies exist. The authors performed a systematic review and meta-analysis of volumetric studies of the hippocampus in patients with mood disorders. METHOD: Studies of hippocampal volume in unipolar and bipolar patients were identified. A meta-analysis of the 12 studies of unipolar depression fulfilling specific criteria was performed. The sample comprised 351 patients and 279 healthy subjects. RESULTS: The studies were highly heterogeneous regarding age and gender distribution, age at onset of the disorder, average number of episodes, and responsiveness to treatment, but the pooled effect size of depression was significant in both hemispheres for the unipolar patients. The weighted average showed a reduction of hippocampal volume of 8% on the left side and 10% on the right side. The causes of the heterogeneity were analyzed, and a meta-regression showed that the total number of depressive episodes was significantly correlated to right but not left hippocampal volume reduction. CONCLUSIONS: Hippocampal volume is reduced in patients with unipolar depression, maybe as a consequence of repeated periods of major depressive disorder. Bipolar patients did not seem to show a reduction in hippocampal volume, but this has been much less investigated.

Adult↗

PubMed2026

Risk-Benefit of Phase 2 Monotherapy Trials in Adult Solid Cancers: A Systematic Review and Meta-Analysis.

Phase 2 (and phase 1 dose expansion, which we label phase 2 for the purposes of this study) cancer trials are the first direct tests of a new drug's efficacy. Because efficacy evidence is lacking, the therapeutic status of drug administration during ethical review is uncertain. We compared the efficacy and safety of cancer monotherapies in phase 2 with phase 3, where clinical equipoise underwrites a therapeutic status for drug administration. In this systematic review and meta-analysis, we searched Clinicaltrials.gov for phase 2 and 3 investigational monotherapy drug trials in six solid malignancies, with primary completion dates 2015-2020, inclusive. Two independent reviewers completed data extraction. Effects were estimated using an inverse-variance weighted random-effects model meta-analysis of proportions using the R package meta. We analyzed 130 phase 2 and 52 phase 3 trial arms, enrolling 6665 and 18,694 patients. The pooled objective response rate was 7% (95% CI 5%-11%) in phase 2 versus 24% in phase 3 (95% CI 17%-31%; p < 0.0001). The median PFS and OS were shorter in phase 2 compared to phase 3 (3.23 vs. 5.43 months, p < 0.0001; 9.46 vs. 14.44 months, p = 0.0001). The pooled rate of drug-related grade 3-4 adverse events was 30% (95% CI 23%-37%) in phase 2 and 25% (95% CI 19%-32%) in phase 3. Monotherapies delivered in phase 2 cancer trials present diminished risk-benefit compared with phase 3 and align with historic estimates for phase 1. Though there may be exceptions, risks for drug administration in phase 2 should generally be justified by appeals to research rather than therapeutic value.

Humans↗

PubMed1988

E-rosettes in aging: meta-analysis of the literature.

In this meta-analysis of the literature, it is affirmed that aging is associated with a small but significant decline in peripheral E-rosette-forming cells while high affinity E-rosettes (active or early rosettes) increase. The author speculates that this differential age effect may reflect the abnormal capping behaviour of E-rosettes or a change in the cell surface charge properties. A type II error is a common trait of the reviewed studies and could well explain the great number of reports concluding that E-rosette-forming cells are unaltered in the elderly.

Adult↗

PubMed1987

References for motor tasks--gender differences across age in motor performance: a meta-analysis.

In 1985 we published a meta-analysis of gender differences across age in motor performance in Psychological Bulletin, but it did not include an indexing of each motor task to the references from which it was obtained. This paper provides a table listing the 20 motor tasks and the references from which data for each task were taken. The range of tasks was from fundamental movements (e.g., catching, jumping, running, throwing) to motor fitness (e.g., agility, arm hang, balance, grip strength) to perceptual-motor abilities (e.g., anticipation timing, fine eye-motor coordination, pursuit-rotor tracking, reaction time). The arm hang was represented in the fewest papers (n = 2) while the dash and long jump were most frequently referenced (n = 21).

Aging↗

PubMed2004

Meta-analysis of genome-wide studies of psoriasis susceptibility reveals linkage to chromosomes 6p21 and 4q28-q31 in Caucasian and Chinese Hans population.

Ten genome-wide scans have been conducted over the past few years in the search for psoriasis susceptibility genes, but only one potential susceptibility region has been consistently replicated. A meta-analysis using the genome-search meta-analysis method was undertaken combining the results of six of these psoriasis genome-wide studies. The results of this analysis revealed linkage to the major histocompatibility complex on chromosome 6p21 that includes the PSORS1 locus. In addition, linkage was also recorded to a region on chromosome 4q28-q31 previously identified only in a Chinese Hans population. Both these regions were statistically significant even after correction for multiple testing. A possible reason for the erratic replication of findings could be the large effect of the PSORS1 locus (6p21) masking the effect of other loci involved in psoriasis. To overcome this problem, we suggest that future studies condition on the effect of the PSORS1 locus.

Asian People↗

PubMed1993

Elective cyclosporine withdrawal after renal transplantation. A meta-analysis.

OBJECTIVE: To determine whether it is safe to electively discontinue cyclosporine therapy after renal transplantation. DATA SOURCES: MEDLINE and bibliographies from recent publications. STUDY SELECTION: Controlled trials assessing the rate of acute rejection, graft loss, and mortality after elective cyclosporine withdrawal. DATA EXTRACTION: We compared outcomes in patients who underwent withdrawal from cyclosporine treatment with patients who were not withdrawn (part 1), and in a separate analysis (part 2), with patients who never received cyclosporine. DATA SYNTHESIS: In part 1 of the meta-analysis, consisting of 10 randomized and seven nonrandomized trials, there was a greater combined rate of acute rejection among patients in whom cyclosporine was withdrawn compared with control patients who continued to receive cyclosporine (weighted difference in episodes per patient, 126; 95% confidence interval [CI], 0.085 to 0.167; P < .001). However, there were no differences in graft loss (weighted difference in grafts lost per patient per year, -0.009; 95% CI, -0.022 to 0.004; P = 0.19) or mortality (weighted difference in deaths per patient per year, -0.005; 95% CI, -0.016 to 0.006; P = .40) attributable to cyclosporine withdrawal. In part 2 of the meta-analysis, consisting of three randomized and three nonrandomized trials, the combined rate of graft loss for patients who were withdrawn from cyclosporine was not significantly different vs control patients who never received cyclosporine (weighted difference in grafts lost per patient per year, -0.020; 95% CI, -0.043 to 0.003; P = .08). However, when the three randomized trials were analyzed separately, graft survival was better in patients who were withdrawn from cyclosporine (weighted difference in grafts lost per patient per year, 0.0382; 95% CI, 0.0002 to 0.0762; P = .049). None of the outcomes was affected by the timing or manner of the cyclosporine withdrawal. CONCLUSIONS: The increased incidence of acute rejection following elective cyclosporine withdrawal does not affect short-term graft or patient survival after renal transplantation. Whether long-term consequences will outweigh the benefits of elective withdrawal remains to be determined.

Cyclosporine↗

PubMed1990

A meta-analysis of estimated effect sizes for group versus individual control treatments.

A meta-analysis was conducted combining results from nine studies, using seventy-five outcome measures of 349 subjects. Only studies that contrasted group, individual, and control treatments with a pretest-posttest design were selected. Estimates of effect sizes were calculated for group, individual, and control treatments across all studies, according to treatment modality (psychotherapy, counseling, or psychoeducation), type of control (no treatment or some treatment), date of the study (1955-1969 or 1977-1982), and the subjects' age (adult, adolescent, or child). Results indicated that both group and individual treatments had a measurable effect that was consistently greater than that of controls. Further, (1) counseling produced much more of an effect than either therapy or psychoeducation; (2) the more recent treatments produced larger effects than the older studies; and (3) group treatments were more effective than individual methods in the treatment of adolescents, but were less effective in the treatment of children.

Humans↗

PubMed2001

[Meta-analysis and 'evidence-based practice' in dentistry].

The dental practitioner may sometimes search for certainty in dental decisions from the dental literature. In this 'Evidence Based Dentistry' situation a meta-analysis, as a structured and statistically supported literature review, may be helpful. The papers that are included in the meta-analysis have to be carefully screened and selected for a correct clinical decision.

Dentistry↗

PubMed2004

Impairments of colour vision induced by organic solvents: a meta-analysis study.

The impairment of colour discrimination induced by occupational exposure to toluene, styrene and mixtures of organic solvents is reviewed and analysed using a meta-analytical approach. Thirty-nine studies were surveyed covering a wide range of exposure conditions. Those studies using the Lanthony Panel D-15 desaturated test (D-15d) were further considered. From these for 15 samples data on colour discrimination ability (Colour Confusion Index, CCI) and exposure levels were provided, required for the meta-analysis. In accordance with previously reported higher CCI values for the exposed groups, the computations yielded positive effect sizes for 13 of the 15 samples, indicating that in the great majority of the studies the exposed groups showed inferior colour discrimination. However, the meta-analysis showed great variation in effect sizes across the studies. Possible reasons for inconsistency among the reported findings are discussed. These pertain to exposure-related parameters, as well as to confounders such as conditions of test administration and characteristics of subject samples. Those factors vary considerably among the studies and might have greatly contributed to divergence in measured colour vision capacity, thereby obscuring consistent effects of organic solvents on colour discrimination.

Color Perception↗

PubMed2004

Neoadjuvant or adjuvant therapy for resectable esophageal cancer: a systematic review and meta-analysis.

BACKGROUND: Carcinoma of the esophagus is an aggressive malignancy with an increasing incidence. Its virulence, in terms of symptoms and mortality, justifies a continued search for optimal therapy. The large and growing number of patients affected, the high mortality rates, the worldwide geographic variation in practice, and the large body of good quality research warrants a systematic review with meta-analysis. METHODS: A systematic review and meta-analysis investigating the impact of neoadjuvant or adjuvant therapy on resectable thoracic esophageal cancer to inform evidence-based practice was produced.MEDLINE, CANCERLIT, Cochrane Library, EMBASE, and abstracts from the American Society of Clinical Oncology and the American Society for Therapeutic Radiology and Oncology were searched for trial reports. Included were randomized trials or meta-analyses of neoadjuvant or adjuvant treatments compared with surgery alone or other treatments in patients with resectable thoracic esophageal cancer. Outcomes of interest were survival, adverse effects, and quality of life. Either one- or three-year mortality data were pooled and reported as relative risk ratios. RESULTS: Thirty-four randomized controlled trials and six meta-analyses were obtained and grouped into 13 basic treatment approaches. Single randomized controlled trials detected no differences in mortality between treatments for the following comparisons:- Preoperative radiotherapy versus postoperative radiotherapy.- Preoperative and postoperative radiotherapy versus postoperative radiotherapy. Preoperative and postoperative radiotherapy was associated with a significantly higher mortality rate.- Postoperative chemotherapy versus postoperative radiotherapy.- Postoperative radiotherapy versus postoperative radiotherapy plus protein-bound polysaccharide versus chemoradiation versus chemoradiation plus protein-bound polysaccharide. Pooling one-year mortality detected no statistically significant differences in mortality between treatments for the following comparisons:- Preoperative radiotherapy compared with surgery alone (five randomized trials).- Postoperative radiotherapy compared with surgery alone (five randomized trials).- Preoperative chemotherapy versus surgery alone (six randomized trials).- Preoperative and postoperative chemotherapy versus surgery alone (two randomized trials).- Preoperative chemoradiation therapy versus surgery alone (six randomized trials). Single randomized controlled trials detected differences in mortality between treatments for the following comparison:- Preoperative hyperthermia and chemoradiotherapy versus preoperative chemoradiotherapy in favour of hyperthermia. Pooling three-year mortality detected no statistically significant difference in mortality between treatments for the following comparison:- Postoperative chemotherapy compared with surgery alone (two randomized trials). Pooling three-year mortality detected statistically significant differences between treatments for the following comparisons:- Preoperative chemoradiation therapy versus surgery alone (six randomized trials) in favour of preoperative chemoradiation with surgery.- Preoperative chemotherapy compared with preoperative radiotherapy (one randomized trial) in favour of preoperative radiotherapy. CONCLUSION: For adult patients with resectable thoracic esophageal cancer for whom surgery is considered appropriate, surgery alone (i.e., without neoadjuvant or adjuvant therapy) is recommended as the standard practice.

Chemotherapy, Adjuvant↗

PubMed2026

Efficacy of Mindfulness-Based Interventions on Anxiety and Sleep Quality in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.

INTRODUCTION: Patients with breast cancer commonly experience anxiety and sleep disturbance during and after treatment, and these symptoms are closely interrelated, negatively affecting the quality of life. Mindfulness-based interventions (MBIs) have been increasingly used as a nonpharmacological supportive approach. This systematic review and meta-analysis aimed to evaluate the effects of MBIs on anxiety and sleep quality in patients with breast cancer. METHODS: A systematic search of PubMed, Web of Science, Cochrane Library, CINAHL, and Embase was conducted up to May 15, 2025. Random-effects meta-analysis was used to estimate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane RoB 2.0, and the certainty of evidence was evaluated with Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS: Twenty-four randomized controlled trials (RCTs) including 3,212 participants were analyzed. MBIs significantly reduced anxiety compared with control groups receiving usual care, no intervention, or wait-list conditions (SMD: -0.47, 95% CI: -0.62 to -0.32), whereas no significant effect was observed for sleep quality. Subgroup analysis indicated that intervention duration accounted for 55.5% of the heterogeneity in anxiety outcomes. All studies were rated as having some concerns regarding risk of bias, primarily due to self-reported outcomes and lack of blinding. Certainty of evidence was moderate for anxiety and low for sleep quality. DISCUSSION: MBIs appear to be effective in reducing anxiety among patients with breast cancer; however, no significant effect was observed for sleep quality. All included studies were rated as having some concerns regarding risk of bias, and the limited reporting of adverse events represents a limitation of the evidence. In addition, substantial heterogeneity in sleep quality outcomes and the limited number of included RCTs restrict exploration of heterogeneity sources and limit generalizability. Further high-quality well-designed RCTs are needed to strengthen and confirm the evidence.

Female↗