Abstract: Background: Chronic obstructive pulmonary disease (COPD) and asthma have a high prevalence and disease burden. Blended self-management interventions, which combine eHealth with face-to-face interventions, can help reduce the disease burden. Objective: This systematic review and meta-analysis aims to examine the effectiveness of blended self-management interventions on health-related effectiveness and process outcomes for people with COPD or asthma. Methods: PubMed, Web of Science, COCHRANE Library, Emcare, and Embase were searched in December 2018 and updated in November 2020. Study quality was assessed using the Cochrane risk of bias (ROB) 2 tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Results: A total of 15 COPD and 7 asthma randomized controlled trials were included in this study. The meta-analysis of COPD studies found that the blended intervention showed a small improvement in exercise capacity (standardized mean difference [SMD] 0.48; 95% CI 0.10-0.85) and a significant improvement in the quality of life (QoL; SMD 0.81; 95% CI 0.11-1.51). Blended intervention also reduced the admission rate (relative ratio [RR] 0.61; 95% CI 0.38-0.97). In the COPD systematic review, regarding the exacerbation frequency, both studies found that the intervention reduced exacerbation frequency (RR 0.38; 95% CI 0.26-0.56). A large effect was found on BMI (d=0.81; 95% CI 0.25-1.34); however, the effect was inconclusive because only 1 study was included. Regarding medication adherence, 2 of 3 studies found a moderate effect (d=0.73; 95% CI 0.50-0.96), and 1 study reported a mixed effect. Regarding self-management ability, 1 study reported a large effect (d=1.15; 95% CI 0.66-1.62), and no effect was reported in that study. No effect was found on other process outcomes. The meta-analysis of asthma studies found that blended intervention had a small improvement in lung function (SMD 0.40; 95% CI 0.18-0.62) and QoL (SMD 0.36; 95% CI 0.21-0.50) and a moderate improvement in asthma control (SMD 0.67; 95% CI 0.40-0.93). A large effect was found on BMI (d=1.42; 95% CI 0.28-2.42) and exercise capacity (d=1.50; 95% CI 0.35-2.50); however, 1 study was included per outcome. There was no effect on other outcomes. Furthermore, the majority of the 22 studies showed some concerns about the ROB, and the quality of evidence varied. Conclusions: In patients with COPD, the blended self-management interventions had mixed effects on health-related outcomes, with the strongest evidence found for exercise capacity, QoL, and admission rate. Furthermore, the review suggested that the interventions resulted in small effects on lung function and QoL and a moderate effect on asthma control in patients with asthma. There is some evidence for the effectiveness of blended self-management interventions for patients with COPD and asthma; however, more research is needed. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019119894; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=119894
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Doel van de workshop: Hoe kun je een ‘systematic review’ opzetten en uitvoeren. Programma: Welke stappen moeten er gezet worden Zelf een vraag formuleren en uitwerken Eerste search doen
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Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements.
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Abstract: Teledentistry offers possibilities for improving efficiency and quality of care and supporting cost-effective healthcare systems. This umbrella review aims to synthesize existing systematic reviews on teledentistry and provide a summary of evidence of its clinical- and cost-effectiveness. A comprehensive search strategy involving various teledentistry-related terms, across seven databases, was conducted. Articles published until 24 April 2023 were considered. Two researchers independently reviewed titles, abstracts and full-text articles. The quality of the included reviews was critically appraised with the AMSTAR-2 checklist. Out of 749 studies identified, 10 were included in this umbrella review. Two reviews focusing on oral-health outcomes revealed that, despite positive findings, there is not yet enough evidence for the long-term clinical effectiveness of teledentistry. Ten reviews reported on economic evaluations or costs, indicating that teledentistry is cost-saving. However, these conclusions were based on assumptions due to insufficient evidence on cost-effectiveness. The main limitation of our umbrella review was the critically low quality of the included reviews according to AMSTAR-2 criteria, with many of these reviews basing their conclusions on low-quality studies. This highlights the need for high-quality experimental studies (e.g., RCTs, factorial designs, stepped-wedge designs, SMARTs and MRTs) to assess teledentistry’s clinical- and cost-effectiveness.
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The aim of this systematic review was to provide an overview of the effectiveness of fundamental movement skill interventions in young children (2–5 years) and to identify elements that determine the effectiveness of these interventions. A systematic literature search was conducted in four electronic databases (PubMed, Academic Search Complete, Education Resources Information Centre and SPORTDiscus). First, intervention-related data (e.g., intervention length, volume, focus, and content) were extracted. Next, the methodological quality and risk of bias of the selected studies were evaluated using a 10-item checklist. Sixteen studies (13 randomised controlled trials and 3 controlled trials) met the inclusion criteria of which 9 had a high methodological quality. Fourteen studies reported statistically significant intervention effects, ranging from small negative to very strong positive effects. Four studies executed a retention test of which two showed positive effects. Elements that influence the effectiveness are: incorporating all fundamental movement skills in the intervention with a variety of activities; combining deliberate practice and deliberate play; the intervention length; the intervention volume and; providing a training programme with coaching during the intervention for the professional involved in delivering the intervention. However more studies containing retention tests are needed.
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In dit review wordt een overzicht gegeven van effect van mobiele applicaties en activity trackers op een gezonde leefstijl. 17 artikelen werden geïncludeerd. De effecten van apps op beweeggedrag lijken positief. Het effect van apps op voeding en gewicht was wisselend. Maar er leek een trend te zijn voor verbetering van het voedingspatroon. Er is nog weinig onderzoek gedaan naar effect van activity trackers op leefstijl, maar eerste resultaten laten een positieve invloed zien op beweeggedrag. Voor apps aanbevolen kunnen worden, is verder onderzoek nodig. Hiervoor is grootschalig onderzoek nodig met uitgebalanceerde controlegroepen en lange termijn follow-up testen.
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Although systematic reviews are considered as central components in evidence-based practice, they currently face an important challenge to keep up with the exponential publication rate of clinical trials. After initial publication, only a minority of the systematic reviews are updated, and it often takes multiple years before these results become accessible. Consequently, many systematic reviews are not up to date, thereby increasing the time-gap between research findings and clinical practice. A potential solution is offered by a living systematic reviews approach. These types of studies are characterized by a workflow of continuous updates which decreases the time it takes to disseminate new findings. Although living systematic reviews are specifically designed to continuously synthesize new evidence in rapidly emerging topics, they have also considerable potential in slower developing domains, such as rehabilitation science. In this commentary, we outline the rationale and required steps to transition a regular systematic review into a living systematic review. We also propose a workflow that is designed for rehabilitation science.
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Not much is known about the etiology, or development, of deviant sexual interests. The aim of this systematic review was to provide a broad overview of current theories on the etiology of sexual deviance. We conducted a systematic search of the databases PubMed and APA PsycInfo (EBSCO). Studies were included when they discussed a theory regarding the etiology or development of sexual deviance. Included studies were assessed on quality criteria for good theories. Common etiological themes were extracted using thematic analysis. We included 47 theories explaining sexual deviance in general as well as various specific deviant sexual interests, such as pedophilia and sadism/masochism. Few theories (k = 7) were of acceptable quality as suggested by our systematic assessment of quality criteria for good theories (QUACGOT). These theories indicated that deviant sexual interests may develop as the result of an interplay of various factors: excitation transfer between emotions and sexual arousal, conditioning, problems with “normative” sexuality, and social learning. Neurobiological findings could not be included as no acceptable quality neurobiological theories could be retrieved. The important roles of excitation transfer and conditioning designate that dynamic, changeable processes take part in the etiology of sexual deviance. These same processes could potentially be deployed to diminish unwanted deviant sexual interests.
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Explainable Artificial Intelligence (XAI) aims to provide insights into the inner workings and the outputs of AI systems. Recently, there’s been growing recognition that explainability is inherently human-centric, tied to how people perceive explanations. Despite this, there is no consensus in the research community on whether user evaluation is crucial in XAI, and if so, what exactly needs to be evaluated and how. This systematic literature review addresses this gap by providing a detailed overview of the current state of affairs in human-centered XAI evaluation. We reviewed 73 papers across various domains where XAI was evaluated with users. These studies assessed what makes an explanation “good” from a user’s perspective, i.e., what makes an explanation meaningful to a user of an AI system. We identified 30 components of meaningful explanations that were evaluated in the reviewed papers and categorized them into a taxonomy of human-centered XAI evaluation, based on: (a) the contextualized quality of the explanation, (b) the contribution of the explanation to human-AI interaction, and (c) the contribution of the explanation to human- AI performance. Our analysis also revealed a lack of standardization in the methodologies applied in XAI user studies, with only 19 of the 73 papers applying an evaluation framework used by at least one other study in the sample. These inconsistencies hinder cross-study comparisons and broader insights. Our findings contribute to understanding what makes explanations meaningful to users and how to measure this, guiding the XAI community toward a more unified approach in human-centered explainability.
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Richtlijnen vormen een belangrijke bron voor zorgprofessionals om evidence-based te kunnen handelen. Richtlijnen zijn veelal gebaseerd op systematic reviews, waarbij alle beschikbare wetenschappelijke literatuur over een bepaald onderwerp systematisch beoordeeld wordt op de kwaliteit van de onderzoeken. Dit artikel gaat over wat er aan bod komt bij een systematic review.
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