Tips and tricks to improve your systematic review manuscript

Systematic Reviews in Medical Education.

It is very encouraging that the annual scientific output now is exceeding 400 publications about laser phototherapy. This is a 20-fold increase from publication rates for low-level laser therapy (LLLT) a decade ago. Six years ago, another editorial in the journal announced that ‘‘low-level laser therapy’’ is not low, and a debate to change this MeSH term was initiated. At the time, we were worried that ’’low level’’ would be associated with inferior scientific quality.. With the progress that has been made in terms of scientific output, and LLLT publications in high-ranked medical journals, this fear has somewhat ceased. Some guidelines and reputed treatment advisory boards (American Physical Therapy Association, National Cancer Institute, Clinical Evidence at BMJ) now recommend varying strengths of LLLT use for conditions such as Achilles tendinopathy, cancer-therapyinduced oral mucositis, and tennis elbow. Still, the most crucial factors for treatment effects are optimal dosing and hitting a sufficient part of the target pathology. In the Cochrane Database of Systematic Reviews, two of three LLLT reviews fail to address the issue of dosing. It is, however, encouraging that one systematic review cites the guidelines of World Association for Laser Therapy (WALT) and addresses dosage by subgrouping trials by doses that are optimal and ones that are not. The review’s overall conclusion is inconclusive and contains only the usual phrase, stating that more studies are needed. However, the ‘‘implications for practice’’ are more descriptive to read. The authors find that although LLLT may be beneficial for pain relief and disability, they also insist that LLLT should not substituted for other beneficial interventions in low back pain. In the jungle of potentially harmful low back pain interventions, I wonder why it is so important to discourage clinical use of LLLT, which the review otherwise finds both harmless and modestly effective. The evidence-based WALT guidelines for LLLT dosage in musculoskeletal disorders were published for the first time in August 2005. What makes the WALT guidelines stronger than guidelines for other empirically based modalities such as acupuncture, is that sound and credible biological mechanisms can explain LLLT actions. The therapeutic windows were first identified by careful investigation of dose– response patterns in pre-clinical studies. For soft tissue inflammation and soft tissue repair, we found consistent evidence of effects from several independent research groups. These pre-clinical findings, combined with the results from clinical LLLT studies, form the rationale for WALT dosage recommendations. The idea with the first generation of WALT guidelines was that they would serve two purposes. On the one hand they could serve as a treatment guide to clinicians, and on the other hand, they could make it possible to identify trials with obviously ineffective doses. The latter was needed because there are a great number of published trials with low fidelity caused by errors in dosing and treatment procedures. These low-fidelity LLLT trials would invariably be included in systematic reviews and meta-analyses such as the Cochrane reviews, which ended up with largely negative conclusions. Before 2005, LLLT devices were largely operating with mean outputs in the lower part of the Class 3 B range and we did not know if there were upper limits for effective doses. To serve both these purposes, we decided to design the first WALT guidelines with minimum dose thresholds for effectiveness. Since 2005, a new generation of more powerful LLLT devices has entered the market. Several dose-finding laboratory studies have recently shown us that more is not necessarily better, and that the positive effects may in fact be lost in overdosing LLLT. This development has prompted us to take the WALT guidelines one step further. I think that the first-generation guidelines served well, and they were also validated by a review finding that 91% of tendinopathy trials with WALT-recommended doses reported positive effects. The value of WALT dosage recommendations to predict clinical effectiveness also led to the discovery of a massive attempt at fraudulent publication. I received two manuscripts for review from different journals, and both reported significant results in spite of LLLT doses well below the threshold normally needed for effectiveness. My skepticism led to a closer scrutiny of the results, and they proved to report exactly the same mean and variance results in both manuscripts. This is a statistical coincidence that is almost impossible in real life. Further explorations revealed that several manuscripts from the same source, with forged results and plagiarized text, were in editorial circulation. With the joint efforts of editors they were stopped and the superiors of the source were informed for further judgment. There are now at least 125 randomized controlled trials investigating the pain-relieving effects of LLLT. Where possible, we have calculated the doses in most of these trials and

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Ulcerative Colitis.

Ensuring rigor in systematic reviews: Part 7, critical appraisal of systematic review quality

Systematic Review to Improve FESS Outcomes in Cystic Fibrosis Patients

Management of rhinosinusitis during pregnancy requires special considerations. 1. Conduct a systematic literature review for acute and chronic rhinosinusitis (CRS) management during pregnancy. 2. Make evidence-based recommendations. The systematic review was conducted using MEDLINE and EMBASE databases and relevant search terms. Title, abstract and full manuscript review were conducted by two authors independently. A multispecialty panel with expertise in management of Rhinological disorders, Allergy-Immunology, and Obstetrics-Gynecology was invited to review the systematic review. Recommendations were sought on use of following for CRS management during pregnancy: oral corticosteroids; antibiotics; leukotrienes; topical corticosteroid spray/irrigations/drops; aspirin desensitization; elective surgery for CRS with polyps prior to planned pregnancy; vaginal birth versus planned Caesarian for skull base erosions/ prior CSF rhinorrhea. Eighty-eight manuscripts underwent full review after screening 3052 abstracts. No relevant level 1, 2, or 3 studies were found. Expert panel recommendations for rhinosinusitis management during pregnancy included continuing nasal corticosteroid sprays for CRS maintenance, using pregnancy-safe antibiotics for acute rhinosinusitis and CRS exacerbations, and discontinuing aspirin desensitization for aspirin exacerbated respiratory disease. The manuscript presents detailed recommendations. The lack of evidence pertinent to managing rhinosinusitis during pregnancy warrants future trials. Expert recommendations constitute the current best available evidence.

Hypo-fractionated stereotactic radiotherapy of five fractions with linear accelerator for vestibular schwannomas: A systematic review and meta-analysis

Extensive Variability in Platelet Count, Bleeding, and Quality of Life Outcome Measures in Adult and Pediatric Immune Thrombocytopenia: An Appraisal from a Critical Review of the Literature

Peer Review and the PJOHNS: Principles, Problems, and Promise

Towards Evidence Based Practice: The American Radium Society (ARS) and American College of Radiology (ACR) Appropriate Use Guidelines on Radiation Therapy for Muscle-Invasive Bladder Cancer

Small esophageal varices in compensated cirrhosis patients: to treat or not to treat?

Objetivo: Realizar revisão sistemática de manuscritos que utilizaram a neuroimagem no estudo da dependência de jogos eletrônicos, a fim de identificar as principais regiões cerebrais alteradas. Métodos: Foram realizadas buscas nos seguintes bancos de dados: ScieELO, BVS, Lilacs, Science Direct On Line e PubMed. Não houve data mínima para a pesquisa, sendo considerados os artigos encontrados até julho de 2013. Os descritores utilizados para a presente revisão sistemática da literatura foram: “PET”, “SPECT”, “MRI”, “DTI”, “EEG”, “imaging”, “neuroimaging”, “spectroscopy”, “functional magnetic ressonance”, “structural magnetic ressonance”, “tractography”, “voxel” e “brain”, individualmente cruzados com os descritores “gaming” e “video game addiction”. Resultados: Dos 52 artigos encontrados, 16 foram selecionados: nove usaram fMRI, quatro usaram sRMI, um usou PET e dois usaram EEG. Em relação às alterações funcionais e estruturais, elas foram mais observadas no lobo frontal (córtex pré-frontal dorsolateral, córtex orbitofrontal, giro pré-frontal, giro frontal médio), parietal, temporal (giro para-hipocampal), núcleos da base, tálamo, ínsula e cerebelo. Conclusão: A despeito dos métodos utilizados, os estudos apontaram convergências quanto às reciprocidades cerebrais. Essas alterações neurais são semelhantes às observadas em pacientes dependentes de substâncias e de internet, especialmente durante o estado de fissura. Apesar de apenas recentemente pesquisas de neuroimagem em dependentes de jogos eletrônicos terem sido realizadas, contamos no momento com achados significativos alinhados à compreensão dos mecanismos neurais associados à dependência de jogos eletrônicos e respectiva inserção como categoria nosológica no âmbito psiquiátrico.

Contributing reviewersA peer-reviewed journal would not survive without the generous time and insightful comments of the reviewers, whose efforts often go unrecognized. Systematic Reviews has been blessed by the support of highly-qualified peer reviewers, and the Editors-in-Chief, David Moher, Lesley Stewart and Paul Shekelle, and staff of the journal would like to show their appreciation by thanking the following for their invaluable assistance with review of manuscripts for the journal in Volume 2 (2013).

The user study is a fundamental method used in HCI. In designing user studies, we often use compensation strategies to incentivize recruitment. However, compensation can also lead to ethical issues, such as coercion. The CHI community has yet to establish best practices for participant compensation. Through a systematic review of manuscripts at CHI and other associated publication venues, we found high levels of variation in the compensation strategies used within the community and how we report on this aspect of the study methods. A qualitative analysis of justifications offered for compensation sheds light into how some researchers are currently contextualizing this practice. This paper provides a description of current compensation strategies and information that can inform the design of compensation strategies in future studies. The findings may be helpful to generate productive discourse in the HCI community towards the development of best practices for participant compensation in user studies.

Outcomes After Tracheostomy in Patients With Severe Acute Brain Injury: A Systematic Review and Meta-Analysis