Browsing by Subject "Systematic review"
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Item An evidence-base and implementation framework for promoting best practices in pharmaceutical interventions for hearing loss (PIHL) research(2017-06-12) Hammill, Tanisha Lee; Champlin, Craig A.; Rascati, Karen L; Wilson, James P; Betancourt, Jose A; Le Prell, Colleen GPharmaceutical interventions for hearing loss (PIHL) have many biological and physiological targets, highly variable study designs, incomparable outcomes, and no Federal Drug Administration (FDA)-approved drug after more than three decades of research. This project seeks to create the platforms and tools for scientific progress in this field with a novel model of translational research management. This effort includes a systematic review of PIHL studies to understand the key elements of study methods being employed across this field. A stakeholders group was developed to identify research barriers, determine prioritized issues to address, and provide expertise and consensus for the development of evidence-based Best Research Practices (BRPs). Using PIHL literature obtained through standardized systematic review search methods, this effort identified, characterized, evaluated and correlated the methodological variables across the full translational scope of PIHL studies, from animal to human species. Publications from original reports of pre-clinical animal or human studies of interventions to prevent or treat hearing loss or peripheral tinnitus caused by noise or blast exposure were included. A total of 3,492 articles published prior to January 2017 were returned in the librarian-assisted, Boolean search. The final set of included articles were limited to noise- or blast-induced hearing loss targets only and data extraction was completed on 213 articles. The establishment of the PIHL network, comprised of over 200 interdisciplinary experts, provides the platform for discussion, consensus and development of state-of-the-science determinations and BRPs. Outcomes will be translated into recommendations for the consideration of the FDA, funding agencies, and primary peer-reviewed journal editorial boards as part of an overall knowledge dissemination, implementation and adoption strategy. Dissemination pathways, including journal special issues, conference presentations, as well as network discussion, consensus, and adoption are explored as key elements of the overall effort. Early disseminations include 6 PIHL Newsletters, approximately 50 articles published or pending publication in four targeted peer-reviewed journals, and 9 presentations at national conferences. Critical review and understanding of the state of current study methods provide the evidence-base to set norms and standards, which can avoid research waste, thus protecting study subjects and resources and more quickly benefit target patient populations.Item Effectiveness of culturally adapted substance use interventions for Latino adolescents : a systematic review and meta-analysis(2015-08) Robles, Eden Hernandez; DiNitto, Diana M.; Padilla, Yolanda; Salas-Wright, Chris; Cynthia Franklin; Maynard, BrandyCultural factors have been shown to have a moderating effect on substance use, thus an increasing number of substance use interventions with Latino adolescents seek to incorporate culture in an attempt to positively impact outcomes. Research on the effectiveness of culturally adapted substance use interventions, however, has produced a body of ambiguous evidence. The purpose of this systematic review is to examine the characteristics and effects of culturally adapted substance use interventions with Latino adolescents on substance use outcomes. The research question guiding this study is: What are the effects of culturally adapted interventions on substance use outcomes with Latino adolescents? A systematic search of thirteen electronic databases, five research registers, five research affiliated websites, reference lists, and a comprehensive gray literature search were undertaken to locate randomized (RCT) or quasi-experimental (QED) studies conducted between 1990 and December 2014 examining substance use outcomes of culturally adapted interventions with Latino adolescents. The search yielded 35,842 titles and abstracts, and the full texts of 108 articles were screened for inclusion. The final sample included 10 studies (7 RCT and 3 QED). Program participants were comprised of 56.5% males; 74.2% were U.S. born; and their mean age was 13.13 years. Meta-analytic results suggest significant effects of moderate magnitude on substance use outcomes at posttest (g=0.328; 95% CI 0.015 to 0.640, p<0.04), and an overall positive and moderate effect at follow-up (g=0.516; 95% CI 0.149 to 0.883, p<.006). Homogeneity analysis revealed the effect size distribution was highly heterogeneous at posttest and follow-up, indicating significant variance in magnitude of effects across studies. Moderator analysis revealed differences in mean effects on study and intervention characteristics. The risk of bias assessment revealed that most studies were at high risk for performance bias and selection bias. While culturally adapted substance use interventions demonstrated positive impacts on substance use overall, there was significant variability across studies. These findings emphasize the need for rigorously conducted studies to better discern the benefits of utilizing culturally adapted interventions for reducing substance use among Hispanic adolescents.Item The manifestation of stuttering in Spanish-English bilingual speakers : a systematic review(2015-05) Nwankpa, Charity Symone; Byrd, Courtney T.; Hampton, ElizabethThe purpose of this systematic review was to analyze the descriptions of bilingual Spanish-English (SE) participants provided in stuttering literature to determine whether critical factors were used to define bilingualism and appropriate criteria were used to classify stuttering. The method included a systematic search of published studies that included bilingual Spanish-English participants who stutter and reviewed the level of detail provided regarding language history, function, proficiency, stability, mode, accent, covert speech, and affective factors. The identification and diagnosis of stuttering was also analyzed using disfluency factors that were reported across the studies. Those factors included formal diagnosis, monolingual guidelines, self-report, parent/teacher concern, informal observation, family history, and disfluency types. Ten studies qualified to be included the bilingualism analysis, consisting of over 15 different speakers who were identified as bilinguals who stutter. Nine out of the 10 studies qualified to be included in the stuttering analysis of the systematic review. Of the 10 studies analyzing bilingualism, the most frequently reported language profile information involved language proficiency, language history, and language function. Affect, accent, mode, and language stability information were the least mentioned language factors in the studies. Of the nine studies included in the disfluency analysis, the most commonly reported disfluency profile information involved disfluency types, comparison to monolingual normative data, and informal observation. The least reported disfluency factors in the studies were formal diagnosis, parent/teacher concern, self-reported stutterer, and family history of stuttering. Results demonstrate that the definition of bilingualism and the classification of stuttering among bilinguals is lacking and inconsistent.Item Review of economic studies of sickle cell disease and adherence to hydroxyurea and clinical and economic outcomes among Texas Medicaid enrollees with sickle cell disease(2019-06-21) Kang, Hyeun Ah; Barner, Jamie C.; Rascati, Karen L; Lawson, Kenneth A; Mignacca, RobertSickle cell disease (SCD) is a rare, inherited blood disorder that affects approximately 100,000 Americans. SCD was recognized as a societal health burden due to pain crises and complications resulting in costly healthcare utilization. This dissertation: 1) summarized the economic burden of SCD in the U.S.; 2) assessed hydroxyurea medication adherence and its association with vaso-occlusive crisis (VOC)-related events and healthcare utilization and costs. The systematic review (N=21 articles) revealed mean total SCD healthcare costs (2019 USD) ranged from $19,464 to $32,446/patient/year, which was 1.7 to 2.9 times greater than the overall population. The retrospective cohort study used Texas Medicaid data from 09/01/2011-08/31/16 with individuals who: 1) were between 2-63 years, 2) had at least one hydroxyurea prescription claim and were treatment naive, and 3) were continuously enrolled. Medical and pharmacy claims were analyzed for over one year to examine their medication use patterns (hydroxyurea adherence and persistence, and pain medication use) and VOC-related healthcare utilization and costs. The association between hydroxyurea adherence (Medication Possession Ratio; MPR) and VOC-related healthcare utilization were assessed using multivariate analyses. A total of 1,035 patients (18.8±12.5 years) were included. Among them, 20.9% were adherent to hydroxyurea (defined as MPR≥0.8) and mean MPR was 0.50 (± 0.30). In the 12 months following hydroxyurea initiation, 771 (74.5%) of the patients experienced ≥1 VOC events (4.1±5.1). After adjusting for covariates, being adherent to hydroxyurea was significantly (p<0.05) associated with beneficial VOC-related health outcomes including a decreased risk and lower hazard rate of VOC events, fewer VOC events, and a shorter hospital LOS. Regarding all-cause and SCD-related healthcare utilization and expenditures, being adherent to hydroxyurea was significantly (p<0.05) associated with decreased hospitalizations and ED visits, increased outpatient visits and prescriptions, and lower total SCD-related healthcare expenditures. These study findings, the high economic burden of SCD and low hydroxyurea adherence, highlight the need for multi-stakeholder efforts to improve hydroxyurea adherence among the SCD population to improve both clinical and economic health outcomes.Item The effectiveness of empirically supported brief interventions for depressive and/or anxiety disorders for primary care patients : a systematic review and meta-analysis(2018-05) Zhang, Anao; Franklin, Cynthia; Beretvas, Natasha; Choi, Namkee G.; DiNitto, Diana M.Depressive and anxiety disorders (DADs) are highly prevalent in U.S. primary care systems. Consequences of DADs for primary care patients are real and substantial. While there exist many empirically supported interventions for DADs, only a few them have been adopted for a primary care population. To date, limited investigation has focused on the effectiveness of these empirically supported interventions for DADs when delivered in primary care settings. This dissertation aims to evaluate the effectiveness of empirically supported brief interventions for DADs for primary care patients. Using a systematic review and meta-analysis approach, this dissertation searches across seven electronic databases, six professional websites, peer-reviewed journal articles’ reference list, and contact field experts for a pool of articles for meta-analysis. An initial pool of 1,140 articles are identified, after title/abstract screening and full-text review, a final sample of 65 articles are included for final summary and data analysis. Publication bias, risk of bias, and study quality rating are conducted in accordance with the Cochrane guidelines. In addition to descriptive statistics of individual studies, an overall treatment effect, assuming a random-effect model, and moderator analysis, assuming a mixed-effect model, are performed using Robust Variance Estimation in Meta-regression. Meta-analytic results indicate an overall statistically significant treatment effect of included interventions for primary care patients’ DADs. Single-predictor moderator analyses find percentage of married participants, treatment modality (individual versus group), and treatment composition (one versus combined approach) significantly moderates treatment effect size estimate. Multiple-predictor moderator analysis finds that, after controlling for other treatment characteristics, interventions delivered outside primary care settings reported significantly higher treatment effect than those delivered inside primary care settings. Discussions on these results and implications for social work practice, research, education and policy are presented