Effectiveness and safety of enhanced postoperative care units for non-cardiac, non-neurological surgery: a systematic review protocol.

OBJECTIVE: The proposed systematic review will evaluate the evidence on the effectiveness and safety of enhanced post-operative care (EPC) units on patient and health service outcomes in adult patients following non-cardiac, non-neurological surgery. INTRODUCTION: The increase in surgical procedures globally has placed a significant economic and societal burden on health care systems. Recognizing this challenge, EPC units have emerged as a model of care, bridging the gap between traditional, ward-level care and intensive care. EPC offers benefits such as higher staff-to-patient ratios, close patient monitoring (eg, invasive monitoring), and access to critical interventions (eg, vasopressor support). However, there is a lack of well-established guidelines and empirical evidence regarding the safety and effectiveness of EPC units for adult patients following surgery. INCLUSION CRITERIA: This review will include studies involving adult patients (≥ 18 years) undergoing any elective or emergency non-cardiac, non-neurological surgery, who have been admitted to an EPC unit. Experimental, quasi-experimental, and observational study designs will be eligible. METHODS: This review will follow the JBI methodology for systematic reviews of effectiveness. The search strategy will identify published and unpublished studies from the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), and Scopus, as well as gray literature sources, from 2010 to the present. Two independent reviewers will screen studies, extract data, and critically appraise selected studies using standardized JBI assessment tools. Where feasible, a statistical meta-analysis will be performed to combine study findings. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. REVIEW REGISTRATION NUMBER: PROSPERO CRD42023455269.

Predatory journals and their practices present a conundrum for systematic reviewers and evidence synthesisers of health research: A qualitative descriptive study.

Predatory journals are a blemish on scholarly publishing and academia and the studies published within them are more likely to contain data that is false. The inclusion of studies from predatory journals in evidence syntheses is potentially problematic due to this propensity for false data to be included. To date, there has been little exploration of the opinions and experiences of evidence synthesisers when dealing with predatory journals in the conduct of their evidence synthesis. In this paper, the thoughts, opinions, and attitudes of evidence synthesisers towards predatory journals and the inclusion of studies published within these journals in evidence syntheses were sought. Focus groups were held with participants who were experienced evidence synthesisers from JBI (previously the Joanna Briggs Institute) collaboration. Utilising qualitative content analysis, two generic categories were identified: predatory journals within evidence synthesis, and predatory journals within academia. Our findings suggest that evidence synthesisers believe predatory journals are hard to identify and that there is no current consensus on the management of these studies if they have been included in an evidence synthesis. There is a critical need for further research, education, guidance, and development of clear processes to assist evidence synthesisers in the management of studies from predatory journals.

Effectiveness of suture button fixation versus screw fixation for the management of acute distal tibiofibular syndesmotic injuries: a systematic review protocol.

OBJECTIVE: The aim of this review is to determine whether suture button fixation is more effective than traditional screw fixation for the management of acute distal tibiofibular syndesmotic injuries. INTRODUCTION: Syndesmotic injuries are common and require surgical management to avoid chronic pain and instability, and to improve long-term functional outcomes. Screw fixation and suture button fixation are the 2 techniques of choice for treatment; however, there remains ongoing debate surrounding which treatment modality delivers the best outcomes, leading to significant variability in practice. The suture button is a relatively new technique; therefore, there is a need for an updated, high-quality systematic review to help guide best practice in syndesmosis injury management. INCLUSION CRITERIA: This review will consider studies comparing suture button versus screw fixation of acute (<6 weeks) distal tibiofibular syndesmotic injuries. Patients aged 18 or over, with syndesmotic injuries requiring surgical stabilization, with or without an associated fracture, will be included. The primary outcome of interest will be composite functional ankle scores. Secondary outcomes will include range of motion, pain, joint malreduction, complications rates, re-operation rates, and return to work/sport. METHODS: This review will be conducted in accordance with the JBI guidelines for systematic reviews of effectiveness. The following electronic databases will be searched: PubMed, Embase, Scopus, The Cochrane Register of Controlled Trials, and Web of Science, in addition to gray literature databases. No publication date or language limits will be applied. Two independent reviewers will screen titles, abstracts, and full-text studies, assessing methodological quality using the JBI critical appraisal tools. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach will be used to assess certainty in the findings. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022331211.

Mapping Clinical Barriers and Evidence-Based Implementation Strategies in Low-to-Middle Income Countries (LMICs).

BACKGROUND: Low-to-middle income countries (LMICs) experience a high burden of disease from both non-communicable and communicable diseases. Addressing these public health concerns requires effective implementation strategies and localization of translation of knowledge into practice. AIM: To identify and categorize barriers and strategies to evidence implementation in LMICs from published evidence implementation studies. METHODS: A descriptive analysis of key characteristics of evidence implementation projects completed as part of a 6-month, multi-phase, intensive evidence-based clinical fellowship program, conducted in LMICs and published in the JBI Database of Systematic Reviews and Implementation Reports was undertaken. Barriers were identified and categorized to the Donabedian dimensions of care (structure, process, and outcome), and strategies were mapped to the Cochrane effective practice and organization of care taxonomy. RESULTS: A total of 60 implementation projects reporting 58 evidence-based clinical audit topics from LMICs were published between 2010 and 2018. The projects included diverse populations and were predominantly conducted in tertiary care settings. A total of 279 barriers to implementation were identified. The most frequently identified groupings of barriers were process-related and associated predominantly with staff knowledge. A total of 565 strategies were used across all projects, with every project incorporating more than one strategy to address barriers to implementation of evidence-based practice; most strategies were categorized as educational meetings for healthcare workers. LINKING EVIDENCE TO ACTION: Context-specific strategies are required for successful evidence implementation in LMICs, and a number of common barriers can be addressed using locally available, low-cost resources. Education for healthcare workers in LMICs is an effective awareness-raising, workplace culture, and practice-transforming strategy for evidence implementation.

Accuracy of core needle biopsy compared to fine needle biopsy for the diagnosis of neoplasm in patients with suspected head and neck cancers: a systematic review protocol of diagnostic test accuracy.

OBJECTIVE: The objective of this review is to determine the difference in diagnostic accuracy of core needle biopsy and fine needle aspiration for patients with a head and neck mass using surgical histopathology as a reference test. The risks and adverse events associated with each technique will also be compared. INTRODUCTION: Tissue diagnosis is critical in evaluation of head and neck lesions to guide management. Options for tissue biopsy include surgical biopsy, fine needle aspiration and core needle biopsy. INCLUSION CRITERIA: Studies that compare ultrasound-guided core needle biopsy and/or fine needle aspiration to investigate lumps in the thyroid, cervical lymph nodes, or salivary glands for malignancy in adult patients will be included. The comparator test will be definitive histology in form of surgical biopsy/excision. METHODS: MEDLINE, Emcare, Embase, Web of Science and Cochrane Register of Diagnostic Accuracy Studies will be searched. Studies will be critically appraised by two independent reviewers for methodological quality, using the modified critical appraisal instrument QUADAS-2 and JBI SUMARI software. Two independent reviewers will extract data from papers included in the review using the standardized data extraction tool available in the JBI Reviewer's Manual. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020140005.

Methodological components and quality of evidence summaries: a scoping review protocol.

OBJECTIVE: The objective of this review is to identify and map the available evidence related to evidence summary methodologies and indicators of quality. INTRODUCTION: It can be challenging for clinicians and policy makers to keep up-to-date with current evidence and best practice. An evidence summary is a way to provide health care decision makers with the most recent, highest quality evidence available on a particular topic in an easily digestible format to facilitate evidence-based clinical decisions. However, objectively evaluating the methodological quality of these types of evidence reviews is challenging. INCLUSION CRITERIA: Articles, papers, books, dissertations, reports and websites will be included if they evaluate, or describe the development or appraisal of, an evidence summary methodology. METHODS: A three-step search strategy will be used to find both published and unpublished literature. The following databases will be searched: US National Library of Medicine Database (PubMed) Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, ProQuest Dissertations and Theses, and Embase. The gray literature search will include relevant government and university websites, the Health Evidence Network website, the World Health Organization (WHO) Health Evidence Network website, the McMaster Health Systems Evidence website, and relevant websites included in the Canadian Agency for Drugs and Technologies in Health (CADTH) Grey Matters Handbook. Sources published in English will be considered, with no date limitation.