Experiences of informal caregivers of people with dementia in low- and middle-income countries: a systematic review protocol.

OBJECTIVE: This review aims to synthesize the experiences of informal caregivers of people with dementia in low- and middle-income countries (LMICs). INTRODUCTION: Globally, the burden of dementia is increasing disproportionately in LMICs. Informal caregivers play a vital role and face multiple challenges in LMICs. Caregivers often lack awareness and skills to provide adequate care for people living with dementia. Many LMICs have limited resources and caregivers lack support services. Understanding their experiences and perceptions may improve interventions, helping caregivers to better support those living with dementia. INCLUSION CRITERIA: Studies from all settings in LMICs will be considered. Qualitative data from qualitative or mixed methods studies that explore caregivers' experiences and perceptions will be included in this review. Participants are informal caregivers of people diagnosed with dementia at any stage, regardless of age, gender, or their relationship with people living with dementia. METHODS: This review will follow the JBI methodology for a qualitative systematic reviews, with meta-aggregation as the synthesis method. The review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A 3-step search strategy will be used to locate published and unpublished studies in MEDLINE, CINAHL, Embase, PsycINFO, AgeLine, LILACS, African Index Medicus, ProQuest Dissertations and Theses, Open Dissertations, Web of Science Core Collection, and Google Scholar. There will be no date or language limitations. All studies will be screened against the inclusion criteria and data will be extracted and critically appraised for methodological quality by 2 independent reviewers using JBI tools. Confidence in the final synthesized findings will be assessed using the ConQual approach. REVIEW REGISTRATION NUMBER: PROSPERO CRD42023453814.

Comparison of bias adjustment in meta-analysis using data-based and opinion-based methods.

INTRODUCTION: Several methods exist for bias adjustment of meta-analysis results, but there has been no comprehensive comparison with unadjusted methods. We compare 6 bias-adjustment methods with 2 unadjusted methods to examine how these different methods perform. METHODS: We re-analyzed a meta-analysis that included 10 randomized controlled trials. Two data-based methods (Welton's data-based approach and Doi's quality effects model) and 4 opinion-informed methods (opinion-based approach, opinion-based distributions combined statistically with data-based distributions, numerical opinions informed by data-based distributions, and opinions obtained by selecting areas from data-based distributions) were used to incorporate methodological quality information into the meta-analytical estimates. The results of these 6 methods were compared with 2 unadjusted models: the DerSimonian-Laird random effects model and Doi's inverse variance heterogeneity model. RESULTS: The 4 opinion-based methods returned the random effects model estimates with wider uncertainty. The data-based and quality effects methods returned different results and aligned with the inverse variance heterogeneity method with some minor downward bias adjustment. CONCLUSION: Opinion-based methods seem to only add uncertainty rather than bias adjust.

Implementing GRADE in systematic reviews that adhere to JBI methodological conduct.

GRADE is a methodological approach used to establish certainty in a body of evidence and is now widely adopted among the evidence synthesis and guideline development community. JBI is an international evidence-based health care organization that provides guidance for a range of evidence synthesis approaches. The GRADE approach is currently endorsed for use in a subset of JBI systematic reviews; however, there is some uncertainty regarding when (and how) GRADE may be implemented in reviews that follow JBI methodology.

Common tool structures and approaches to risk of bias assessment: implications for systematic reviewers.

There are numerous tools available to assess the risk of bias in individual studies in a systematic review. These tools have different structures, including scales and checklists, which may or may not separate their items by domains. There are also various approaches and guides for the process, scoring, and interpretation of risk of bias assessments, such as value judgments, quality scores, and relative ranks. The objective of this commentary, which is part of the JBI Series on Risk of Bias, is to discuss some of the distinctions among different tool structures and approaches to risk of bias assessment and the implications of these approaches for systematic reviewers.

The revised JBI critical appraisal tool for the assessment of risk of bias for quasi-experimental studies.

Systematic reviews of effectiveness offer a rigorous synthesis of the best evidence available regarding the effects of interventions or treatments. Randomized controlled trials are considered the optimal study design for evaluating the effectiveness of interventions and are the ideal study design for inclusion in a systematic review of effectiveness. In the absence of randomized controlled trials, quasi-experimental studies may be relied on to provide information on treatment or intervention effectiveness. However, such studies are subject to unique considerations regarding their internal validity and, consequently, the assessment of the risk of bias of these studies needs to consider these features of design and conduct. The JBI Effectiveness Methodology Group has recently commenced updating the suite of JBI critical appraisal tools for quantitative study designs to align with the latest advancements in risk of bias assessment. This paper presents the revised critical appraisal tool for risk of bias assessment of quasi-experimental studies; offers practical guidance for its use; provides examples for interpreting the results of risk of bias assessment; and discusses major changes from the previous version, along with the justifications for those changes.

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.

Non-operative management for high-grade splenic injury: a systematic review protocol.

OBJECTIVE: The objective of this review is to establish whether embolization is more effective than clinical observation for adult patients with grade III-V splenic injuries. Findings will be used to guide future practice and, if necessary, inform future research design and conduct. INTRODUCTION: The spleen is one of the most frequently injured intra-abdominal organs, with a reported adult mortality of 7% to 18% following trauma. Non-operative management has become a standard of care for hemodynamically stable patients. In clinical practice, the decision whether to prophylactically embolize or manage high-grade injuries with observation alone remains controversial. INCLUSION CRITERIA: Sources including adult patients with grade III-V splenic injuries secondary to blunt trauma will be included in this review. Eligible studies must include comparisons between 2 cohorts of patients undergoing either prophylactic embolization or clinical observation only. Outcomes will include mortality rate, failure of treatment, intensive care unit admission, length-of-hospital stay, blood transfusion requirements, and patient satisfaction. METHODS: A systematic review with meta-analysis will be conducted. PubMed, Embase, and CINAHL will be searched for eligible studies, as will trial registries and sources of gray literature. Study selection, quality appraisal, and outcome data extraction will be performed in duplicate. Methodological quality will be evaluated with appropriate JBI critical appraisal tools. Studies will, where possible, be pooled in statistical meta-analysis. A random effects model will be used and statistical analysis will be performed. The certainty of the findings will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. REVIEW REGISTRATION: PROSPERO CRD42023420220.

Oncological and functional outcomes of transoral surgery compared with non-surgical management in small-volume oropharyngeal cancer: a systematic review protocol.

OBJECTIVE: The objective of this systematic review is to investigate oncological and functional outcomes following primary transoral surgery compared with non-surgical management in patients with small-volume (T1-2, N0-2) oropharyngeal cancer. INTRODUCTION: The incidence of oropharyngeal cancer is rising. Transoral surgery was introduced to provide a minimally invasive treatment option for patients with small-volume oropharyngeal cancer and to avoid the morbidity that results from open surgery and the potential acute and late toxicities of chemoradiotherapy. INCLUSION CRITERIA: The review will include all studies on adult patients with small-volume oropharyngeal cancer managed by transoral surgery or non-surgical management with radiotherapy and/or chemotherapy. All patients must have undergone treatment with curative intent. Participants who underwent palliative treatment will be excluded. METHODS: This review will follow the JBI methodology for systematic reviews of effectiveness. Eligible study designs will include randomized controlled trials, quasi-experimental studies, and prospective or retrospective cohort studies. Databases to be searched will include PubMed, Embase, CINAHL, Cochrane CENTRAL, and multiple trial registries from 1972. Titles and abstracts will be reviewed, and full-text articles will be retrieved if they meet the inclusion criteria. All eligible studies will be critically appraised by 2 independent reviewers using the appropriate JBI tools for experimental and observational designs. Where possible, outcome data from studies will be pooled with statistical meta-analysis to compare both oncological and functional outcomes between the two groups. All time to event to data will be converted to a common metric for oncological outcomes. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be followed to assess the certainty of findings. REVIEW REGISTRATION: PROSPERO CRD4202235209.

From critical appraisal to risk of bias assessment: clarifying the terminology for study evaluation in JBI systematic reviews.

The foundations for critical appraisal of literature have largely progressed through the development of epidemiologic research methods and the use of research to inform medical teaching and practice. This practical application of research is referred to as evidence-based medicine and has delivered a standard for the health care profession where clinicians are equally as engaged in conducting scientific research as they are in the practice of delivering treatments. Evidence-based medicine, now referred to as evidence-based health care, has generally been operationalized through empirically supported treatments, whereby the choice of treatments is substantiated by scientific support, usually by means of an evidence synthesis. As evidence synthesis methodology has advanced, guidance for the critical appraisal of primary research has emphasized a distinction from the assessment of internal validity required for synthesized research. This assessment is conceptualized and branded in various ways in the literature, such as risk of bias, critical appraisal, study validity, methodological quality, and methodological limitations. This paper provides a discussion of the definitions and characteristics of these terms, concluding with a recommendation for JBI to adopt the term "risk of bias" assessment.

The revised JBI critical appraisal tool for the assessment of risk of bias for randomized controlled trials.

JBI recently began the process of updating and revising its suite of critical appraisal tools to ensure that these tools remain compatible with recent developments within risk of bias science. Following a rigorous development process led by the JBI Effectiveness Methodology Group, this paper presents the revised critical appraisal tool for the assessment of risk of bias for randomized controlled trials. This paper also presents practical guidance on how the questions of this tool are to be interpreted and applied by systematic reviewers, while providing topical examples. We also discuss the major changes made to this tool compared to the previous version and justification for why these changes facilitate best-practice methodologies in this field.

How should we handle predatory journals in evidence synthesis? A descriptive survey-based cross-sectional study of evidence synthesis experts.

Synthesizers of evidence are increasingly likely to encounter studies published in predatory journals during the evidence synthesis process. The evidence synthesis discipline is uniquely positioned to encounter novel concerns associated with predatory journals. The objective of this research was to explore the attitudes, opinions, and experiences of experts in the synthesis of evidence regarding predatory journals. Employing a descriptive survey-based cross-sectional study design, these experts were asked a series of questions regarding predatory journals to explore these attitudes, opinions, and experiences. Two hundred and sixty four evidence synthesis experts responded to this survey. Most respondents agreed with the definition of a predatory journal (86%), however several (19%) responded that this definition was difficult to apply practically. Many respondents believed that studies published in predatory journals are still eligible for inclusion into an evidence synthesis project. However, this was only after the study had been determined to be 'high-quality' (39%) or if the results were validated (13%). While many respondents could identify common characteristics of these journals, there was still hesitancy regarding the appropriate methods to follow when considering including these studies into an evidence synthesis project.

Revising the JBI quantitative critical appraisal tools to improve their applicability: an overview of methods and the development process.

JBI offers a suite of critical appraisal instruments that are freely available to systematic reviewers and researchers investigating the methodological limitations of primary research studies. The JBI instruments are designed to be study-specific and are presented as questions in a checklist. The JBI instruments have existed in a checklist-style format for approximately 20 years; however, as the field of research synthesis expands, many of the tools offered by JBI have become outdated. The JBI critical appraisal tools for quantitative studies (eg, randomized controlled trials, quasi-experimental studies) must be updated to reflect the current methodologies in this field. Cognizant of this and the recent developments in risk-of-bias science, the JBI Effectiveness Methodology Group was tasked with updating the current quantitative critical appraisal instruments. This paper details the methods and rationale that the JBI Effectiveness Methodology Group followed when updating the JBI critical appraisal instruments for quantitative study designs. We detail the key changes made to the tools and highlight how these changes reflect current methodological developments in this field.

Investigating different typologies for the synthesis of evidence: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify evidence synthesis types and previously proposed classification systems, typologies, or taxonomies that have guided evidence synthesis. INTRODUCTION: Evidence synthesis is a constantly evolving field. There is now a plethora of evidence synthesis approaches used across many different disciplines. Historically, there have been numerous attempts to organize the types and methods of evidence synthesis in the form of classification systems, typologies, or taxonomies. This scoping review will seek to identify all the available classification systems, typologies, or taxonomies; how they were developed; their characteristics; and the types of evidence syntheses included within them. INCLUSION CRITERIA: This scoping review will include discussion papers, commentaries, books, editorials, manuals, handbooks, and guidance from major organizations that describe multiple approaches to evidence synthesis in any discipline. METHODS: The Evidence Synthesis Taxonomy Initiative will support this scoping review. The search strategy will aim to locate both published and unpublished documents utilizing a three-step search strategy. An exploratory search of MEDLINE has identified keywords and MeSH terms. A second search of MEDLINE, Embase, CINAHL with Full Text, ERIC, Scopus, Compendex, and JSTOR will be conducted. The websites of relevant evidence synthesis organizations will be searched. Identified documents will be independently screened, selected, and extracted by two researchers, and the data will be presented in tables and summarized descriptively. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT: Open Science Framework https://osf.io/qwc27.