bias. In addition, there were no significant differences in intensive care unit (ICU) mortality, in-hospital mortality, 28-day mortality, or ICU length of stay between the groups.CONCLUSION: Discontinuing NE prior to AVP was associated with a lower incidence of hypotension in patients recovering from septic shock. However, our results should be interpreted with caution, due to the considerable between-study heterogeneity.]]>
Arginine Vasopressin ; Arginine ; Bias (Epidemiology) ; Consensus ; Hospital Mortality ; Humans ; Hypotension ; Incidence ; Intensive Care Units ; Length of Stay ; Mortality ; Norepinephrine ; Odds Ratio ; Population Characteristics ; Sepsis ; Shock, Septic ; Treatment Outcome ; Vasoconstrictor Agents

Cardiovascular disease (CVD) is considered a primary driver of global mortality and is estimated to be responsible for approximately 17.9 million deaths annually. Consequently, a substantial body of research related to CVD has developed, with an emphasis on identifying strategies for the prevention and effective treatment of CVD. In this review, we critically examine the existing CVD literature, and specifically highlight the contribution of Mendelian randomization analyses in CVD research. Throughout this review, we assess the extent to which research findings agree across a range of studies of differing design within a triangulation framework. If differing study designs are subject to non-overlapping sources of bias, consistent findings limit the extent to which results are merely an artefact of study design. Consequently, broad agreement across differing studies can be viewed as providing more robust causal evidence in contrast to limiting the scope of the review to a single specific study design. Utilising the triangulation approach, we highlight emerging patterns in research findings, and explore the potential of identified risk factors as targets for precision medicine and novel interventions.
Artifacts ; Bias (Epidemiology) ; Cardiovascular Diseases ; Mendelian Randomization Analysis ; Mortality ; Precision Medicine ; Random Allocation ; Risk Factors

Bias ; Coronavirus Infections ; epidemiology ; transmission ; Humans ; Pandemics ; Pneumonia, Viral ; epidemiology ; transmission ; Uncertainty

Arm ; Asian Continental Ancestry Group ; Bias (Epidemiology) ; Carboplatin ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Humans ; Maintenance Chemotherapy ; Ovarian Neoplasms ; Prognosis ; Quality of Life ; Recombination, Genetic ; Sample Size

bias of 0.005 (95% CI −0.011 to 0.021) with 95% limits of agreement of −0.16 to 0.17 between vFFR and FFR. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 78.0%, 87.1%, 72.5%, 58.7%, and 92.6%, respectively, using the FFR cutoff of 0.80. They were 87.0%, 95.0%, 80.0%, 54.3%, and 98.5%, respectively, with the FFR cutoff of 0.75. The area under the receiver-operating characteristics curve of vFFR versus obstructive CTA stenosis was 0.88 versus 0.61 for the FFR cutoff of 0.80, respectively; it was 0.94 versus 0.62 for the FFR cutoff of 0.75.CONCLUSION: Our novel, fully automated, on-site vFFR technology showed excellent diagnostic performance for the detection of lesion-specific ischemia.]]>
Angiography ; Bias (Epidemiology) ; Constriction, Pathologic ; Coronary Angiography ; Fractional Flow Reserve, Myocardial ; Humans ; Ischemia ; Patient-Specific Modeling ; Sensitivity and Specificity

Several reviews have assessed the relationship between exposure to ambient air pollution and adverse birth outcomes during pregnancy, but the results remain controversial. The objective of this study was to assess this correlation quantitatively and to explore sources of heterogeneity. We included all published case-control or cohort studies that evaluated the correlation between ambient air pollution and low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Analytical methods and inclusion criteria were provided on the PROSPERO website (CRD42018085816). We evaluated pooled effects and heterogeneity. Subgroup analyses (grouped by exposure period, study settings, study design, exposure types, data source, Newcastle-Ottawa quality score (NOS), and adjustment for smoking or meteorological factors) were also conducted and publication bias was examined. The risk of bias in systematic reviews (ROBIS) tool was used to evaluate the overall risk of bias in this review. Forty studies met the inclusion criteria. We observed pooled odds ratios (ORs) of 1.03-1.21 for LBW and 0.97-1.06 for PTB when mothers were exposed to CO, NO₂, NO_x, O₃, PM_2.5, PM₁₀, or SO₂ throughout their pregnancy. For SGA, the pooled estimate was 1.02 in relation to NO₂ concentrations. Subgroup analysis and sensitivity analysis decreased the heterogeneity to some extent, such as the subgroups of continuous measures (OR=0.98 (0.97-0.99), I²=0.0%) and NOS>7 (OR=0.98 (0.97-0.99), I²=0.0%) in evaluating the association between PTB and NO₂. This review was completed with a low risk of bias. High concentrations of air pollution were significantly related to the higher risk of adverse birth outcomes. However, the sources of heterogeneity among studies should be further explored.
Air Pollutants/adverse effects* ; Air Pollution/adverse effects* ; Bias ; Environmental Exposure ; Female ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Maternal Exposure ; Odds Ratio ; Pregnancy ; Pregnancy Outcome ; Premature Birth/epidemiology* ; Risk Assessment

PURPOSE: The purpose of this review was to evaluate the effects of emergency nursing simulation program on nursing students and nurses. METHODS: This systematic review was performed as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and using the R program meta package (version 4.9-2). RISS, KISS, and DBpia Library databases were searched for studies published between June 2000 and August 2018 using the following key words: (Emerge* OR nursing) AND (nurs* OR simulation). Selected studies were assessed for methodological quality using Risk of Bias for Non randomized Studies. RESULTS: 7 studies were identified and all of them met the inclusion criteria. The outcome variables were significant clinical performance, self-efficacy except knowledge, and problem-solving ability. CONCLUSION: This review provides updated evidence of the simulation-based education program in emergency nursing. Further studies are required to increase generalizability using randomized population, research design and controlled trials with sufficient sample size. Moreover, valid measurements are needed to assess the main outcomes.
Bias (Epidemiology) ; Education ; Emergencies ; Emergency Nursing ; Humans ; Korea ; Nursing Care ; Nursing ; Research Design ; Sample Size ; Simulation Training ; Students, Nursing

BACKGROUND: Standardization of creatinine assay is consistently performed and much effort has been put into improving the accuracy of the results. We aimed to analyze the results of accuracy-based proficiency testing of creatinine assays performed by the Korea Association of External Quality Assessment Service from 2011 to 2017 to assess the current state of creatinine assays in Korea. METHODS: From 2011 to 2017, the accuracy-based proficiency testing of creatinine was performed twice a year. We analyzed the results obtained from the participating laboratories and calculated the year-wise bias. The acceptable limit of bias was as follows: ±11.4% for creatinine concentration >1.0 mg/dL, and 0.114 mg/dL for creatinine concentration ≤1.0 mg/dL. The trend of bias with the major instruments and reagent manufacturers were analyzed. RESULTS: The number of participating laboratories was 54 in 2011, which gradually increased to 146–178 after 2015. For each of the three samples used in the survey, the percentage of laboratories whose biases in the results were within the acceptable limits was 33.3% for the first time in 2011, which gradually increased to 74.7%–85.0% after 2014. The mean biases in all the results of the participating laboratories were 11.1% in 2011 (1st trial) and 2.4% in 2017 (2nd trial). The biases in the results with the major instruments and reagents differed according to the manufacturers. CONCLUSIONS: The mean bias in the results obtained from the participating laboratories in the accuracy-based proficiency testing of creatinine surveys showed a decreasing trend.
Bias (Epidemiology) ; Creatinine ; Indicators and Reagents ; Korea

OBJECTIVE: To systematically review the evaluation of the diagnostic accuracy of pre-treatment apparent diffusion coefficient (ADC) and change in ADC during the intra- or post-treatment period, for the prediction of locoregional failure in patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: Ovid-MEDLINE and Embase databases were searched up to September 8, 2018, for studies on the use of diffusion-weighted magnetic resonance imaging for the prediction of locoregional treatment response in patients with HNSCC treated with chemoradiation or radiation therapy. Risk of bias was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. RESULTS: Twelve studies were included in the systematic review, and diagnostic accuracy assessment was performed using seven studies. High pre-treatment ADC showed inconsistent results with the tendency for locoregional failure, whereas all studies evaluating changes in ADC showed consistent results of a lower rise in ADC in patients with locoregional failure compared to those with locoregional control. The sensitivities and specificities of pre-treatment ADC and change in ADC for predicting locoregional failure were relatively high (range: 50–100% and 79–96%, 75–100% and 69–95%, respectively). Meta-analytic pooling was not performed due to the apparent heterogeneity in these values. CONCLUSION: High pre-treatment ADC and low rise in early intra-treatment or post-treatment ADC with chemoradiation, could be indicators of locoregional failure in patients with HNSCC. However, as the studies are few, heterogeneous, and at high risk for bias, the sensitivity and specificity of these parameters for predicting the treatment response are yet to be determined.
Bias (Epidemiology) ; Carcinoma, Squamous Cell ; Diffusion ; Epithelial Cells ; Head ; Humans ; Magnetic Resonance Imaging ; Neck ; Population Characteristics ; Sensitivity and Specificity

bias factor of this study and further studies supplementing these factors are needed.]]>
Bias (Epidemiology) ; Cognition ; Humans ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pilot Projects ; Placebos ; Prefrontal Cortex ; Sample Size ; Transcranial Magnetic Stimulation ; Treatment Outcome