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AbstractObjectiveTo determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression.DesignIndividual participant data meta-analysis.Data sourcesMedline, Medline In-Process and Other Non-Indexed Citations, PsycINFO, and Web of Science (January 2000-February 2015).Inclusion criteriaEligible studies compared PHQ-9 scores with major depression diagnoses from validated diagnostic interviews. Primary study data and study level data extracted from primary reports were synthesized. For PHQ-9 cut-off scores 5-15, bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, among studies that used semistructured diagnostic interviews, which are designed for administration by clinicians; fully structured interviews, which are designed for lay administration; and the Mini International Neuropsychiatric (MINI) diagnostic interviews, a brief fully structured interview. Sensitivity and specificity were examined among participant subgroups and, separately, using meta-regression, considering all subgroup variables in a single model.ResultsData were obtained for 58 of 72 eligible studies (total n=17 357; major depression cases n=2312). Combined sensitivity and specificity was maximized at a cut-off score of 10 or above among studies using a semistructured interview (29 studies, 6725 participants; sensitivity 0.88, 95% confidence interval 0.83 to 0.92; specificity 0.85, 0.82 to 0.88). Across cut-off scores 5-15, sensitivity with semistructured interviews was 5-22% higher than for fully structured interviews (MINI excluded; 14 studies, 7680 participants) and 2-15% higher than for the MINI (15 studies, 2952 participants). Specificity was similar across diagnostic interviews. The PHQ-9 seems to be similarly sensitive but may be less specific for younger patients than for older patients; a cut-off score of 10 or above can be used regardless of age..ConclusionsPHQ-9 sensitivity compared with semistructured diagnostic interviews was greater than in previous conventional meta-analyses that combined reference standards. A cut-off score of 10 or above maximized combined sensitivity and specificity overall and for subgroups.RegistrationPROSPERO CRD42014010673.

AbstractObjectiveTo evaluate the accuracy of the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) to screen for major depression among people with physical health problems.DesignSystematic review and individual participant data meta-analysis.Data sourcesMedline, Medline In-Process and Other Non-Indexed Citations, PsycInfo, and Web of Science (from inception to 25 October 2018).Review methodsEligible datasets included HADS-D scores and major depression status based on a validated diagnostic interview. Primary study data and study level data extracted from primary reports were combined. For HADS-D cut-off thresholds of 5-15, a bivariate random effects meta-analysis was used to estimate pooled sensitivity and specificity, separately, in studies that used semi-structured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders), fully structured interviews (eg, Composite International Diagnostic Interview), and the Mini International Neuropsychiatric Interview. One stage meta-regression was used to examine whether accuracy was associated with reference standard categories and the characteristics of participants. Sensitivity analyses were done to assess whether including published results from studies that did not provide raw data influenced the results.ResultsIndividual participant data were obtained from 101 of 168 eligible studies (60%; 25 574 participants (72% of eligible participants), 2549 with major depression). Combined sensitivity and specificity was maximised at a cut-off value of seven or higher for semi-structured interviews, fully structured interviews, and the Mini International Neuropsychiatric Interview. Among studies with a semi-structured interview (57 studies, 10 664 participants, 1048 with major depression), sensitivity and specificity were 0.82 (95% confidence interval 0.76 to 0.87) and 0.78 (0.74 to 0.81) for a cut-off value of seven or higher, 0.74 (0.68 to 0.79) and 0.84 (0.81 to 0.87) for a cut-off value of eight or higher, and 0.44 (0.38 to 0.51) and 0.95 (0.93 to 0.96) for a cut-off value of 11 or higher. Accuracy was similar across reference standards and subgroups and when published results from studies that did not contribute data were included.ConclusionsWhen screening for major depression, a HADS-D cut-off value of seven or higher maximised combined sensitivity and specificity. A cut-off value of eight or higher generated similar combined sensitivity and specificity but was less sensitive and more specific. To identify medically ill patients with depression with the HADS-D, lower cut-off values could be used to avoid false negatives and higher cut-off values to reduce false positives and identify people with higher symptom levels.Trial registrationPROSPERO CRD42015016761.

According to the latest reports from WHO, the incidence of antibiotic-resistant bacterial infections is increasing worldwide, resulting in increased morbidity and mortality and a rising pressure on health-care systems. However, the development of new antibiotics is an expensive and time-consuming process, urging scientists to seek alternative antimicrobial strategies. Over the past few decades, the concept of therapeutic administration of bacteriophages (also known as phages) has gained popularity worldwide. Although conceptually promising, the widespread implementation of phage therapy in routine clinical practice is restricted by the scarcity of safety and efficacy data obtained according to the strict standards of the applicable clinical trial regulations. In this systematic review, we list clinical data published between Jan 1, 2000 and Aug 14, 2021 on the safety and efficacy of phage therapy for difficult-to-treat bacterial infections, and provide an overview of trials and case studies on the use of phage therapy in several medical disciplines.

An interdisciplinary team of university faculty members collaborated to develop an intervention to address a deficiency in student information literacy skills. The team developed video modules that instruct users how to create, use and maintain a ProQuest RefWorks account; a citation management software (CMS) tool that is compatible with Google Docs word processing. The research team collected YouTube and ProQuest RefWorks analytics as well as pre/post survey data from university students who participated in a pilot using the video modules. Results indicate that the modules impacted student information literacy skills; specifically, in-text citation and referencing. Based on the results, we also describe next steps for this research.

Systematic reviews and meta-analyses are proliferating as they are an important building block to inform evidence-based guidelines and decision-making. Enforcement of best practice in clinical trials is firmly on the research agenda of good clinical practice, but there is less clarity as to how evidence syntheses that combine these studies can be influenced by bad practice. Our aim was to conduct a living systematic review of articles that highlight flaws in published systematic reviews to formally document and understand these problems. We conducted a comprehensive assessment of all literature examining problems, which relate to published systematic reviews. The first iteration of our living systematic review (https://systematicreviewlution.com/) has found 485 articles documenting 67 discrete problems relating to the conduct and reporting of systematic reviews which can potentially jeopardize their reliability or validity. Many hundreds of articles highlight that there are many flaws in the conduct, methods, and reporting of published systematic reviews, despite the existence and frequent application of guidelines. Considering the pivotal role that systematic reviews have in medical decision-making due to having apparently transparent, objective, and replicable processes, a failure to appreciate and regulate problems with these highly cited research designs is a threat to credible science. [Display omitted] •Living systematic review to organize and understand problems with published systematic reviews.•Comprehensive searches between 2000 and 2022 identified 485 included articles pertaining to 67 discrete problems with systematic reviews.•Problems with systematic reviews relate to their ability to be comprehensive, rigorous, transparent, and objective.•Not all problems are covered by existing systematic review guidelines and methods.•This living research aims to be a learning resource to improve the reliability and validity of future systematic reviews.

AbstractObjectiveTo update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression overall and by study or participant subgroups.DesignSystematic review and individual participant data meta-analysis.Data sourcesMedline, Medline In-Process, and Other Non-Indexed Citations via Ovid, PsycINFO, Web of Science searched through 9 May 2018.Review methodsEligible studies administered the PHQ-9 and classified current major depression status using a validated semistructured diagnostic interview (designed for clinician administration), fully structured interview (designed for lay administration), or the Mini International Neuropsychiatric Interview (MINI; a brief interview designed for lay administration). A bivariate random effects meta-analytic model was used to obtain point and interval estimates of pooled PHQ-9 sensitivity and specificity at cut-off values 5-15, separately, among studies that used semistructured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual), fully structured interviews (eg, Composite International Diagnostic Interview), and the MINI. Meta-regression was used to investigate whether PHQ-9 accuracy correlated with reference standard categories and participant characteristics.ResultsData from 44 503 total participants (27 146 additional from the update) were obtained from 100 of 127 eligible studies (42 additional studies; 79% eligible studies; 86% eligible participants). Among studies with a semistructured interview reference standard, pooled PHQ-9 sensitivity and specificity (95% confidence interval) at the standard cut-off value of ≥10, which maximised combined sensitivity and specificity, were 0.85 (0.79 to 0.89) and 0.85 (0.82 to 0.87), respectively. Specificity was similar across reference standards, but sensitivity in studies with semistructured interviews was 7-24% (median 21%) higher than with fully structured reference standards and 2-14% (median 11%) higher than with the MINI across cut-off values. Across reference standards and cut-off values, specificity was 0-10% (median 3%) higher for men and 0-12 (median 5%) higher for people aged 60 or older.ConclusionsResearchers and clinicians could use results to determine outcomes, such as total number of positive screens and false positive screens, at different PHQ-9 cut-off values for different clinical settings using the knowledge translation tool at www.depressionscreening100.com/phq.Study registrationPROSPERO CRD42014010673.

Background Monitoring resistance training has a range of unique difficulties due to differences in physical characteristics and capacity between athletes, and the indoor environment in which it often occurs. Traditionally, methods such as volume load have been used, but these have inherent flaws. In recent times, numerous portable and affordable devices have been made available that purport to accurately and reliably measure kinetic and kinematic outputs, potentially offering practitioners a means of measuring resistance training loads with confidence. However, a thorough and systematic review of the literature describing the reliability and validity of these devices has yet to be undertaken, which may lead to uncertainty from practitioners on the utility of these devices. Objective A systematic review of studies that investigate the validity and/or reliability of commercially available devices that quantify kinetic and kinematic outputs during resistance training. Methods Following PRISMA guidelines, a systematic search of SPORTDiscus, Web of Science, and Medline was performed; studies included were (1) original research investigations; (2) full-text articles written in English; (3) published in a peer-reviewed academic journal; and (4) assessed the validity and/or reliability of commercially available portable devices that quantify resistance training exercises. Results A total of 129 studies were retrieved, of which 47 were duplicates. The titles and abstracts of 82 studies were screened and the full text of 40 manuscripts were assessed. A total of 31 studies met the inclusion criteria. Additional 13 studies, identified via reference list assessment, were included. Therefore, a total of 44 studies were included in this review. Conclusion Most of the studies within this review did not utilise a gold-standard criterion measure when assessing validity. This has likely led to under or overreporting of error for certain devices. Furthermore, studies that have quantified intra-device reliability have often failed to distinguish between technological and biological variability which has likely altered the true precision of each device. However, it appears linear transducers which have greater accuracy and reliability compared to other forms of device. Future research should endeavour to utilise gold-standard criterion measures across a broader range of exercises (including weightlifting movements) and relative loads.

When conducting exhaustive searches for systematic reviews, information professionals search multiple databases with overlapping content. They typically remove duplicate records to reduce the reviewers' workload associated with screening titles and abstracts; sometimes the reviewers remove the duplicates. Several articles have been published recently on de-duplication methods. In the authors' opinion, these methods are either very time consuming or impractical, as they require uploading large files to an online platform. A recent overview article compared existing software programs but found that none was truly satisfactory. Unique identifiers for journal articles are digital object identifiers (DOIs) and PubMed IDs (PMIDs). However, these identifiers are not present in every database. When they are present, they often cannot be exported easily. Thus, they cannot be relied upon to identify duplicates. An alternative involves using pagination, because the often large page numbers in scientific journals, in combination with other fields, can serve as a type of unique identifier.

Background Fixture congestion (defined as a minimum of two successive bouts of match-play, with an inter-match recovery period of < 96 h) is a frequent and contemporary issue in professional soccer due to increased commercialisation of the sport and a rise in the number of domestic and international cup competitions. To date, there is no published systematic review or meta-analysis on the impact of fixture congestion on performance during soccer match play. Objective We sought to conduct a systematic review and meta-analysis of the literature related to the effects of fixture congestion on physical, technical, and tactical performance in professional soccer match-play. Methods Adhering to PRISMA guidelines and following pre-registration with the Open Science Framework ( https://osf.io/fqbuj ), a comprehensive and systematic search of three research databases was conducted to identify articles related to soccer fixture congestion. For inclusion in the systematic review and meta-analysis, studies had to include male professional soccer players, a congestion period that contained two matches ≤ 96 h, and have outcome measures related to physical, technical or tactical performance. Exclusion criteria comprised non-male and/or youth players, data that only assessed impact of congestion on injury, used simulated protocols, or were grey literature, such as theses or dissertations. Results Out of sixteen articles included in the systematic review, only five were eligible for the meta-analysis, and the only variable that was measured consistently across studies was total distance covered. Fixture congestion had no impact on total distance covered [ p  = 0.134; pooled standardized mean difference; Hedge’s G  = 0.12 (− 0.04, 0.28)]. Between-study variance, heterogeneity, and inconsistency across studies were moderate [Cochrane’s Q  = 6.7, p  = 0.150, I 2  = 40.7% (CI 0.00, 93.34)]. Data from articles included in the systematic review suggest fixture congestion has equivocal effects on physical performance, with variation between studies and low quality of research design in some instances. Tactical performance may be negatively impacted by fixture congestion; however, only one article was identified that measured this element. Technical performance is unchanged during fixture congestion; however, again, research design and the sensitivity and relevance of methods and variables require improvement. Conclusion Total distance covered is not impacted by fixture congestion. However, some studies observed a negative effect of fixture congestion on variables such as low- and moderate-intensity distance covered, perhaps suggesting that players employ pacing strategies to maintain high-intensity actions. There is a lack of data on changes in tactical performance during fixture congestion. With ever increasing numbers of competitive matches scheduled, more research needs to be conducted using consistent measures of performance (e.g., movement thresholds) with an integration of physical, technical and tactical aspects.

Objectives The lack of a common definition for precarious employment (PE) severely hampers the comparison of studies within and between countries, consequently reducing the applicability of research findings. We carried out a systematic review to summarize how PE has been conceptualized and implemented in research and identify the construct's dimensions in order to facilitate guidance on its operationalization. Methods According to PRISMA guidelines, we searched Web of Science and Scopus for publications with variations of PE in the title or abstract. The search returned 1225 unique entries, which were screened for eligibility. Exclusion criteria were (i) language other than English, (ii) lack of a definition for PE, and (iii) non-original research. A total of 63 full-text articles were included and qualitative thematic-analysis was performed in order to identify dimensions of PE. Results We identified several theory-based definitions of PE developed by previous researchers. Most definitions and operationalizations were either an accommodation to available data or the direct result of qualitative studies identifying themes of PE. The thematic-analysis of the selected articles resulted in a multidimensional construct including the following three dimensions: employment insecurity, income inadequacy, and lack of rights and protection. Conclusions Despite a growing number of studies on PE, most fail to clearly define the concept, severely restricting the advancement of the research of PE as a social determinant of health. Our combined theoretical and empirical review suggests that a common multidimensional definition could be developed and deployed in different labor market contexts using a variety of methodological approaches.