Analysis of risk of bias assessments in a sample of intervention systematic reviews, Part II: focus on risk of bias tools reveals few meet current appraisal standards.

Objectives: Risk of bias (RoB) assessment is a critical part of any systematic review (SR). There are multiple tools available for assessing RoB of the studies included in a SR. The conduct of these assessments in intervention SRs are addressed by three items in AMSTAR-2, considered the preferred tool for critically appraising an intervention SR.

Guidance to best tools and practices for systematic reviews.

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards.

Guidance to best tools and practices for systematic reviews.

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards.

Guidance to best tools and practices for systematic reviews.

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards.

Guidance to Best Tools and Practices for Systematic Reviews.

» Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards.

Guidance to best tools and practices for systematic reviews.

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards.

Guidance to best tools and practices for systematic reviews.

Data continue to accumulate indicating that many systematic reviews are methodologically flawed, biased, redundant, or uninformative. Some improvements have occurred in recent years based on empirical methods research and standardization of appraisal tools; however, many authors do not routinely or consistently apply these updated methods. In addition, guideline developers, peer reviewers, and journal editors often disregard current methodological standards.

Self-management and independence guidelines for the care of people with spina bifida.

Self-management and independence behaviors are associated with improved health conditions common to spina bifida such as skin integrity and bowel and bladder management. While most children with spina bifida ultimately achieve basic self-care behaviors, (e.g.

Self-management and spina bifida: A systematic review of the literature.

Background: Self-management is critical to optimizing the health of individuals with a chronic condition or disability and is, therefore, a central concept in individual and family-centered healthcare delivery. The purpose of this review is to report the state of the science of self-management for individuals with spina bifida (SB) from a lifespan perspective.

Objective: This review will summarize the (a) development and use of self-management skills and behaviors across the life span, (b) factors related to self-management behaviors, (c) development of generic or condition-specific measures of self-management used with a spina bifida population, and (d) development and/or outcomes of interventions to improve self-management in SB.

Interrater reliability and convergent validity of the American Academy for Cerebral Palsy and Developmental Medicine methodology for conducting systematic reviews.

Aim: The aim of this study was to evaluate the interrater reliability and convergent validity of the American Academy for Cerebral Palsy and Developmental Medicine's (AACPDM) methodology for conducting systematic reviews (group design studies).

Method: Four clinicians independently rated 24 articles for the level of evidence and conduct using AACPDM methodology. Study conduct was also assessed using the Effective Public Health Practice Project scale.

Rehabilitation techniques to maximize spasticity management.

Improvement in functional skills is typically a goal of spasticity management. Spasticity management alone will improve the positive signs of the upper motor neuron syndrome without functional change. In this review, we demonstrate that a variety of therapy modalities are required to facilitate these improvements and impact the negative signs of the upper motor neuron syndrome.

Intrathecal baclofen in cerebral palsy: A decade of treatment outcomes.

Continuous intrathecal baclofen (CITB) is considered a standard treatment for spasticity in patients with cerebral palsy (CP). This review summarizes the recent literature and assesses the evidence for the efficacy of ITB for spasticity and its related sequelae in patients with CP. The literature was searched using electronic databases and reference lists from March 2000 through April 2007.

A review of the complications of intrathecal baclofen in patients with cerebral palsy.

Intrathecal baclofen (ITB) has become a standard treatment for spasticity in patients with cerebral palsy (CP) over the last ten years. This review summarizes and assesses the evidence for the safety of ITB in patients with CP. The literature was searched using electronic databases and reference lists from March 2000 through April 2007.

Autologous blood injection and botulinum toxin for resistant plantar fasciitis accompanied by spasticity.

An originally ambulatory 18-yr-old woman with spastic left hemiplegic cerebral palsy developed left plantar fasciitis with a gradual loss of function requiring use of a wheelchair. Her symptoms were resistant to physical therapy. Two hundred units of botulinum toxin A was diluted in 4 mL of saline and injected into the gastrocnemius.

Facts and myths about therapeutic interventions in cerebral palsy: integrated goal development.

This article explores a variety of myths and facts about therapy for children who have cerebral palsy. Current evidence is used to refute popular myths and debunk harmful ones. A way of integrating interventions is suggested and a planning process for timing interventions is proposed.

Human Immunodeficiency Virus Infection: Complications and Outcome of Orthopaedic Surgery.

Orthopaedic surgeons practicing in areas with a high prevalence of human immunodeficiency virus (HIV) infection may expect that up to 7% of their patients who undergo emergent procedures and 1% to 3% of those who undergo elective surgery will be HIV-positive. Although basic science studies have demonstrated impairment of defenses to routine orthopaedic pathogens as well as to opportunistic organisms, clinical studies have shown that this impairment has not resulted in an increased incidence of postoperative infections or failure of wound healing in the asymptomatic HIV-positive patient. Even for the symptomatic patient, current medical management appears adequate to reduce the risk of early postoperative infection.

Vertical changes in high mandibular plane cases following enucleation of second premolars.

The records of 23 patients who underwent mandibular second premolar enucleation in the early mixed dentition were studied. The patients were selected at random from a group which had mandibular plane angles in excess of 38 degrees to SN and had not worn headgear prior to mechanical orthodontic therapy. Pre- and posttreatment measurements were compared to measurements made in an earlier study by Isaacson et al.