Publications by authors named "Sunita Vohra"
Background: Increasing evidence has emerged for traditional, complementary and integrative medicine (TCIM) to treat COVID-19 which requires systematic summaries of the net benefits of interventions against standard care and one another. The study aims to conduct a systematic review and network meta-analysis (NMA) regarding TCIM therapies for treating mild/moderate acute COVID-19, potentially informing the WHO guideline development and clinical decision-making.
Methods And Analysis: We will search Embase, MEDLINE, Virtual Health Library on Traditional Complementary and Integrative Medicine, Cochrane Central Register of Controlled Trials, WHO's International Clinical Trials Registry Platform with additional searches of Chinese and Korean literature sources for randomised controlled trials comparing TCIM with placebo, standard care, no treatment or with an alternate type of TCIM to treat COVID-19.
Article Synopsis
- Trial registration is essential for reducing bias and enhancing transparency in clinical research, particularly regarding medication trials.
- This study examined how trial registration status affects harm estimates in randomized controlled trials, analyzing data from systematic reviews published between 2015 and 2020.
- Results showed that prospectively registered trials reported higher odds of harm compared to non-registered and retrospectively registered trials, while no significant difference was found between non-registered and retrospectively registered trials.
This prospective, community-based, active surveillance study aimed to report the incidence of moderate, severe, and serious adverse events (AEs) after chiropractic (n = 100) / physiotherapist (n = 50) visit in offices throughout North America between October-2015 and December-2017. Three content-validated questionnaires were used to collect AE information: two completed by the patient (pre-treatment [T0] and 2-7 days post-treatment [T2]) and one completed by the provider immediately post-treatment [T1]. Any new or worsened symptom was considered an AE and further classified as mild, moderate, severe or serious.
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- The study investigates how the lack of blinding in randomized controlled trials affects the estimation of medication-related harms, highlighting that this issue is often overlooked.
- Researchers analyzed 629 meta-analyses involving over 10,000 trials, focusing on both blinded and non-blinded conditions, and found that non-blinded trials tended to significantly underestimate harms.
- The results suggest that not properly blinding participants and healthcare providers can lead to flawed assessments of medication risks, emphasizing the importance of adequate blinding in trials when possible.
Article Synopsis
- - This review examines the effectiveness of scalable mind-body internet and mobile-based interventions (IMIs), such as cognitive behavioral therapy and yoga, on reducing depression and anxiety in adults with chronic health conditions, based on data from various randomized controlled trials.
- - The analysis found a significant reduction in symptoms, with medium effect sizes for both depression (SMD = -0.33) and anxiety (SMD = -0.26), indicating that these interventions can be helpful alternatives to medication.
- - Recommendations include improving participant demographic data reporting, especially regarding technology use, and further researching non-CBT interventions to enhance understanding and effectiveness in this field.
Article Synopsis
- Randomized controlled trials (RCTs) are essential for studying the effects of healthcare interventions, emphasizing the importance of reporting both benefits and harms.
- The CONSORT Harms 2022 has been developed to replace the older CONSORT Harms 2004 checklist, enhancing the way harms are reported in trials by modifying 13 items and adding 3 new ones.
- The article outlines how CONSORT Harms 2022 integrates with the main CONSORT checklist, urging authors and reviewers to adopt this updated approach until future guidelines are released.
Objectives: In evidence synthesis practice, dealing with studies with no cases in both arms has been a tough problem, for which there is no consensus in the research community. In this study, we propose a method to measure the potential impact of studies with no cases for meta-analysis results which we define as harms index (Hi) and benefits index (Bi) as an alternative solution for deciding how to deal with such studies.
Methods: Hi and Bi are defined by the minimal number of cases added to the treatment arm (Hi) or control arm (Bi) of studies with no cases in a meta-analysis that lead to a change of the direction of the estimates or its statistical significance.
Article Synopsis
- Opioid use disorder (OUD) is a major cause of preventable deaths among young people globally, and this study aims to understand its connection with preexisting mental health conditions.
- A retrospective study involving 1,848 individuals with OUD and 7,392 matched controls from Alberta, Canada, analyzed the link between OUD and conditions like anxiety, depression, and alcohol-related disorders.
- The results indicated that young people with anxiety or depressive disorders have a significantly higher risk for developing OUD, especially when combined with alcohol-related issues, highlighting the need for early identification and intervention.
Article Synopsis
- Clear and complete information on study outcomes in clinical trial protocols is essential for regulatory approvals, standardized practices, and transparency in research, but current guidance on these requirements is inconsistent.
- To address these gaps, there's a need for harmonized standards that integrate with existing frameworks like the SPIRIT 2013 statement.
- The SPIRIT-Outcomes 2022 extension was developed through expert consultations, a comprehensive review of existing guidelines, and a structured voting process among international panelists to establish essential reporting items for trial outcomes.*
Article Synopsis
- * The goal is to create unified standards for reporting trial outcomes by integrating new guidelines with the existing CONSORT 2010 statement.
- * A thorough review, expert consultations, and an international voting process led to identifying 128 recommendations for better outcome reporting, most of which were not covered by the previous CONSORT 2010 statement.
Article Synopsis
- Paediatric anxiety disorders (AD) affect 10-20% of children and adolescents globally, but there is a lack of understanding regarding effective treatments due to variable outcomes in research trials.
- This scoping review aims to systematically identify and synthesize the outcomes reported in trials focused on interventions for paediatric AD, utilizing a robust methodology for article selection and analysis.
- The findings will be shared with clinicians and researchers to enhance outcome measurement in trials and contribute to the creation of a Core Outcome Set specifically for paediatric AD studies.
Article Synopsis
- The study aimed to evaluate the validity of data extraction in systematic reviews of adverse events, assess the impact of errors on results, and create a framework for classifying these errors.
- Data was sourced from PubMed, focusing on systematic reviews of randomized controlled trials related to healthcare interventions published between January 2015 and January 2020.
- Results showed that data extraction errors occurred in 17% of trials, with common types being numerical errors (49.2%) and ambiguous errors (29.9%), affecting the credibility of 85.1% of the reviewed systematic reviews.
N-of-1 Trials, Their Reporting Guidelines, and the Advancement of Open Science Principles.
Harv Data Sci Rev
September 2022
Article Synopsis
- * Best practices like the SPENT and CENT guidelines promote transparent reporting and contribute to the goals of open science, which aims to enhance research collaboration and accessibility.
- * While N-of-1 trials foster patient-centered research and greater equity, they also highlight concerns about post hoc analysis monitoring and confidentiality, particularly for sensitive data in rare diseases.
Article Synopsis
- Shared decision-making (SDM) involves incorporating patients' values and preferences in clinical decisions and may be useful for treating opioid use disorder (OUD), but its effectiveness is not well established.
- A scoping review analyzed 14 peer-reviewed studies, focusing on how adult patients with OUD engage in their treatment decisions, but none used validated measures for SDM.
- Though some studies indicated potential benefits of SDM in improving patient outcomes, further research is needed to fully understand its impact and effectiveness in OUD treatment.*
Article Synopsis
- Patient safety research is shifting towards community healthcare, highlighting existing knowledge gaps in manual therapy professions that could hinder safety initiatives in musculoskeletal care.* -
- The study explored chiropractors' and physiotherapists' views on patient safety linked to spinal manipulation therapy, using the SafetyNET Survey and thematic analysis to identify key perceptions and influences.* -
- Results revealed five themes related to patient safety, emphasizing the importance of collaboration, standardization, and addressing fears among healthcare providers, aligning with WHO principles on enhancing patient safety strategies in different healthcare environments.*
Introduction: Many individuals living with HIV use natural health products (NHPs) in an effort to decrease medication side effects and to enhance overall well-being.
Methods: An active surveillance study of adult patients (≥ 18 years) with HIV was conducted between 2012 and 2014 to detect prescription drug and NHP use and associated adverse events (AEs) in the last month.
Results: Of the 167 participants, 85 (50.
Article Synopsis
- Mental illness significantly contributes to non-fatal disease worldwide, leading patients to seek natural health products (NHPs) as safer alternatives to conventional medications, despite unknown risks of adverse events (AEs) and interactions with prescribed drugs.
- The study aimed to assess the prevalence of adult mental health patients using only prescription meds, only NHPs, both, or neither, and to identify common products and AEs experienced in the past month.
- Results showed that among 3079 patients, those using both NHPs and prescriptions reported the highest AEs (58.8%), suggesting that combining these increases the risk of experiencing adverse effects compared to those using only one type of treatment.
Article Synopsis
- The study aims to understand how to effectively integrate complementary therapies into conventional pediatric care by examining the experiences of parents, healthcare providers, and therapy providers.
- Conducted in a Canadian children's hospital, the qualitative research involved interviews with 50 individuals to identify key factors that facilitate this integration.
- Findings suggest that open-mindedness, effective communication, and a willingness to redefine positive outcomes can help overcome barriers to combining complementary and conventional therapies in hospital settings.
Article Synopsis
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a long-term illness characterized by severe fatigue, cognitive issues, and changes in sleep and bodily functions.
- A systematic review was conducted to evaluate the effectiveness of mind-body interventions (MBIs) like mindfulness and relaxation techniques in treating ME/CFS symptoms in adults.
- The review identified 12 relevant studies, showing that MBIs can lead to improvements in fatigue, anxiety/depression, and quality of life, although issues like small sample sizes and potential bias highlight the need for more standardized research in this area.
Backgrounds: Zero-events studies frequently occur in systematic reviews of adverse events, which consist of an important source of evidence. We aimed to examine how evidence of zero-events studies was utilized in the meta-analyses of systematic reviews of adverse events.
Methods: We conducted a survey of systematic reviews published in two periods: January 1, 2015, to January 1, 2020, and January 1, 2008, to April 25, 2011.
Article Synopsis
- * A systematic review analyzed data from various medical databases to identify AEs in studies involving children up to 21 years old participating in MBIs, including 441 primary studies.
- * Out of the studies reviewed, 85.5% did not report any AEs, while only 21 studies reported AEs, revealing a total of 37 AEs, mostly unreported in terms of severity or duration, indicating a significant gap in safety data for MBIs used in children.