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The Prevalence Of Autism Spectrum Disorders In China: A Comprehensive Meta-Analysis, Fei Wang, Li Lu, Shi-Bin Wang, Ling Zhang, Chee H. Ng, Gabor S. Ungvari, Xiao-Lan Cao, Jian-Ping Lu, Cai-Lan Hou, Fu-Jun Jia, Yu-Tao Xiang

Medical Papers and Journal Articles

There are conflicting prevalence estimates of autism spectrum disorders (ASDs) in mainland China (China thereafter). This study is a comprehensive meta-analysis of the pooled prevalence of ASDs in the general population in China. Study investigators independently conducted a systematic literature search of the following databases: PubMed, EMBASE, PsycINFO, China National Knowledge Infrastructure, Chinese biomedical literature service system, and Wan Fang. Studies reporting prevalence of ASDs and autism in Chinese population were identified and analysed using the Comprehensive Meta-Analysis program with the random effects model. Forty-four studies were included in the meta-analysis comprising 2,337,321 subjects of whom 46.66 % were females. …

Physician-Assisted Suicide And Euthanasia: Emerging Issues From A Global Perspective, Charles L. Sprung, Margaret Somerville, Lukas Radbruch, Nathalie Steiner Collet, Gunnar Duttge, Jefferson P. Piva, Massimo Antonelli, Daniel P. Sulmasy, Willem Lemmens, E Wesley Ely

Medical Papers and Journal Articles

Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn’t be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and violated, including administering lethal drugs without patient consent, absence of terminal illness, untreated psychiatric diagnoses, and nonreporting; 2. Lack of self-determination: Psychological and social motives characterize requests for PAS-E more than physical symptoms or rational choices; many requests disappear with improved symptom control and psychological support; 3. Inadequate palliative care: Better palliative care makes most patients …

Looking Both Ways: A Review Of Methods For Assessing Research Impacts On Policy And The Policy Utilisation Of Research, Robyn S. Newson, Lesley A. King, Lucie Rychetnik, Andrew J. Milat, Adrian E. Bauman

Medical Papers and Journal Articles

Background: Measuring the policy and practice impacts of research is becoming increasingly important. Policy impacts can be measured from two directions – tracing forward from research and tracing backwards from a policy outcome. In this review, we compare these approaches and document the characteristics of studies assessing research impacts on policy and the policy utilisation of research.

Methods: Keyword searches of electronic databases were conducted in December 2016. Included studies were published between 1995 and 2016 in English and reported methods and findings of studies measuring policy impacts of specified health research, or research use in relation to a specified …

Does Citation Matter? Research Citation In Policy Documents As An Indicator Of Research Impact – An Australian Obesity Policy Case-Study, Robyn Newson, Lucie Rychetnik, Lesley King, Andrew Milat, Adrian Bauman

Medical Papers and Journal Articles

Background: Citation of research in policy documents has been suggested as an indicator of the potential longer-term impacts of research. We investigated the use of research citations in childhood obesity prevention policy documents from New South Wales (NSW), Australia, considering the feasibility and value of using research citation as a proxy measure of research impact.

Methods: We examined childhood obesity policy documents produced between 2000 and 2015, extracting childhood obesity-related references and coding these according to reference type, geographical origin and type of research. A content analysis of the policy documents examined where and how research was cited in the …

Exploring Tutor Perceptions And Current Practices In Facilitating Diagnostic Reasoning In Preclinical Medical Students: Implications For Tutor Professional Development Needs, Jane E. Keir, Shannon L. Saad, Lorna Davin

Medical Papers and Journal Articles

Introduction: This study explores tutors’ experience of teaching diagnostic reasoning (DR) – a key component of clinical reasoning – to build understanding into the use of explicit strategies in facilitating development of DR skills in preclinical medical students.

Methods: A qualitative, interpretive study was undertaken with 14 preclinical problem-based learning tutors who participated in semi-structured interviews. A thematic analysis was conducted to identify key factors that influence students’ learning of diagnostic reasoning.

Results: Tutor dispositions towards facilitating learning of DR were variable in this study. Explicit strategies to teach DR were thought to exert positive influences on the development of …

A Profiling Analysis Of Contributions Of Cigarette Smoking, Dietary Calcium Intakes, And Physical Activity To Fragility Fracture In The Elderly, Thuy T. Pham, Diep N. Nguyen, Eryk Dutkiewicz, Jacqueline R. Center, John A. Eisman, Tuan V. Nguyen

Medical Papers and Journal Articles

Fragility fracture and bone mineral density (BMD) are influenced by common and modifiable lifestyle factors. In this study, we sought to define the contribution of lifestyle factors to fracture risk by using a profiling approach. The study involved 1683 women and 1010 men (50+ years old, followed up for up to 20 years). The incidence of new fractures was ascertained by X-ray reports. A “lifestyle risk score” (LRS) was derived as the weighted sum of effects of dietary calcium intake, physical activity index, and cigarette smoking. Each individual had a unique LRS, with higher scores being associated with a healthier …

Perceptions Of Shared Care Among Survivors Of Colorectal Cancer From Non-English-Speaking And English-Speaking Backgrounds: A Qualitative Study, Lawrence Tan, Gisselle Gallego, Thi T.C Nguyen, Les Bokey, Jennifer Reath

Medical Papers and Journal Articles

Background: Colorectal cancer (CRC) survivors experience difficulty navigating complex care pathways. Sharing care between GPs and specialist services has been proposed to improve health outcomes in cancer survivors following hospital discharge. Culturally and Linguistically Diverse (CALD) groups are known to have poorer outcomes following cancer treatment but little is known about their perceptions of shared care following surgery for CRC. This study aimed to explore how non-English-speaking and English-speaking patients perceive care to be coordinated amongst various health practitioners.

Methods: This was a qualitative study using data from face to face semi-structured interviews and one focus group in a culturally …

Prevalence Of Insomnia Symptoms And Their Associated Factors In Patients Treated In Outpatient Clinics Of Four General Hospitals In Guangzhou, China, Wei Zheng, Xin-Ni Luo, Hai-Yan Li, Xiao-Yin Ke, Qing Dai, Chan-Juan Zhang, Chee H. Ng, Gabor S. Ungvari, Yu-Tao Ziang, Yu-Ping Ning

Medical Papers and Journal Articles

Background: Data on the prevalence of insomnia symptoms in medical outpatient clinics in China are lacking. This study examined the prevalence of insomnia symptoms and their socio-demographic correlates in patients treated at medical outpatient clinics affiliated with four general hospitals in Guangzhou, a large metropolis in southern China.

Method: A total of 4399 patients were consecutively invited to participate in the study. Data on insomnia and its socio-demographic correlates were collected with standardized questionnaires.

Results: The prevalence of any type of insomnia symptoms was 22.1% (95% confidence interval (CI): 20.9–23.3%); the prevalence of difficulty initiating sleep was 14.3%, difficulty maintaining …

Healing Conversations: Developing A Practical Framework For Clinical Communication Between Aboriginal Communities And Healthcare Practitioners, Andrea Mckivett, David Paul, Nicky Hudson

Medical Papers and Journal Articles

In recognition of the ongoing health disparities experienced by Aboriginal and Torres Strait Islander peoples (hereafter Aboriginal), this scoping review explores the role and impact of the clinical communication process on Aboriginal healthcare provision. A medical education lens is applied, looking at the utility of a tailored clinical communication framework to assist health practitioners work more effectively with Aboriginal peoples and communities. The initial framework, building on existing communication guides, proposes four domains: content, process, relational and environmental. It places emphasis on critical self-reflection of the health practitioner’s own cultural identity and will be guided by collective Aboriginal world-views in …

Qualitative Methods In Pharmacy Research, Gisselle Gallego, Lotte Stig Norgaard

Medical Papers and Journal Articles

Over the past years, there has been an increase in the use of qualitative methods in health services research, including pharmacy research. Pharmacy practice researchers can use these methods to understand, explain, discover, and explore both patients’ and health care practitioners’ thoughts, perceptions, and feelings. Qualitative research can also be used for the “democratisation” of research methods through research that is inclusive, collaborative, and involves partnerships and co-production. There is a wide spectrum of qualitative research methods that might be used in pharmacy research. This Special Issue showcases five articles in different settings and countries with diverse participants that seek …

Adherence To Prescribing Restrictions For Her2-Positive Metastatic Breast Cancer In Australia: A National Population-Based Observational Study (2001-2016), Benjamin Daniels, Federico Girosi, Hanna Tervonen, Belinda E. Kiely, Sarah J. Lord, Nehmat Houssami, Sally-Anne Pearson

Medical Papers and Journal Articles

Background: Targeted cancer therapy is often complex, involving multiple agents and chemotherapeutic partners. In Australia, prescribing restrictions are put in place to reflect existing evidence of cost-effectiveness of these medicines. As therapeutic options continue to expand, these restrictions may not be perceived to align with best practice and it is not known if their use in the real-world clinic adheres to these restrictions. We examined the treatment of women receiving trastuzumab for HER2-positive metastatic breast cancer (HER2+MBC) to determine the extent to which treatment adhered to national prescribing restrictions.

Patients and methods: Our population-based, retrospective cohort study used dispensing records …

A Research And Evaluation Capacity Building Model In Western Australia, Roanna Lobo, Gemma Crawford, Jonathan Hallett, Sue Laing, Donna B. Mak, Jonine Jancey, Sally Rowell, Kahlia Mccausland, Lisa Bastian, Anne Sorenson, P.J. Matt Tilley, Simon Yam, Jude Comfort, Sean Brennan, Maryanne Doherty

Medical Papers and Journal Articles

Evaluation of public health programs, services and policies is increasingly required to demonstrate effectiveness. Funding constraints necessitate that existing programs, services and policies be evaluated and their findings disseminated. Evidence-informed practice and policy is also desirable to maximise investments in public health. Partnerships between public health researchers, service providers and policymakers can help address evaluation knowledge and skills gaps. The Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (SiREN) aims to build research and evaluation capacity in the sexual health and blood-borne virus sector in Western Australia (WA). Partners’ perspectives of the SiREN model after 2 …

Variations In The Management Of Acute Illness In Children With Congenital Adrenal Hyperplasia: An Audit Of Three Paediatric Hospitals, Georgina L. Chrisp, Ann M. Maguire, Maria Quartararo, Henrik Falhammar, Bruce R. King, Craig F. Munns, David J. Torpy, Shihab Hameed, R Louise Rushworth

Medical Papers and Journal Articles

Objective: Episodes of acute adrenal insufficiency (AI)/adrenal crises (AC) are a serious consequence of congenital adrenal hyperplasia (CAH). This study aimed to assess morbidity from acute illness in CAH and identify factors associated with use of IV hydrocortisone, admission and diagnosis of an AC.

Method: An audit of acute illness presentations among children with CAH to paediatric hospitals in New South Wales, Australia, between 2000 and 2015.

Results: There were 321 acute presentations among 74 children with CAH. Two thirds (66.7%, n=214) of these resulted in admission and 49.2% (n=158) of the patients received intravenous (IV) hydrocortisone. An AC was …

'Compassion, The First Emotion Ditched When I'M Busy'. The Struggle To Maintain Our Common Humanity, Lorna Davin, Jill Thistlethwaite, Emma Bartle

Medical Papers and Journal Articles

Introduction: A considerable body of literature has been built around the socialisation of medical students and junior doctors into the culture of medicine, yet our appreciation of how their affective learning is shaped through practice, over time, continues to challenge our understanding and subsequent educational practice. This study addresses this gap by using compassion as a lens to unpack affective learning.

Methods: This research asked interns undertaking their first year of medical practice “What have been the main influences (positive and/or negative) in how you have learned to express compassion for your patients when working in the clinical context?" Their …

Systematic Review Of Pain Medicine Content, Teaching, And Assessment In Medical School Curricula Internationally, Elspeth E. Shipton, Frank Bate, Raymond Garrick, Carole Steketee, Edward A. Shipton, Eric J. Visser

Medical Papers and Journal Articles

Introduction: Pain management is a major health care challenge in terms of the significant prevalence of pain and the negative consequences of poor management. Consequently, there have been international calls to improve pain medicine education for medical students. This systematic review examines the literature on pain medicine education at medical schools internationally, with a particular interest in studies that make reference to: a defined pain medicine curriculum, specific pain medicine learning objectives, dedicated pain education modules, core pain topics, medical specialties that teach pain medicine, elective study opportunities, hours allocated to teaching pain medicine during the curriculum, the status of …

Who Enrols And Graduates From Web-Based Pharmacy Education - Experiences From Northern Sweden, Sofia Mattsson, Maria Gustafsson, Sofia Svahn, Helena Norberg, Gisselle Gallego

Medical Papers and Journal Articles

Introduction: As a response to the shortage of prescriptionists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was introduced at Umeå University in 2003. This study explored who is likely to enrol and graduate from the web-based bachelor program and whether the program has addressed the shortage of prescriptionists in rural Northern Sweden.

Methods: Data from three different sources were included in this study; the initial cohort including students admitted to the program in 2003 (survey), the entire cohort including all people admitted to the program between 2003 and 2014 (university's admissions data) and the alumni cohort …

Feedback From Activity Trackers Improves Daily Step Count After Knee And Hip Arthroplasty: A Randomized Controlled Trial, Neill Van Der Walt, Lucy J. Salmon, Benjamin Gooden, Matthew C. Lyons, Michael O'Sullivan, Kaka Martina, Leo A. Pinczewski, Justin P. Roe

Medical Papers and Journal Articles

Background: Commercial wrist-worn activity monitors have the potential to accurately assess activity levels and are being increasingly adopted in the general population. The aim of this study was to determine if feedback from a commercial activity monitor improves activity levels over the first 6 weeks after total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Methods: One hundred sixty-three consecutive subjects undergoing primary TKA or THAwere randomized into 2 groups. Subjects received an activity tracker with the step display obscured 2 weeks before surgery and completed patient-reported outcome measures (PROMs). On day 1 after surgery, participants were randomized to either …

Cultural Considerations At End Of Life In A Geriatric Inpatient Rehabilitiation Setting, Melissa J. Bloomer, Mari Botti, Fiona Runacres, Peter Poon, Jakqui Barnfield, Alison M. Hutchinson

Medical Papers and Journal Articles

Aim: To explore the impact of cultural factors on the provision of end-of-life care in a geriatric inpatient rehabilitation setting.

Background: Australia’s ageing population is now also one of the most culturally diverse. Individuals from culturally and linguistically diverse backgrounds may have specific care needs at the end of life according to various aspects of their culture.

Design: A mixed method approach using a retrospective audit of existing hospital databases, deceased patients’ medical records, and in-depth interviews with clinicians.

Findings: Patients’ and families’ cultural needs were not always recognised or facilitated in end-of-life care, resulting in missed opportunities to tailor …

The Association Between Post-Stroke Depression, Aphasia, And Physical Independence In Stroke Patients At 3-Month Follow-Up, Shuo Wang, Chun-Xue Wang, Ning Zhang, Yu-Tao Xiang, Yang Yang, Yu-Zhi Shi, Yi-Ming Deng, Mei-Fang Zhu, Fei Liu, Ping Yu, Gabor S. Ungvari, Chee H. Ng

Medical Papers and Journal Articles

Objective: Few studies have examined the association between post-stroke depression (PSD), aphasia, and physical independence in Chinese patients. This study investigated the above association in stroke patients in China at 3-month follow-up.

Methods: Altogether 270 patients within 14 days after ischemic stroke were recruited and followed up at 3 months. PSD, aphasia, and physical functional status were measured using the Stroke Aphasia Depression Questionnaire (SADQ), Western Aphasia Battery (WAB), and modified Rankin Scale (mRS), respectively. Patients with mRS total score >2 were considered as having “physical dependence.”

Results: Out of 248 patients at 3-month follow up, 119 (48%) were rated …

Management Of Amiodarone-Induced Thyrotoxicosis At A Cardiac Transplantation Centre, Michelle Isaacs, Monique Costin, Ron Bova, Helen L. Barrett, Drew Heffernan, Katherine Samaras, Jerry R. Greenfield

Medical Papers and Journal Articles

Background: Amiodarone-induced thyrotoxicosis (AIT) is associated with significant morbidity and mortality, particularly in patients with cardiac failure. The aim of the study was to evaluate the management of AIT at a tertiary hospital specialising in cardiac failure and transplantation.

Methods: Retrospective audit of 66 patients treated for AIT by Endocrinology (2007–2016), classified as type 1 (T1) or type 2 (T2) based on radiological criteria. Main outcome measurements were response rate to initial treatment, time to euthyroidism, and frequency/safety of thyroidectomy.

Results: Mean age was 60 ± 2 years; 80% were male. Sixty-four patients commenced medical treatment: thionamides (THIO) in 23, …

What’S Old Is New Again: The Sacroiliac Joint As A Cause Of Lateralizing Low Back Pain, Jennifer Saunders, Manuel Cusi, Hans Van Der Wall

Medical Papers and Journal Articles

It has not been easy to identify mechanical failure of the sacroiliac joint (SIJ) with traditional imaging. The integrated model of function (Lee and Vleeming, 1998) suggests that under normal circumstances, form and force closure combined contribute to sacral nutation and “locking” the SIJ for optimal load transfer. This model is supported by clinical evidence and scintigraphic findings that contribute to successful therapy in 80% of cases. Single-photon emission computed tomography and x-ray computed tomography (SPECT-CT), a hybrid device, was used in a study of 1200 patients (64% female and 36% male patients with an average age of 42 years; …

Progression-Free Survival As A Surrogate Endpoint For Overall Survival In Modern Ovarian Cancer Trials: A Meta-Analysis, Katrin M. Sjoquist, Sarah J. Lord, Michael L. Friedlander, Robert John Simes, Ian C. Marschner, Chee Khoon Lee

Medical Papers and Journal Articles

Background: Progression-free survival (PFS) has been adopted as the primary endpoint in many randomized controlled trials, and can be determined much earlier than overall survival (OS). We investigated whether PFS is a good surrogate endpoint for OS in trials of first-line treatment for epithelial ovarian cancer (EOC), and whether this relationship has changed with the introduction of new treatment types.

Methods: In a meta-analysis, we identified summary data [hazard ratio (HR) and median time] from published randomized controlled trials. Linear regression was used to assess the association between treatment effects on PFS and OS overall, and for subgroups defined by …

Changing Medical Student Attitudes To Patient Safety: A Multicentre Study, Kim Oates, Ian Wilson, Wendy Hu, Ben Walker, Amanda Nagle, Janice Wiley

Medical Papers and Journal Articles

Background: Although patient safety is becoming widely taught in medical schools, its effect has been less rigorously evaluated. We describe a multicentre study to evaluate student changes in patient safety attitudes using a standardized instrument, the Attitudes to Patient Safety Questionnaire3 (APSQ3).

Methods: A patient safety training package designed for medical students was delivered in the first year and second year in four Australian medical schools. It comprises eight face-to-face modules, each of two hours. Seminars start with an interactive introduction using questions, video and role play, followed by small group break-outs to discuss a relevant case study. Groups are …

'Death Is Difficult In Any Language': A Qualitative Study Of Palliative Care Professionals' Experiences When Providing End-Of-Life Care To Patients From Culturally And Linguistically Diverse Backgrounds, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Background: Ethnic minority patients have unique challenges in accessing health services. These include language difficulties, unfamiliarity with the health system, lower rates of cancer screening and survival, higher rates of reported side effects from cancer treatment and poorer quality of life. Little is known about this patient group when transitioning to palliative care.

Aim: To elicit the experiences of palliative care health professionals when providing care for patients from culturally and linguistically diverse backgrounds which differ from mainstream Australian language and culture.

Design: An emergent qualitative design, informed by theoretical and procedural direction from grounded theory research.

Setting/participants: Four focus …

Identifying Systems Barriers That May Prevent Bereavement Service Access To Bereaved Carers: A Report From An Australian Specialist Palliative Care Service, Jane Phillips, Elizabeth A. Lobb, Paula Mohacsi, Nicole Heneka, David Currow

Medical Papers and Journal Articles

Background: Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers.

Aim: To map how effectively a specialist palliative care service linked bereavement service to bereaved carers.

Methodology: A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin.

Results: Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half …

Help-Seeking Experiences Of Bereaved Adolescents: A Qualitative Study, Karl Andriessen, Elizabeth Lobb, Jane Mowll, Michael Dudley, Brian Draper, Philip Mitchell

Medical Papers and Journal Articles

Despite the potentially devastating effects of a death on the lives of adolescents, little is known about their help-seeking experiences. We interviewed by telephone 39 bereaved adolescents on their help-seeking experiences. Thematic analysis resulted in three themes: Formal support, Informal support and School-related support. Participants provided a critical appraisal of positive and negative experiences, and noted barriers and facilitators for help-seeking. As adolescents bereaved through suicide may receive less social support, professional help is a much needed auxiliary. Parental encouragement is important in accessing adequate professional help.

Rheumatoid Leptomeningitis Presenting With An Acute Neuropsychiatric Disorder, Michal Lubomski, Joanne Sy, Michael Buckland, Andie S. Lee, Bethan Richards, Elizabeth Thompson, Michael Fulham, Nora Breen, Kirsty Morris, G Michael Halmagyi

Medical Papers and Journal Articles

Leptomeningitis is a rare central nervous system manifestation of rheumatoid arthritis, generally in patients with established chronic rheumatoid disease. We report a 41-year-old man without previous rheumatoid arthritis or psychiatric disorder who presented with an acute neuropsychiatric disturbance and polyarthralgia. His MR scan of brain showed asymmetric bifrontal leptomeningitis, confirmed on (18F)-fluoro-D-glucose-positron emission tomography. Other investigations showed highly positive serum and cerebrospinal fluid anti-cyclic citrullinated peptide. A leptomeningeal biopsy showed necrotising leptomeningeal inflammation with ill-defined granulomas and lymphoplasmacytic infiltrate without organisms. Prolonged high-dose corticosteroids and then rituximab resulted in recovery. Chronic leptomeningitis can present with an acute neuropsychiatric disorder. We …

Culturally And Linguistically Diverse Palliative Care Patients' Journeys At The End-Of-Life, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Objective: To understand the clinical and psychosocial journey of culturally and linguistically diverse (CALD) palliative care patients.

Method: This study was conducted at a subacute hospital with a specialist palliative care unit and a community palliative care service in a metropolitan region of New South Wales, Australia. Medical records of 100 deceased patients from CALD backgrounds over a 12-month period from 2014 to 2015 were recorded on a data mining tool. The cohort had transitioned to either community or inpatient palliative care services with a life-limiting illness. We used descriptive statistical analyses to identify the patients’ end-of-life journeys in the …

The Effect Of Self-Selected Complementary Therapies On Cancer Patients' Quality Of Life And Symptom Distress: A Prospective Cohort Study In An Integrative Oncology Setting, N J. Stomski, A Petterson, L J. Kristjanson, Elizabeth Lobb, M B. Phillips, A Williams, P Morrison, D Joske

Medical Papers and Journal Articles

Objective: To examine the effectiveness of a multifaceted complementary therapies intervention, delivered in a systematic manner within an Australian public hospital setting, on quality of life and symptom distress outcomes for cancer patients.

Methods: Adults receiving treatment for any form of cancer were eligible to participate in this study. Self-referred participants were offered a course of six complementary therapy sessions. Measures were administered at baseline, and at the third and sixth visit. The primary outcomes were quality of life and symptom distress. Linear mixed models were used to assess change in the primary outcomes.

Results: In total, 1376 cancer patients …

Depressive Symptoms In Patients With Irritable Bowel Syndrome: A Meta-Analysis Of Comparative Studies, Qing-E Zhang, Fei Wang, Geng Qin, Wei Zheng, Chee H. Ng, Gabor S. Ungvari, Zhen Yuan, Songli Mei, Gang Wang, Yu-Tao Xiang

Medical Papers and Journal Articles

Depression is common in patients with irritable bowel syndrome (IBS), but the reported prevalence across different studies is inconsistent. This meta-analysis systematically examined the presence and severity of depressive symptoms in patients with IBS. Two investigators independently performed a literature search. The pooled depressive symptom severity was calculated using a random effects model. Subgroup, sensitivity and meta-regression analyses were conducted to examine the moderating factors of the development of depressive symptoms. Twenty four studies (n=2,837) comparing depressive symptoms between IBS patients (n=1,775) and healthy controls (n=1,062) were identified; 14 (58.3%) studies were rated as high quality. Compared to healthy controls, …