Public Health Commons^™

Nutrient Profile Assessment Of A Meal Program Impact On Older Adults' Diet Quality And Food Security Status, Millicent Yaa Gyasiwaa Ms

Theses and Dissertations--Nutrition and Food Systems

The rise in food insecurity globally has ignited institutions and organizations to implement policies and programs to reduce the burden on vulnerable people including older adults and people living in underserved areas. Though programs such as congregate, home-delivered meals, and pantries have been initiated to contribute to reducing food insecurity the nutrient content of these meals including recovered meals and their effect on food security status, food quality, and health has not been widely studied. The current study, Meals on Wings (MOW), assessed the nutrient profile of the free meals offered 4 times per week for 3 months, from May …

Role Of Social Determinants Of Health And The Renin- Angiotensin Aldosterone System In Risk For Hypertensive Disorders Of Pregnancy And Related Adverse Outcomes., Esther Letushila Ndashaala

Theses and Dissertations--Nutrition and Food Systems

Background: Hypertensive disorders of pregnancy (HDP) represent a significant public health issue, contributing to maternal and fetal morbidity and mortality. Women from lower socioeconomic backgrounds or marginalized racial and ethnic groups face higher risks of HDP, which have been incompletely described. In addition, risk for HDP may be linked to a reduction in the normal activity of the renin-angiotensin-aldosterone system (RAAS). This study investigates the role of socioeconomic factors and RAAS components in the risk for HDP and adverse maternal and neonatal outcomes. Methods: This study is a secondary analysis of data from 180 pregnant individuals from a high-risk maternal-fetal …

Autochthonous Plasmodium Vivax Infections, Florida, Usa, 2023, Swamy Rakesh Adapa, Kami Kim, Liwang Cui

College of Medicine & TGH Faculty Publications

During May–July 2023, a cluster of 7 patients at local hospitals in Florida, USA, received a diagnosis of Plasmodium vivax malaria. Whole-genome sequencing of the organism from 4 patients and phylogenetic analysis with worldwide representative P. vivax genomes indicated probable single parasite introduction from Central/South America.

Addressing Healthcare Disparities Faced By Aging Down Syndrome Populations, Rhea Mistry

Pitzer Senior Theses

Down syndrome (DS) is a chromosomal genetic condition that impacts the development of the body and brain. The life expectancy of individuals with DS has drastically improved over the decades, increasing from 9 years in 1929 to 25 years in 1983 and further reaching 60 years by 2002. Individuals with DS face a variety of prominent co-occurring health conditions that are subject to change over time, including cognitive, visual, and hearing impairments, sleep apnea, cardiovascular defects, Down syndrome regression disorder, and dementia. Despite this increase in life span, DS is still most familiar to pediatric care providers, resulting in healthcare …

Association Between Symptom Burden And Early Lymphatic Abnormalities After Regional Nodal Irradiation For Breast Cancer, Alison K Yoder, Tianlin Xu, Peter Youssef, Sarah Desnyder, Kathryn E Marqueen, Lynn Isales, Ruitao Lin, Benjamin D Smith, Wendy A Woodward, Michael C Stauder, Eric A Strom, Melissa B Aldrich, Simona F Shaitelman

Faculty, Staff and Student Publications

PURPOSE: Dermal backflow visualized on near-infrared fluorescence lymphatic imaging (NIRF-LI) signals preclinical lymphedema that precedes the development of volumetrically defined lymphedema. We sought to evaluate whether dermal backflow correlates with patient-reported lymphedema outcomes (PRLO) surveys in breast cancer patients treated with regional nodal irradiation (RNI).

METHODS AND MATERIALS: Patients with breast cancer planned for axillary dissection and RNI prospectively underwent perometry, NIRF-LI, and PRLOs (the Lymphedema Symptom Intensity and Distress Survey [LSIDS] and QuickDASH) at baseline, after surgery, and at 6, 12, and 18 months after radiation. Clinical lymphedema was defined as an arm volume increase ≥5% over baseline. Trends …

Using Education To Improve Glycemic Management Within An Emergency Department, Rebecca Olson

Master's Theses and Capstones

Background: Patients with diabetes mellitus (DM) frequently visit acute care facilities for a variety of reasons. Proper management of this comorbidity increases patient safety, satisfaction, and quality care. Patients with persistent dysglycemic events in acute care facilities have an increased risk of complications and death during their stay. Lack of education can contribute to gaps in proper management within this population and therefore must be improved for better patient outcomes.

Methods: The Plan-Do-Check-Act design from the A3 Problem Solving model was used to guide a quality improvement project which focused on improving staff education and confidence surrounding glycemic management. The …

Systemic Treatment Of Patients With Metastatic Breast Cancer: Asco Resource-Stratified Guideline Q And A, Sana Al Sukhun, Bogda Koczwara, Sarah Temin, Banu K Arun

Faculty, Staff and Student Publications

The Systemic Treatment of Patients with Metastatic Breast Cancer: @ASCO Resource-Stratified Guideline Q and A presents takeways, rationale, and key recommendations based on #JCOGO full guideline for patients by menopausal and marker status.

Modernizing And Harmonizing Regulatory Data Requirements For Genetically Modified Crops-Perspectives From A Workshop, Nicholas P Storer, Abigail R Simmons, Jordan Sottosanto, Jennifer A Anderson, Ming Hua Huang, Debbie Mahadeo, Carey A Mathesius, Mitscheli Sanches Da Rocha, Shuang Song, Ewa Urbanczyk-Wochniak

Faculty, Staff and Student Publications

Genetically modified (GM) crops that have been engineered to express transgenes have been in commercial use since 1995 and are annually grown on 200 million hectares globally. These crops have provided documented benefits to food security, rural economies, and the environment, with no substantiated case of food, feed, or environmental harm attributable to cultivation or consumption. Despite this extensive history of advantages and safety, the level of regulatory scrutiny has continually increased, placing undue burdens on regulators, developers, and society, while reinforcing consumer distrust of the technology. CropLife International held a workshop at the 16th International Society of Biosafety Research …

Hpv Vaccination In Africa In The Covid-19 Era: A Cross-Sectional Survey Of Healthcare Providers' Knowledge, Training, And Recommendation Practices, Joel Fokom Domgue, Issimouha Dille, Sharon Kapambwe, Robert Yu, Freddy Gnangnon, Lameck Chinula, Gad Murenzi, Nomonde Mbatani, Mala Pande, Fatoumata Sidibe, Joseph Kamgno, Bangaly Traore, Hicham El Fazazi, Mamadou Diop, Pierre-Marie Tebeu, Mohenou Isidore Diomande, Fabrice Lecuru, Isaac Adewole, Marie Plante, Partha Basu, Jean-Marie Dangou, Sanjay Shete

Faculty, Staff and Student Publications

INTRODUCTION: Although the burden of cervical cancer in Africa is highest, HPV vaccination coverage remains alarmingly low in this region. Providers' knowledge and recommendation are key drivers of HPV vaccination uptake. Yet, evidence about providers' knowledge and recommendation practices about the HPV vaccine against a backdrop of emerging vaccine hesitancy fueled by the COVID-19 pandemic is lacking in Africa.

METHODS: A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior training, the availability of the HPV vaccine in their practice, whether they recommended the HPV vaccine, …

Secondhand Tobacco Smoke Exposure In Homes And Vehicles In Youth: Disparities Among Racial, And Sexual And Gender Minorities, Rajesh Talluri, Sahil S Shete, Surendra S Shastri, Sanjay Shete

Faculty, Staff and Student Publications

BACKGROUND: Secondhand smoke exposure (SHSe) among youth is a serious public health concern, leading to an increased risk of conditions such as asthma and respiratory infections. However, there is little research on SHSe among vulnerable populations, such as racial and sexual minorities. Understanding the factors associated with youth SHSe in homes and vehicles is crucial to developing better protective policies.

METHODS: This study utilized 2020 data from the National Youth Tobacco Survey, a representative sample of middle- and high-school students in the US. The primary outcomes were youth SHSe at home and while riding in a vehicle. Multinomial regression models …

Exploring Measurement Tools Used To Assess Knowledge, Attitudes, And Perceptions Of Pregnant Women Toward Prenatal Screening: A Systematic Review, Lea Sacca, Yasmine Zerrouki, Sara Burgoa, Goodness Okwaraji, Ashlee Li, Shaima Arshad, Maria Gerges, Stacey Tevelev, Sophie Kelly, Michelle Knecht, Panagiota Kitsantas, Robert Hunter, Laurie Scott, Alexis Piccoli Reynolds, Gabriela Colon, Michele Retrouvey

Faculty, Staff and Student Publications

There is a lack of standardized measurement tools globally to assess knowledge, attitudes, and perceptions of expecting women toward prenatal screening. The purpose of this systematic review was to identify reasons women pursue or decline prenatal screening and compare the strengths and limitations of available measurement tools used to assess pregnant women's perceptions, knowledge, and attitudes toward prenatal screening. This review followed the five-step York methodology by Arksey and O'Malley and incorporated recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist for the extraction, analysis, and presentation of results. The five steps consisted of: (1) identification of …

Using Phosphatidylethanol As An Adjunct To Self-Reported Alcohol Use Improves Identification Of Liver Fibrosis Risk, Pamela M. Murnane, Majid Afshar, Gabriel Chamie, Robert L. Cook, Tekeda Ferguson, Lamia Y. Haque, Karen R. Jacobson, Amy C. Justice, Theresa W. Kim, Mandana Khalili, Evgeny Krupitsky, Kathleen A. Mcginnis, Patricia Molina, Winnie R. Muyindike, Bronwyn Myers, Veronica L. Richards, Kaku So-Armah, Scott Stewart, Mark S. Sulkowski, Phyllis C. Tien, Judith A. Hahn

School of Public Health Faculty Publications

Introduction: Accurate assessment of alcohol use informs prevention and management of liver disease. We examined whether phosphatidylethanol (PEth, an alcohol metabolite) blood concentrations are associated with liver fibrosis risk independently of self-reported alcohol use, among persons with and without HIV. Methods: We pooled individual-level data from 12 studies from the United States, Russia, Uganda, and South Africa with PEth, AUDIT-C (Alcohol Use Disorders Identification Test-Consumption), and FIB-4 measurements. We conducted mixed-effects logistic regression of the relationship between PEth and AUDIT-C as continuous variables (after checking linearity), with high FIB-4 ( ≥ 2.67). We divided PEth (range 0-1000) by 83.3 to …

Understanding Guardian Perceptions Of Whole-Foods Plant-Based Diets As Interventions In Pediatric Medicine, Vijay R. Luthra

Honors Undergraduate Theses

The obesity epidemic is widespread in American society, often affecting children who bear its consequences innocently. Due to a lack of nutrition knowledge, children rely on caregivers to meet their nutritional needs and instill healthy habits. This study examines parents' attitudes, knowledge, and behaviors, as well as perceived barriers to adopting a whole-foods plant-based diet (WFPD) for their children. Using a modified survey instrument by Morton et al., this study focused on parents and children regarding dietary choices. Participants were recruited from the waiting area of a pediatric clinic at the Medical College of Georgia between April and May 2023. …

The Impact Of Gestational Diabetes Mellitus And Maternal Oral Microbiome: A Scoping Review, Jaclyn P. Langan

Honors Undergraduate Theses

Background: Gestational diabetes mellitus (GDM) is a common pregnancy-related metabolic disorder associated with adverse maternal and fetal outcomes. Recent research has highlighted the potential role of the oral microbiome in the pathophysiology of various systemic conditions, including diabetes mellitus. However, the impact of GDM on the maternal oral microbiome remains relatively understudied. Understanding alterations in the oral microbiome during pregnancy complicated by GDM could provide valuable insights into the mechanistic links between systemic metabolic disorders and oral health.

Objective: The objective of this scoping review was to comprehensively examine the existing literature on the relationship between GDM and maternal oral …

Unraveling The Effects Of The Covid-19 Pandemic On Staphylococcus Aureus Carriage: A Comparative Research Of Pre- And Post-Pandemic Samples, Catherine G. Johnston

Honors Undergraduate Theses

The COVID-19 pandemic brought about significant changes in the epidemiology of Staphylococcus aureus carriage and disease. This study aims to assess these changes by leveraging respiratory samples collected from a longstanding cohort, comparing the genomic characteristics of S. aureus isolates from pre- and post-pandemic periods. We analyzed S. aureus genomes and phenotypically determined macrolide resistance to characterize population structure, antibiotic resistance, and virulence profiles. Changes in S. aureus carriage rates, macrolide resistance, disease occurrence, and population structure between samples collected pre- and post-pandemic were examined. By using respiratory samples, chart reviews, and risk factor questionnaires of 498 children from a …

Grading Of Malnutrition Among Under 5 Children Residing In Urban Slum In Mysuru Using Who Classification And Indian Academy Of Pediatrics (Iap) Classification: A Comparative Study, Ravali Annaram Dr, Amogha Shree Dr, Saurish Hegde Dr, Krishnaveni Y S Dr

Digital Journal of Clinical Medicine

Background

Malnutrition in Indian children under five is widespread, driven by insufficient food intake and diseases like diarrhoea and respiratory infections. Factors such as food security, maternal literacy, and healthcare access influence malnutrition rates. Growth monitoring utilizes WHO standards globally and IAP guidelines in India. Implementing these charts improves early identification and management of malnutrition, crucial for addressing childhood health challenges in India. This study compare the prevalence of malnutrition in WHO classification with Indian Academy of Paediatrics (IAP) classification among under 5 children residing in urban slum.

Methodology

A community based cross-sectional study was conducted among children aged 6 …

The Sewage Microbiome Dynamics Of Different Serving Neighborhoods In Charleston, Illinois, Sandra Chiamaka Okoye

Masters Theses

The complex microbial ecosystem within sewage systems holds significant implications for environmental and public health. Unlike studies on wastewater treatment plant microbiomes, upstream sewage systems have not been studied widely. This research investigated the dynamic sewage microbiome across diverse serving neighborhoods in Charleston, Illinois, encompassing residential, hospital, industrial, and university areas. Drawing upon recent advancements in microbiome research, the study aimed to unravel the spatial and temporal variations in microbial structures. Three times between June to December 2023 sewage samples were collected from manholes in the areas mentioned above. Community DNA was extracted and sequenced for the V4-V5 region of …

Identification Of Novel 3d-Genome Altering And Complex Structural Variants Underlying Retinitis Pigmentosa Type 17 Through A Multistep And High-Throughput Approach, Suzanne E De Bruijn, Daan M Panneman, Nicole Weisschuh, Elizabeth L Cadena, Erica G M Boonen, Lara K Holtes, Galuh D N Astuti, Frans P M Cremers, Nico Leijsten, Jordi Corominas, Christian Gilissen, Anna Skowronska, Jessica Woodley, Andrew D Beggs, Vasileios Toulis, Di Chen, Michael E Cheetham, Alison J Hardcastle, Terri L Mclaren, Tina M Lamey, Jennifer A Thompson, Fred K Chen, John N De Roach, Isabella R Urwin, Lori S Sullivan, Susanne Roosing

Faculty, Staff and Student Publications

INTRODUCTION: Autosomal dominant retinitis pigmentosa type 17 (adRP, type RP17) is caused by complex structural variants (SVs) affecting a locus on chromosome 17 (chr17q22). The SVs disrupt the 3D regulatory landscape by altering the topologically associating domain (TAD) structure of the locus, creating novel TAD structures (neo-TADs) and ectopic enhancer-gene contacts. Currently, screening for RP17-associated SVs is not included in routine diagnostics given the complexity of the variants and a lack of cost-effective detection methods. The aim of this study was to accurately detect novel RP17-SVs by establishing a systematic and efficient workflow.

METHODS: Genetically unexplained probands diagnosed with adRP …

Variant Of The Lactase Lct Gene Explains Association Between Milk Intake And Incident Type 2 Diabetes, Kai Luo, Guo-Chong Chen, Yanbo Zhang, Jee-Young Moon, Jiaqian Xing, Brandilyn A Peters, Mykhaylo Usyk, Zheng Wang, Gang Hu, Jun Li, Elizabeth Selvin, Casey M Rebholz, Tao Wang, Carmen R Isasi, Bing Yu, Rob Knight, Eric Boerwinkle, Robert D Burk, Robert C Kaplan, Qibin Qi

Faculty, Staff and Student Publications

Cow's milk is frequently included in the human diet, but the relationship between milk intake and type 2 diabetes (T2D) remains controversial. Here, using data from the Hispanic Community Health Study/Study of Latinos, we show that in both sexes, higher milk intake is associated with lower risk of T2D in lactase non-persistent (LNP) individuals (determined by a variant of the lactase LCT gene, single nucleotide polymorphism rs4988235 ) but not in lactase persistent individuals. We validate this finding in the UK Biobank. Further analyses reveal that among LNP individuals, higher milk intake is associated with alterations in gut microbiota (for …

The Relationship Of Neighborhood Disadvantage, Biological Aging, And Psychosocial Risk And Resilience Factors In Heart Failure Incidence Among Black Persons: A Moderated Mediation Analysis, Ganga S Bey, James R Pike, Anthony S Zannas, Qian Xiao, Bing Yu, Amil M Shah, Priya Palta

Faculty, Staff and Student Publications

Objectives: Deprived living environments contribute to greater heart failure (HF) risk among non-Hispanic Black persons, who disproportionately occupy disadvantaged neighborhoods. The mechanisms for these effects are not fully explicated, partially attributable to an insufficient understanding of the individual factors that contribute additional risk or resilience to the impact of neighborhood disadvantage on health. The objective of this study was, therefore, to clarify the complex pathways over which such exposures act to facilitate more targeted, effective interventions. Given the evidence for a mediating role of biological age and a moderating role of individual psychosocial characteristics in the neighborhood disadvantage-HF link, we …

Sars-Cov-2 Infection History Is Positively Correlated With Frequency Of Psychotic Symptoms In Schizophrenia, Jackson D. Beecher

Honors Undergraduate Theses

Previous work in human and animal studies has implicated aberrant insular cortex (IC) activity in the pathophysiology of hallucinations. Of note, the IC overlaps with the olfactory cortex (OC), a region of the brain that receives extensive projections from sensory neurons of the olfactory epithelium. SARS-CoV-2 (COVID-19) is a highly infectious coronavirus with a demonstrated ability to cause anosmia; the virus does this by colocalizing with and damaging support cells in the olfactory epithelium, ultimately leading to alterations in olfactory receptor cell signaling to the OC. Given the overlap between OC and IC, we asked the question of whether COVID-19 …

Alopecia As An Early Clinical Marker For Azathioprine Induced Myelosuppression: A Case Report, Nilanjana Dutta , Final Year Mbbs, Dr. M Suresh Babu , Professor, Dr. Subramanian Ramaswamy , Professor, Dr. Mahabaleshwar Mamadapur , Assistant Professor

Digital Journal of Clinical Medicine

Azathioprine is a pro-drug and is metabolized by the TPMT enzyme in the body. In South Asians, Azathioprine is known to cause alopecia and bone marrow suppression in patients with TPMT enzyme deficiency. In India, the prevalence of TPMT mutation varies from 1.2- 10%. A new mutation was detected in 2014, NUDT15 whose incidence varies from 8.5-16%. Patients with mutation in both TPMT and NUDT15 develop myelosuppression faster. In our case, alopecia manifested as the first clinical feature of Azathioprine myelosuppression. Physicians need to recognize early clinical clues (alopecia) to avoid the impending development of myelosuppression and to look for …

A Real World Study Of Adherence To Insulin In Diabetic Humans-Stadium Study, Dipsanker Chatterjee, Subham Das

Digital Journal of Clinical Medicine

Background:

With an ever-increasing prevalence of diabetes, lack of adherence to insulin treatment in even a small percentage of patients is a major issue and can lead to significant burden on the healthcare system. This survey analysis seeks to investigate the insulin adherence patterns to identify the factors associated with medication adherence.

Methodology:

The current cross-sectional survey was conducted among diabetes patients on insulin treatment. A list of questions about insulin adherence was provided to the participants in the study and the responses were recorded. The data was analysed using Graph Pad Prism.

Results:

Around 23.2 and 18.6 % of …

Internet Addiction: A Growing Threat: A Cross-Sectional Among The Undergraduate Medical Students Of Tertiary Care Hospital, Mysuru, Rakesh M, Diksha Goswami, Sunil Kumar D, Shwethashree M

Digital Journal of Clinical Medicine

Background: The internet has quickly become a part of our lives, impacting every part of our existence. Its use has expanded beyond simply being a communication tool and a source of information. The objective of the study is to assess the prevalence of Internet addiction among the Undergraduate medical students of Mysuru.

Methods: This cross-sectional study was conducted among 255 medical students of a Tertiary care Hospital, Mysuru for three months from September 1^st to November 30^th,2023. Data was collected using a semi-structured questionnaire. The semi-structured questionnaire covered details of demographic data and twenty questions of the …

Placenta Accreta Spectrum Disorder As First Trimester Pregnancy Termination Complication; Case Series, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Placenta Accreta Spectrum (PAS) disorder is rare (2% according to ACOG) condition of pregnancy when the placenta grows deeply into myometrium. This leads to failure of placenta to separate normally from myometrium after delivery and leads to massive hemorrhage. The PAS is classified as PA (Placenta Accreta), PI (Placenta Increta) and PP ( Placenta Percreta), on basis of depth of trophoblastic invasion. Increase in no. of cesarean sections, increasing the incidence of PAS. Cesarean scar on uterus promotes placental tissue to invade deeply in subsequent pregnancy. Antenatal scanning and color imaging can detect PAS, at a very early stage. Here …

Gender Equality– A Sustainable Development Goal In Progress At A Medical College And Hospital In South India, Mr. Manoj S M, Kusuma Kasapura Shivashankar, Suma M. Natraj, Praveen Kulkarni

Digital Journal of Clinical Medicine

Background: Gender Equality is one of the most important SDG and attaining it will ensure a peaceful, prosperous and a balanced world with equal opportunities for both women and men. The Indian scenario in the field of women education has changed with mindset of most parents undergoing a paradigm shift and many girls are encouraged to attend schools, colleges and women are allowed to work. Considering the above shift, our study intended to find out if the same was true and SDG-5, Gender Equality was attained or in progress at our medical college and hospital and hence the study.

Methods: …

The Balm Framework Of Clinical Excellence: An Adoptable Model For Sub-Saharan Africa., Taoreed Adegoke Azeez

Digital Journal of Clinical Medicine

Clinical excellence is the ability to provide rigorous, evidence-based, and rewarding care to the right patients. The BALM (brilliance, attitude, leadership, and materials) framework is a novel model for adjudicating clinical excellence. There are a few models and frameworks for evaluating clinical excellence, but each has its flaws and does not consider the peculiarities of economically-challenged regions such as sub-Saharan Africa. Coincidentally, such low-resource areas have an urgent need for a framework to assess clinical excellence because of their low health-related indices. The five-step mode of professional excellence is a well-recognised tool and was the model upon which the BALM …

Alkaptonuria Presenting With Back Pain: A Diagnostic Dilemma, Arnav Salar, Dyuksha Arora, Mahabaleshwar Mamadapur

Digital Journal of Clinical Medicine

Alkaptonuria is a rare inborn error of metabolism due to a deficiency of homogentisate 1,2 dioxygenase, resulting in homogentisic acid accumulation in tissues. It is characterised by homogentisic aciduria, ochronosis, and arthritis. We hereby discuss a 46-year-old male who presented with progressive lower back pain and polyarthralgia for ten years, initially diagnosed as ankylosing spondylitis. Characteristic skin pigmentation, ochronosis, and radiological findings led to the correct diagnosis of alkaptonuria. This case highlights the importance of considering alkaptonuria as a differential diagnosis for chronic back pain and arthritis, mainly when sacroiliac joints are spared, and ochronosis is present. While no cure …

Knowledge, Attitudes, And Practices Among Health Care Professionals In A Tertiary Care Teaching Hospital, Mysuru, Rakesh M, Dr Sunil Kumar D, Dr Shwethashree M, Kodeeswaran M, Aradhya M. Gowda

Digital Journal of Clinical Medicine

ABSTRACT

Background: Biomedical waste (BMW) refers to waste generated during the diagnosis, treatment, or immunization of humans or animals, posing risks to health and the environment if not managed properly. Proper knowledge, attitudes, and practices (KAP) among healthcare professionals are essential for effective BMW management. This study assessed the KAP of healthcare workers regarding BMW in a tertiary care teaching hospital.

Methods: A cross-sectional study was conducted among 149 healthcare professionals at a private medical college from April 10 to May 10, 2023. Participants were selected using simple random sampling, including consultants, postgraduates, interns, nursing staff, laboratory technicians, and housekeeping …

The Pros And Cons Of Systematic Review And Meta-Analysis: Methodological Insights And Future Directions, Malik Maaz Ahmad, Imran Ahmed Khan, Harish Chandra Tiwari

Digital Journal of Clinical Medicine

Systematic reviews (SR) and meta-analyses (MA) are the highest level of evidence in the hierarchy of scientific evidence which aggregate data from various studies, offering a comprehensive overview of a particular topic. This approach reduces the influence of isolated studies that may have small sample sizes or unique biases, leading to more robust conclusions. By combining data from multiple studies, the overall sample size is increased enhancing the statistical power and precision of the results. The value of SR and MA is often compromised by the poor quality of the primary studies they include, which can lead to misleading conclusions. …