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The Combination of Estimates from Different Experiments
Abstract
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... This method enhances statistical power and precision, providing a more robust estimate of overall risk and identifying patterns despite varying levels of bias and internal validity across studies. [35] ...
... However, the wide CI from no effect (0.50) to a high risk (12.18) indicates substantial uncertainty and reflects the high heterogeneity among studies, attributed to variations in risk factors, methodologies, and populations. [35][36][37] These findings emphasize the build-up phase as a critical risk factor, [32] in contrast to the comparable safety profiles of SCIT protocols. [33] The pooled OR underscores the overall risk, but the broad CI highlights the need for high-quality research to reduce variability and refine these estimates. ...
... However, the wide CI reflects considerable uncertainty, with the true effect potentially ranging from no risk (0.50) to a significantly elevated risk (12.18). [35][36][37] Such variability underscores the high heterogeneity among studies, as indicated by the I² statistic of 92.34%, which reveals that 92% of the observed variability in effect sizes is attributable to differences between studies rather than random chance. [36] The substantial heterogeneity necessitates the use Note: The forest plot illustrates individual study effect sizes (blue dots) with 95% confidence intervals (horizontal lines), a fixed-effect model pooled estimate (green square) with narrower confidence intervals, and a random-effect model pooled estimate (red square) with wider confidence intervals that account for heterogeneity. ...
... The statistical analysis was based on the dichotomous method, assuming either a fixed-effects model to calculate the log odds ratio (LogOR), and them back-transform LogOR to odd ratio (OR) with a 95 % confidence interval (CI = 95 %). The heterogeneity measures of the studies was assessed using the statistical parameter of heterogeneity I 2 [34], the weighted sum of square of deviation of individual effect size from pooled effect size computed by fixed effect method (Q statistic), and the relative excess in Q over its degree of freedom (H 2 ) [35]. I 2 with a value ranging from 0 % to 100 %, where 0 % indicates no heterogeneity, <25 % indicates low heterogeneity, 25-50 % indicates moderate heterogeneity, 50-75 % indicates high heterogeneity and ≥75 % indicates very high heterogeneity. ...
... I 2 with a value ranging from 0 % to 100 %, where 0 % indicates no heterogeneity, <25 % indicates low heterogeneity, 25-50 % indicates moderate heterogeneity, 50-75 % indicates high heterogeneity and ≥75 % indicates very high heterogeneity. It is suggested to use a significance level of 10 % instead of 5 % for the significance value of the Q statistic [35]. A complete uniformity is denoted by H = 1. ...
... The assessment of heterogeneity was conducted using the I² statistic (Higgins & Thompson, 2002) [33] and the Qtest (Cochran, 1954). [34] Sensitivity analysis was conducted by omitting one literature at each analysis to evaluate the effect of each study on the overall result. ...
... The assessment of heterogeneity was conducted using the I² statistic (Higgins & Thompson, 2002) [33] and the Qtest (Cochran, 1954). [34] Sensitivity analysis was conducted by omitting one literature at each analysis to evaluate the effect of each study on the overall result. [33] The Baujat plot method was used to complement the sensitivity analysis in order to investigate the source of heterogeneity when the leave-one-out analysis provided insu cient results. ...
Purpose The aim of this systematic review and meta-analysis is to determine the efficacy and safety of selective internal radiation therapy (SIRT) using yttrium-90 (Y-90) combined with immune checkpoint inhibitors (ICIs) in the treatment of hepatocellular carcinoma (HCC). Materials and Methods We systematically searched Embase, Cochrane Central Register of Controlled Trials, Pubmed/Medline, and Web of Science from inception to September 10th of 2024 for studies published with the following medical subject heading terms: “selective internal radiation therapy”, “immunotherapy”, “immune checkpoint inhibitors”, and “hepatocellular carcinoma”. In addition, the references of included studies and systematic reviews were evaluated for additional studies. The outcomes of interest were median overall survival (mOS), median progression-free survival (mPFS), median time to tumor progression (mTTP), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). A subgroup analysis of ORR was conducted based on patients' BCLC staging, along with a comparison between studies that initiated ICIs prior to SIRT and those that administered SIRT before ICIs. Results The review included seven studies, consisting of four clinical trials and three retrospective cohort studies, with a total of 184 patients. The pooled analysis demonstrated an ORR of 58.08% (95% CI: 39.07–77.09) and a DCR of 85.03% (95% CI: 76.23–93.83). The pooled mTTP, mPFS and mOS resulted in 7.17 months (95% CI: 5.05–9.29), 7.12 months (95% CI: 5.29–8.95) and 20.43 months (95% IC: 17.58–23.29), respectively. The subgroup analysis of ORR according to the patients’ BCLC staging, including BCLC-B and BCLC-C, resulted in a pooled ORR of 75.71% (95% CI: 57.71–93.71) and 60.86% (95% CI: 37.10–84.63), respectively, with no significant difference between groups (p = 0.33). There was no significant difference in the subgroup analysis between studies that initiated ICIs prior to SIRT and those that administered SIRT before starting ICIs. During treatment 53.48% (95% CI: 25.89–80.06) of the patients experienced grades 1–2 adverse events, and 16.17% (95% CI: 6.52–28.52) experienced grades 3–4 adverse events. One patient in the analysis experienced a grade 5 adverse event. Conclusion The findings of this systematic review and meta-analysis indicate that the combination of SIRT using Y-90 with ICIs may offer a durable treatment response and promising efficacy with an acceptable safety profile for HCC. However, results should be interpreted with caution due to the limited number of published studies and the need for further investigation regarding patient selection, treatment sequence, efficacy, and safety.
... Second, we tested whether effect sizes differed across datasets. Based on the conventional heterogeneity tests using the Q-statistics (Cochran 1954;Hedges and Schauer 2019), and the percentage of the variance across studies indicated by I 2 effects (Higgins and Thompson 2002), Q-statistics were considered significant at p ≤ 0.10 and the I 2 effect was considered large at I 2 ≥ 70. ...
Introduction
Individuals' math value beliefs are theorized to influence who persists in STEM. However, the existing findings on gender differences in adolescents' math value beliefs are inconsistent. The goal of this study was to use three existing datasets to help clarify when gender differences emerge for high school adolescents and for whom (i.e., adolescents across historical time, grade level, and race/ethnicity). Specifically, we examined the extent to which gender differences in adolescents' math value beliefs (i.e., interest, utility, and attainment) replicated (1) across three datasets spanning the 1990s to 2010s, (2) from 9th–12th grade, and (3) within each of the four largest U.S. racial/ethnic groups (i.e., Asian, Black, Latine, and White adolescents).
Methods
We tested these aims with three existing longitudinal U.S. datasets: the California Achievement Motivation Project (CAMP) (n = 8855), the Childhood and Beyond Study (CAB) (n = 582), and the High School Longitudinal Study (HSLS) (n = 21,000). Students were in high school (9th–12th grade) and half were girls (49%–53%). All three datasets included measures with the same or similar math value belief items, making conceptual replication possible.
Results and Conclusions
Overall, we did not find strong evidence for meaningful gender differences in adolescents' math value beliefs overall. We did find meaningful gender differences in the oldest data set (CAB). When examined within each racial/ethnic group, we found no evidence of gender differences in math value beliefs among Black or Latine adolescents, but some differences among Asian and White adolescents. The findings align with the gender similarities hypothesis, suggesting adolescent girls and boys had similar math value beliefs.
... Because in two studies the intervention was considered as an invitation for screening rather than the participation in the screening, we performed a sensitivity analysis including only data from studies for which the intervention group did effectively undergo screening for AF after receiving the invitation. Heterogeneity was assessed by the χ² test on Cochran's Q statistic 21 , and quantified by I² values, assuming that I² values of <25%, 50 -75%, and >75% ...
Background
Recommendations on atrial fibrillation (AF) screening by various scientific societies are inconsistent due to uncertainty about its benefit. This study aimed to summarize data from randomized controlled trials (RCTs) on the impact of AF screening on thromboembolism, major bleeding, and mortality.
Methods
We searched PubMed/MEDLINE and Embase to identify studies providing relevant data through September 05, 2024. Risk ratios for each reported outcome of interest were pooled through a meta-analysis with random effects models.
Results
We included 6 RCTs reporting data from 74 145 patients. AF screening was associated with higher AF detection compared with no intervention [risk ratio (RR) 2.54, 95% confidence interval (CI): 1.57–4.11, p < 0.001], and more common initiation of oral anticoagulation (RR 2.19, 1.51–3.18, p < 0.001). Incident ischemic stroke (RR 0.93, 0.87–1.00, p = 0.048) and thromboembolism including ischemic stroke, transient ischemic attack, or systemic embolism (0.93, 95% CI: 0.87–0.99, p = 0.026) were less frequent in individuals who underwent AF screening versus controls. There was no difference for major bleeding (RR 0.99, 95% CI: 0.93–1.06, p = 0.830), hemorrhagic stroke (RR 0.94, 95% CI: 0.80–1.11, p = 0.497) and all-cause mortality (RR 0.99, 95% CI: 0.95–1.02, p = 0.411).
Conclusion
Our findings suggest that AF screening might be beneficial, especially in reducing thromboembolic events.
... The heterogeneity between studies was tested using the Q-statistic, which is a weighted sum of the squares of the deviations of individual study OR estimates from the overall estimate. 18,19 When the ORs are homogeneous, Q follows a chi-squared distribution with r -1 (r is the number of studies), degrees of freedom (df). When P<0.50 then the heterogeneity was considered to be statistically significant. ...
Objective: Methyleneterahydrofolate reductase (MTHFR) A1298C polymorphism has been reported a risk factor for nonsyndromic cleft/palate (NSCL/P) in several published articles but results were inconclusive. To confirm the association between maternal MTHFR A1298C polymorphism and NSCL/P risk, a meta-analysis was conducted. Method: Case control articles for maternal MTHFR A1298C polymorphism and NSCL/P risk were identified by search of databases including PubMed, Google Scholar, Elsevier and Springer Link for the period up to December, 2013. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to assess the association. Results: Meta-analysis of ten included studies showed that there was no significant association between maternal MTHFR A1298C polymorphism and risk of NSCL/P under five genetic models (for C versus A, OR= 1.007, 95 % CI= 0.89-1.13, P=0.90; for CC versus AA, OR=0.851, 95 % CI = 0.63-1.15, P=0.30.; for AC versus AA, OR= 1.033, 95 % CI= 0.88-1.21, P= 0.69; for CC+AC versus AA, OR= 1.005, 95 % CI= 0.86-1.17, P=0.94; for CC versus AC+AA, OR= 0.86, 95 % CI= 0.64-1.15, P= 0.32). Conclusion: In conclusion, results of present meta-analysis demonstrate that maternal MTHFR A1298C polymorphism may not be a risk factor for developing NSCL/P in offspring. Further studies with large sample sizes are needed to evaluate the association of maternal MTHFR A1298C polymorphism with NSCL/P in more detail. DOI: http://dx.doi.org/10.3126/ajms.v6i1.10281 Asian Journal of Medical Sciences Vol.6(1) 2015 16-21
... Heterogeneity was evaluated using the Q test for Heterogeneity (Cochran, 1954) and the I 2 index (Higgins & Thompson, 2002), with a significance level set at 0.05 and I 2 values of approximately 25%, 50%, and 75% considered as indicative of low, moderate, and high heterogeneity, respectively (Higgins & Thompson, 2002). Note that I 2 is not an absolute measure of heterogeneity. ...
The purpose of evaluating psychological and educational tests and disseminating test review reports is to enhance the use of tests and professional practice. There are several test review protocols and models in various countries designed to assess the quality of commercial tests, but non-commercialized tests are still yet to be evaluated thoroughly. This study indicates significant progress in test evaluations with systematic reviewing and meta-analyses, focusing on tests published in scientific journals and other channels. Our approach combines test review protocols, such as the Spanish model, with systematic reviewing and meta-analyses to evaluate non-commercial tests, such as the Generalized Problematic Internet Use Scale-2. We explore the advantages of this integrated approach and propose modifications to the test review protocol to accommodate the unique characteristics of noncommercial tests. This document also discusses the differences between international and national reviews, highlighting the importance of local norms from a practitioner’s perspective.
... Heterogeneity was examined using the Q statistic, with p ≤ 0.10 considered statistically significant [37]. Inconsistency was examined using I-squared (I 2 ). ...
Objective
The lack of consensus on the benefits and harms of standard therapies, including surgery (SRx), radiotherapy (RTx), chemotherapy (CTx), and their combinations among early‐stage MCC, prompted this study.
Methods
A systematic review and meta‐analysis of randomized and non‐randomized studies published between January 01, 1972, and January 31, 2023, and having overall survival (OS), local recurrence (LR), regional recurrence (RR), disease‐specific survival (DSS), and/or disease‐free survival (DFS) as outcomes was conducted using the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (NCBI), Scopus (ELSEVIER), and Web of Science (CLAVIRATE) databases. Hazard ratios (HRs) and their variances were pooled using the inverse variance heterogeneity model.
Results
Forty‐nine studies representing 46,215 participants were included in the meta‐analysis. A statistically significant improvement in OS was observed for groups administered adjuvant RTx (SRx + RTx) compared to SRx only (HR = 0.78, 95% CI, 0.62–0.99), albeit with statistically significant heterogeneity (Q = 532.30, p < 0.001) and a large amount of inconsistency (I² = 94%, 95% CI, 93.0–95.5). Both LR (HR = 1.52, 95% CI, 0.37–6.19) and RR (HR = 0.41, 95% CI, 0.09–1.78) were not statistically significant. In addition, DSS (HR = 0.58, 95% CI, 0.24–1.40) was not statistically significant but DFS was (HR = 0.35, 95% CI, 0.13–0.93). Subgroup analyses revealed that adjuvant radiotherapy was more effective in local than regional MCC. The E‐value suggested that the RTx dose was a confounder of the observed effectiveness of adjuvant RTx; and also, the use of CTx following adjuvant RTx, did not impact the strength of evidence for OS.
Conclusions
Although adjuvant RTx improves survival and recurrence outcomes among early‐stage MCC, the safety and effectiveness of standard therapies in MCC remains poorly studied and, thus, affects the synthesis of evidence across important patient and clinical characteristics. Future research on the comparative effectiveness of different therapies is needed.
... Analiz sürecinde JAMOVI (v.2.4) yazılımının MAJOR eklentisi kullanılarak meta analiz gerçekleştirilmiştir. Korelasyon değerleri ve örneklem büyüklüklerine dayalı tüm meta analizlerde, sosyal bilimlerde etki büyüklüklerinin çeşitlilik gösterdiği çalışmalarda önerildiği üzere, Field ve Gillet'in (2010) metoduna göre rastgele etki modeli tercih edilmiştir. Analiz bulguları arasında toplam araştırma sayısı, örneklemlerin büyüklüğü, Fisher r-to-z dönüşümü uygulanmış korelasyon katsayısı, %95 güven aralığı alt ve üst sınırları, tau² (DerSimonian ve Laird, 1986), Q testi (Cochran, 1954), I² değeri ( ...
Bakım verici, hasta olan bireyi destekleyen ve en fazla bakımı üstlenen ana kişidir. Ailede bakıma ihtiyaç duyan bir bireyin varlığı, bu rolü üstlenen aile üyelerinin günlük rutinlerini değiştirmekte ve onları uyum sağlamaları gereken yeni olgularla karşı karşıya bırakmaktadır. Hastalık sürecinin uzun olması, hayatı tehdit etmesi, semptomların artması gibi faktörler, bakım vericinin sorumluluklarını artırmakta ve ailedeki rollerini etkilemektedir. Bu noktada, bakım vericilerin anksiyete ve depresyon düzeyleri de merak edilen bir konudur. Bu çalışmanın amacı; Yükseköğretim Ulusal Tez Merkezi ile Google Scholar veri tabanlarında yayınlanan ve kapsam olarak tedavi gören bireylerin yakınlarının anksiyete ve depresyon düzeyleri arasındaki ilişkiyi temel alan tez ve makale çalışmalarının meta analiz yöntemi ile incelenmesidir. Meta analiz yapılmasında gerekli örneklem sayısını bulunduran ve Pearson korelasyon katsayısını (r) içeren 8 çalışma araştırma kapsamına alınmıştır. Meta analiz çalışmasında yayın yanlılık varlığının ölçülmesi için huni saçılım grafiği ve Classic fail-safe N analizleri ayrı şekillerde uygulanmış ve test sonuçlarında yayın yanlılığının olduğuna yönelik herhangi bir kanıta saptanmamıştır. Etki büyüklüğünün hesaplanabilmesi için rastgele etkiler modeli kullanılmıştır. Analiz sonucunda tedavi gören bireylerin yakınlarının anksiyete ve depresyon düzeylerinin ilişkisinin anlamlı olduğu, ilişkiye dair etki büyüklüğünün 0.740 değeri ile yüksek düzeyde ve pozitif yönlü olduğu sonucuna varılmıştır.
... Considering the expected variability in bisphosphonate usage, treatment duration, and patient demographics, a random-effects model was employed in the analysis. Heterogeneity was assessed using Cochran's Q test and Higgins's I 2 statistic (15,16). To assess the robustness of the effects in our analysis, we will employ a sensitivity analysis using the leave-one-out meta-analysis approach. ...
Background
The increasing prevalence of glucocorticoid-induced osteoporosis (GIOP) due to long-term glucocorticoid therapy underscores the need for effective treatment options. Denosumab and bisphosphonates, both key in managing GIOP, require further comparative evaluation to determine their relative efficacy and safety profiles.
Methods
We conducted a systematic review and meta-analysis, adhering to PRISMA guidelines. Our analysis included randomized controlled trials (RCTs) comparing denosumab with bisphosphonates in GIOP management. The outcomes were percent changes in bone mineral density (BMD) at various sites, bone turnovers markers (BTMs) and the incidence of adverse events.
Results
Our study comprised five RCTs with 1,043 participants. The results showed a significant mean difference in BMD percentage change from baseline at LS of 2.87% (95% CI: 1.86 to 3.87, p<0.001) and at TH of 1.39% (95% CI: 0.15 to 2.64, p=0.03). Additionally, the safety profile of denosumab was found to be comparable to bisphosphonates, with no significant increase in the incidence of adverse events or serious adverse reactions.
Conclusions
Denosumab proved more effective in enhancing BMD than bisphosphonates in GIOP, maintaining a comparable safety profile. However, the study’s limitations, including heterogeneity and the need for longer-term research, were noted.
... meta analizlerde, sosyal bilimlerde etki büyüklüklerinin çeşitlilik gösterdiği çalışmalarda önerildiği üzere, Field ve Gillet'in (2010) metoduna göre rastgele etki modeli tercih edilmiştir. Analiz bulguları arasında toplam çalışma sayısı, örneklem büyüklüğü, Fisher r-to-z dönüşümü uygulanmış korelasyon katsayısı, %95 güven aralığı alt ve üst sınırları, tau² (DerSimonian ve Laird, 1986), Q testi(Cochran, 1954), I² değeri(Higgins ve Thompson, 2002) ve yayın yanlılığı göstergeleri değerlendirilmiştir. Etki büyüklüğünün gücünü ölçmek için Cohen ve arkadaşlarının önerdiği şu eşik değerler dikkate alınmıştır: çok zayıf düzeyde (EB≤0,10H0: Sağlık çalışanlarının mobbing ve iş tatmini düzeyleri arasında genelleştirilmiş etki büyüklüğüne ilişkin istatistiksel anlamlı ilişki yoktur. ...
ÖZET: Mobbing, iş yerinde belirli bir kişiye karşı birkaç ay boyunca sistemli olarak duygusal zarar veren davranışlara maruz bırakılarak bireyin dışlanması ve yıpratılması sürecidir. İş tatmini ise, bireyin iş deneyimlerinden kaynaklanan olumlu ya da olumsuz tutumlarını ve işine karşı hissettiği memnuniyet ya da memnuniyetsizlik durumunu ifade eder. Mobbing, çalışanın iş yaşamını olumsuz etkileyerek iş tatmini üzerinde negatif duygular oluşturabilir. Bu etkileşim, akademik çalışmalarda ilgi çeken bir konu haline gelmiştir. Bu çalışmanın amacı; Yükseköğretim Ulusal Tez Merkezi ve google scholar veri tabanlarında yayınlanan ve kapsam olarak Türkiye'deki sağlık çalışanlarının mobbing ve iş tatmini düzeyleri arasındaki ilişkiyi temel alan tez ve makale çalışmalarının meta analiz yöntemi ile incelenmesidir. Meta analiz yapılması için ihtiyaç duyulan örneklem sayısını barındıran ve Pearson korelasyon katsayısını (r) içeren 7 çalışma araştırma kapsamına alınmıştır. Meta analiz çalışmasında yayın yanlılığı varlığının ölçülmesi için huni saçılım grafiği ve Classic fail-safe N analiz yöntemleri ayrı ayrı uygulanmış ve yapılan test ile yayın yanlılığının varlığı ile ilgili herhangi bir kanıt bulunamamıştır. Etki büyüklüğünün hesaplanabilmesi adına rastgele etkiler modeli kullanılmıştır. Analiz sonucunda sağlık çalışanlarının mobbing ve iş tatmini düzeyleri arasındaki ilişkinin anlamlı olduğu, ilişkiye dair etki büyüklüğünün-0.486 değeri ile orta düzeyde ve negatif yönlü olduğu sonucuna varılmıştır.
... Yükseköğretim Ulusal Tez Merkezi'nde (YÖKTEZ) yayınlanan tezler içerisinde sağlık çalışanlarının duygusal emek düzeylerinin cinsiyet faktörü açısından irdelenen çalışmaların meta analiz yöntemi ile incelenmesidir. (Cochran, 1954), I² değeri (Higgins ve Thompson, 2002) ve yayın yanlılığı göstergeleri değerlendirilmiştir. Etki büyüklüğünün gücünü ölçmek için Cohen ve arkadaşlarının önerdiği şu eşik değerler dikkate alınmıştır: çok zayıf düzeyde (EB≤0,10), zayıf düzeyde (0,11≤EB≤0,30), orta düzeyde (0,31≤EB≤0,50), güçlü düzeyde (0,51≤EB≤0,80) ve çok güçlü düzeyde (EB≥0,81) (Cohen vd., 2007). ...
Amaç: Günümüzde sağlık çalışanları sürekli olarak hastaların beklentilerine karşılık vermekte ve yaşamları tehlike altında olan insanların yaşamını sürdürmeleri için var olan çabalarıyla çalışmaktadır. Pandemi dönemi ve sonrası artan çalışma temposu sağlık çalışanlarında olumsuz sonuçlara sebep olabilmektedir. Gün geçtikçe artan iş yükleri ve stres altındaki çalışma koşulları ile depresyon, anksiyete ve tükenmişlik düzeyleri etkilenebilmektedir. Bu çalışmanın amacı; Yükseköğretim Ulusal Tez Merkezi'nde (YÖKTEZ) yayınlanan ve kapsam olarak sağlık çalışanlarının anksiyete ve tükenmişlik düzeyleri arasındaki ilişkiyi temel alan çalışmaların meta analiz yöntemi ile incelenmesidir. Yöntem: Meta analiz için gerekli olan örneklem sayısına sahip olan ve Pearson korelasyon katsayısını (r) içeren 13 çalışma araştırma kapsamına alınmıştır. Meta analiz yönteminde, istatistiki analize tabi tutulacak çalışmaların araştırmaya dâhil edilebilmesi için çeşitli kriterler belirlenmiştir. Bu kriterler; (i) ilgili araştırmalarda sağlık çalışanlarının anksiyete ve sağlık tükenmişlik düzeyleri arasındaki ilişkiyi incelemesi, (ii) sağlık çalışanlarının anksiyete ve tükenmişlik düzeyleri arasındaki ilişkinin tespit edilebilmesi amacıyla bu çalışmaların korelasyon katsayısını (r) içermesi ve (iii) gerekli örneklem sayısını içermesi olarak belirlenmiştir. Meta-analizin gerçekleştirilmesinde JAMOVI (v.2.4) paket programının MAJOR eklentisi kullanılmıştır. Bulgular: Bu meta analiz çalışmasında yayın yanlılığının olup olmadığının ölçülmesi amacıyla huni saçılım grafiği ve Classic fail-safe N analiz yöntemleri ayrı ayrı uygulanmış ve yapılan test sonucunda yayın yanlılığının varlığına yönelik herhangi bir kanıt bulunamamıştır. Etki büyüklüğünün hesaplanabilmesi amacıyla hangi modelin kullanılacağının tespiti için heterojenlik testi yapılmış ve etki büyüklükleri dağılımının yüksek düzeyde heterojenlik gösterdiği tespit edilmiştir. Bu nedenle etki büyüklüğünün hesaplanabilmesi için rastgele etkiler modeli kullanılmıştır. Genel olarak, sağlık çalışanlarının anksiyete ve sağlık tükenmişlik düzeyleri arasındaki ilişkinin pozitif yönde anlamlı olduğu sonucuna varılmıştır. Sonuç: Analiz sonucunda; sağlık çalışanlarının anksiyete ve tükenmişlik düzeyleri arasındaki ilişkinin anlamlı olduğu, ilişkiye dair etki büyüklüğünün 0.345 değeri ile orta düzeyde ve pozitif yönlü olduğu tespit edilmiştir.
Introduction: Nowadays, healthcare professionals are constantly responding to the expectations of patients and working with their best efforts to sustain the lives of people whose lives are in danger. The increased work tempo during and after the pandemic period may cause negative consequences in healthcare professionals. Depression, anxiety and burnout levels can be affected by increasing workloads and working conditions under stress. The aim of this study is to examine the studies published in the National Thesis Centre of Higher Education (YÖKTEZ) and based on the relationship between anxiety and burnout levels of healthcare professionals by meta-analysis method. Methods: Thirteen studies that had the required sample size for meta-analysis and included Pearson correlation coefficient (r) were included in the study. In the meta-analysis method, various criteria were determined for the inclusion of the studies to be subjected to statistical analysis. These criteria were determined as; (i) examining the relationship between anxiety and health burnout levels of health workers, (ii) including the correlation coefficient (r) of these studies in order to determine the relationship between anxiety and burnout levels of health workers, and (iii) including the required sample size. The MAJOR plug-in of the JAMOVI (v.2.4) package programme was used to perform the meta-analysis. Results: In this meta-analysis study, funnel scatter plot and Classic fail-safe N analysis methods were applied separately to measure the presence of publication bias, and no evidence for the presence of publication bias was found as a result of the test. Heterogeneity test was performed to determine which model to use in order to calculate the effect size and it was determined that the distribution of effect sizes showed a high level of heterogeneity. Therefore, random effects model was used to calculate the effect size. In general, it was concluded that the relationship between anxiety and health burnout levels of health workers was positively significant. Conclusion: As a result of the analysis, it was determined that the relationship between anxiety and burnout levels of healthcare workers was significant, and the effect size of the relationship was moderate and positive with a value of 0.345.
... Relevant data from eligible trials were combined in a random effects model to identify the mean difference in each outcome when legumes were provided. We used the Cochrane Q test [26] and I 2 statistic [27] to measure the heterogeneity of pooled data. Three sensitivity analyses were conducted following the initial pooling of data: (1) influence analysis to evaluate the impact of each individual trial on the pooled result by systematically removing each trial's data one at a time; (2) potential for small study effects with an Egger's test [28]; (3) impact of potential small study effects when indicated with the trim and fill method [29]. ...
Background
Legumes are widely considered one of the most beneficial food groups to consume. They are high in fibre and plant-based protein as well as naturally low in sodium, saturated fats, and sugars. However, legumes do not feature prominently in the modern diet, and previous evidence syntheses show inconsistent results on cardiometabolic risk profile when increasing legume intakes. This review examines the impact of legume intake on cardiometabolic profile and gut microbiome.
Methods
EMBASE, OVID Medline, and the Cochrane Central Register of Controlled Trials were searched up to 15 May 2024 with checking of relevant reference lists and bibliographies. Relevant data were extracted into pre-tested forms and risk of bias was assessed with Cochrane RoB2. Searches, screening, and risk of bias assessment were done independently by two reviewers. We have considered trials where legumes were provided to adults, with and without pre-existing conditions (i.e. type 2 diabetes, heart disease or dyslipidaemia), in randomised controlled trials of at least six weeks duration on cardiometabolic risk factors and gut microbiome outcomes. Trial data were pooled using random effects models. Prespecified regression analyses were then performed to identify the factors influencing pooled results. Certainty of evidence was assessed with GRADE.
Results
We identified 30 papers of 24 trials with 33 eligible comparisons where legumes (daily average 86 g (range 2-251)) were provided to 1,938 participants. No eligible studies reported on microbiome outcomes. There was moderate certainty evidence that higher legume intakes improved total cholesterol (mean difference (MD) -0.23mmol/L, 95%CI -0.33 to -0.13), LDL cholesterol (MD -0.16mmol/L (-0.24 to -0.08)), and fasting blood glucose (MD -0.18mmol/L (-0.30 to -0.06)). The majority of trial comparisons (70%) provided an isoenergetic control food. Pooled results were influenced by underlying differences between trials such as type and format of legumes provided, but not consistently across multiple outcomes.
Conclusions
Increasing legume intakes improved some blood lipid and glucose parameters, but not all. Isoenergetic comparisons in trials may obscure changes in cardiometabolic risk factors due to greater satiation or reduced intake, and no trials greater than six weeks duration were identified to consider the microbiome-mediated health effects with greater legume intakes. Future trials in these areas are necessary.
Trial registration
Prospero ID CRD42023456953.
... We estimated the amount of heterogeneity (i.e., τ 2 ) using the restricted maximum-likelihood estimator (Viechtbauer, 2005). Additionally, we calculated the Q-test (Cochran, 1954) and I 2 statistic (Deeks et al., 2019). The I 2 statistic is a commonly used test that represents the proportion of observed variance that cannot be attributed to sampling error (Borenstein et al., 2017;J. ...
Following a suicide attempt, only a third of people receive outpatient treatment. This highlights the need to rethink our approach to treatment, to include the consideration of low-threshold brief interventions and contacts. Therefore, in this study, we investigated the extent to which such brief interventions and contacts (BICs) are effective. PubMed, Cochrane, Embase, ProQuest, and PsycINFO were searched by independent researchers according to the PRISMA guidelines. This meta-analysis included randomized clinical trials (RCTs) that tested BIC in adults after a suicide attempt. It examined the effectiveness of BIC on (1) re-attempts at follow-up, (2) self-harm at follow-up, (3) suicidal ideation at follow-up, and (4) linkage to mental health services at follow-up. The findings from 54 RCTs confirmed that BICs are effective: (1) Re-attempts at the follow-up phase were significantly reduced in the BIC group compared with control (-0.35, 95% CI: -0.54, –0.15). (2) There was no difference between the groups in the recurrence of self-harm and (3) in the severity of suicidal ideation at follow-up. (4) The linkage to mental health services at follow-up was significantly higher in the BIC group compared with control (0.60, 95% CI: 0.05, 1.15). In this largest meta-analysis to date, there are clear implications for clinical practice: BICs, often consisting of only one session, are effective in reducing the recurrence of suicide attempts and can be used to help people find a connection to the mental healthcare system after a suicide attempt. Thus, these interventions should be integrated into suicide prevention strategies.
... Heterogeneity of the study effect sizes was evaluated using Cochran's Q statistic and I 2 statistic. [51,52] Significant heterogeneity was defined by P < 0.05 for the Cochran Q statistic or by I 2 values >50%. Publication bias was examined ...
Introduction
Methicillin-resistant Staphylococcus aureus (MRSA) colonization in neonatal intensive care units (NICUs) is a significant global health concern, leading to severe infections, extended hospital stays, and substantial economic burdens on health-care systems. To develop effective infection control strategies, we need to fill existing gaps in our understanding of MRSA epidemiology in neonates. The aim of this systematic review is to provide an extensive analysis of the proportion of MRSA colonizations in NICUs.
Methods
We used a comprehensive search strategy across databases such as Medline, Embase, Global Health, Web of Science, and Global Index Medicus, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were independently reviewed and selected based on a variety of criteria, including the inclusion of neonates tested for MRSA colonization during NICU stay, and the reporting of community-acquired and hospital-acquired MRSA (CA-MRSA and HA-MRSA) incidence levels. Exclusion criteria included studies outside NICUs, those focused on specific MRSA outbreaks or clinical infections, review studies, and those lacking abstracts or full texts. Five authors independently extracted data, which was summarized and checked for quality. Statistical analysis included a random-effects model to compute pooled proportions, stratification by geographical location, evaluation of heterogeneity, and examination of publication bias.
Results
Our systematic review evaluated 62 studies out of an initial 536 records identified. The majority of the selected studies were conducted in high-income countries, primarily in the United States. From these studies, we estimated a cumulative incidence rate of 7.2% for MRSA colonization in NICUs. When the source of MRSA was considered, CA-MRSA incidence was 2.7%, while HA-MRSA incidence was notably higher at 11%. A subgroup analysis showed geographical differences in the cumulative incidence of MRSA colonization in NICUs, with Brazil having the lowest incidence and Taiwan the highest. The proportion of HA-MRSA colonization also varied significantly by country, with South Korea reporting higher incidence rates than the United States. However, the differences in CA-MRSA colonization rates between countries and WHO regions were not statistically significant.
Conclusions
Our systematic review found a cumulative incidence of 7.2% for MRSA colonization in NICUs, with HA-MRSA (11%) being more prevalent than CA-MRSA (2.7%). Regional variations were detected, with Taiwan exhibiting the highest cumulative incidence and South Korea having both the highest CA-MRSA and HA-MRSA. These findings underline the substantial public health impact of MRSA, especially in NICUs, necessitating context-specific prevention and control strategies. Future research should strive to address these regional disparities and aspire to attain a more globally representative understanding of MRSA colonization rates.
... Risk of bias was assessed using funnel plots where appropriate. Heterogeneity was assessed with I 2 and Cochran's Q (Cochran, 1954). Log odds ratios were converted back into odds ratios for ease of presentation and both odds ratios and log odds ratios were reported. ...
Background
To evaluate the effect of financial incentives on engagement in parenting programs for disruptive behavior disorders, as well as effect on child behavior. As a secondary aim, demographic differences were investigated as effect modifiers.
Methods
We searched PubMed, CINAHL, Sociological Abstracts, Cochrane Trials, and PsycINFO for randomized controlled trials and quasi experimental studies offering parents a financial incentive for engagement with parenting programs targeting disruptive behavior in children aged under 18, vs no incentive. Engagement in each group was evaluated at four stages: connection, attendance, participation, and enaction. Per protocol (CRD42022336210) random effects meta‐analysis was conducted using Stata‐16. Meta‐analyses of binary data used a log odds ratio and continuous data was standardized using Hedges' g.
Results
We identified 2438 papers and screened 35 at full length. We included eight independent cohorts from seven papers. Parents invited to incentive arms were more likely to complete a threshold of sessions than parents invited to control arms (odds ratio 2.51 95% CI 1.42–4.48). Parents were more likely to agree to participate when they knew they were joining the incentive program (odds ratio 1.40, 95% CI 1.20–1.65) and parents in the incentive group were more likely than parents in the control group to reach a completion threshold of sessions (odds ratio 1.76 95% CI 1.17–2.66).
Conclusion
Incentives increase parenting programs engagement among parents who are invited and among parents who have begun attending programs. Incentives are an effective potential tool for increasing engagement but further research is needed to establish acceptability and optimal design.
... The study employed the standardized mean difference as the final measurement and analyzed the findings using a random-effects model. The level of heterogeneity (tau² ) was determined using the restricted maximum-likelihood estimate (Viechtbauer, 2005), alongside the I² measure and the Q-test for heterogeneity (Cochran, 1954), with the value of tau² provided. In cases where heterogeneity was observed (tau² > 0), a range of predictions for real outcomes was generated. ...
The Flipped Classroom (FC) model, a teaching method used in various educational settings, including language learning, aims to improve student engagement and understanding. Its application in English language learning involves restructuring traditional teaching and learning methods. This study was meticulously designed to assess FC's effectiveness in improving English language proficiency. A comprehensive meta-analysis was conducted on research articles from January 2021 to November 2023, retrieved from ERIC and the Scopus Index. After a rigorous independent review and data extraction process by two reviewers, nine studies with a total of 705 participants were included. The methodological quality of the selected articles was evaluated using the Fail-Safe N for Publication Bias Assessment. The results, which showed that FC was more effective than conventional methods in enhancing overall English language proficiency (SMD=0.85, 95% CI -0.57 to 1.12, P<.001, I2=65.45%), knowledge (SMD=0.84, 95% CI -0.55 to 1.12, P<.001, I2=49.49%), and skills (SMD=0.70, 95% CI -0.30 to 1.11, P<.01, I2=75.97%), instill confidence in the robustness of our findings. These results suggest that FC has the potential to significantly improve English language acquisition outcomes. However, further research with larger sample sizes is needed to confirm and strengthen these results.
... Convenient sampling technique is used to collect responses. (Cochran, 1954) proposed a statistical approach for determining appropriate sample size in order to properly validate statistical findings. ...
... An I 2 value of 0%-25% represents insignificant heterogeneity, 26%-50% represents low, 51%-75% represents moderate, and > 75% represents high. The evidence of statistically significant differences between subgroups was investigated using the Cochran's Q statistics (Cochran 1954). All analyses were performed using the R package "meta" in R, Version 4.2.1 (Schwarzer 2022). ...
The Practice Environment Scale of the Nursing Work Index has been used worldwide to measure nurse work environments. International benchmark values for this scale can assist managers in assessing their work environment. The objective was to conduct a meta‐analysis of this instrument's composite and subscale values across continents, nursing unit types, and time. Studies published up until September 30, 2023 were identified in CINAHL, MEDLINE, and Embase. One‐hundred and sixty publications representing 38 countries were included. Most studies were rated as high certainty and low to moderate risk of bias. The pooled point estimate (2.70) indicated that hospital work environments were modestly positive. The weakest work environment domain was Staffing and Resource Adequacy (2.47). Europe had significantly weaker work environments than Asia and North America. Africa and South America had few studies. Better work environments were reported in neonatal intensive care, as compared to medical surgical and critical care units. A small, positive slope over time, which was detected in the three continents, was significant in North America. To promote evidence‐based management globally, benchmark values are now available by setting and continent.
... Formicidae), we created a final set of models that only comprised these two groups as moderators. Cochran's Q test was used to measure the heterogeneity among studies (Cochran, 1954). The Cerrado regions were omitted from these meta-analytic models as the response variables did not vary significantly between regions, nor did regions contribute to explaining variance as a random effect (Table A2; Figure A2). ...
Cerrado is the largest and most biodiverse savannah worldwide. However, only a reduced amount of this ecosystem is conserved, and in the last decades, the vast agricultural expansion resulted in the substitution of native vegetation for exotic pasturelands.
Insects are key components for both native and exotic ecosystems in Cerrado, performing critical functions for ecosystem maintenance. Our goal was to evaluate how the transformation of natural Cerrado into cattle pastures (exotic pastures) affects the insect communities in this biome.
We conducted a meta‐analysis using data on species richness and abundance data of insect assemblages from conserved Cerrado and exotic pastures. The analysis was based on a set of 23 scientific articles. Fourteen studies focused on Coleoptera and nine on Hymenoptera.
Conserved Cerrado encompassed a higher species richness of insects than exotic pastures, but their abundance did not differ between these two habitats. However, dung beetle abundance increases significantly in disturbed Cerrado over time. Synanthropic species that thrive in altered environments could be masking the actual decline in abundance of species sensitive to environmental disturbances provoked by exotic pastures.
Our results highlight the consequences of the structural homogenisation of the Cerrado into cattle pastures. That is, despite having a similar open‐canopy vegetation structure, this land‐use change leads to a significant loss of insect species, resulting in a drastic simplification of insect communities. This study reinforces the importance of maintaining native Cerrado patches in order to maintain diverse and functional ecosystems in this region.
... p < .001 (Cochran, 1954), and there is clear evidence that more than 80% of the dispersion would reflect variation in true effects when there is no sampling error (I 2 = 82.52%; Higgins & Thompson, 2002). ...
... Then, we imported this data into the STATA version 17 statistical software program to analyze the combined results. Measuring heterogeneity based on statistical findings, outcome presentations, and methodologies was done using the I 2 statistic and a chi-squared test by Cochran's Q statistic with a 5% significance level [40]. I 2 values of 25%, 50%, and 75% are considered indicative of low, moderate, and high heterogeneity, respectively [41]. ...
Introduction
: Depression is a common and debilitating mental health issue among refugees in East Africa, who face numerous challenges. However, there is a lack of systematic reviews and meta-analyses that have explored the pooled prevalence and associated factors of depression among refugees in East Africa. This study aims to investigate the pooled prevalence of depression and its associated factors among refugees living in East Africa.
Methods
A systematic search was conducted across several databases, including PubMed/MEDLINE, CINAHL, ScienceDirect, African Journals of Online (AJOL), and Google Scholar. The quality of the included studies was assessed using a Joanna Briggs Institute (JBI) quality appraisal tool. Statistical analysis was carried out using STATA-17 software packages, and a meta-analysis was conducted using a random-effects model. Heterogeneity among the studies was assessed using the I² statistic. Publication bias was evaluated using the DOI plot, Luis Furuya Kanamori (LFK) index, and Egger’s test. For associated factors of depression, effect sizes (odds ratio) with 95% confidence intervals were analyzed.
Result
A total of eight studies involving 6,388 participants were included in this systematic review and meta-analysis, all of which were assessed to have a low risk of bias. The pooled prevalence of depression was 50.60%, with a 95% CI (35.49%, 65.71). Regarding factors associated with depression; being female [(OR = 2.01; 95% CI (1.06, 3.82)], having poor social support [OR 5.88; 95% CI (2.53, 13.67)], and experienced eight or more traumatic events [OR = 3.31;95% CI (1.74, 6.31) were positively associated factors with depression.
Conclusion
The pooled prevalence of depression among refugees in East Africa was found to be significantly high. Female participants, poor social support, and experienced eight or more traumatic events were factors affecting depression among refugees in East Africa. Therefore, policymakers and health personnel in East Africa should prioritize addressing the needs of female participants, individuals with poor social support, and those who have experienced eight or more traumatic events.
... Risk of publication bias was assessed using Egger's asymmetry test for funnel plot asymmetry, by examining the portrayal of the funnel plots and with Rosenthal's fail-safe n (Egger et al., 1997;Rosenthal, 1979). Heterogeneity across studies was estimated with Cochran's Q and the I 2 statistic (Cochran, 1954;Higgins et al., 2003). Two sensitivity analyses were conducted to assess the impact of comparator type on the robustness of our results by excluding active cognitive control comparators, as well as non-randomized study designs. ...
... Degree of heterogeneity ( 2 ), was estimated using the restricted maximum-likelihood estimator (18). In addition to the estimate of 2 , thetest for heterogeneity (19) and the 2 statistic (20) are reported. Irrespective of the heterogeneity values detected (̂2 > 0, regardless of the results of the -test), a prediction interval for the true outcomes is also provided (21). ...
... The heterogeneity assessment was performed using Cochran's Q test [25] and I 2 statistics [26]; I 2 values of 25%, 50%, and 75% were regarded as low, moderate, and high heterogeneity, respectively. Publication bias was assessed when a subgroup included more than 10 studies, using a visual funnel plot analysis and quantitative Egger's test [27]. ...
Background: The prognosis for patients with lung cancer bone metastases has improved with the use of novel systemic agents. These patients might need surgery or radiotherapy to alleviate symptoms or maintain function. However, there is currently no disease specific algorithm to guide multidisciplinary decisions. Methods: The inclusion criteria encompassed studies with ≥10 patients offering multivariate analysis data on survival that were published after 2000 until September 2023. Clinical factors were categorized based on their characteristics and the pooled hazard ratios (HRs) for each category were calculated. A treatment algorithm was proposed based on clinical importance and the pooled HRs. Results: Fifteen studies involving 3759 patients with lung cancer bone metastases were included. The median survival ranged between 1.8–28.3 months (median: 12.4). Among the studies involving patients with EGFR+ or treated with TKIs, the median survival ranged between 19.5–28.3 months. The most reported significant factor was ECOG performance (nine studies) followed by chemotherapy use (six studies). In the pooled analyses, the pooled HR [95% confidence interval (CI)] of the EGFR status category was 2.109 (1.345–3.305); the ECOG performance category was 2.007 (1.536–2.622); the visceral metastases category was 2.060 (1.370–3.098); the bone metastases characteristics category (e.g., multiplicity, weight-bearing bone metastases) was 1.910 (1.443–2.527); the body weight category was 1.805 (1.334–2.442); the anti-absorbants category was 1.784 (1.448–2.196); the systemic treatment category was 1.695 (1.407–2.041); the skeletal-related event category was 1.616 (1.063–2.458); the smoking status category was 1.530 (1.306–1.793); the gender category was 1.482 (1.270–1.729); and the histology category was 1.450 (1.186–1.772). Conclusions: Oncological prognoses are influenced by various interrelated factors. Our treatment algorithm supports multidisciplinary strategies for managing NSCLC bone metastases, considering the complex factors influencing prognosis.
... Namely, we need to test whether the variation of the effects are due to sampling or there might be an underlying distribution causing such variation. The homogeneity statistics, Cochran's Q [19], is the appropriate and conventional homogeneity test, which addresses this question. The null hypothesis is that all effect sizes are the same and the observed variation is only due to sampling error. ...
Online media provides opportunities for marketers through which they can deliver effective brand messages to a wide range of audiences. Advertising technology platforms enable advertisers to reach their target audience by delivering ad impressions to online users in real time. In order to identify the best marketing message for a user and to purchase impressions at the right price, we rely heavily on bid prediction and optimization models. Even though the bid prediction models are well studied in the literature, the equally important subject of model evaluation is usually overlooked. Effective and reliable evaluation of an online bidding model is crucial for making faster model improvements as well as for utilizing the marketing budgets more efficiently. In this paper, we present an experimentation framework for bid prediction models where our focus is on the practical aspects of model evaluation. Specifically, we outline the unique challenges we encounter in our platform due to a variety of factors such as heterogeneous goal definitions, varying budget requirements across different campaigns, high seasonality and the auction-based environment for inventory purchasing. Then, we introduce return on investment (ROI) as a unified model performance (i.e., success) metric and explain its merits over more traditional metrics such as click-through rate (CTR) or conversion rate (CVR). Most importantly, we discuss commonly used evaluation and metric summarization approaches in detail and propose a more accurate method for online evaluation of new experimental models against the baseline. Our meta-analysis-based approach addresses various shortcomings of other methods and yields statistically robust conclusions that allow us to conclude experiments more quickly in a reliable manner. We demonstrate the effectiveness of our evaluation strategy on real campaign data through some experiments.
... As shown in Table 5, including the results of the applied Q-test (Cochran, 1954) and related statistics, given that the Tau 2 value returned positive results, it can be affirmed that a certain degree of heterogeneity is present within the study sample. Nevertheless, it is worth noting that the Q statistic retrieved positive yet relatively low values, which, although effectively points out the existence of heterogeneity between the introduced registers, may be influenced by the relatively low number of registers (k = 18, coming from nine different publications) that were addressed in this meta-analysis. ...
As robotics become increasingly present in about every area of the human daily life scheme, their presence in the educational world has become increasingly common, especially with regard to earlier stages and in relation to disciplines framed within the Science, Technology, Engineering, and Mathematics (STEM) concept, given its innate links to these programmable companions. Consequentially, the main objective of this study is to analyze the evolution in time of robotic learning mediation of STEM-based teaching and learning in the Primary Education stage. To achieve this objective, a systematic review of the literature and a meta-analysis were conducted to retrieve experiences of interest (n = 13; n = 8). The present study indicates that, despite certain hiatuses, this educational research field has been of global increasing interest, implementing a variety of robotic-related products that, in the end, have been reported to cause a moderate benefit regarding the acquisition and strengthening of STEM competences. Future research lines are discussed, pointing to the urgent need to establish a framework of reference for didactic planning around these resources in order to extend their use to every potential teacher in the target stage.
... There are several tests and metrics of betweendataset heterogeneity, borrowed from applications of meta-analysis in other fields. The most popular are Cochran's Q test of homogeneity [9], the I 2 metric [obtained by (Q-degrees of freedom)/Q] and the between-study variance estimator τ 2 [21]. There are shortcomings to all of them [26]. ...
Replication helps ensure that a genotype-phenotype association observed in a genome-wide association (GWA) study represents a credible association and is not a chance finding or an artifact due to uncontrolled biases. We discuss prerequisites for exact replication, issues of heterogeneity, advantages and disadvantages of different methods of data synthesis across multiple studies, frequentist vs. Bayesian inferences for replication, and challenges that arise from multi-team collaborations. While consistent replication can greatly improve the credibility of a genotype-phenotype association, it may not eliminate spurious associations due to biases shared by many studies. Conversely, lack of replication in well-powered follow-up studies usually invalidates the initially proposed association, although occasionally it may point to differences in linkage disequilibrium or effect modifiers across studies.
... Lin, 1997) and for het-SKAT (Lee and others, 2013). Alternatively, one could let E(µ sj ) = 0 and V ar(µ sj ) + V ar(τ sj ) = 0, which is assumed in fixed effect meta analysis (Cochran, 1954). Han and Eskin (2011); Tang and Lin (2014) studied a combination of two models, E(µ sj ) = 0 or V ar(µ sj ) + E(τ sj ) = 0. ...
Meta-analysis of multiple genome-wide association studies (GWAS) is effective for detecting single or multi marker associations with complex traits. We develop a flexible procedure ("STAMP") based on mixture models to perform region based meta-analysis of different phenotypes using data from different GWAS and identify subsets of associated phenotypes. Our model framework helps distinguish true associations from between-study heterogeneity. As a measure of association we compute for each phenotype the posterior probability that the genetic region under investigation is truly associated. Extensive simulations show that STAMP is more powerful than standard approaches for meta analyses when the proportion of truly associated outcomes is 50\%. For other settings, the power of STAMP is similar to that of existing methods. We illustrate our method on two examples, the association of a region on chromosome 9p21 with risk of fourteen cancers, and the associations of expression of quantitative traits loci (eQTLs) from two genetic regions with their cis-SNPs measured in seventeen tissue types using data from The Cancer Genome Atlas (TCGA).
... Compared to the RE model, the FE model leads to an inflation of z-scores starting 300 ms post-stimulus. Note that this is consistent with the result of Cochran's Q-test for effect size heterogeneity [9] indicating non-zero betweensubject variability after 200 ms post-stimulus (p < 0.05), but not before. ...
Hierarchically-organized data arise naturally in many psychology and neuroscience studies. As the standard assumption of independent and identically distributed samples does not hold for such data, two important problems are to accurately estimate group-level effect sizes, and to obtain powerful statistical tests against group-level null hypotheses. A common approach is to summarize subject-level data by a single quantity per subject, which is often the mean or the difference between class means, and treat these as samples in a group-level t-test. This 'naive' approach is, however, suboptimal in terms of statistical power, as it ignores information about the intra-subject variance. To address this issue, we review several approaches to deal with nested data, with a focus on methods that are easy to implement. With what we call the sufficient-summary-statistic approach, we highlight a computationally efficient technique that can improve statistical power by taking into account within-subject variances, and we provide step-by-step instructions on how to apply this approach to a number of frequently-used measures of effect size. The properties of the reviewed approaches and the potential benefits over a group-level t-test are quantitatively assessed on simulated data and demonstrated on EEG data from a simulated-driving experiment.
... Before likelihood-based fitting procedures for hierarchical models became ubiquitous, Cochran developed a moment-based approach for fitting a univariate (p = q = 1) hierarchical linear model (Cochran, 1937;Yates and Cochran, 1938;Cochran, 1954). The method takes group-specific estimates of the effects and then uses weighted moments of these estimates to approximate the population parameters. ...
Hierarchical models allow for heterogeneous behaviours in a population while simultaneously borrowing estimation strength across all subpopulations. Unfortunately, existing likelihood-based methods for fitting hierarchical models have high computational demands, and these demands have limited their adoption in large-scale prediction and inference problems. This paper proposes a moment-based procedure for estimating the parameters of a hierarchical model which has its roots in a method originally introduced by Cochran in 1937. The method trades statistical efficiency for computational efficiency. It gives consistent parameter estimates, competitive prediction error performance, and substantial computational improvements. When applied to a large-scale recommender system application and compared to a standard maximum likelihood procedure, the method delivers competitive prediction performance while reducing the sequential computation time from hours to minutes.
Background
Since the inception of the ASHAs in the year 2005, their work horizons have increased from Reproductive, Maternal, Newborn, Child, and Adolescent health (RMNCH + A), Communicable and Non-Communicable Diseases (CD & NCD) to oral health, ophthalmologic care, and other supportive community level healthcare services. The present literature lacks comprehensive understanding and synthesis of domain-wise knowledge of ASHAs and the factors affecting their knowledge. Therefore, this study aimed to synthesize and collate the relevant evidence to understand the overall knowledge of ASHAs.
Methods
This systematic review and meta-analysis sourced literature from Google Scholar, PubMed, and Web of Science. Of the 1062 articles identified, 37 articles were selected for narrative synthesis and meta-analysis which focused on knowledge of ASHAs. In meta-analysis, pooled prevalence was estimated using the random effect model. Meta-analysis was performed using the statistical software R version. 3.6.1 for Microsoft Windows.
Results
The overall pooled prevalence of knowledge regarding maternal, neonatal/child health, communicable, and non-communicable diseases among ASHAs was 62%, 69%, 62%, and 73%, respectively. The level of education, years of experience, inadequate supervision, and training were the factors affecting their knowledge and subsequently its translation into practices within the community. The review also evidenced variation of knowledge among ASHAs across domains and geographical regions of India.
Conclusion
The systematic review and meta-analysis highlight that ASHAs have proven to be indispensable assets to India’s healthcare system with their strengths lying in maternal and child health programs. To further enhance their impact, it is imperative to invest in areas where they lack knowledge such as disease surveillance, and preventive healthcare. Empowering ASHAs with necessary resources, and training will not only enhance their capabilities but also contribute to the overall improvement of the healthcare system in India.
Reproductive pathologies in dairy cattle significantly impact animal welfare, profitability, and productivity. The objective of this study was to estimate the prevalence of the main reproductive pathologies that have affected livestock farming in Colombia during the period between 2019 and 2022 through a systematic review and meta–analysis. A meta–analysis was carried out where the prevalence of diseases was identified, where initially a systematic review was accomplish with the PRISMA methodology, using the databases PubMed, Science Direct, Dialnet, Google Scholar. Inclusion and exclusion criteria were defined, the quality of the studies was evaluated and data was extracted from the selected articles to analyze the information using the OpenMeta [Analyst]® software, in order to standardize the findings obtained. From an initial 3,883 bibliographic references, 28 studies met the inclusion criteria. Infectious Bovine Rhinotracheitis (IBR) exhibited the highest prevalence, ranging from 0.00% to 77.30%, followed by Bovine Neosporosis (17.55% – 61.34%) and Bovine Viral Diarrhea (BVD) (16.14% – 44.13%). Brucellosis (0.01% – 1.65%) and Leptospirosis (1.48% – 24.33%) displayed the lowest overall prevalence. Data for other reproductive diseases was either absent or excluded based on the defined criteria. The identified prevalence of reproductive diseases in Colombian dairy cattle highlights the need for improved farm health protocols and management practices. Furthermore, a scarcity of studies across different regions suggests a gap in knowledge regarding the true national prevalence of these diseases. This knowledge is crucial for establishing effective health and animal welfare plans.
Importance
Previous meta-analyses suggest that fluoride exposure is adversely associated with children’s IQ scores. An individual’s total fluoride exposure comes primarily from fluoride in drinking water, food, and beverages.
Objective
To perform a systematic review and meta-analysis of epidemiological studies investigating children’s IQ scores and prenatal or postnatal fluoride exposure.
Data Sources
BIOSIS, Embase, PsycInfo, PubMed, Scopus, Web of Science, CNKI, and Wanfang, searched through October 2023.
Study Selection
Studies reporting children’s IQ scores, fluoride exposure, and effect sizes.
Data Extraction and Synthesis
Data were extracted into the Health Assessment Workplace Collaborative system. Study quality was evaluated using the OHAT risk-of-bias tool. Pooled standardized mean differences (SMDs) and regression coefficients were estimated with random-effects models.
Main Outcomes and Measures
Children’s IQ scores.
Results
Of 74 studies included (64 cross-sectional and 10 cohort studies), most were conducted in China (n = 45); other locations included Canada (n = 3), Denmark (n = 1), India (n = 12), Iran (n = 4), Mexico (n = 4), New Zealand (n = 1), Pakistan (n = 2), Spain (n = 1), and Taiwan (n = 1). Fifty-two studies were rated high risk of bias and 22 were rated low risk of bias. Sixty-four studies reported inverse associations between fluoride exposure measures and children’s IQ. Analysis of 59 studies with group-level measures of fluoride in drinking water, dental fluorosis, or other measures of fluoride exposure (47 high risk of bias, 12 low risk of bias; n = 20 932 children) showed an inverse association between fluoride exposure and IQ (pooled SMD, −0.45; 95% CI, −0.57 to −0.33; P < .001). In 31 studies reporting fluoride measured in drinking water, a dose-response association was found between exposed and reference groups (SMD, −0.15; 95% CI, −0.20 to −0.11; P < .001), and associations remained inverse when exposed groups were restricted to less than 4 mg/L and less than 2 mg/L; however, the association was null at less than 1.5 mg/L. In analyses restricted to low risk-of-bias studies, the association remained inverse when exposure was restricted to less than 4 mg/L, less than 2 mg/L, and less than 1.5 mg/L fluoride in drinking water. In 20 studies reporting fluoride measured in urine, there was an inverse dose-response association (SMD, −0.15; 95% CI, −0.23 to −0.07; P < .001). Associations remained inverse when exposed groups were restricted to less than 4 mg/L, less than 2 mg/L, and less than 1.5 mg/L fluoride in urine; the associations held in analyses restricted to the low risk-of-bias studies. Analysis of 13 studies with individual-level measures found an IQ score decrease of 1.63 points (95% CI, −2.33 to −0.93; P < .001) per 1-mg/L increase in urinary fluoride. Among low risk-of-bias studies, there was an IQ score decrease of 1.14 points (95% CI, –1.68 to –0.61; P < .001). Associations remained inverse when stratified by risk of bias, sex, age, outcome assessment type, country, exposure timing, and exposure matrix.
Conclusions and Relevance
This systematic review and meta-analysis found inverse associations and a dose-response association between fluoride measurements in urine and drinking water and children’s IQ across the large multicountry epidemiological literature. There were limited data and uncertainty in the dose-response association between fluoride exposure and children’s IQ when fluoride exposure was estimated by drinking water alone at concentrations less than 1.5 mg/L. These findings may inform future comprehensive public health risk-benefit assessments of fluoride exposures.
The biology underlying the connection between social relationships and health is largely unknown. Here, leveraging data from 42,062 participants across 2,920 plasma proteins in the UK Biobank, we characterized the proteomic signatures of social isolation and loneliness through proteome-wide association study and protein co-expression network analysis. Proteins linked to these constructs were implicated in inflammation, antiviral responses and complement systems. More than half of these proteins were prospectively linked to cardiovascular disease, type 2 diabetes, stroke and mortality during a 14 year follow-up. Moreover, Mendelian randomization (MR) analysis suggested causal relationships from loneliness to five proteins, with two proteins (ADM and ASGR1) further supported by colocalization. These MR-identified proteins (GFRA1, ADM, FABP4, TNFRSF10A and ASGR1) exhibited broad associations with other blood biomarkers, as well as volumes in brain regions involved in interoception and emotional and social processes. Finally, the MR-identified proteins partly mediated the relationship between loneliness and cardiovascular diseases, stroke and mortality. The exploration of the peripheral physiology through which social relationships influence morbidity and mortality is timely and has potential implications for public health.
Amaç: Akılcı ilaç kullanımı ilaçla tedavinin etkili, güvenli ve ekonomik bir şekilde tatbikine imkan sağlayan planlama, uygulama, kontrol etme ve önlem alma işlemidir. Sağlık okuryazarlığı ise, kaliteli, etkili ve güvenli bir sağlık hizmeti sunulmasında bireylerin rahatsızlıklarını doğru ifade edebilmelerini, sağlık çalışanları ile etkili iletişim kurabilmelerini ve tıbbı öneri ve tedavi yönergelerini anlayıp uygulayabilmelerini geliştiren ve destekleyen önemli bir durumdur. Bu çalışmanın amacı; Yükseköğretim Ulusal Tez Merkezi'nde (YÖKTEZ) yayınlanan akılcı ilaç kullanımı ile sağlık okuryazarlığı arasındaki ilişkiyi temel alan tezlerin meta-analiz yöntemi ile incelenmesidir. Yöntem: Meta-analiz için gerekli olan örneklem sayısına sahip olan ve Pearson korelasyon katsayısını (r) içeren 10 çalışma araştırma kapsamına alınmıştır. Meta analiz yönteminde, istatistiki analize tabi tutulacak çalışmaların araştırmaya dâhil edilebilmesi için çeşitli kriterler belirlenmiştir. Bu kriterler; (i) ilgili araştırmaların akılcı ilaç kullanımı ve sağlık okuryazarlığı arasındaki ilişkiyi incelemesi, (ii) akılcı ilaç kullanımı ve sağlık okuryazarlığı arasındaki ilişkinin tespit edilebilmesi amacıyla bu çalışmaların korelasyon katsayısını (r) içermesi ve (iii) gerekli örneklem sayısını içermesi olarak belirlenmiştir. Meta-analizin gerçekleştirilmesinde JAMOVI (v.2.4) paket programının MAJOR eklentisi kullanılmıştır. Bulgular: Bu meta analiz çalışmasında yayın yanlılığının olup olmadığının ölçülmesi amacıyla huni saçılım grafiği ve Classic fail-safe N analiz yöntemleri ayrı ayrı uygulanmış ve yapılan test sonucunda yayın yanlılığının varlığına yönelik herhangi bir kanıt bulunamamıştır. Etki büyüklüğünün hesaplanabilmesi amacıyla hangi modelin kullanılacağının tespiti için heterojenlik testi yapılmış ve etki büyüklükleri dağılımının yüksek düzeyde heterojenlik gösterdiği tespit edilmiştir. Bu nedenle etki büyüklüğünün hesaplanabilmesi için rastgele etkiler modeli kullanılmıştır. Genel olarak, akılcı ilaç kullanımı ve sağlık okuryazarlığı arasındaki ilişkinin pozitif yönde anlamlı olduğu sonucuna varılmıştır. Sonuç: Analiz sonucunda; akılcı ilaç kullanımı ve sağlık okuryazarlığı arasındaki ilişkinin anlamlı olduğu, ilişkiye dair etki büyüklüğünün 0.415 değeri ile orta düzeyde ve pozitif yönlü olduğu tespit edilmiştir.
Introduction: Rational drug use is the process of planning, implementing, controlling, and taking precautions that enable the effective, safe and economical application of drug treatment. Health literacy, on the other hand, is an important condition that improves and supports individuals' ability to express their discomfort correctly, to communicate effectively with health professionals, and to understand and apply medical advice and treatment guidelines in the provision of quality, effective, and safe health care. The aim of this study is to examine the thesis based on the relationship between rational drug use and health literacy published in the National Thesis Centre for Higher Education (YÖKTEZ) by meta-analysis method. Methods: Ten studies that had the required sample size for meta-analysis and included Pearson correlation coefficient (r) were included in the study. In the meta-analysis method, various criteria were determined for the inclusion of the studies to be subjected to statistical analysis. These criteria were determined as (i) the relevant studies should examine the relationship between rational drug use and health literacy, (ii) these studies should include the correlation coefficient (r) in order to determine the relationship between rational drug use and health literacy, and (iii) they should include the required sample size. The MAJOR plug-in of the JAMOVI (v.2.4) package programme was used to perform the meta-analysis. Results: In this meta-analysis study, funnel scatter plot and Classic fail-safe N analysis methods were applied separately in order to measure the presence of publication bias and no evidence for the presence of publication bias was found as a result of the test. Heterogeneity test was performed to determine which model to use in order to calculate the effect size and it was determined that the distribution of effect sizes showed a high level of heterogeneity. Therefore, random effects model was used to calculate the effect size. In general, it was concluded that the relationship between rational drug use and health literacy is positively significant. Conclusion: As a result of the analysis, it was determined that the relationship between rational drug use and health literacy is significant, and the effect size of the relationship is moderate and positive with a value of 0.415.
Amaç: Duygusal emek, bireyin davranışlarını örgütün hedeflerine uygun şekilde şekillendirmesi anlamına gelir. Başka bir deyişle, bireylerin belirli durumlarda hangi duyguların uygun olduğunu ve bu duyguların diğer kişilere nasıl yansıtılması gerektiğini öğrendikleri bir süreçtir. Duygusal emek ile çalışan bireyler daha fazla çaba göstererek sergilediği davranışı hisseder ve duygularını daha etkili yöneterek daha samimi davranışlar gösterebilmektedir. Sağlık sektöründe çalışan bireylerin yaşam kalitesi göz önünde bulundurulduğunda duygusal emek düzeylerinin ne şekilde farklılaştığı merak edilen bir konudur. Bu çalışmanın amacı; Yükseköğretim Ulusal Tez Merkezi'nde (YÖKTEZ) yayınlanan tezler içerisinde sağlık çalışanlarının duygusal emek düzeylerinin cinsiyet faktörü açısından irdelenen çalışmaların meta analiz yöntemi ile incelenmesidir. Yöntem: Meta analiz için gerekli olan kadın ve erkek örneklem sayısı, duygusal emek düzeylerine vermiş oldukları cevapların ortalama değerleri ve standart sapma değerlerine sahip olan 12 çalışma araştırma kapsamına alınmıştır. Meta-analiz yönteminde, istatistiksel analize tabi tutulacak çalışmaların araştırmaya dahil edilebilmesi için çeşitli kriterler belirlenmiştir. Bu kriterler; (i) ilgili araştırmaların cinsiyete göre duygusal emek düzeylerini incelemesi, (ii) duygusal emek düzeylerinin cinsiyetler arasındaki farkını belirlemek amacıyla bu çalışmaların etki büyüklüğünü (Cohen's d veya Hedges'g) içermesi ve (iii) gerekli örneklem sayısını içermesi olarak belirlenmiştir. Meta-analizin gerçekleştirilmesinde JAMOVI (v.2.4) paket programının MAJOR eklentisi kullanılmıştır. Bulgular: Bu meta analiz çalışmasında yayın yanlılığının olup olmadığının ölçülmesi amacıyla huni saçılım grafiği ve Classic fail-safe N analiz yöntemleri ayrı ayrı uygulanmış ve yapılan test sonucunda yayın yanlılığının varlığına yönelik herhangi bir kanıt bulunamamıştır. Etki büyüklüğünün hesaplanabilmesi amacıyla hangi modelin kullanılacağının tespiti için heterojenlik testi yapılmış ve etki büyüklüğünün ortak bir etki büyüklüğünü paylaşması sonucunda homojen bir dağılım gösterdiği tespit edilmiştir. Bu nedenle çalışmaların etki yönünün ve derecesinin belirlenebilmesi amacıyla sabit etki modeli kullanılmıştır. Analiz sonucunda, genel etki büyüklüğünün 0.126 olarak bulunduğu ve bu etki büyüklüğünün %95 güven aralığı, 0.047 ile 0.205 arasında yer aldığı tespit edilmiştir (p<0.002). Sonuç: Analiz sonucunda; erkek çalışanların kadın çalışanlara göre duygusal emek düzeylerinin daha yüksek olduğu ve bu ilişkinin zayıf düzeyde olduğu tespit edilmiştir.
Introduction: The concept of emotional labour is the regulation of an individual's behaviours in a way to serve the goals of the organisation. In other words, it is the process in which individuals learn which emotions are appropriate for certain situations and how these emotions should be shown to other individuals. Individuals working with emotional labour feel the behaviour they exhibit by making more effort and can show more sincere behaviours by managing their emotions more effectively. Considering the quality of life of individuals working in the health sector, it is a curious issue how emotional labour levels differ. The aim of this study is to examine the studies examining the emotional labour levels of healthcare workers in terms of gender factor in the theses published in the National Thesis Centre of Higher Education (YÖKTEZ) by meta-analysis method. Methods: The number of male and female samples required for meta-analysis, the mean values and standard deviation values of the answers given to emotional labour levels were included in 12 studies. In the meta-analysis method, various criteria were determined for the inclusion of the studies to be subjected to statistical analysis. These criteria were determined as; (i) the relevant studies examine emotional labour levels by gender, (ii) these studies include the effect size (Cohen's d or Hedges'g) to determine the difference of emotional labour levels between genders, and (iii) they include the required sample size (n=3362). The MAJOR plug-in of the JAMOVI (v.2.4) package programme was used to perform the meta-analysis. Results: In this meta-analysis, the funnel scatter plot and Classic fail-safe N analysis methods were applied separately to assess the presence of publication bias, and no evidence of such bias was found. A heterogeneity test was conducted to determine the appropriate model for calculating the effect size, and it was established that the effect size followed a homogeneous distribution, indicating a common effect size. Therefore, the fixed-effect model was used to estimate the direction and magnitude of the effect across the studies. The analysis revealed that the overall effect size was 0.126, with a 95% confidence interval ranging from 0.047 to 0.205 (p<0.002). Conclusion: As a result; emotional labour levels of male employees compared to female employees is higher and this relationship is at a weak level has been identified.
ການຄົ້ນຄວ້າຄັ້ງນີ້ມີຈຸດປະສົງ 1) ເພື່ອສຶກສາ ລະດັບຄວາມເພິ່ງພໍໃຈ, ປັດໄຈຄຸນນະພາບການໃຫ້ບໍ ລິການ ແລະ 2) ເພື່ອສຶກສາປັດໄຈຄຸນນະພາບການໃຫ້ບໍລິການທີ່ມີຜົນຕໍ່ຄວາມເພິ່ງພໍໃຈຂອງຜູ້ໃຊ້ບໍລິການຮ້ານ ອາຫານ ເອັມເຄ ໃນນະຄອນຫຼວງວຽງຈັນ ນໍາໃຊ້ວິທີການຄົ້ນຄ້ວາແບບປະລິມານໂດຍໃຊ້ແບບສອບຖາມທີ່ຜ່ານການກວດສອບຄວາມເຊື່ອຫມັ້ນ (Reliability) ທັງສະບັບມີຄ່າເທົ່າກັບ 0.87 ເປັນເຄື່ອງມືໃນການເກັບຂໍ້ມູນຈາກລູກຄ້າຫຼືຜູ້ໃຊ້ບໍລິການທັງໃນ 3 ສາຂາໃນນະຄອນຫຼວງວຽງຈັນຈໍານວນ 385 ຄົນ ໃຊ້ໂປຣແກຣມສຳເລັດຮູບທາງສະຖິຕິ SPSS ວິເຄາະຫາຄ່າສະເລ່ຍ (Mean) ຄ່າຜັນປ່ຽນມາດຕະຖານ (SD) ແລະ ວິເຄາະປັດໄຈດ້ານຄຸນນະພາບການໃຫ້ບໍລິການທີ່ມີຜົນຕໍ່ຄວາມເພິ່ງພໍໃຈຂອງຜູ້ໃຊ້ບໍລິການໂດຍການວິເຄາະດ້ວຍນຳໃຊ້ ການວິເຄາະສົມຜົນທົດຖອຍແບບພະຫຸຄູນແບບເປັນຂັ້ນຕອນ (Stepwise Multiple Regres-sion Analysis) ຜົນການວິໄຈພົບວ່າ ພົບວ່າປັດໄຈຄວາມເປັນຮູບປະທໍາຂອງການບໍລິການມີຄ່າສະເລ່ຍ 4.54 ຈັດຢູ່ໃນລະດັບຫຼາຍທີ່ສຸດ, ປັດໄຈການຕອບສະໜອງຕໍ່ລູກຄ້າມີຄ່າສະເລ່ຍ 4.10 ຈັດຢູ່ໃນລະດັບຫຼາຍ, ປັດໄຈການໃຫ້ຄວາມເຊື່ອໝັ້ນຕໍ່ລູກຄ້າມີຄ່າສະເລ່ຍ 3.89 ຈັດຢູ່ໃນລະດັບຫຼາຍ, ປັດໄຈຄວາມໜ້າເຊື່ອຖື ແລະ ປັດໄຈການຮູ້ຈັກ - ເຂັ້າໃຈລຸກຄ້າ ມີຄ່າສະເລ່ຍ 3.64 ຈັດຢູ່ໃນລະດັບຫຼາຍ ແລະ ລະດັບຄວາມເພີ່ງພໍໃຈຂອງຜູ້ໃຊ້ບໍລິການມີຄ່າສະເລ່ຍ 3.92 ຈັດຢູ່ໃນອັນດັບຫຼາຍ ແລະ ພົບວ່າປັດໄຈຄຸນນະພາບການໃຫ້ບໍລິການມີຜົນຕໍ່ກັບຄວາມເພີ່ງພໍໃຈຂອງຜູ້ໃຊ້ບໍລິການ ຮ້ານອາຫານ ເອັມເຄ ໃນນະຄອນຫຼວງວຽງຈັນ ທີ່ລະດັບຄວາມສຳຄັນທາງສະຖິຕິທີ່ 0.05. ຄໍາສັບສໍາຄັນ: ຄຸນນະພາບການໃຫ້ບໍລິການ, ຄວາມເພິ່ງພໍໃຈຂອງຜູ້ໃຊ້ບໍລິການ, ຮ້ານອາຫານ ເອັມເຄ
Purpose
The purpose of this study is to analyze the relationship between lean manufacturing and corporate environmental performance. Scholarly literature has extensively addressed the relationship between those two areas but empirical papers present mixed and inconsistent results, calling for further analysis to establish a clearer understanding of the actual relationship and to identify the causes of conflicting findings across studies. Given the importance of sustainable practices in the current business landscape, this paper aims to provide a comprehensive overview of this relationship through a meta-analysis of previous research, with a focus on integrating quantitative findings to shed light on the potential impact of lean manufacturing on environmental performance and report its intensity with Pearson’s correlation coefficient.
Design/methodology/approach
This paper analyzes the data from 29 primary studies published between 2001 and 2022 that have empirically measured the relationship between lean manufacturing and corporate environmental performance and that have been identified in the Web of Science and SCOPUS databases through an exhaustive review of the literature. To integrate previous empirical results and evaluate the evidence for the lean manufacturing’s influence on environmental performance, a meta-analytic methodology was adopted through the Hedges–Olkin random effect approach, based on correlations.
Findings
Main findings support the notion that a significant, positive, rather moderated, relationship exists between lean manufacturing and environmental performance, with an overall correlation coefficient r ¯ = 0.25. The result seems robust, as several tests confirm that publication bias is unlikely. Overall, various lean practices are correlated to varying degrees with different measures of environmental performance. The environmental efficiency of external lean practices is higher than that observed for internal practices and quality management has a more pronounced effect than other internal lean practices. The 2008 global crisis did not change these relationships and the impact of lean manufacturing on environmental performance does not seem to be moderated by the degree of environmental awareness of the country where applied.
Research limitations/implications
The results conclude that a significant, positive relationship exists between lean manufacturing and environmental performance ( r ¯ = 0.25). This study tests certain factors that exhibit varying effect sizes and moderate the overall outcome, highlighting that the environmental efficiency of external lean practices is higher than that observed for internal practices. In addition, it suggests a more pronounced effect of quality management among other internal lean practices.
Practical implications
This study provides companies with an opportunity to align their operational strategies with environmental sustainability goals. Understanding that various lean practices exhibit diverse levels of correlation with multiple measures of environmental performance, decision-makers can prioritize their efforts and apply the lean practices that have a stronger effect on the desired environmental outcomes to improve their environmental impact. Conversely, managers are aware that certain lean practices have a week relationship with some environmental performance so they can avoid overestimating environmental benefits of lean manufacturing. Finally, results underscore the importance of organizational commitment to environmental sustainability.
Originality/value
It is, to the best of the authors’ knowledge, the first meta-analytic study to investigate the strength of the association between lean manufacturing and environmental performance and to test whether various lean practices are correlated to different measures of environmental performance. It fills this gap in the literature and therefore it represents a valuable contribution to the field. In addition, this paper explores certain factors that moderate the overall outcome.
Introduction
The prevalence of metabolic syndrome among type 2 diabetes mellitus patients was inconsistent in Ethiopia. Therefore, we aimed to pool the prevalence of metabolic syndrome among type 2 diabetes mellitus patients using a systematic review and meta-analysis.
Methods
PubMed, EMBASE, and Cochrane Library databases were systematically searched for relevant articles from January 2023 to January 2024. In addition, a manual search was conducted using published articles’ reference lists. The random-effects model was used to pool prevalence from individual studies. All analysis was performed using R software.
Results
A total of nine articles met the inclusion criteria and were included in the analysis. The participants’ average age was 59.8 ± 3.84 years old. The pooled prevalence of MetS in T2DM patients was 53% (95% CI: 47–58). A significant heterogeneity was found across the included studies (P < 0.001, I2 = 92%). Based on diagnostic criteria, the prevalence of MetS in T2DM patients was 49% (95% CI: 43–56), 57% (95% CI: 47–67), 57% (95% CI: 43–77), and 44% (95% CI: 20-58) based on IDF, NCEP-ATP II, 2009 harmonized, and WHO criteria. By gender, the prevalence of MetS in T2DM patients was 48% (95% CI: 28–68) for females and 32% (95% CI: 17–49) for males.
Conclusion
This study found that over half of type 2 diabetes mellitus patients in Ethiopia are affected by metabolic syndrome, with a higher prevalence observed in females compared to males. The NCEP-ATP II and 2009 harmonized criteria consistently yielded similar prevalence rates of metabolic syndrome. These findings highlight the importance of educating T2DM patients on preventing and managing cardiovascular disease and its related complications.
ResearchGate has not been able to resolve any references for this publication.