Brief Communication
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Prevalence and methodological quality of systematic reviews in Korean medical journals
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Seong Jung Kim
, Mi Ah Han
, Jae Hung Jung
, Eu Chang Hwang
, Hae Ran Kim
, Sang Eun Yoon
, Seo-Hee Kim
, Pius Kim, So-Yeong Kim
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Epidemiol Health. 2023;45:e2023017. Published online February 6, 2023
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DOI: https://doi.org/10.4178/epih.e2023017
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Abstract
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Abstract
This study aimed to assess and evaluate the prevalence and methodological quality of systematic reviews (SRs) published in major Korean medical journals (KMJs). The top 15 journals with the highest Korean Medical Citation Index, published between 2018 to 2021, were selected. We assessed the methodological quality of SRs using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). In total, 126 SRs were included, with an average of 32 SRs being reported annually. The overall prevalence of SRs in KMJs was 2.8%, with an increase from 2.6% in 2018 to 3.4% in 2021. Overall, the methodological quality of SRs was low (9.5% low, 90.5% critically low). More than 80% of the studies adhered to critical domain items such as a comprehensive literature search and risk of bias assessment, but for items such as protocol registration and listing excluded studies and the justification for exclusion, the adherence rate was less than 15%. While the number of SRs in KMJs steadily increased, the overall confidence in the methodological quality was low to critically low. Therefore, in order to provide the best evidence for decision-making in clinical and public health areas, editors, reviewers, and authors need to pay more attention to improving the quality of SRs.
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Summary
Korean summary
한국의학저널에서 체계적 문헌고찰의 수는 꾸준히 증가했지만 방법론적 품질은 전반적으로 낮았다. 임상 및 공중 보건 분야에서 의사 결정을 위한 최상의 근거를 제공하기 위해 편집자, 심사자 및 저자는 체계적 문헌고찰의 품질을 개선하는 데 더 많은 관심을 기울여야 할 것이다.
Key Message
While the number of systematic reviews in Korean medical journals steadily increased, the overall confidence of methodological quality was low to critically low. Therefore, in order to provide the best evidence for decision-making in clinical and public health areas, editors, reviewers, and authors need to pay more attention to improving the quality of systematic reviews.
Systematic Reviews
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Associations of daily diet-related greenhouse gas emissions with the incidence and mortality of chronic diseases: a systematic review and meta-analysis of epidemiological studies
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Jee Yeon Hong
, Young Jun Kim
, Sanghyuk Bae
, Mi Kyung Kim
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Epidemiol Health. 2023;45:e2023011. Published online December 30, 2022
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DOI: https://doi.org/10.4178/epih.e2023011
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Abstract
OBJECTIVES
Although the entire process extending from food production to dietary consumption makes a large contribution to total greenhouse gas (GHG) emissions, little and inconsistent evidence exists on the epidemiological associations of daily diet-related GHG emissions with chronic disease risk or all-cause mortality. This systematic review and meta-analysis explored the observational epidemiological relationship between daily diet-related GHG emissions and health outcomes, including the risk of chronic diseases and all-cause mortality.
METHODS
Original articles published in English until May 2022 were identified by searching PubMed, Ovid-Embase, Web of Science, CINAHL, and Google Scholar. The extracted data were pooled using both fixed-effects and random-effects meta-analyses and presented as hazard and risk ratios (RRs) with 95% confidence intervals (CIs).
RESULTS
In total, 7 cohort studies (21 study arms) were included for qualitative synthesis and meta-analysis. The GHG emissions of dietary consumption showed a significant positive association with the risk of chronic disease incidence and mortality in both fixed-effects and random-effects models (fixed: RR, 1.04; 95% CI, 1.03 to 1.05; random: RR, 1.04; 95% CI, 1.02 to 1.06). This positive association was robust regardless of how daily diet-related GHG emissions were grouped. More strongly animal- based diets showed higher GHG emissions. However, there were only a few studies on specific chronic diseases, and the subgroup analysis showed insignificant results. There was no evidence of publication bias among the studies (Egger test: p=0.79).
CONCLUSIONS
A higher GHG-emission diet was found to be associated with a greater risk of all-cause mortality.
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Summary
Korean summary
식이로부터 배출되는 GHG양은 메타분석의 고정 효과 모델과 확률 효과 모델 모두에서 만성 질환 발병률 및 사망 위험과 유의미한 양의 상관 관계를 보여주었습니다. 동물성 식단은 더 높은 GHG 배출량을 나타냈으나, 특정 만성질환에 대한 연구의 수가 적었고 질환 별 하위군 분석에서 유의미한 결과를 보이지 않았습니다. 결론적으로 온실가스 배출량이 많은 식단은 모든 원인으로 인한 사망 위험이 더 큰 것으로 나타났습니다.
Key Message
Daily food consumption contributes a large part of greenhouse gas (GHG) emissions, however, no review study was conducted. This study is the first review paper that reviews the relationship between greenhouse gas (GHG) emissions from daily diet and chronic disease risk and all-cause mortality. GHG emissions from the daily diet were significantly positively associated with disease risk and mortality. Animal-based diets contributed most to diet-derived GHG emissions. Men tended to have diets with higher GHG emissions compared to women. At times when the response to climate change is urgent, this study can help many policymakers and health officials.
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The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis
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Mozhgan Ahmadinezhad
, Leila Mounesan
, Amin Doosti-Irani
, Manijeh Yousefi Behzadi
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Epidemiol Health. 2022;44:e2022097. Published online October 28, 2022
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DOI: https://doi.org/10.4178/epih.e2022097
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Abstract
OBJECTIVES
Q fever, caused by the bacterium, is a major zoonotic disease around the world. This disease is common in the Eastern Mediterranean region; therefore, we conducted the first systematic review and meta-analysis on its prevalence in humans, animals, and ticks in the Eastern Mediterranean region.
METHODS
Major Iranian and international databases were searched from 2000 to 2021. We extracted the prevalence of Q fever in blood samples from animals and milk samples from animals, ticks, and humans as the main outcome. We reported the prevalence of seropositivity and molecular positivity as point estimates and 95% confidence intervals (CIs).
RESULTS
In this review, 112 papers were identified. The overall seroprevalence of Q fever was 22.4% (95% CI, 19.8 to 25.1). The pooled prevalence of Q fever in ticks was 17.5% (95% CI, -1.3 to 36.4). The prevalence was 25.5% (95% CI, 16.1 to 34.9) in humans. The prevalence of Q fever in animal blood samples from goats, sheep, camels, cattle, cats, dogs, horses, and buffalo were 28.1%, 25.1%, 25.0%, 20.1%, 9.8%, 8.4%, 6.5%, and 6.3%, respectively. Furthermore, the prevalence of Q fever in milk samples of animals was higher in cattle (20.3%) than in sheep (20.0%), goats (16.4%), and camels (3.3%).
CONCLUSIONS
Coxiella burnetii infections are common in humans and in a wide range of animal species, but they are still not recognized in many countries in the Eastern Mediterranean region, thus presenting a significant threat to human and animal health in the region.
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Summary
Korean summary
Key Message
Methods
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Meta-analysis of diagnostic test accuracy studies with multiple thresholds for data integration
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Sung Ryul Shim
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Epidemiol Health. 2022;44:e2022083. Published online September 28, 2022
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DOI: https://doi.org/10.4178/epih.e2022083
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Abstract
OBJECTIVES
The objective of this study is to introduce methods to use all of the information without omission when individual studies provide multiple effect sizes according to multiple cut-off values (thresholds) during diagnostic test accuracy (DTA) for data integration. For diagnostic test meta-analysis, a general performance method for synthesizing data according to one cut value in one study and a performance method for synthesizing data according to two or more cut values in one study were compared and analyzed.
METHODS
As sample data for meta-analysis of DTA studies, 13 DTA studies on prostate cancer (34 effect sizes including total cut-offs) were collected. The summary statistics were calculated and the summary line was analyzed using the “meta”, “mada”, and “diagmeta” packagesof the R software.
RESULTS
The summary statistics of the random effect model univariate analysis of the “meta” package with a single cut-off corresponding to the highest Youden index in a single study and those of the bivariate analysis of the “mada” package were highly similar. However, in the bivariate analysis of the “diagmeta” package including all cut-off values, the sensitivity decreased and the specificity increased as the amount of data increased.
CONCLUSIONS
Considering the heterogeneity of the summary receiver op erating characteristic curve and the use of all given cut-offs, the use of the bivariate analysis model of the “diagmeta” package is recommended. This study focused on practical methods of DTA rather than theoretical concepts for use by researchers whose fields of study are non-statistics related. By performing this study, we hope that many researchers will use R software to determine the DTA more easily, and that there will be greater interest in related research.
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Summary
Korean summary
본 연구는 진단검사 메타분석시 개별 대상연구가 다수의 기준치 (cut-off value, threshold)에 따른 여러 개의 효과크기를 제공하고 있을 때, 정보의 누락없이 이를 모두 사용하는 방법과 더불어 기존의 수행방법도 비교 분석하였기에 연구에 적합한 모델 선택에 도움이 될 것이다.
Key Message
The objective of this study is to introduce methods to use all of the information without omission when indi¬vidual studies provide multiple effect sizes according to multiple cut-off values (thresholds) during diagnostic test accuracy (DTA) for data integration.
Systematic Reviews
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Systematic review and meta-analysis of cancer risks in relation to environmental waste incinerator emissions: a meta-analysis of case-control and cohort studies
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Kiook Baek, Jong-Tae Park, Kyeongmin Kwak
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Epidemiol Health. 2022;44:e2022070. Published online September 1, 2022
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DOI: https://doi.org/10.4178/epih.e2022070
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Abstract
OBJECTIVES
Various toxic substances can be generated from incinerators, exposing nearby residents, and epidemiological studies have shown wide variations in risk estimates for cancer risk in populations living close to incinerators.
METHODS
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search and systematic review were conducted to identify studies conducted on general populations exposed to environmental incinerator emissions and cancer outcomes. Meta-analysis was performed according to the cancer types for which 2 or more studies were reported. Subgroup analysis was done for sex, the exposure estimation method, the study period, and the type of outcome.
RESULTS
Eleven studies were found for the qualitative review and meta-analysis. Seven studies had a case-control design, and 4 had a cohort design. The pooled effect size was not significant for breast, colorectal, liver, lung, lymphohematopoietic, stomach, bladder, central nervous system, and laryngeal cancers, non-Hodgkin lymphoma, sarcoma, leukemia, and all cancers. In the subgroup analysis, the pooled effect size of laryngeal cancer in females was 1.82 (95% confidence interval, 1.10 to 3.01), although only 2 studies were identified.
CONCLUSIONS
The meta-analysis did not provide evidence of an increased risk for any cancer among populations living near waste incinerators, except for laryngeal cancer in females. However, since relatively few studies were reviewed and some cancer types showed significant increases in individual studies, this evidence needs to be updated regularly.
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Summary
Korean summary
본 연구에서는 현재까지 소각장 인근 주민들의 암 위험도에 대해 보고된 환자-대조군 연구 및 코호트 연구를 체계적 문헌고찰과 메타분석법을 활용하여 분석하였다. 총 11개의 문헌에서 보고한 암 위험도를 암종별로 분석한 결과 소각장 인근 거주로 인한 암 위험도 상승이 유의하게 상승한 암종은 없었다. 세부 그룹 분석에서 여성의 후두암이 비록 단 2개 문헌에서만 보고하고 있었지만 유의한 상승을 보였다. 본 연구는 현재까지 논란이 많은 소각장 인근 거주와 암 발생 위험도의 증가에 대해 관찰연구로서 생태학적 연구를 배제하고 비교적 역학적 증거로서 가치가 높은 연구방법인 환자-대조군 연구와 코호트 연구를 고찰한 의의가 있으며, 본 연구의 방법론을 활용하면 추후 같은 주제의 증거를 지속적으로 갱신하여 종합할 수 있으리라 기대한다.
Key Message
This meta-analysis showed a lack of evidence of elevated risk of specific cancers after pooling the effect sizes by cancer type, except for laryngeal cancer in women. However, due to the small number of included studies, the evidence needs to be monitored and updated on a regular basis in the future.
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The effect of peer support in diabetes self-management education on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis
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Akhmad Azmiardi
, Bhisma Murti
, Ratih Puspita Febrinasari
, Didik Gunawan Tamtomo
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Epidemiol Health. 2021;43:e2021090. Published online October 22, 2021
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DOI: https://doi.org/10.4178/epih.e2021090
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6,142
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190
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4
Citations
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Diabetes self-management education (DSME) programs are a strategy to maintain healthy behaviors. Nevertheless, limited evidence has been reported from systematic evaluations of the effects of DSME integrated with peer support on glycemic control. This study aimed to review the effectiveness of DSME interventions integrated with peer support on glycemic control in patients with type 2 diabetes.
METHODS
A systematic search was carried out in electronic databases, including PubMed, Cochrane Library, ProQuest, SpringerLink, ScienceDirect, Scopus, and Google Scholar, for English-language articles published from 2005 until 2020. The effect size was estimated as the standard mean difference (SMD). The Cochrane Collaboration’s Risk of Bias tool was employed to assess the risk of bias.
RESULTS
Twelve studies were included in this study. DSME integrated with peer support effectively reduced glycated hemoglobin A1c (HbA1c) levels, with a statistically significant effect (SMD, -0.41; 95% confidence interval [CI], -0.69 to -0.13; p<0.001). Programs with a sample size <100 (SMD, -0.45; 95% CI, -0.79 to -0.11; p=0.009), duration of intervention ≤6 months (SMD, -0.52; 95% CI, -0.96 to -0.07; p=0.020), baseline HbA1c <8.5% (SMD, -0.42; 95% CI, -0.77 to -0.07; p=0.020), delivery by group (SMD, -0.28; 95% CI, -0.51 to -0.06; p=0.010), and high frequency of contact (SMD, -0.29; 95% CI, -0.48 to -0.10; p=0.003) had statistically significant effects on reducing HbA1c levels in patients with type 2 diabetes.
CONCLUSIONS
DSME integrated with peer support effectively enhances glycemic control in patients with type 2 diabetes. Programs with smaller participants groups, shorter interventions, weekly meetings, and closer group sessions improved glycemic control in patients with type 2 diabetes.
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Summary
Korean summary
Key Message
We reviewed and assessed the quality of the twelve articles included in this systematic review and meta-analysis. The findings of this review show that peer support integrated with diabetes self-management education programs can significantly enhance glycemic control in type 2 diabetes patients. Peer support is a critical component of a successful diabetes self-management programme in patients with type 2 diabetes. interventions programme with smaller groups, shorter durations, lower HbA1c baseline levels, group sessions, and high frequencies of sessions significantly enhanced glycemic control.
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Citations
Citations to this article as recorded by

- The current diabetes education experience: Findings of a cross-sectional survey of adults with type 2 diabetes
Kelley M. Baker, Carine M. Nassar, Neelam Baral, Michelle F. Magee
Patient Education and Counseling.2023; 108: 107615. CrossRef - 2023 update on Italian guidelines for the treatment of type 2 diabetes
Edoardo Mannucci, Riccardo Candido, Lina delle Monache, Marco Gallo, Andrea Giaccari, Maria Luisa Masini, Angela Mazzone, Gerardo Medea, Basilio Pintaudi, Giovanni Targher, Marina Trento, Giuseppe Turchetti, Valentina Lorenzoni, Matteo Monami
Acta Diabetologica.2023;[Epub] CrossRef - Family doctors’ attitudes toward peer support programs for type 2 diabetes and/or coronary artery disease: an exploratory survey among German practitioners
K. Majjouti, L. Küppers, A. Thielmann, M. Redaélli, F. Vitinius, C. Funke, I. van der Arend, L. Pilic, M. Hessbrügge, S. Stock, B. Weltermann, D. Wild
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Tricia S. Tang, Rowshanak Afshar, Thomas Elliott, Jason Kong, Sabrina Gill
Diabetic Medicine.2022;[Epub] CrossRef
COVID-19: Original Article
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The role of vitamin D deficiency on COVID-19: a systematic review and meta-analysis of observational studies
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Mehmet Onur Kaya
, Esra Pamukçu
, Burkay Yakar
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Epidemiol Health. 2021;43:e2021074. Published online September 23, 2021
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DOI: https://doi.org/10.4178/epih.e2021074
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11,053
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578
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29
Citations
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes.
METHODS
We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level.
RESULTS
Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390).
CONCLUSIONS
According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.
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Summary
Korean summary
Key Message
Although vaccination has started, it seems that Covid-19 will continue to threaten public health for a long time. In addition to the vaccine, the use of supplements to support the immune system may also be important. The purpose of this study is to indicate the possible effect of low serum vitamin D (25(OH)D<20 ng/mL or 50nmol/L) on the Covid-19 infection and outcomes. According to our remarkable results, vitamin D deficiency increases the risk of Covid-19 infection and the potential for the severity of the disease. Therefore, vitamin D supplements should be added to prevention and treatment protocols for Covid-19 disease.
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Citations
Citations to this article as recorded by

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John V. Schloss
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Lillie Monroe-Lord, Elgloria Harrison, Azam Ardakani, Xuejling Duan, Lily Spechler, Tia D. Jeffery, Phronie Jackson
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Brief Communication
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A comparison of meta-analysis results with and without adjustment for the healthy worker effect: cancer mortality among workers in the semiconductor industry
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Sung-Ho Hwang
, Moon-Young Park
, Won Jin Lee
, Inho Park
, Kimyong Hong
, Donguk Park
, Kyoung-Mu Lee
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Epidemiol Health. 2021;43:e2021057. Published online September 8, 2021
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DOI: https://doi.org/10.4178/epih.e2021057
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Abstract
Summary
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Abstract
OBJECTIVES
This study compared the results of meta-analysis with and without adjustment for the healthy worker effect on the association between working in the semiconductor industry and cancer mortality.
METHODS
Six studies that reported standardized mortality ratios (SMRs) for cancers were selected for meta-analysis. Using a random-effects model, the SMR results from each study were combined for all cancers and leukemias to estimate the summary SMRs (95% confidence interval, CI). To adjust for the healthy worker effect, the relative standardized mortality ratio (rSMR=SMRx/SMRnot x) were calculated using observed and expected counts for the specific cause of interest (i.e., all cancers and leukemias) and the observed and expected counts for all other causes of mortality. Then, the rSMR results were combined to estimate the summary rSMRs (95% CIs).
RESULTS
The SMRs for all causes of mortality among semiconductor industry workers ranged from 0.25 to 0.80, which reflects a significant healthy worker effect. A remarkable difference was found between the summary SMRs and the summary rSMRs. The summary SMR for all cancers was 0.70 (95% CI, 0.63 to 0.79) whereas the summary rSMR was 1.38 (95% CI, 1.20 to 1.59). The summary SMR for leukemia was 0.88 (95% CI, 0.72 to 1.07), and the summary rSMR was 1.88 (95% CI, 1.20 to 2.95).
CONCLUSIONS
Our results suggest that adjustment for the healthy worker effect (i.e., rSMR) may be useful in meta-analyses of cohort studies reporting SMRs.
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Summary
Korean summary
본 연구에서는 반도체 근로자의 암사망률을 일반 인구와 비교하여 표준화사망비(SMR)를 제시한 연구를 대상으로 한 메타분석에서, summary SMR값(95% CI)과 건강근로자효과에 대해 보정한 rSMR을 산출한 후 종합한 summary rSMR값(95% CI)을 비교하였다. 모든 암의 경우 summary SMR=0.70 (0.63-0.79), summary rSMR=1.38(1.20-1.59)로 나타났으며, 백혈병의 경우 summary SMR=0.88 (0.72-1.07), summary rSMR=1.88(1.20-2.95)로 나타났다. 본 연구결과는 SMR 연구를 종합하는 메타분석 연구에서 rSMR과 같은 건강근로자효과에 대해 보정하는 방법론을 적용할 수 있음을 보여주는 사례이다.
Key Message
The relevance of epidemiological research reporting the standardized mortality ratios (SMRs) for workers in the semiconductor industry is often limited by the healthy worker effect. One of the simple correction methods in the relative standardized mortality ratio (rSMR). We observed significant rightward shift when the summary rSMRs were compared with the summary rSMRs, which suggest that adjustment for the healthy worker effect (i.e., rSMR) may be useful in meta-analyses of cohort studies reporting SMRs.
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Citations
Citations to this article as recorded by

- Health risks, emergency preparedness and Norwegian-Russian cooperation on Svalbard. A systematic review
Turid Austin Wæhler, Tor Ingebrigtsen
International Journal of Circumpolar Health.2022;[Epub] CrossRef
COVID-19: Systematic Review
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Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence
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Md Mahbub Hossain
, Abida Sultana
, Neetu Purohit
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Epidemiol Health. 2020;42:e2020038. Published online June 2, 2020
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DOI: https://doi.org/10.4178/epih.e2020038
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29,150
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Supplementary Material
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Abstract
Objectives
Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent coronavirus disease 2019 (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases.
Methods
We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population.
Results
Among 1,364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes.
Conclusions
This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.
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Summary
Korean summary
Key Message
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Citations
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Psychology Research and Behavior Management.2021; Volume 14: 695. CrossRef - Impact of COVID-19 Institutional Isolation Measures on Postnatal Women in Level 3 COVID Facility in Northern India
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Journal of South Asian Federation of Obstetrics and Gynaecology.2021; 13(1): 50. CrossRef - MENTAL HEALTH CHALLENGES, RESILIENCE AND COPING STYLE CONTRIBUTING TO THE WELL BEING OF PATIENTS RECOVERED FROM COVID - 19.
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PARIPEX INDIAN JOURNAL OF RESEARCH.2021; : 60. CrossRef - Holistic approach supporting mental wellbeing of people in enforced quarantine in South Australia during the COVID‐19 pandemic
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Physical education of students.2021; 25(3): 158. CrossRef - Unpacking the impact of the COVID-19 pandemic: identifying structural domains
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Psychology Research and Behavior Management.2021; Volume 14: 877. CrossRef - Differences Between the Psychiatric Symptoms of Healthcare Workers Quarantined at Home and in the Hospital After Contact With a Patient With Middle East Respiratory Syndrome
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Systematic Review
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Risk factors for stomach cancer: a systematic review and meta-analysis
-
Jalal Poorolajal
, Leila Moradi
, Younes Mohammadi
, Zahra Cheraghi
, Fatemeh Gohari-Ensaf
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Epidemiol Health. 2020;42:e2020004. Published online February 2, 2020
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DOI: https://doi.org/10.4178/epih.e2020004
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs.
METHODS
PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.
RESULTS
Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies.
CONCLUSIONS
This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.
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Summary
Korean summary
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Reviews
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The global prevalence of dental healthcare needs and unmet dental needs among adolescents: a systematic review and meta-analysis
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Mahin Ghafari
, Samira Bahadivand-Chegini
, Tayebeh Nadi
, Amin Doosti-Irani
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Epidemiol Health. 2019;41:e2019046. Published online October 27, 2019
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DOI: https://doi.org/10.4178/epih.e2019046
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11,176
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223
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6
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Abstract
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Supplementary Material
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Abstract
OBJECTIVES
Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents.
METHODS
PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included.
RESULTS
The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0).
CONCLUSIONS
The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.
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Summary
Korean summary
Key Message
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Citations
Citations to this article as recorded by

- Perception of malocclusion and school performance in adolescents: a systematic review
Ana Carla Souza COSTA, Djessyca Miranda e PAULO, Maria Tereza Campos VIDIGAL, Walbert de Andrade VIEIRA, Andres Felipe Millan CARDENAS, Luiz Renato PARANHOS
Brazilian Oral Research.2023;[Epub] CrossRef - Use of the sociodental approach in estimating orthodontic treatment needs in adolescent patients
Wan Nurazreena Wan Hassan, Mohd Zambri Mohamed Makhbul, Zamros Yuzadi Mohd Yusof
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie.2022; 83(4): 244. CrossRef - Impacts of using orthodontic appliances on the quality of life of children and adolescents: systematic review and meta-analysis
Maria Tereza Campos Vidigal, Caio Melo Mesquita, Murilo Navarro de Oliveira, Walbert de Andrade Vieira, Cauane Blumenberg, Gustavo G Nascimento, Matheus Melo Pithon, Luiz Renato Paranhos
European Journal of Orthodontics.2022; 44(4): 359. CrossRef - Minimal Important Difference of the Psychosocial Impact of Dental Aesthetics Questionnaire Following Orthodontic Treatment: A Cohort Study
Wan Nurazreena Wan Hassan, Mohd Zambri Mohamed Makhbul, Zamros Yuzadi Mohd Yusof, Siti Adibah Othman
Children.2022; 9(4): 506. CrossRef - Association between malocclusion in the mixed dentition with breastfeeding and past nonnutritive sucking habits in school-age children
Glauber S. Belitz, Lara J. N. Furlan, Jessica K. Knorst, Luana C. Berwig, Thiago M. Ardenghi, Vilmar A. Ferrazzo, Mariana Marquezan
The Angle Orthodontist.2022; 92(5): 669. CrossRef - Changes and determinants of unmet oral health treatment need
Eeva Torppa‐Saarinen, Mimmi Tolvanen, Satu Lahti, Anna Liisa Suominen
Community Dentistry and Oral Epidemiology.2021; 49(2): 158. CrossRef
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Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs
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Hassan Ahmadi Gharaei
, Mostafa Dianatinasab
, Seyyed Mostafa Kouhestani
, Mohammad Fararouei
, Hossein Moameri
, Reza Pakzad
, Reza Ghaiasvand
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Epidemiol Health. 2019;41:e2019030. Published online July 4, 2019
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DOI: https://doi.org/10.4178/epih.e2019030
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10,505
View
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271
Download
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12
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Abstract
PDF
Supplementary Material
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Abstract
OBJECTIVES
Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients’ quality of life, disease progress, and survival.
METHODS
The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design.
RESULTS
The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity.
CONCLUSIONS
Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.
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Summary
Korean summary
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Citations
Citations to this article as recorded by

- Breast cancer survivors–supportive care needs: systematic review
Rahimeh Khajoei, Mahnaz Ilkhani, Payam Azadeh, Sima Zohari Anboohi, Fatemah Heshmati Nabavi
BMJ Supportive & Palliative Care.2023; : spcare-2022-003931. CrossRef - Global and regional geographical prevalence of depression in gastric cancer: a systematic review and meta-analysis
Mostafa Kouhestani, Hasan Ahmadi Gharaei, Mohammad Fararouei, Hasan Hosienpour Ghahremanloo, Reza Ghaiasvand, Mostafa Dianatinasab
BMJ Supportive & Palliative Care.2022; 12(e4): e526. CrossRef - The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer
Hassan Okati-Aliabad, Alireza Ansari-Moghadam, Mahdi Mohammadi, Shiva Kargar, Fariba Shahraki-Sanavi
Supportive Care in Cancer.2022; 30(1): 703. CrossRef - Association of Chinese herbal medicine use with the depression risk among the long-term breast cancer survivors: A longitudinal follow-up study
Shu-Yi Yang, Hanoch Livneh, Jing-Siang Jhang, Shu-Wen Yen, Hua-Lung Huang, Michael W. Y. Chan, Ming-Chi Lu, Chia-Chou Yeh, Chang-Kuo Wei, Tzung-Yi Tsai
Frontiers in Psychology.2022;[Epub] CrossRef - Effectiveness of Matrix Treatment on Depression and Temptation in Consumption in Amphetamine Dependent Individuals
Homayoun Farhad, Shahnam Abolghasemi, Tahereh Hamzehpoor
Iranian Evolutionary and Educational Psychology.2022; 4(4): 76. CrossRef - Feasibility of modified radical mastectomy with nipple-areola preservation combined with stage I prosthesis implantation using air cavity-free suspension hook in patients with breast cancer
Jiaqi Liu, Heshan Yu, Yuxiao He, Ting Yan, Yu Ding, Jun Chu, Ning Gao, Xiaona Lin, Yanbin Xu, Guijin He
World Journal of Surgical Oncology.2021;[Epub] CrossRef - Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study
Abdallah Y. Naser, Anas Nawfal Hameed, Nour Mustafa, Hassan Alwafi, Eman Zmaily Dahmash, Hamad S. Alyami, Haya Khalil
Frontiers in Psychology.2021;[Epub] CrossRef - Body image, internalized stigma and enacted stigma predict psychological distress in women with breast cancer: A serial mediation model
Mohammadali Amini‐Tehrani, Hadi Zamanian, Mona Daryaafzoon, Seyedehroja Andikolaei, Mahshid Mohebbi, Arefeh Imani, Bita Tahmasbi, Sahar Foroozanfar, Zahra Jalali
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Penelope Aggeli, Georgia Fasoi, Afroditi Zartaloudi, Konstantinos Kontzoglou, Michael Kontos, Theocharis Konstantinidis, Ioannis Kalemikerakis, Ourania Govina
Asia-Pacific Journal of Oncology Nursing.2021; 8(2): 147. CrossRef - Prevalence of Severe Depression in Iranian Women with Breast Cancer: A Meta-Analysis
Parvaneh Isfahani, Marziye Arefy, Monire Shamsaii
Depression Research and Treatment.2020; 2020: 1. CrossRef - Factor structure and reliability of Persian version of hospital anxiety and depression scale in patients with breast cancer survivors
Karimollah Hajian-Tilaki, Erfaneh Hajian-Tilaki
Health and Quality of Life Outcomes.2020;[Epub] CrossRef - Patient‐centred communication for women with breast cancer: Relation to body image perception
Fariba Ghaffari, Akram Ghahramanian, Vahid Zamanzadeh, Tonia C. Onyeka, Arefeh Davoodi, Effat Mazaheri, Mohammad Asghari‐Jafarabadi
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A systematic review and meta-analysis of the genetic characterization of human echinococcosis in Iran, an endemic country
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Abolghasem Siyadatpanah
, Davood Anvari
, Amir Emami Zeydi
, Seyed Abdollah Hosseini
, Ahmad Daryani
, Shahabeddin Sarvi
, Christine M. Budke
, Reza Esmaeelzadeh Dizaji
, Mohammad Ali Mohaghegh
, Mohammad Hasan Kohansal
, Samira Dodangeh
, Reza Saberi
, Shirzad Gholami
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Epidemiol Health. 2019;41:e2019024. Published online June 15, 2019
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DOI: https://doi.org/10.4178/epih.e2019024
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10,913
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Abstract
Human echinococcosis is an infectious disease caused by tapeworms belonging to the species Echinococcus. This parasite has a worldwide distribution and is considered a neglected tropical disease by the World Health Organization. Due to the diversity of Echinococcus spp. hosts, as well as variation in geographical, climatic, and socio-ethnic conditions, the question of the strains or genotypes of Echinococcus spp. that are involved in human infections is important. The aim of this study was to provide a summary of the available data on genotypes of Echinococcus obtained from the Iranian population. Four international databases (PubMed, Scopus, Science Direct, and Web of Science) and 4 Persian databases (Magiran, Scientific Information Database, Iran Medex, and IranDoc) were searched for cross-sectional studies that reported the genotypes of Echinococcus spp. in human echinococcosis cases using molecular methods in Iran through July 2018. The Newcastle-Ottawa Scale was used to assess the quality of the selected studies. A total of 559 cases of human cystic echinococcosis were reported in the 21 included articles. The majority of cases belonged to genotype G1 (89.2%; 95% confidence interval [CI], 80.1 to 95.8), genotype G6 (8.2%; 95% CI, 2.8 to 15.9), and genotype G3 (2.3%; 95% CI, 1.1 to 3.9). Since genotype G1 of Echinococcus appears to be the most prevalent genotype affecting humans in Iran, disease control initiatives aimed at sheep intermediate hosts may be the most beneficial. In addition, educational programs and serological screening in individuals may help reduce the national impact of the disease.
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- Echinococcus granulosus sensu lato Genotypes in Different Hosts Worldwide: A Systematic Review
Carlos Manterola, Armando Totomoch-Serra, Claudio Rojas, Ángela L. Riffo-Campos, Nayely García-Méndez
Acta Parasitologica.2022; 67(1): 161. CrossRef - Proteomic Profile of Echinococcus granulosus: A Systematic Review
Nayely García-Méndez, Carlos Manterola, Armando Totomoch-Serra, Angela L. Riffo-Campos, César A. Brito-Carreón
Journal of Parasitology.2022;[Epub] CrossRef - Cystic Echinococcosis in Central Iran: G1 and G6 Genotypes in Patients
Saeed Kargar, Abdolhossein Dalimi, Gilda Eslami, Bahador Hajimohammadi, Ahmad Shirinzadeh, Abdolhamid Amouei, Mohammad Zare, Jamal Jafari-Nedooshan, Naeimeh Heiranizadeh, Mahmood Akhavan Tafti, Salman Ahmadian, Saeedeh Sadat Hosseini, Vahideh Askari, Mary
Surgical Infections.2022; 23(5): 451. CrossRef - Clinical and molecular features of human cystic echinococcosis in Tehran, Iran, 2011-2019
NargesAmani Hamedani, Majid Pirestani, Abdolhossein Dalimi
Asian Pacific Journal of Tropical Medicine.2022; 15(12): 558. CrossRef -
Current situation and future prospects of
Echinococcus granulosus
vaccine candidates: A systematic review
Davood Anvari, Fatemeh Rezaei, Alireza Ashouri, Saeed Rezaei, Hamidreza Majidiani, Abdol Sattar Pagheh, Fatemeh Rezaei, Seyyed Ali Shariatzadeh, Amir Fotovati, Abolghasem Siyadatpanah, Shirzad Gholami, Ehsan Ahmadpour
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Davood Anvari, Nima Pourmalek, Saeed Rezaei, Amir Fotovati, Seyed Abdollah Hosseini, Ahmad Daryani, Adel Spotin, Shahabeddin Sarvi, Mona Hosseini, Mohammad Reza Narouei, Mohammad Kalkali, Faezeh Pendar, Shirzad Gholami
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Davood Anvari, Elahe Narouei, Mona Hosseini, Mohammad Reza Narouei, Ahmad Daryani, Seyyed Ali Shariatzadeh, Abdol Sattar Pagheh, Shirzad Gholami, Shahabeddin Sarvi, Dariush Sargazi, Reza Saberi, Seyed Abdollah Hosseini, Abolghasem Siyadatpanah
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Salar ZARRABİ AHRABİ, Rasoul MADANİ, Majid MONTAZER BAVİLİ, Ahmad BABAZADEH BEDOUSTANİ
Clinical and Experimental Health Sciences.2020;[Epub] CrossRef - Epidemiology of echinococcosis in Iran: a systematic review and meta-analysis
Shima Mahmoudi, Setareh Mamishi, Maryam Banar, Babak Pourakbari, Hossein Keshavarz
BMC Infectious Diseases.2019;[Epub] CrossRef
Methods
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Network meta-analysis: application and practice using R software
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Sung Ryul Shim
, Seong-Jang Kim
, Jonghoo Lee
, Gerta Rücker
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Epidemiol Health. 2019;41:e2019013. Published online April 8, 2019
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DOI: https://doi.org/10.4178/epih.e2019013
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25,472
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1,369
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110
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Abstract
The objective of this study is to describe the general approaches to network meta-analysis that are available for quantitative data synthesis using R software. We conducted a network meta-analysis using two approaches: Bayesian and frequentist methods. The corresponding R packages were “gemtc” for the Bayesian approach and “netmeta” for the frequentist approach. In estimating a network meta-analysis model using a Bayesian framework, the “rjags” package is a common tool. “rjags” implements Markov chain Monte Carlo simulation with a graphical output. The estimated overall effect sizes, test for heterogeneity, moderator effects, and publication bias were reported using R software. The authors focus on two flexible models, Bayesian and frequentist, to determine overall effect sizes in network meta-analysis. This study focused on the practical methods of network meta-analysis rather than theoretical concepts, making the material easy to understand for Korean researchers who did not major in statistics. The authors hope that this study will help many Korean researchers to perform network meta-analyses and conduct related research more easily with R software.
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Summary
Korean summary
통계프로그램으로서의 R이 대세인 연구환경에서 R을 활용한 체계적인 메타분석 안내서가 요구되어지며 본 연구는 이에 대한 좋은 해답이 될 것이다. 더욱이 본 연구는 네트워크 메타분석 (Network meta-analysis)의 이론과 더불어 R을 활용한 실습위주의 내용으로 구성되어져 있어 누구나 쉽게 실행할 수 있을 것이다.
본 연구를 통하여 많은 연구자들이 보다 쉽게 본인의 연구분야에 적용하여 관련 연구가 활성화되기를 바란다.
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Intervention meta-analysis: application and practice using R software
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Sung Ryul Shim
, Seong-Jang Kim
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Epidemiol Health. 2019;41:e2019008. Published online March 28, 2019
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DOI: https://doi.org/10.4178/epih.e2019008
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Abstract
The objective of this study was to describe general approaches for intervention meta-analysis available for quantitative data synthesis using the R software. We conducted an intervention meta-analysis using two types of data, continuous and binary, characterized by mean difference and odds ratio, respectively. The package commands for the R software were “metacont”, “metabin”, and “metagen” for the overall effect size, “forest” for forest plot, “metareg” for meta-regression analysis, and “funnel” and “metabias” for the publication bias. The estimated overall effect sizes, test for heterogeneity and moderator effect, and the publication bias were reported using the R software. In particular, the authors indicated methods for calculating the effect sizes of the target studies in intervention meta-analysis. This study focused on the practical methods of intervention meta-analysis, rather than the theoretical concepts, for researchers with no major in statistics. Through this study, the authors hope that many researchers will use the R software to more readily perform the intervention meta-analysis and that this will in turn generate further related research.
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Summary
Korean summary
통계프로그램으로서의 R이 대세인 연구환경에서 R을 활용한 체계적인 메타분석 안내서가 요구되어지며 본 연구는 이에 대한 좋은 해답이 될 것이다. 더욱이 본 연구는 메타분석 (Intervention meta-analysis)의 이론과 더불어 R을 활용한 실습위주의 내용으로 구성되어져 있어 누구나 쉽게 실행할 수 있을 것이다.
본 연구를 통하여 많은 연구자들이 보다 쉽게 본인의 연구분야에 적용하여 관련 연구가 활성화되기를 바란다.
Key Message
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