Introduction to Meta‐Analysis

Borenstein, Michael; Hedges, Larry V.; Higgins, Julian P. T.; Rothstein, Hannah R.

doi:10.1002/9781119558378

Cited by 2,512 publications

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“…Essentially, if one seeks to assess the overall effect of n studies using intervention (1) and control (2) groups, this corresponds to calculating MD n mean differences and weighted standard deviations s n to generate n confidence intervals, respectively, given by Borenstein et al (26):…”

Section: Meta-analysismentioning

confidence: 99%

“…At last, the result is summarized on a single sample, which is pooled according to a pre-defined criterion. In this work, such a criterion is the inverse variance (26):…”

Section: Meta-analysismentioning

confidence: 99%

“…where w n is the weight associated with each study. In this way, the studies are weighed according to the within-study variance s 2 n and the estimate of the between-studies variance T 2 , which, in turn, is calculated by the DerSimonian-Laird method (26).…”

Section: Meta-analysismentioning

confidence: 99%

“…The differences between the different types of experiments in the results of the included studies were reduced by the focus of the inclusion and exclusion criteria on the general effect of exercise on seizure susceptibility and variation in the size of the effect in the animal model. Heterogeneity was evaluated by χ 2 -statistics followed by I² and its confidence interval CI (95%) described according to Borenstein et al (26). The overall effect was evaluated by the Z-value where significant effects were considered when p < 0.05.…”

Section: Subgroup Analysis and Investigation Of Heterogeneitymentioning

confidence: 99%

“…A left-oriented test was adopted but inverting the order of the means MD n = x n,2 − x n,1 . As discussed in Borenstein et al (26), the direction of the effect is arbitrary but can be conveniently defined according to its application. Since a longer latency, in terms of epileptiform activity is desired in clinical trials, this notation was adapted to visually match the other ones, which point to the negative direction for a successful intervention.…”

Section: Latency To Seizure Onsetmentioning

confidence: 99%

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The Potential Role of Previous Physical Exercise Program to Reduce Seizure Susceptibility: A Systematic Review and Meta-Analysis of Animal Studies

et al. 2021

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Background: Clinical and pre-clinical studies indicate a reduction in seizure frequency as well as a decrease in susceptibility to subsequently evoked seizures after physical exercise programs. In contrast to the influence of exercise after epilepsy previously established, various studies have been conducted attempting to investigate whether physical activity reduces brain susceptibility to seizures or prevents epilepsy. We report a systematic review and meta-analysis of different animal models that addressed the impact of previous physical exercise programs to reduce seizure susceptibility.Methods: We included animal model (rats and mice) studies before brain insult that reported physical exercise programs compared with other interventions (sham, control, or naïve). We excluded studies that investigated animal models after brain insult, associated with supplement nutrition or drugs, that did not address epilepsy or seizure susceptibility, ex vivo studies, in vitro studies, studies in humans, or in silico studies. Electronic searches were performed in the MEDLINE (PubMed), Web of Science (WOS), Scopus, PsycINFO, Scientific Electronic Library Online (SciELO) databases, and gray literature, without restrictions to the year or language of publication. We used SYRCLE's risk of bias tool and CAMARADES checklist for study quality. We performed a synthesis of results for different types of exercise and susceptibility to seizures by random-effects meta-analysis.Results: Fifteen studies were included in the final analysis (543 animals), 13 of them used male animals, and Wistar rats were the most commonly studied species used in the studies (355 animals). The chemoconvulsants used in the selected studies were pentylenetetrazol, penicillin, kainic acid, pilocarpine, and homocysteine. We assessed the impact of study design characteristics and the reporting of mitigations to reduce the risk of bias. We calculated a standardized mean difference effect size for each comparison and performed a random-effects meta-analysis. The meta-analysis included behavioral analysis (latency to seizure onset, n = 6 and intensity of motor signals, n = 3) and electrophysiological analysis (spikes/min, n = 4, and amplitude, n = 6). The overall effect size observed in physical exercise compared to controls for latency to seizure onset was −130.98 [95% CI: −203.47, −58.49] (seconds) and the intensity of motor signals was −0.40 [95% CI: −1.19, 0.40] (on a scale from 0 to 5). The largest effects were observed in electrophysiological analysis for spikes/min with −26.96 [95% CI: −39.56, −14.36], and for spike amplitude (μV) with −282.64 [95% CI: −466.81, −98.47].Discussion:Limitations of evidence. A higher number of animal models should be employed for analyzing the influence of exerciseon seizure susceptibility. The high heterogeneity in our meta-analysis is attributable to various factors, including the number of animals used in each study and the limited number of similar studies. Interpretation. Studies selected in this systematic review and meta-analysis suggest that previous physical exercise programs can reduce some of the main features related to seizure susceptibility [latency seizure onset, spikes/min, and spike amplitude (μV)] induced by the administration of different chemoconvulsants.Systematic Review Registration: PROSPERO, identifier CRD42021251949; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=251949.

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Section: Meta-analysismentioning

confidence: 99%

“…At last, the result is summarized on a single sample, which is pooled according to a pre-defined criterion. In this work, such a criterion is the inverse variance (26):…”

Section: Meta-analysismentioning

confidence: 99%

Section: Meta-analysismentioning

confidence: 99%

Section: Subgroup Analysis and Investigation Of Heterogeneitymentioning

confidence: 99%

Section: Latency To Seizure Onsetmentioning

confidence: 99%

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The Potential Role of Previous Physical Exercise Program to Reduce Seizure Susceptibility: A Systematic Review and Meta-Analysis of Animal Studies

et al. 2021

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Overweight, Obesity, and Depression

Luppino¹,

Wit²,

Bouvy³

et al. 2010

Arch Gen Psychiatry

3,376

1,309

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School-Based Randomized Controlled Trial of an HIV/STD Risk-Reduction Intervention for South African Adolescents

Jemmott¹,

Jemmott²,

O’Leary³

et al. 2010

Arch Pediatr Adolesc Med

101

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To test the efficacy of a school-based human immunodeficiency virus/sexually transmitted disease (HIV/STD) risk-reduction intervention for South African adolescents.Design: A cluster-randomized, controlled design with assessments of self-reported sexual behavior collected before intervention and 3, 6, and 12 months after intervention.Setting: Primary schools in a large, black township and a neighboring rural settlement in Eastern Cape Province, South Africa.Participants: Nine of 17 matched pairs of schools were randomly selected. Sixth-grade students with parent or guardian consent were eligible.Interventions: Two 6-session interventions based on behavior-change theories and qualitative research. The HIV/STD risk-reduction intervention targeted sexual risk behaviors; the attention-matched health promotion control intervention targeted health issues unrelated to sexual behavior.Outcome Measures: The primary outcome was self report of unprotected vaginal intercourse in the previous 3 months averaged over the 3 follow-ups. Secondary outcomes were other sexual behaviors.Results: A total of 1057 (94.5%) of 1118 eligible students (mean age,12.4 years) participated, with 96.7% retained at the 12-month follow-up. Generalized estimating equation analyses adjusted for clustering from 18 schools revealed that, averaged over the 3 follow-ups, a significantly smaller percentage of HIV/STD risk-reduction intervention participants reported having unprotected vaginal intercourse (odds ratio [OR] ,0.51; 95% confidence interval [CI], 0.30-0.85), vaginal intercourse (OR,0.62; 95% CI, 0.42-0.94), and multiple sexual partners (OR,0.50; 95% CI, 0.28-0.89), when adjusted for baseline prevalences, compared with health-promotion control participants. Conclusion:This is the first large-scale, community-level, randomized intervention trial to show significant effects on the HIV/STD sexual risk behavior of South African adolescents in the earliest stages of entry into sexual activity.

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Introduction to Meta‐Analysis

Cited by 2,512 publications

References 0 publications

The Potential Role of Previous Physical Exercise Program to Reduce Seizure Susceptibility: A Systematic Review and Meta-Analysis of Animal Studies

The Potential Role of Previous Physical Exercise Program to Reduce Seizure Susceptibility: A Systematic Review and Meta-Analysis of Animal Studies

Overweight, Obesity, and Depression

School-Based Randomized Controlled Trial of an HIV/STD Risk-Reduction Intervention for South African Adolescents

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