@article{HeneghanWardPereraetal.2012, author = {Heneghan, Carl and Ward, Alison and Perera, Rafael and Bankhead, Clare and Fuller, Alice and Stevens, Richard and Bradford, Kairen and Tyndel, Sally and Alonso-Coello, Pablo and Ansell, Jack and Beyth, Rebecca and Bernardo, Artur and Christensen, Thomas Decker and Cromheecke, Manon and Edson, Robert G and Fitzmaurice, David and Gadisseur, Alain PA and Garcia-Alamino, Josep M and Gardiner, Chris and Hasenkam, Michael and Jacobson, Alan and Kaatz, Scott and Kamali, Farhad and Khan, Tayyaba Irfan and Knight, Eve and Kortke, Heinrich and Levi, Marcel and Matchar, David Bruce and Menendez-Jandula, Barbara and Rakovac, Ivo and Schaefer, Christian and Siebenhofer, Andrea and Souto, Juan Carlos and Sunderji, Rubina and Gin, Kenneth and Shalansky, Karen and V{\"o}ller, Heinz and Wagner, Otto and Zittermann, Armin}, title = {Self-monitoring of oral anticoagulation systematic review and meta-analysis of individual patient data}, series = {The lancet}, volume = {379}, journal = {The lancet}, number = {9813}, publisher = {Elsevier}, address = {New York}, organization = {Self-Monitoring Trialist Collabora}, issn = {0140-6736}, doi = {10.1016/S0140-6736(11)61294-4}, pages = {322 -- 334}, year = {2012}, abstract = {Background Uptake of self-testing and self-management of oral coagulation has remained inconsistent, despite good evidence of their effectiveness. To clarify the value of self-monitoring of oral anticoagulation, we did a meta-analysis of individual patient data addressing several important gaps in the evidence, including an estimate of the effect on time to death, first major haemorrhage, and thromboembolism. Methods We searched Ovid versions of Embase (1980-2009) and Medline (1966-2009), limiting searches to randomised trials with a maximally sensitive strategy. We approached all authors of included trials and requested individual patient data: primary outcomes were time to death, first major haemorrhage, and first thromboembolic event. We did prespecified subgroup analyses according to age, type of control-group care (anticoagulation-clinic care vs primary care), self-testing alone versus self-management, and sex. We analysed patients with mechanical heart valves or atrial fibrillation separately. We used a random-effect model method to calculate pooled hazard ratios and did tests for interaction and heterogeneity, and calculated a time-specific number needed to treat. Findings Of 1357 abstracts, we included 11 trials with data for 6417 participants and 12 800 person-years of follow-up. We reported a significant reduction in thromboembolic events in the self-monitoring group (hazard ratio 0.51; 95\% CI 0.31-0.85) but not for major haemorrhagic events (0.88, 0.74-1.06) or death (0.82, 0.62-1.09). Participants younger than 55 years showed a striking reduction in thrombotic events (hazard ratio 0.33, 95\% CI 0.17-0.66), as did participants with mechanical heart valve (0.52, 0.35-0.77). Analysis of major outcomes in the very elderly (age >= 85 years, n=99) showed no significant adverse effects of the intervention for all outcomes. Interpretation Our analysis showed that self-monitoring and self-management of oral coagulation is a safe option for suitable patients of all ages. Patients should also be offered the option to self-manage their disease with suitable health-care support as back-up.}, language = {en} } @article{KrokeSchmidtAminietal.2022, author = {Kroke, Anja and Schmidt, Annemarie and Amini, Anna M. and Kalotai, Nicole and Lehmann, Andreas and Haardt, Julia and Bauer, J{\"u}rgen M. and Bischoff-Ferrari, Heike A. and Boeing, Heiner and Egert, Sarah and Ellinger, Sabine and K{\"u}hn, Tilman and Louis, Sandrine and Lorkowski, Stefan and Nimptsch, Katharina and Remer, Thomas and Schulze, Matthias B. and Siener, Roswitha and Stangl, Gabriele and Volkert, Dorothee and Zittermann, Armin and Buyken, Anette E. and Watzl, Bernhard and Schwingshackl, Lukas}, title = {Dietary protein intake and health-related outcomes: a methodological protocol for the evidence evaluation and the outline of an evidence to decision framework underlying the evidence-based guideline of the German Nutrition Society}, series = {European journal of nutrition}, volume = {61}, journal = {European journal of nutrition}, number = {4}, publisher = {Springer Nature}, address = {Heidelberg}, organization = {German Nutr Soc}, issn = {1436-6207}, doi = {10.1007/s00394-021-02789-5}, pages = {2091 -- 2101}, year = {2022}, abstract = {Purpose: The present work aimed to delineate (i) a revised protocol according to recent methodological developments in evidence generation, to (ii) describe its interpretation, the assessment of the overall certainty of evidence and to (iii) outline an Evidence to Decision framework for deriving an evidence-based guideline on quantitative and qualitative aspects of dietary protein intake. Methods A methodological protocol to systematically investigate the association between dietary protein intake and several health outcomes and for deriving dietary protein intake recommendations for the primary prevention of various non-communicable diseases in the general adult population was developed. Results The developed methodological protocol relies on umbrella reviews including systematic reviews with or without meta-analyses. Systematic literature searches in three databases will be performed for each health-related outcome. The methodological quality of all selected systematic reviews will be evaluated using a modified version of AMSTAR 2, and the outcome-specific certainty of evidence for systematic reviews with or without meta-analysis will be assessed with NutriGrade. The general outline of the Evidence to Decision framework foresees that recommendations in the derived guideline will be given based on the overall certainty of evidence as well as on additional criteria such as sustainability. Conclusion The methodological protocol permits a systematic evaluation of published systematic reviews on dietary protein intake and its association with selected health-related outcomes. An Evidence to Decision framework will be the basis for the overall conclusions and the resulting recommendations for dietary protein intake.}, language = {en} }