Cochrane Database of Systematic ReviewsAntibody tests for identification of current and past infection with SARS-CoV-2 (Review)

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Rapid, point-of-care antigen and molecular-based tests for diagnosis of SARS-CoV-2 infection (Review)

Aims: Type 1 diabetes is characterised by the destruction of pancreatic βcells. Significant levels of βcells remain at diagnosis. Preserving these cells improves glucose control and protects from long-term complications. We undertook a systematic review and meta-analyses of all randomised controlled trials (RCTs) of interventions to preserve βcell function in people newly diagnosed with type 1 diabetes. This paper reports the results of interventions for improving glucose control to assess whether they preserve βcell function. Methods: Searches for RCTs in MEDLINE, Embase, Cochrane CENTRAL, ClinicalTrials.gov and WHO International Clinical Trials Registry. Eligible studies included newly diagnosed patients with type 1 diabetes, any intervention to improve glucose control and at least 1 month of follow-up. Data were extracted using a predefined data-extraction sheet with 10% of extractions checked by a second reviewer. Results: Twenty-eight studies with 1662 participants were grouped by intervention into six subgroups (alternative insulins, subcutaneous and intravenous insulin delivery, intensive therapy, glucose sensing, adjuncts). Only three studies demonstrated an improvement in glucose control as well as βcell function. These interventions included intensive insulin therapy and use of an alternative insulin. Conclusions: This is the largest comprehensive review of RCTs in this area. It demonstrates a lack of robust evidence that interventions to improve glucose control preserve βcell function in new onset type 1 diabetes, although analysis was hampered by low-quality evidence and inconsistent reporting of studies.Development of guidelines to support the design of trials in this field is a priority.

Purpose: This systematic review aims to identify instrument-based tests for quantifying vitreous inflammation in uveitis, report the test reliability and the level of correlation with clinician grading. Methods: Studies describing instrument-based tests for detecting vitreous inflammation were identified by searching bibliographic databases and trials registers. Test reliability measures and level of correlation with clinician vitreous haze grading are extracted. Results: Twelve studies describing ultrasound, optical coherence tomography (OCT), and retinal photography for detecting vitreous inflammation were included: Ultrasound was used for detection of disease features, whereas OCT and retinal photography provided quantifiable measurements. Correlation with clinician grading for OCT was 0.53-0.60 (three studies) and for retinal photography was 0.51 (1 study). Both instruments showed high inter-and intra-observer reliability (>0.70 intraclass correlation and Cohen's kappa), where reported in four studies. Conclusion: Retinal photography and OCT are able to detect and measure vitreous inflammation. Both techniques are reliable, automatable, and warrant further evaluation.

BackgroundCurrent follow‐up models in cancer are seen to be unsustainable and inflexible, and there is growing interest in alternative models, such as patient‐initiated follow‐up (PIFU). It is therefore important to understand whether PIFU is acceptable to patients and healthcare professionals (HCPs).MethodsStandard systematic review methodology aimed at limiting bias was used for study identification (to January 2022), selection and data extraction. Thematic synthesis was undertaken for qualitative data, and survey findings were tabulated and described.ResultsNine qualitative studies and 22 surveys were included, mainly in breast and endometrial cancer. Women treated for breast or endometrial cancer and HCPs were mostly supportive of PIFU. Facilitators for PIFU included convenience, control over own health and avoidance of anxiety‐inducing clinic appointments. Barriers included loss of reassurance from scheduled visits and lack of confidence in self‐management. HCPs were supportive of PIFU but concerned about resistance to change, unsuitability of PIFU for some patients and costs.ConclusionPIFU is viewed mostly positively by women treated for breast or endometrial cancer, and by HCPs, but further evidence is needed from a wider range of cancers, men, and more representative samples.A protocol was registered with PROSPERO (CRD42020181412).

Background: The support provided by people with the same condition, including inflammatory bowel diseases (IBD) has the potential to improve a range of psychosocial outcomes by allowing people with the disease to receive emotional support as well as to learn coping strategies from more experienced peers. The aim of this systematic review was to summarise the evidence on peer support interventions and their effectiveness on people with IBD.Methods: Bibliographic databases, conference proceedings, grey literature, and clinical trial registers were searched from inception to November 2021. Comparative and single-arm studies that evaluated interventions that were solely or contained in part peer support, on people with IBD and/or their carers were included. Effectiveness was evaluated in a range of outcomes relating to physical and psychosocial function, disease control and healthcare utilisation. Data for each of the outcomes were tabulated and presented in narrative synthesis. Study design specific tools were used to assess risk of bias in duplicate.Results: Fourteen completed studies and five ongoing studies met the inclusion criteria. Substantial heterogeneity was observed in the studies in relation to the intervention type. Overall, no significant evidence of beneficial effects of peer support interventions on quality of life and other psychosocial outcomes was found. As all but one of the included studies analysed only the total effect of the interventions, it was not possible to isolate the effect of the peer support components. The appropriateness of outcomes and outcome measurement tools for the assessment of the effects of peer support interventions was a key issue. Conclusions: New randomised controlled trials are needed to evaluate the (net) effects of peer support only. Agreement on the choice of reliable and validated measurement tools and on the outcomes to be targeted by standalone peer support interventions would provide a focus for further intervention design and evaluation.Systematic review registration: The protocol was accepted in the international prospective register of systematic reviews (PROSPERO CRD42020168817). This work was part supported by a grant from Bowel Research UK.

Background The support provided by people with the same condition, including inflammatory bowel diseases (IBD), has the potential to improve a range of psychosocial outcomes by allowing people with the disease to receive emotional support as well as to learn coping strategies from more experienced peers. The aim of this systematic review was to summarise the evidence on peer support interventions and their effectiveness on people with IBD. Methods Bibliographic databases, conference proceedings, grey literature, and clinical trial registers were searched from inception to November 2021. Comparative and single-arm studies that evaluated interventions that were solely or contained in part peer support, for people with IBD and/or their carers of any age and in any setting were included. Effectiveness was evaluated using outcomes relating to physical and psychosocial function, disease control and healthcare utilisation. Data for each outcome were tabulated and presented in a narrative synthesis. Study design specific tools were used to assess risk of bias. Study selection and risk of bias assessment were undertaken by two reviewers independently. Results Fourteen completed studies and five ongoing studies met the inclusion criteria. Substantial heterogeneity was observed in the studies in relation to the intervention type and peer support was usually part of a wider intervention. All but one study analysed the total effect of the intervention, so it was not possible to fully isolate the effect of the peer support alone. The appropriateness of outcomes and outcome measurement tools for the assessment of effects was a further key issue. As such, overall, no significant evidence of beneficial effects of peer support interventions on quality of life and other psychosocial outcomes was found. Conclusions New randomised controlled trials designed to isolate the effects of peer support are needed to evaluate the (net) effects of peer support only. Agreement on the outcomes to be targeted, and the choice of reliable and validated measurement tools for standalone peer support interventions would provide a focus for further intervention design and evaluation. Systematic review registration The protocol was accepted in the international prospective register of systematic reviews (PROSPERO CRD42020168817).