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.