The systematic review protocol was registered in PROSPERO on October 19th, 2017 with the number: CRD42017080039 and is available from: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=80039.

the aim of this systematic review was to assess the performance of anthropometric tools to determine obesity in the general population (CRD42018086888). Our review included 32 studies. To detect obesity with body mass index (BMI), the meta-analyses rendered a sensitivity of 51.4% (95% CI 38.5-64.2%) and a specificity of 95.4% (95% CI 90.7-97.8%) in women, and 49.6% (95% CI 34.8-64.5%) and 97.3% (95% CI 92.1-99.1%), respectively, in men. For waist circumference (WC), the summary estimates for the sensitivity were 62.4% (95% CI 49.2-73.9%) and 88.1% for the specificity (95% CI 77.0-94.2%) in men, and 57.0% (95% CI 32.2-79.0%) and 94.8% (95% CI 85.8-98.2%), respectively, in women. The data were insufficient to pool the results for waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) but were similar to BMI and WC. In conclusion, BMI and WC have serious limitations for use as obesity screening tools in clinical practice despite their widespread use. No evidence supports that WHR and WHtR are more suitable than BMI or WC to assess body fat. However, due to the lack of more accurate and feasible alternatives, BMI and WC might still have a role as initial tools for assessing individuals for excess adiposity until new evidence emerges. Obesity is widely recognised as a pandemic public health problem. According to the World Health Organization (WHO), in 2016 more than 650 million adults worldwide were obese 1. These numbers have almost tripled since 1975 2. Obesity increases the risk for many chronic diseases, such as diabetes mellitus, cardiovascular diseases and cancers 3 , and is possibly associated with mental health disorders 4. Associations have been shown to be strongest between obesity and the incidence of diabetes mellitus, particularly in women (risk ratio [RR] 12.41, 95% confidence interval [CI] 9.03-17.06). Primary care is considered one of the main settings for the prevention, screening and management of obesity 5. Individual studies indicate that patients are more likely to lose weight when they receive recommendations for lifestyle changes from their primary care physicians 6. Because it can be difficult for physicians to accurately determine obesity solely through visually inspecting their patients 7 , they need a reliable, efficient screening tool in order to ensure that those who need management and treatment receive it. WHO conceptualises obesity as "abnormal or excessive fat accumulation that may impair health" 1. It is most commonly assessed using body mass index (BMI), a simple and quick anthropometric tool that has a low cost. Adults with a BMI greater than or equal to 30 are classified as being obese 1 (Table 1). However, several researchers and professional associations 8-14 consider the use of BMI as the primary clinical index of obesity insufficient. They have called for a new definition that fully accounts for the complexity of the disease relating to the quantity, distribution and secretory function of adipose tissue. A substantial body of evidence has shown that obesity (BMI ≥ 30) is ass...

ObjectivesOccupational injuries and diseases are a huge public health problem and cause extensive suffering and loss of productivity. Nevertheless, many occupational health and safety (OHS) guidelines are still not based on the best available evidence. In the last decade, numerous systematic reviews on behavioural, relational and mixed interventions to reduce occupational injuries and diseases have been carried out, but a comprehensive synopsis is yet missing. The aim of this overview of reviews is to provide a comprehensive basis to inform evidence-based decision-making about interventions in the field of OHS.MethodsWe conducted an overview of reviews. We searched MEDLINE (Ovid), the Cochrane Library (Wiley), epistemonikos.org and Scopus (Elsevier) for relevant systematic reviews published between January 2008 and June 2018. Two authors independently screened abstracts and full-text publications and determined the risk of bias of the included systematic reviews with the ROBIS (Risk of Bias in Systematic Reviews) tool.ResultsWe screened 2287 abstracts and 200 full-texts for eligibility. Finally, we included 25 systematic reviews with a low risk of bias for data synthesis and analysis. We identified systematic reviews on the prevention of occupational injuries, musculoskeletal, skin and lung diseases, occupational hearing impairment and interventions without specific target diseases. Several interventions led to consistently positive results on individual diseases; other interventions did not show any effects, or the studies are contradictory. We provide detailed results on all included interventions.DiscussionTo our knowledge, this is the first comprehensive overview of behavioural, relational and mixed interventions and their effectiveness in preventing occupational injuries and diseases. It provides policymakers with an important basis for making evidence-based decisions on interventions in this field.PROSPERO registration numberCRD42018100341

BackgroundOver the past years, implementation science has gained more and more importance in German-speaking countries. Reliable and valid questionnaires are needed for evaluating the implementation of evidence-based practices. On an international level, several initiatives focused on the identification of questionnaires used in English-speaking countries but limited their search processes to mental health and public health settings. Our aim was to identify questionnaires used in German-speaking countries measuring the implementation of interventions in public health and health care settings in general and to assess their psychometric properties.MethodsWe searched five different bibliographic databases (from 1985 to August 2017) and used several other search strategies (e.g., reference lists, forward citation) to obtain our data. We assessed the instruments, which were identified in an independent dual review process, using 12 psychometric rating criteria. Finally, we mapped the instruments’ scales and subscales in regard to the constructs of the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcome Framework (IOF).ResultsWe identified 31 unique instruments available for the assessment of implementation science constructs. Hospitals and other health care settings were the ones most often investigated (23 instruments), while education and childcare settings, workplace settings, and community settings lacked published instruments. Internal consistency, face and content validity, usability, and structural validity were the aspects most often described. However, most studies did not report on test-retest reliability, known-groups validity, predictive criterion validity, or responsiveness. Overall, the majority of studies did not reveal high-quality instruments, especially regarding the psychometric criteria internal consistency, structural validity, and criterion validity. In addition, we seldom detected instruments operationalizing the CFIR domains intervention characteristics, outer setting, and process, and the IOF constructs adoption, fidelity, penetration, and sustainability.ConclusionsOverall, a sustained and continuous effort is needed to improve the reliability and validity of existing instruments to new ones. Instruments applicable to the assessment of implementation constructs in public health and community settings are urgently needed.Trial registrationThe systematic review protocol was registered in PROSPERO on October 19, 2017, under the following number: CRD42017075208.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0837-3) contains supplementary material, which is available to authorized users.

Ziel dieser Arbeit war daher, die wissenschaftlichen Grundlagen der VU unter Verwendung des GRADE (Grading of Recommendations Assessment, Development and Evaluation) Ansatzes zu aktualisieren. Die wissenschaftliche Evidenz für Untersuchungen und Beratungen, die derzeit Teil der VU sind, wurde aktualisiert und um weitere potentiell relevante Untersuchungen erweitert. Vertreter/innen der Bevölkerung diskutierten in drei Fokusgruppen ihre Erwartungen an die VU. In einem strukturierten Prozess wurden von einem Beratungsgremium evidenzbasier-Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (

Purpose: Despite evidence from clinical guideline development that physicians and patients show discordance in what they consider important in outcome selection and prioritization, it is unclear to what extent outcome preferences are concordant between experts and citizens when it comes to the context of primary prevention. Therefore, the objective of this study was to assess whether expert judgments about the importance of beneficial and harmful outcomes differ from citizen preferences when considering intervention options for a periodic health examination (PHE) program. Participants and Methods:We conducted an online survey using a modified Delphi approach. The target population for the survey consisted of citizens who had attended the PHE (n=18) and experts who made evidence-based recommendations (n=11). Citizens and experts assigned a score on a 9-point Likert scale for each outcome of 14 interventions. We analyzed the intragroup agreement based on Krippendorff's alpha and the intergroup agreement using the cube root product measure (CRPm). We further tested for significant differences between the groups using the Mann U-test. Results: Agreements within the groups of citizens and experts varied across the interventions and tended to be poor (α ≤0 to 0.20) or fair (α = 0.21 to 0.40), with three exceptions showing moderate agreement (α = 0.44 to 0.55). The agreements between the citizens and experts across the interventions was fair (CRPm = 0.28) during the first Delphi rating round. The mean differences between the citizens and experts on the Likert scale ranged from 0.0 to 3.8 during the first rating round and from 0.0 to 3.3 during the second. Across interventions, the citizens rated the outcomes as more important than the experts did (p<0.01). Individual participants' ratings varied substantially. Conclusion:Because experts generally underestimated the outcomes' importance to citizens, the involvement of citizens in guideline panels for preventive services is important.