Papers by Charlene Soobiah
PloS one, 2012
The burden of H1N1 among socially disadvantaged populations is unclear. We aimed to synthesize ho... more The burden of H1N1 among socially disadvantaged populations is unclear. We aimed to synthesize hospitalization, severe illness, and mortality data associated with pandemic A/H1N1/2009 among socially disadvantaged populations. Studies were identified through searching MEDLINE, EMBASE, scanning reference lists, and contacting experts. Studies reporting hospitalization, severe illness, and mortality attributable to laboratory-confirmed 2009 H1N1 pandemic among socially disadvantaged populations (e.g., ethnic minorities, low-income or lower-middle-income economy countries [LIC/LMIC]) were included. Two independent reviewers conducted screening, data abstraction, and quality appraisal (Newcastle Ottawa Scale). Random effects meta-analysis was conducted using SAS and Review Manager. Sixty-two studies including 44,777 patients were included after screening 787 citations and 164 full-text articles. The prevalence of hospitalization for H1N1 ranged from 17-87% in high-income economy countrie...
BMJ (Clinical research ed.), 2014
To examine the safety, effectiveness, and cost effectiveness of long acting insulin for type 1 di... more To examine the safety, effectiveness, and cost effectiveness of long acting insulin for type 1 diabetes. Systematic review and network meta-analysis. Medline, Cochrane Central Register of Controlled Trials, Embase, and grey literature were searched through January 2013. Randomized controlled trials or non-randomized studies of long acting (glargine, detemir) and intermediate acting (neutral protamine Hagedorn (NPH), lente) insulin for adults with type 1 diabetes were included. 39 studies (27 randomized controlled trials including 7496 patients) were included after screening of 6501 titles/abstracts and 190 full text articles. Glargine once daily, detemir once daily, and detemir once/twice daily significantly reduced hemoglobin A1c compared with NPH once daily in network meta-analysis (26 randomized controlled trials, mean difference -0.39%, 95% confidence interval -0.59% to -0.19%; -0.26%, -0.48% to -0.03%; and -0.36%, -0.65% to -0.08%; respectively). Differences in network meta-ana...
Human Pathology, 2015
Fine needle aspiration (FNA) with cytologic analysis is an initial step in diagnosing thyroid nod... more Fine needle aspiration (FNA) with cytologic analysis is an initial step in diagnosing thyroid nodules that are suspicious for cancer. We systematically reviewed the test accuracy of B-type Raf kinase (BRAF(V600E)) gene mutation analysis plus conventional FNA in the diagnosis of papillary thyroid cancer. We identified studies reporting BRAF(V600E) mutation analysis after FNA for evaluation of thyroid nodules through searching MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, scanning reference lists of relevant studies, and contacting experts. Two independent reviewers screened literature results, abstracted data, and appraised study quality. When appropriate, bivariate and univariate random-effects meta-analyses of sensitivity and specificity were considered for all outcomes. Forty-seven studies met our inclusion criteria after screening 1560 citations and 169 full-text articles. The included studies enrolled approximately 16170 patients with 9924 FNA samples evaluated for BRAF(V600E) mutation. Univariate pooled sensitivity was 69% (95% confidence interval, 61%-76%) for papillary thyroid cancer. For thyroid nodules that were diagnosed cytologically as suspicious for papillary thyroid cancer, univariate pooled sensitivity using FNA and BRAF(V600E) results was 52% (95% confidence interval, 39%-64%). Despite its high specificity, our meta-analysis shows that BRAF(V600E) mutation analysis has a low sensitivity in diagnosing papillary thyroid cancer in thyroid nodules. The feasibility of this test as a single molecular tool is not well established, which indicates the need for well-designed prospective clinical studies.
BMC Medicine, 2015
Serotonin (5-HT3) receptor antagonists are commonly used to decrease nausea and vomiting for surg... more Serotonin (5-HT3) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients, but these agents may be harmful. We conducted a systematic review on the comparative safety of 5-HT3 receptor antagonists. Searches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT3 receptor antagonists with each other, placebo, and/or other antiemetic agents for patients undergoing surgical procedures. Screening search results, data abstraction, and risk of bias assessment were conducted by two reviewers independently. Random-effects pairwise meta-analysis and network meta-analysis (NMA) were conducted. PROSPERO registry number: CRD42013003564. Overall, 120 studies and 27,787 patients were included after screening of 7,608 citations and 1,014 full-text articles. Significantly more patients receiving granisetron plus dexamethasone experienced an arrhythmia relative to placebo (odds ratio (OR) 2.96, 95 % confidence interval (CI) 1.11-7.94), ondansetron (OR 3.23, 95 % CI 1.17-8.95), dolasetron (OR 4.37, 95 % CI 1.51-12.62), tropisetron (OR 3.27, 95 % CI 1.02-10.43), and ondansetron plus dexamethasone (OR 5.75, 95 % CI 1.71-19.34) in a NMA including 31 randomized clinical trials (RCTs) and 6,623 patients of all ages. No statistically significant differences in delirium frequency were observed across all treatment comparisons in a NMA including 18 RCTs and 3,652 patients. Granisetron plus dexamethasone increases the risk of arrhythmia.
BMC Medicine, 2015
Background: Serotonin (5-HT 3 ) receptor antagonists are commonly used to decrease nausea and vom... more Background: Serotonin (5-HT 3 ) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients. We conducted a systematic review on the comparative efficacy of 5-HT 3 receptor antagonists. Methods: Searches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT 3 receptor antagonists with each other, placebo, and/or combined with other antiemetic agents for patients undergoing surgical procedures. Screening search results, data abstraction, and risk of bias assessment were conducted by two reviewers independently. Random-effects pairwise meta-analysis and network meta-analysis (NMA) were conducted. PROSPERO registry number: CRD42013003564. Results: Overall, 450 studies and 80,410 patients were included after the screening of 7,608 citations and 1,014 full-text articles. Significantly fewer patients experienced nausea with any drug relative to placebo, except for ondansetron plus metoclopramide in a NMA including 195 RCTs and 24,230 patients. Significantly fewer patients experienced vomiting with any drug relative to placebo except for palonosetron plus dexamethasone in NMA including 238 RCTs and 12,781 patients. All agents resulted in significantly fewer patients with postoperative nausea and vomiting versus placebo in a NMA including 125 RCTs and 16,667 patients. Conclusions: Granisetron plus dexamethasone was often the most effective antiemetic, with the number needed to treat ranging from two to nine.
BMJ Open, 2015
Introduction: Individual patient data (IPD) metaanalysis (MA) offers advantages over aggregate MA... more Introduction: Individual patient data (IPD) metaanalysis (MA) offers advantages over aggregate MA of using standardised criteria for patient characteristics across trials, and allowing reliable investigation of subgroup effects of interventions. Network metaanalysis (NMA) allows for the comparison of multiple treatments in a comprehensive analysis and the determination of the best treatment among several competing treatments, including those that have never been compared in a head-to-head study. Including IPD in NMA may enable the prevention of misleading inferences due to several biases, such as aggregation bias. Application of IPD-NMA methods in healthcare have begun to appear in medical journals. Our objective is to conduct a scoping review of existing IPD-NMA methods, and summarise their properties. We also aim to describe the characteristics of empirical IPD-NMAs, and examine how their results are reported.
Influenza and other respiratory viruses, 2013
Previous reviews found that the H1N1 pandemic was associated with a large proportion of hospitali... more Previous reviews found that the H1N1 pandemic was associated with a large proportion of hospitalizations, severe illness, workplace absenteeism, and high costs. However, the burden among socially disadvantaged groups of the population is unclear. This is a summary of a previously published systematic review commissioned by the World Health Organization on the burden of H1N1 pandemic (influenza A/Mexico/2009 (H1N1)) among socially disadvantaged populations. MEDLINE and EMBASE were searched to identify studies reporting hospitalization, severe illness, and mortality attributable to the 2009 H1N1 pandemic among socially disadvantaged populations, including ethnic minorities and low-income or lower-middle-income economy countries (LIC/LMIC). SAS and Review Manager were used to conduct random effects meta-analysis. Forty-eight cohort studies and 14 companion reports including 44Â 777 patients were included after screening 787 citations and 164 full-text articles. Twelve of the included st...
Systematic reviews, 2014
Epilepsy affects about 1% of the general population. Anti-epileptic drugs (AEDs) prevent or termi... more Epilepsy affects about 1% of the general population. Anti-epileptic drugs (AEDs) prevent or terminate seizures in individuals with epilepsy. Pregnant women with epilepsy may continue taking AEDs. Many of these agents cross the placenta and increase the risk of major congenital malformations, early cognitive and developmental delays, and infant mortality. We aim to evaluate the comparative safety of AEDs approved for chronic use in Canada when administered to pregnant and breastfeeding women and the effects on their infants and children through a systematic review and network meta-analysis. Studies examining the effects of AEDs administered to pregnant and breastfeeding women regardless of indication (e.g., epilepsy, migraine, pain, psychiatric disorders) on their infants and children will be included. We will include randomized clinical trials (RCTs), quasi-RCTs, non-RCTs, controlled before-after, interrupted time series, cohort, registry, and case-control studies. The main literatu...
BMC pharmacology & toxicology, Jan 26, 2015
Patients may experience nausea and vomiting when undergoing chemotherapy or surgery requiring ane... more Patients may experience nausea and vomiting when undergoing chemotherapy or surgery requiring anesthesia. Serotonin 5-hydroxytryptamine 3 (5-HT3) receptor antagonists are effective antiemetics, yet may cause adverse cardiac events, such as arrhythmia. We aimed to identify interventions that mitigate the cardiac risk of 5-HT3 receptor antagonists. Electronic databases, trial registries, and references were searched. Studies on patients undergoing chemotherapy or surgery examining interventions to monitor cardiac risk of 5-HT3 receptor antagonists were included. Search results were screened and data from relevant studies were abstracted in duplicate. Risk of bias of included studies was assessed using the Cochrane Effective Practice and Organisation of Care (EPOC) group's risk-of-bias tool. Due to a dearth of included studies, meta-analysis was not conducted. Two randomized clinical trials (RCT) and 1 non-randomized clinical trial (NRCT) were included after screening 7,637 titles ...
Systematic Reviews, 2013
Background: Opioids are prescribed frequently and increasingly for the management of chronic non-... more Background: Opioids are prescribed frequently and increasingly for the management of chronic non-cancer pain (CNCP). Current systematic reviews have a number of limitations, leaving uncertainty with regard to the benefits and harms associated with opioid therapy for CNCP. We propose to conduct a systematic review and meta-analysis to summarize the evidence for using opioids in the treatment of CNCP and the risk of associated adverse events.
Systematic reviews, 2013
Type 2 diabetes mellitus (T2DM) results from insulin resistance and relative insulin deficiency. ... more Type 2 diabetes mellitus (T2DM) results from insulin resistance and relative insulin deficiency. T2DM treatment is a step-wise approach beginning with lifestyle modifications (for example, diet, exercise), followed by the addition of oral hypoglycemic agents (for example, metformin). Patients who do not respond to first-line therapy are offered second-line therapy (for example, sulfonylureas). Third-line therapy may include insulin and/or dipeptidyl peptidase-4 (DPP-4) inhibitors.It is unclear whether DPP-4 inhibitors are safer and more effective than intermediate acting insulin for third-line management of T2DM. As such, our objective is to evaluate the comparative effectiveness, safety and cost-effectiveness of DPP-4 inhibitors versus intermediate acting insulin for T2DM patients who have failed both first- and second-line diabetes treatments. Electronic searches of MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, and grey literature (for example, trial registries,...
BMJ (Clinical research ed.), 2014
To examine the safety, effectiveness, and cost effectiveness of long acting insulin for type 1 di... more To examine the safety, effectiveness, and cost effectiveness of long acting insulin for type 1 diabetes. Systematic review and network meta-analysis. Medline, Cochrane Central Register of Controlled Trials, Embase, and grey literature were searched through January 2013. Randomized controlled trials or non-randomized studies of long acting (glargine, detemir) and intermediate acting (neutral protamine Hagedorn (NPH), lente) insulin for adults with type 1 diabetes were included. 39 studies (27 randomized controlled trials including 7496 patients) were included after screening of 6501 titles/abstracts and 190 full text articles. Glargine once daily, detemir once daily, and detemir once/twice daily significantly reduced hemoglobin A1c compared with NPH once daily in network meta-analysis (26 randomized controlled trials, mean difference -0.39%, 95% confidence interval -0.59% to -0.19%; -0.26%, -0.48% to -0.03%; and -0.36%, -0.65% to -0.08%; respectively). Differences in network meta-ana...
BMJ open, 2014
To evaluate the effectiveness and safety of dipeptidyl peptidase-4 (DPP-4) inhibitors versus inte... more To evaluate the effectiveness and safety of dipeptidyl peptidase-4 (DPP-4) inhibitors versus intermediate-acting insulin for adults with type 2 diabetes mellitus (T2DM) and poor glycaemic control despite treatment with two oral agents. Studies were multicentre and multinational. Ten studies including 2967 patients with T2DM. Studies that examined DPP-4 inhibitors compared with each other, intermediate-acting insulin, no treatment or placebo in patients with T2DM. Primary outcome was glycosylated haemoglobin (HbA1c). Secondary outcomes were healthcare utilisation, body weight, fractures, quality of life, microvascular complications, macrovascular complications, all-cause mortality, harms, cost and cost-effectiveness. 10 randomised clinical trials with 2967 patients were included after screening 5831 titles and abstracts, and 180 full-text articles. DPP-4 inhibitors significantly reduced HbA1c versus placebo in network meta-analysis (NMA; mean difference (MD) -0.62%, 95% CI -0.93% to ...
Otolaryngology -- Head and Neck Surgery, 2013
Canadian Medical Association Journal, 2013
O lder adults experiencing memory and cognition deficits without substantial limitations in activ... more O lder adults experiencing memory and cognition deficits without substantial limitations in activities of daily living may be given a diagnosis of mild cognitive impairment. 1 These patients often present with subjective memory loss, impairment of cognitive function and no change in their basic daily functioning. Mild cognitive impairment has recently been recognized as a distinct condition, with a prevalence that ranges from 3% to 42% and increases with age. 2 Because of the growing proportion of older adults worldwide, the prevalence of this condition will only increase in the future. 3 Each year, 3%-17% of people with mild cognitive impairment experience progression to dementia, 4-6 a rate that increases to between 11% and 33% by 2 years after the initial diagnosis. 7 More than 4.6 million new cases of dementia are diagnosed each year, 3 and efforts to reduce this public health burden are essential. Strategies to delay the progression of mild cognitive impairment are being sought to meet this challenge.
Academic Medicine, 2014
Harassment and discrimination include a wide range of behaviors that medical trainees perceive as... more Harassment and discrimination include a wide range of behaviors that medical trainees perceive as being humiliating, hostile, or abusive. To understand the significance of such mistreatment and to explore potential preventive strategies, the authors conducted a systematic review and meta-analysis to examine the prevalence, risk factors, and sources of harassment and discrimination among medical trainees. In 2011, the authors identified relevant studies by searching MEDLINE and EMBASE, scanning reference lists of relevant studies, and contacting experts. They included studies that reported the prevalence, risk factors, and sources of harassment and discrimination among medical trainees. Two reviewers independently screened all articles and abstracted study and participant characteristics and study results. The authors assessed the methodological quality in individual studies using the Newcastle-Ottawa Scale. They also conducted a meta-analysis. The authors included 57 cross-sectional and 2 cohort studies in their review. The meta-analysis of 51 studies demonstrated that 59.4% of medical trainees had experienced at least one form of harassment or discrimination during their training (95% confidence interval [CI]: 52.0%-66.7%). Verbal harassment was the most commonly cited form of harassment (prevalence: 63.0%; 95% CI: 54.8%-71.2%). Consultants were the most commonly cited source of harassment and discrimination, followed by patients or patients' families (34.4% and 21.9%, respectively). This review demonstrates the surprisingly high prevalence of harassment and discrimination among medical trainees that has not declined over time. The authors recommend both drafting policies and promoting cultural change within academic institutions to prevent future abuse.
Pediatric Rheumatology, 2014
Background: Sleep problems are common among children with chronic illnesses such as Juvenile Idio... more Background: Sleep problems are common among children with chronic illnesses such as Juvenile Idiopathic Arthritis (or JIA). However, little is known about the frequency and severity of sleep disturbance(s) and the factors that are associated with sleep problems in children with JIA. The mechanism(s) of the relationships characterizing the development or exacerbation of sleep problems in children with JIA are still unknown, however studies have reported an association. The purpose of this study was to synthesize existing research related to sleep problems in children with JIA. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement guided the conduct and reporting of this review. An experienced librarian conducted searches in MEDLINE, EMBASE, PsychINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from inception to January 2012, to identify potentially relevant citations. Two members independently selected, rated methodological quality using the QUIPS tool, and extracted data from included studies. Results: Ten studies were included and findings varied across studies; studies were mostly cross-sectional, or casecontrolled designs, with only one cohort study available. Four studies found that children and adolescents diagnosed with JIA had significantly more sleep disturbances when compared to healthy controls. Pain was most often associated with sleep disturbances. The heterogeneous findings highlight the complex relationships between JIA and sleep, and low methodological quality of studies in the field. Conclusions: This review supports an association between poor sleep and increased symptoms related to JIA, specifically the experience of pain. However, results need to be interpreted cautiously given the inconsistent findings regarding factors associated with sleep problems in JIA, the limited evidence available, and its low quality. Furthermore it is not yet determined if the poor sleep patterns predate the symptoms reported with JIA. More research is vital to understanding the factors that predict or perpetuate poor sleep in children and adolescents diagnosed with JIA.
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Papers by Charlene Soobiah