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Article: Nonpharmaceutical interventions to prevent viral respiratory infection in community settings: an umbrella review.

Zhao, Hedi / Jatana, Sukhdeep / Bartoszko, Jessica / Loeb, Mark

2022 Volume 8, Issue 2

Abstract: Background: Respiratory viruses pose an important public health threat to most communities. Nonpharmaceutical interventions (NPIs) such as masks, hand hygiene or physical distancing, among others, are believed to play an important role in reducing ... ...

Abstract	Background: Respiratory viruses pose an important public health threat to most communities. Nonpharmaceutical interventions (NPIs) such as masks, hand hygiene or physical distancing, among others, are believed to play an important role in reducing transmission of respiratory viruses. In this umbrella review, we summarise the evidence of the effectiveness of NPIs for the prevention of respiratory virus transmission in the community setting. Observations: A systematic search of PubMed, Embase, Medline and Cochrane reviews resulted in a total of 24 studies consisting of 11 systematic reviews and meta-analyses, 12 systematic reviews without meta-analyses and one standalone meta-analysis. The current evidence from these data suggests that hand hygiene is protective against respiratory viral infection. The use of hand hygiene and facemasks, facemasks alone and physical distancing were interventions with inconsistent evidence. Interventions such as school closures, oral hygiene or nasal saline rinses were shown to be effective in reducing the risk of influenza; however, the evidence is sparse and mostly of low and critically low quality. Conclusions: Studies on the effectiveness of NPIs for the prevention of respiratory viral transmission in the community vary in study design, quality and reported effectiveness. Evidence for the use of hand hygiene or facemasks is the strongest; therefore, the most reasonable suggestion is to use hand hygiene and facemasks in the community setting.
Language	English
Publishing date	2022-05-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2827830-6
ISSN	2312-0541
ISSN	2312-0541
DOI	10.1183/23120541.00650-2021
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Article ; Online: Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing

Bartoszko, Jessica J / Mitchell, Robyn / Katz, Kevin / Mulvey, Michael / Mataseje, Laura

Microbiology spectrum

2022 Volume 10, Issue 4, Page(s) e0097522

Abstract: Data regarding the epidemiology of extensively drug-resistant (XDR) carbapenemase- ... ...

Abstract	Data regarding the epidemiology of extensively drug-resistant (XDR) carbapenemase-producing
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Bacterial Proteins/genetics ; Canada/epidemiology ; Drug Resistance, Bacterial ; Enterobacteriaceae Infections/drug therapy ; Escherichia coli ; Humans ; Microbial Sensitivity Tests ; beta-Lactamases/genetics
Chemical Substances	Anti-Bacterial Agents ; Bacterial Proteins ; beta-Lactamases (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6)
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2807133-5
ISSN	2165-0497 ; 2165-0497
ISSN (online)	2165-0497
ISSN	2165-0497
DOI	10.1128/spectrum.00975-22
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Article ; Online: Conduct and reporting of multivariate network meta-analyses: a scoping review.

Bartoszko, Jessica J / Gutiérrez García, Mayra / Díaz Martínez, Juan Pablo / Yegorov, Sergey / Brignardello-Petersen, Romina / Mertz, Dominik / Thabane, Lehana / Loeb, Mark

Journal of clinical epidemiology

2023 Volume 166, Page(s) 111238

Abstract: Objectives: Combining multivariate and network meta-analysis methods simultaneously in a multivariate network meta-analysis (MVNMA) provides the methodological framework to analyze the largest amount of evidence relevant to decision-makers (i.e., from ... ...

Abstract	Objectives: Combining multivariate and network meta-analysis methods simultaneously in a multivariate network meta-analysis (MVNMA) provides the methodological framework to analyze the largest amount of evidence relevant to decision-makers (i.e., from indirect evidence and correlated outcomes). The objectives of this scoping review were to summarize the characteristics of MVNMAs published in the health sciences literature and map the methodological guidance available for MVNMA. Study design and setting: We searched MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature from inception to 28 August 2023, along with citations of included studies, for quantitative evidence syntheses that applied MVNMA and articles addressing MVNMA methods. Pairs of reviewers independently screened potentially eligible studies. Collected data included bibliographic, methodological, and analytical characteristics of included studies. We reported results as total numbers, frequencies, and percentages for categorical variables and medians and interquartile ranges for continuous variables that were not normally distributed. Results: After screening 1,075 titles and abstracts, and 112 full texts, we included 38 unique studies, of which, 10 were quantitative evidence syntheses that applied MVNMA and 28 were articles addressing MVNMA methods. Among the 10 MVNMAs, the first was published in 2013, four used studies identified from already published systematic reviews, and eight addressed pharmacological interventions, which were the most common interventions. They evaluated interventions for metastatic melanoma, colorectal cancer, prostate cancer, oral hygiene, disruptive behavior disorders, rheumatoid arthritis, narcolepsy, type 2 diabetes, and overactive bladder syndrome. Five MVNMAs analyzed two outcomes simultaneously, and four MVNMAs analyzed three outcomes simultaneously. Among the articles addressing MVNMA methods, the first was published in 2007 and the majority provided methodological frameworks for conducting MVNMAs (26/28, 93%). One study proposed criteria to standardize reporting of MVNMAs and two proposed items relevant to the quality assessment of MVNMAs. Study authors used data from 18 different illnesses to provide illustrative examples within their methodological guidance. Conclusions: The application of MVNMA in the health sciences literature is uncommon. Many methodological frameworks are published; however, standardization and specific criteria to guide reporting and quality assessment are lacking. This overview of the current landscape may help inform future conduct of MVNMAs and research on MVNMA methods.
MeSH term(s)	Humans ; Male ; Network Meta-Analysis ; Multivariate Analysis
Language	English
Publishing date	2023-12-09
Publishing country	United States
Document type	Meta-Analysis ; Journal Article ; Review
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2023.111238
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Article ; Online: Extracorporeal membrane oxygenation for COVID-19-associated severe acute respiratory distress syndrome in Canada: Analysis of data from the Canadian Nosocomial Infection Surveillance Program.

Qaddoura, Amro / Bartoszko, Jessica / Mitchell, Robyn / Frenette, Charles / Johnston, Lynn / Mertz, Dominik / Pelude, Linda / Thampi, Nisha / Smith, Stephanie W

Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada

2024 Volume 8, Issue 4, Page(s) 272–282

Abstract: Background: Extracorporeal membrane oxygenation (ECMO) for COVID-19 across Canada has not been well-described. We studied trends for patients with COVID-19-related acute respiratory distress syndrome who received ECMO.: Methods: Multicentre ... ...

Abstract	Background: Extracorporeal membrane oxygenation (ECMO) for COVID-19 across Canada has not been well-described. We studied trends for patients with COVID-19-related acute respiratory distress syndrome who received ECMO. Methods: Multicentre retrospective cohort study using data from the Canadian Nosocomial Infection Surveillance Program across four different waves. Surveillance data was collected between March 2020 and June 2022. We reported data stratified by ECMO status and wave. Results: ECMO recipients comprised 299 (6.8%) of the 4,408 critically ill patients included. ECMO recipients were younger (median age 49 versus 62 years, Conclusions: Our findings suggest that critically ill patients in Canadian hospitals who received ECMO had different characteristics from those who did not receive ECMO. We also observed a trend of decreased mortality over the waves for the ECMO group. Possible explanatory factors may include potential delay in ECMO initiation during Wave 1, evolution of the virus, better understanding of COVID-19 disease and ECMO use, and new medical treatments and vaccines available in later waves. These findings may provide insight for future potential pandemics.
Language	English
Publishing date	2024-01-16
Publishing country	Canada
Document type	Journal Article
ISSN	2371-0888
ISSN (online)	2371-0888
DOI	10.3138/jammi-2023-0015
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Article ; Online: The burden of influenza in older adults: meeting the challenge.

Bartoszko, Jessica / Loeb, Mark

Aging clinical and experimental research

2019 Volume 33, Issue 3, Page(s) 711–717

Abstract: Influenza is an acute respiratory infection for which vaccination is our best prevention strategy. Small seasonal changes in circulating influenza viruses (antigenic drift) result in the need for annual influenza vaccination, in which the vaccine ... ...

Abstract	Influenza is an acute respiratory infection for which vaccination is our best prevention strategy. Small seasonal changes in circulating influenza viruses (antigenic drift) result in the need for annual influenza vaccination, in which the vaccine formulation is updated to better match the predominant circulating influenza viruses that have undergone important antigenic changes. Although the burden of influenza infection and its complications is the highest in older adults, vaccine effectiveness is the lowest in this vulnerable population. This is largely due to waning of the immune response with age known as "immune senescence", and presents an important, unmet challenge. Possible strategies to tackle this include adjuvant and high-dose vaccines, and herd immunity induced by greater vaccine uptake.
MeSH term(s)	Aged ; Humans ; Influenza Vaccines ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Vaccination
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2019-07-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/s40520-019-01279-3
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Article ; Online: Medical masks vs N95 respirators for preventing COVID-19 in healthcare workers: A systematic review and meta-analysis of randomized trials.

Bartoszko, Jessica J / Farooqi, Mohammed Abdul Malik / Alhazzani, Waleed / Loeb, Mark

Influenza and other respiratory viruses

2020 Volume 14, Issue 4, Page(s) 365–373

Abstract: Background: Respiratory protective devices are critical in protecting against infection in healthcare workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative ... ...

Abstract	Background: Respiratory protective devices are critical in protecting against infection in healthcare workers at high risk of novel 2019 coronavirus disease (COVID-19); however, recommendations are conflicting and epidemiological data on their relative effectiveness against COVID-19 are limited. Purpose: To compare medical masks to N95 respirators in preventing laboratory-confirmed viral infection and respiratory illness including coronavirus specifically in healthcare workers. Data sources: MEDLINE, Embase, and CENTRAL from January 1, 2014, to March 9, 2020. Update of published search conducted from January 1, 1990, to December 9, 2014. Study selection: Randomized controlled trials (RCTs) comparing the protective effect of medical masks to N95 respirators in healthcare workers. Data extraction: Reviewer pair independently screened, extracted data, and assessed risk of bias and the certainty of the evidence. Data synthesis: Four RCTs were meta-analyzed adjusting for clustering. Compared with N95 respirators; the use of medical masks did not increase laboratory-confirmed viral (including coronaviruses) respiratory infection (OR 1.06; 95% CI 0.90-1.25; I Limitations: Indirectness and imprecision of available evidence. Conclusions: Low certainty evidence suggests that medical masks and N95 respirators offer similar protection against viral respiratory infection including coronavirus in healthcare workers during non-aerosol-generating care. Preservation of N95 respirators for high-risk, aerosol-generating procedures in this pandemic should be considered when in short supply.
MeSH term(s)	COVID-19 ; Coronavirus Infections/prevention & control ; Health Personnel ; Humans ; Infection Control/methods ; Masks/standards ; Occupational Exposure/prevention & control ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Randomized Controlled Trials as Topic ; Respiratory Protective Devices/standards ; Respiratory Protective Devices/supply & distribution ; Respiratory Tract Infections/prevention & control ; Respiratory Tract Infections/virology ; Ventilators, Mechanical/standards
Keywords	covid19
Language	English
Publishing date	2020-04-21
Publishing country	England
Document type	Comparative Study ; Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2274538-5
ISSN	1750-2659 ; 1750-2640
ISSN (online)	1750-2659
ISSN	1750-2640
DOI	10.1111/irv.12745
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Article ; Online: Prognostic factors for streptococcal toxic shock syndrome: systematic review and meta-analysis.

Bartoszko, Jessica J / Elias, Zeyad / Rudziak, Paulina / Lo, Carson K L / Thabane, Lehana / Mertz, Dominik / Loeb, Mark

BMJ open

2022 Volume 12, Issue 12, Page(s) e063023

Abstract: Objectives: To quantify the prognostic effects of demographic and modifiable factors in streptococcal toxic shock syndrome (STSS).: Design: Systematic review and meta-analysis.: Data sources: MEDLINE, EMBASE and CINAHL from inception to 19 ... ...

Abstract	Objectives: To quantify the prognostic effects of demographic and modifiable factors in streptococcal toxic shock syndrome (STSS). Design: Systematic review and meta-analysis. Data sources: MEDLINE, EMBASE and CINAHL from inception to 19 September 2022, along with citations of included studies. Eligibility criteria: Pairs of reviewers independently screened potentially eligible studies of patients with Group A Data extraction and synthesis: We performed random-effects meta-analysis after duplicate data extraction and risk of bias assessments. We rated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach. Results: One randomised trial and 40 observational studies were eligible (n=1918 patients). We found a statistically significant association between clindamycin treatment and mortality (n=144; OR 0.14, 95% CI 0.06 to 0.37), but the certainty of evidence was low. Within clindamycin-treated STSS patients, we found a statistically significant association between intravenous Ig treatment and mortality (n=188; OR 0.34, 95% CI 0.15 to 0.75), but the certainty of evidence was also low. The odds of mortality may increase in patients ≥65 years when compared with patients 18-64 years (n=396; OR 2.37, 95% CI 1.47 to 3.84), but the certainty of evidence was low. We are uncertain whether non-steroidal anti-inflammatory drugs increase the odds of mortality (n=50; OR 4.14, 95% CI 1.13 to 15.14; very low certainty). Results failed to show a significant association between any other prognostic factor and outcome combination (very low to low certainty evidence) and no studies quantified the association between a prognostic factor and morbidity post-infection in STSS survivors. Conclusions: Treatment with clindamycin and within clindamycin-treated patients, IVIG, was each significantly associated with mortality, but the certainty of evidence was low. Future research should focus on morbidity post-infection in STSS survivors. Prospero registration number: CRD42020166961.
MeSH term(s)	Humans ; Shock, Septic/drug therapy ; Clindamycin/therapeutic use ; Prognosis ; Streptococcal Infections/diagnosis ; Streptococcal Infections/drug therapy ; Streptococcus pyogenes ; Immunoglobulins, Intravenous
Chemical Substances	Clindamycin (3U02EL437C) ; Immunoglobulins, Intravenous
Language	English
Publishing date	2022-12-01
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2022-063023
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Article ; Online: Effectiveness of the influenza vaccine at reducing adverse events in patients with heart failure: A systematic review and meta-analysis.

Gupta, Christopher / Sachdeva, Anjali / Khamar, Jigish / Bu, Cecilia / Bartoszko, Jessica / Loeb, Mark

Vaccine

2022 Volume 40, Issue 25, Page(s) 3433–3443

Abstract: Background: The association between influenza and adverse vascular events in patients with heart failure is well documented. The effect of the influenza vaccine on preventing such adverse events is uncertain. This systematic review and meta-analysis ... ...

Abstract	Background: The association between influenza and adverse vascular events in patients with heart failure is well documented. The effect of the influenza vaccine on preventing such adverse events is uncertain. This systematic review and meta-analysis addressed whether vaccination against influenza reduces adverse vascular events and mortality in heart failure patients. Methods: MEDLINE and EMBASE databases were comprehensively searched, study screening and quality assessment were completed, and data was synthesized. Eligible studies investigated heart failure patients who received the influenza vaccine, and reported outcomes within 12 months, compared to heart failure patients who did not receive the influenza vaccine. The following 6 outcomes were assessed: all-cause mortality, cardiovascular-related mortality, all-cause hospitalization, cardiovascular-related hospitalization, non-fatal myocardial infarction, and non-fatal stroke. Risk of bias was assessed using the Newcastle-Ottawa Scale and a GRADE assessment was completed. A random-effects meta-analysis was performed to estimate the pooled risk ratio (RR), 95% confidence intervals (CIs), and heterogeneity using I Results: After synthesizing data from 7 non-randomized studies (247,842 patients), the results demonstrate the risk of all-cause mortality is significantly reduced within 12 months of a heart failure patient receiving the influenza vaccine (RR = 0.75, 95% CI 0.71-0.79; P<0.0001); very low certainty of evidence. The risk of cardiovascular-related mortality was significantly reduced (RR = 0.77, 95% CI 0.73-0.81; P<0.0001); low certainty of evidence. The pooled risk of all-cause hospitalization was higher among vaccinated heart failure patients (RR = 1.24, 95% CI 1.13-1.35; P<0.0001), based on two studies; very low certainty of evidence and considerable heterogeneity (I Conclusions: Influenza vaccination appears to reduce adverse cardiovascular events, although the certainty of the evidence is low or very low. Rigorous randomized controlled trial evidence is needed to further examine the protective effect of the influenza vaccine in heart failure patients.
MeSH term(s)	Heart Failure/complications ; Heart Failure/mortality ; Heart Failure/therapy ; Humans ; Influenza Vaccines/therapeutic use ; Influenza, Human/prevention & control ; Myocardial Infarction/prevention & control ; Stroke/prevention & control
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2022-05-11
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	605674-x
ISSN	1873-2518 ; 0264-410X
ISSN (online)	1873-2518
ISSN	0264-410X
DOI	10.1016/j.vaccine.2022.04.039
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Article ; Online: Impact of Allocation Concealment and Blinding in Trials Addressing Treatments for COVID-19: A Methods Study.

Zeraatkar, Dena / Pitre, Tyler / Diaz-Martinez, Juan Pablo / Chu, Derek / Rochwerg, Bram / Lamontagne, Francois / Kum, Elena / Qasim, Anila / Bartoszko, Jessica J / Brignardello-Peterson, Romina

American journal of epidemiology

2023 Volume 192, Issue 10, Page(s) 1678–1687

Abstract: We aimed to assess the impact of allocation concealment and blinding on the results of coronavirus disease 2019 (COVID-19) trials, using the World Health Organization COVID-19 database (to February 2022). We identified 488 randomized trials comparing ... ...

Abstract	We aimed to assess the impact of allocation concealment and blinding on the results of coronavirus disease 2019 (COVID-19) trials, using the World Health Organization COVID-19 database (to February 2022). We identified 488 randomized trials comparing drug therapeutics with placebo or standard care in patients with COVID-19. We performed random-effects meta-regressions comparing the results of trials with and without allocation concealment and blinding of health-care providers and patients. We found that, compared with trials with allocation concealment, trials without allocation concealment may estimate treatments to be more beneficial for mortality, mechanical ventilation, hospital admission, duration of hospitalization, and duration of mechanical ventilation, but results were imprecise. We did not find compelling evidence that, compared with trials with blinding, trials without blinding produce consistently different results for mortality, mechanical ventilation, and duration of hospitalization. We found that trials without blinding may estimate treatments to be more beneficial for hospitalizations and duration of mechanical ventilation. We did not find compelling evidence that COVID-19 trials in which health-care providers and patients are blinded produce different results from trials without blinding, but trials without allocation concealment estimate treatments to be more beneficial compared with trials with allocation concealment. Our study suggests that lack of blinding may not always bias results but that evidence users should remain skeptical of trials without allocation concealment.
MeSH term(s)	Humans ; COVID-19 ; Bias ; Hospitalization
Language	English
Publishing date	2023-05-30
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2937-3
ISSN	1476-6256 ; 0002-9262
ISSN (online)	1476-6256
ISSN	0002-9262
DOI	10.1093/aje/kwad131
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Article ; Online: Medical masks vs N95 respirators for preventing COVID‐19 in healthcare workers

Bartoszko, Jessica J. / Farooqi, Mohammed Abdul Malik / Alhazzani, Waleed / Loeb, Mark

Influenza and Other Respiratory Viruses

A systematic review and meta‐analysis of randomized trials

2020 Volume 14, Issue 4, Page(s) 365–373

Keywords	Public Health, Environmental and Occupational Health ; Epidemiology ; Pulmonary and Respiratory Medicine ; Infectious Diseases ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	2274538-5
ISSN	1750-2659 ; 1750-2640
ISSN (online)	1750-2659
ISSN	1750-2640
DOI	10.1111/irv.12745
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