Empathy assessment in healthcare students is highly heterogeneous: A systematic review and meta-analysis(2012-2016)

BACKGROUND Clinical empathy leads to improved patient satisfaction and better clinical outcomes. Currently, there are multiple empathy scales with minimal or no efforts to produce an integrated definition of clinical empathy which can be assessed sufficiently by only a few scales. Moreover, there is an unclear overall reliability of these empathy scales, hence limiting comparative evaluation.AIM To examine which empathy scales have been used in healthcare students and to estimate their overall internal consistency.METHODS A systematic review was performed with inclusion criteria any empirical study with quantitative data examining empathy of healthcare students toward patients between 2012 and 2016. A random effects model was used to produce a pooled estimate of the Cronbach's alphas. The Hakstian-Whalen transformation was used for analyses based on the Rodriguez-Maeda method. Heterogeneity was quantified using the I2 statistic and further investigated with subgroup analysis and meta-regression. Publication bias was assessed using funnel plots, Egger's test, Begg's test, and the trim and fill analysis.RESULTSThirteen scales have been used to assess clinical empathy in healthcare students from forty nine studies with total sample size 49384 students. The most frequently used scale is the Jefferson Scale of Physician Empathy followed by Davis' Interpersonal Reactivity Index. The overall reliability was 0.805(95%CI0.786-0.823), which is acceptable, but there was heterogeneity and publication bias. Some heterogeneity was explained by the different countries(regions) of the studies under investigation and student types but most heterogeneity remained unexplained.CONCLUSION The results indicate that scales have satisfactory internal consistency but there are a multitude of scales, definitions and empathy components. Future research should focus on standardizing scales and creating consensus statements regarding the definition of empathy and use of appropriate scales.

Multi-mechanical waves against Alzheimer’s disease pathology:a systematic review

Alzheimer’s disease(AD)is the most common cause of dementia,afecting approximately 40 million people worldwide.The inefectiveness of the available pharmacological treatments against AD has fostered researchers to focus on alternative strategies to overcome this challenge.Mechanical vibrations delivered in diferent stimulation modes have been associated with marked improvements in cognitive and physical performance in both demented and nondemented elderly.Some of the mechanical-based stimulation modalities in eforts are earlier whole-body vibration,transcranial ultrasound stimulation with microbubble injection,and more recently,auditory stimulation.However,there is a huge variety of treatment specifcations,and in many cases,conficting results are reported.In this review,a search on Scopus,PubMed,and Web of Science databases was performed,resulting in 37 papers.These studies suggest that mechanical vibrations delivered through diferent stimulation modes are efective in attenuating many parameters of AD pathology including functional connectivity and neuronal circuit integrity defcits in the brains of AD patients,as well as in subjects with cognitive decline and non-demented older adults.Despite the evolving preclinical and clinical evidence on these therapeutic modalities,their translation into clinical practice is not consolidated yet.Thus,this comprehensive and critical systematic review aims to address the most important gaps in the reviewed protocols and propose optimal regimens for future clinical application.