Reproducibility and replicability of systematic reviews

Irreproducibility of research causes a major concern in academia.This concern affects all study designs regardless of scientific fields.Without testing the reproducibility and replicability it is almost impossible to repeat the research and to gain the same or similar results.In addition,irreproducibility limits the translation of research findings into practice where the same results are expected.To find the solutions,the Interacademy Partnership for Health gathered academics from established networks of science,medicine and engineering around a table to introduce seven strategies that can enhance the reproducibility:pre-registration,open methods,open data,collaboration,automation,reporting guidelines,and post-publication reviews.The current editorial discusses the generalisability and practicality of these strategies to systematic reviews and claims that systematic reviews have even a greater potential than other research designs to lead the movement toward the reproducibility of research.Moreover,I discuss the potential of reproducibility,on the other hand,to upgrade the systematic review from review to research.Furthermore,there are references to the successful and ongoing practices from collaborative efforts around the world to encourage the systematic reviewers,the journal editors and publishers,the organizations linked to evidence synthesis,and the funders and policy makers to facilitate this movement and to gain the public trust in research.

Transcranial magnetic stimulation for geriatric depression: Promises and pitfalls

As the global population gets older, depression in the elderly is emerging as an important health issue. A major challenge in treating geriatric depression is the lack of robust efficacy for many treatments that are of significant benefit to depressed working age adults. Repetitive transcranial magnetic stimulation(r TMS) is a novel physical treatment approach used mostly in working age adults with depression. Many TMS trials and clinics continue to exclude the elderly from treatment citing lack of evidence in this age group. In this review, we appraise the evidence regarding the safety and efficacy of rT MS in the elderly. A consistent observation supporting a high degree of tolerability and safety among the elderly patients emerged across the Randomised Controlled Trials and the uncontrolled trials. Further, there is no reliable evidence negating the utility of rT MS in the elderly with depression. We also identified several factors other than age that moderate the observed variations in the efficacy of rT MS in the elderly. These factors include but not limited to:(1) brain atrophy;(2) intensity and number of pulses(dose-response relationship); and(3) clinical profile of patients. On the basis of the current evidence, the practice of excluding elderly patients from TMS clinics and trials cannot be supported.

Exercise interventions for older adults: A systematic review of meta-analyses

Background:The evidence concerning which physical exercise characteristics are most effective for older adults is fragmented.We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of metaanalyses of exercise interventions in older adults.Methods:We searched the Cochrane Database of Systematic Reviews,PsycInfo,MEDLINE,Embase,CINAHL,AMED,SPORTDiscus,and Web of Science for articles that met the following criteria:(1)meta-analyses that synthesized measures of improvement(e.g.,effect sizes)on any outcome identified in studies of exercise interventions;(2)participants in the studies meta-analyzed were adults aged 65+or had a mean age of 70+;(3)meta-analyses that included studies of any type of exercise,including its duration,frequency,intensity,and mode of delivery;(4)interventions that included multiple components(e.g.,exercise and cognitive stimulation),with effect sizes that were computed separately for the exercise component;and(5)meta-analyses that were published in any year or language.The characteristics of the reviews,of the interventions,and of the parameters improved through exercise were reported through narrative synthesis.Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews.The study included 56 meta-analyses that were heterogeneous in relation to population,sample size,settings,outcomes,and intervention characteristics.Results:The largest effect sizes for improvement were found for resistance training,meditative movement interventions,and exercise-based active videogames.Conclusion:The review identified important gaps in research,including a lack of studies investigating the benefits of group interventions,the characteristics of professionals delivering the interventions associated with better outcomes,and the impact of motivational strategies and of significant others(e.g.,carers)on intervention delivery and outcomes.

Executive Function Training for Children with Attention Deficit Hyperactivity Disorder

Background： Accumulating evidence indicates that attention deficit hyperactivity disorder （ADHD） is associated with core deficits in executive function （EF） which predicts poorer academic and occupational functioning. This makes early intervention targeting EF impairments important to prevent long-term negative outcomes. Cognitive training is a potential ADHD treatment target. The present study aimed to explore the efficacy, feasibility, and acceptability of a cognitive training program （targeting child＇s multiple EF components and involving parent support in daily life）, as a nonpharmacological intervention for children with ADHD. Methods： Forty-four school-age children with ADHD and their parents participated in 12 sessions of EF training （last for 12 weeks） and 88 health controls （HC） were also recruited. Training effects were explored using both neuropsychological tests （Stroop color-word test, Rey-Osterrieth complex figure test, trail making test, tower of Hanoi, and false-belief task） and reports of daily life （ADHD rating scale-IV, Conners＇ parent rating scale, and behavior rating inventory of executive function [BRIEF]） by analysis of paired sample t-test and Wilcoxon signed-rank test. The differences on EF performances between children with ADHD after training and HC were explored using multivariate analysis. Results： The results （before vs. after EF training） showed that after intervention, the children with ADHD presented better performances of EF both in neuropsychological tests （word interference of Stroop： 36.1 ± 14.6 vs. 27.1 ± 11.1, t = 4.731, P 〈 0.001 ; shift time of TMT： 194.9 ± 115.4 vs. 124.8 ± 72.4, Z = -4.639, P 〈 0.001 ; false-belief task： χ^2 = 6.932, P = 0.008） and reports of daily life （global executive composite of BRIEF： 148.9 ± 17.5 vs. 127.8 ± 17.5, t =6.433, P 〈 0.001）. The performances on EF tasks for children with ADHD after EF training could match with the level of HC children. The ADHD symptoms （ADHD rating scale total score： 32.4 ± 8.9 vs. 22.9 ± 8.2, t = 6.331, P 〈 0.001） and behavioral problems of the children as reported by parents also reduced significantly after the intervention. Participants reported that the EF training program was feasible to administer and acceptable. Conclusions： The EF training program was feasible and acceptable to children with ADH D and parents. Although replication with a larger sample and an active control group are needed, EF training program with multiple EF focus and parent involving in real-life activities could be a potentially promising intervention associated with significant EF （near transfer） and ADHD symptoms improvement （far transfer）.