The rate of preterm birth is a public health concern worldwide because it is increasing and efforts to prevent it have failed. We report a Clinically Relevant Complex Systematic Review (CSCSR) designed to identify and evaluate the best available evidence in support of the association between periodontal status in women and pregnancy outcome of preterm low birth weight. We hypothesize that the traditional limits of research synthesis must be expanded to incorporate a translational component. As a proof-of-concept model, we propose that this CSCSR can yield greater validity of efficacy and effectiveness through supplementing its recommendations with data of the proteomic signature of periodontal disease in pregnancy, which can contribute to addressing specifically the predictive validity for adverse outcomes. For this CRCSR, systematic reviews were identified through The National Library of MedicinePubmed, The Cochrane library, CINAHL, Google Scholar, Web of Science, and the American Dental Association web library. Independent reviewers quantified the relevance and quality of this literature with R-AMSTAR. Homogeneity and inter-rater reliability testing were supplemented with acceptable sampling analysis. Research synthesis outcomes were analyzed qualitatively toward a Bayesian inference, and converge to demonstrate a definite association between maternal periodontal disease and pregnancy outcome. This CRCSR limits heterogeneity in terms of periodontal disease, outcome measure, selection bias, uncontrolled confounders and effect modifiers. Taken together, the translational CRCSR model we propose suggests that further research is advocated to explore the fundamental mechanisms underlying this association, from a molecular and proteomic perspective.
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机译:早产率在全世界范围内都是公共卫生关注的问题,因为早产率正在增加,并且防止早产的努力失败。我们报告临床相关复杂系统评价(CSCSR),旨在识别和评估最佳证据,以支持妇女牙周状况与早产低体重妊娠结局之间的关联。我们假设必须扩大研究综合的传统局限性以纳入翻译成分。作为概念验证模型,我们建议该CSCSR可以通过在其建议中补充妊娠牙周疾病的蛋白质组学特征数据,从而提高疗效和有效性,从而有助于明确应对不良结局的预测有效性。对于此CRCSR,通过美国国家医学图书馆,Cochrane图书馆,CINAHL,Google Scholar,Web of Science和美国牙科协会网络图书馆进行了系统评价。独立评审人员通过R-AMSTAR量化了这些文献的相关性和质量。均质性和评定者之间的可靠性测试辅以可接受的抽样分析。对研究综合成果进行了贝叶斯定性的定性分析,并收敛以证明母亲牙周疾病与妊娠结果之间存在明确的联系。该CRCSR限制了牙周疾病,结局指标,选择偏倚,不受控制的混杂因素和效果修饰因子方面的异质性。综上所述,我们提出的翻译CRCSR模型表明,从分子和蛋白质组学的角度,我们主张开展进一步的研究以探索这种关联的基本机制。
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