Welcome to our ‘Most Read’ blog where we highlight the articles that have resonated the most with our readers. This month we have several new entries spanning a diverse array of topics, from mental health to respiratory health to health economics.
Atypical pathogens in patients with severe pneumonia
In order to understand the prevalence of severe pneumonia caused by atypical pathogens, Wang et al. conducted a systematic review and meta-analysis, searching various medical databases for relevant studies published until November 2022. Unlike previous global reports, data in this study were not limited to studies conducted in developed countries and data from developing countries were also included. Meta-regression analysis was also used to explore potential sources of heterogeneity. After analysing the data from 75 eligible studies with a total of 18,379 cases of severe pneumonia, the researchers found that the overall prevalence of atypical pneumonia was 8.1%. The pooled estimated prevalence of Chlamydia was 1.8%, Mycoplasma was 2.8% and Legionella was 4.0%. However, the authors note that the substantial heterogeneity observed was not fully explained by the variables examined.
Menu calorie counts and obesity-related cancer rates
This study aimed to assess the impact of menu calorie labelling on reducing obesity-related cancer burdens in the United States. Using a cost–effectiveness analysis, Du et al. estimated the impact of the policy on reducing obesity-related cancer rates and associated costs among 235 million US adults aged at least 20, over a simulated lifetime starting from 2015. On the basis of consumer behaviour alone, the policy was associated with the prevention of 28,000 new cancer cases and 16,700 cancer deaths. From both healthcare and societal perspectives, the policy was associated with net cost savings of US$1,460 million and US$1,350 million, respectively. However, the authors acknowledge that given the nature of modelling research, this study does not provide a real-world evaluation of the impact of policy implementation on health and economic outcomes.
Need to clamp indwelling urinary catheters before removal
This meta-analysis aimed to assess the effect of bladder training through clamping on bladder and urethral function in patients with indwelling urinary catheters of different durations. The researchers searched multiple databases for relevant studies published between January 2000 and February 2022. In total, 17 papers, including 15 randomised controlled trials (RCTs) and 2 quasi-RCTs, involving a total of 3,908 participants, were included in the meta-analysis. They found that the clamping group had a significantly higher risk of urinary tract infections and a longer time to the first void compared with the free drainage group. Subgroup analysis focusing on indwelling catheter durations of seven days or less indicated that clamping significantly increased the risk of urinary tract infections and lengthened the time to the first void compared with free drainage. Sensitivity analysis was conducted and partially accounted for statistical heterogeneity; however, several factors associated with heterogeneity remained unclear.
Below are the top ten most-read papers in BMJ Open during April 2023:
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