Meta-Analysis

A meta-analysis of 12 studies finds mortality rising stepwise from mild to severe frailty as defined by the electronic frailty index, with substantial heterogeneity and no claim by its authors that this shows predictive performance.

A meta-analysis of ten randomised trials favours exercise on frailty scores, but heterogeneity is 88%, the prediction interval crosses the null, and superiority of any one modality is not established.

A meta-analysis of ten randomised trials in 562 adults finds no significant difference with content-matched delivery, at very low certainty for pain and low certainty for disability, and its authors state this is not evidence of equivalence.

A meta-analysis of nine randomised trials finds home-delivered exercise rehabilitation in adults with cancer improved cardiorespiratory fitness and quality of life with good adherence, but heterogeneity was high and the population was not older or frail.

A network meta-analysis of 92 randomised trials finds app-based, virtual-reality and telerehabilitation interventions give small to moderate average improvements in pain and disability, but certainty is mostly low or very low and no format can be called superior.

A systematic review and meta-analysis of five randomised trials finds methylphenidate-based interventions improve depressive symptoms more than placebo, usual care or background antidepressants in adults receiving palliative care, though evidence certainty is very low to low.

A systematic review and meta-analysis of 16 studies finds frailty-targeted cardiovascular rehabilitation improves physical performance and walking distance in frail older adults with cardiovascular disease, but shows no clear benefit on mortality, hospitalisation or activities of daily living.

A systematic review and meta-analysis of 3,497 adults finds outpatient parenteral antibiotic therapy for infective endocarditis associated with lower mortality and less kidney injury than hospital-based treatment.

A systematic review and meta-analysis of 57 cohort studies finds frailty independently predicts worse functional outcomes, higher mortality and increased readmission risk in hospitalised older adults.

A Bayesian component-network meta-analysis of individual participant data from 34 randomised trials identifies which specific components of task-shared psychosocial interventions, delivered by non-specialist workers, most improve outcomes for depression and anxiety.

A Cochrane review of eight randomised trials finds lumbar supports offer little to no benefit alone for chronic low back pain, a small short-term pain reduction only when added to anti-inflammatory drugs, and no eligible evidence exists at all for other mobility or gait assistive devices.

A meta-analysis finds the Clinical Frailty Scale is a validated prognostic tool specifically in elderly heart failure populations, though the finding should not be generalised to non-cardiac frailty pathways.

A Bayesian network meta-analysis of 51 randomised trials finds digital exercise interventions produce domain-specific cognitive benefits in older adults, with remote exercise and non-immersive exergames flagged as practical options for rural and resource-limited settings, though certainty of evidence is very low for most comparisons.

A meta-analysis of 14 randomised trials finds short-term exercise improves gait speed and functional mobility in frail older adults, but falls-incidence data were too sparse to pool, leaving the link between functional gains and actual falls reduction unresolved.

A major update of the Cochrane review on swallowing therapy for dysphagia in acute and subacute stroke, now spanning 181 randomised trials and 11,500 participants, finds moderate-certainty evidence for behavioural interventions and neuromuscular electrical stimulation.

A systematic review and meta-analysis of 20 randomised trials finds education alone underperforms exercise and multimodal physiotherapy on short-term pain and function for patellofemoral pain, though health-professional-delivered education performs comparably by medium-term follow-up.

A Bayesian component network meta-analysis of individual participant data from 30 trials finds strengthening social support, behavioural activation and problem management drive most of the benefit in non-specialist-delivered psychosocial interventions, while specialist techniques such as cognitive reframing showed detrimental effects when delivered by non-specialists.

A meta-analysis of eight randomised trials finds mobile-health-supported remote or hybrid cardiac rehabilitation performs as well as, or better than, centre-based rehabilitation on exercise capacity in heart failure, though certainty is low to moderate.

A GRADE-assessed systematic review and meta-analysis of 27 trials finds reablement-based home rehabilitation has low-to-very-low-certainty evidence of improving daily function, while structured exercise-based rehabilitation does show benefit.

A systematic review and meta-analysis finds pharmacist involvement in OPAT multidisciplinary teams improves monitoring adherence and reduces prescribing errors, though impact on readmissions remains inconsistent.

A meta-analysis of 15 randomised trials finds structured exercise reduces depressive symptoms in rheumatoid arthritis with moderate certainty.

A meta-analysis of 27 randomised controlled trials in community-dwelling older adults found activity- and exercise-based home rehabilitation improved daily-living function and physical performance, while reablement-based approaches showed no significant effect.

A systematic review and meta-analysis of 11 studies (n=2,568) found ceftriaxone associated with significantly increased 30-day mortality (OR 3.33, 95% CI 2.17–5.10) compared with antistaphylococcal penicillins or cefazolin for MSSA bloodstream infections. A concurrent cost analysis of CADD-pump-based OPAT demonstrated 88% cost savings versus inpatient care, providing the delivery mechanism for safer beta-lactam alternatives.