To assess the impact of restricting systematic reviews of conventional or alternative medical treatments or diagnostic tests to English-language publications. We systematically searched MEDLINE (Ovid), the Science Citation Index Expanded (Web of Science), and Current Contents Connect (Web of Science) up to April 24, 2020. Eligible methods studies assessed the impact of restricting systematic reviews to English-language publications on effect estimates and conclusions. Two reviewers independently screened the literature; one investigator performed the data extraction, a second investigator checked for completeness and accuracy. We synthesized the findings narratively. Eight methods studies (10 publications) met the inclusion criteria; none addressed language restrictions in diagnostic test accuracy reviews. The included studies analyzed nine to 147 meta-analyses and/or systematic reviews. The proportions of non-English-language publications ranged from 2% to 100%. Based on five methods studies, restricting literature searches or inclusion criteria to English-language publications led to a change in statistical significance in 23/259 meta-analyses (9%). Most commonly, the statistical significance was lost, but had no impact on the conclusions of systematic reviews. Restricting systematic reviews to English-language publications appears to have little impact on the effect estimates and conclusions of systematic reviews.

Introduction: Our purpose was to study whether the time to target temperature correlates with neurologic outcome in patients after cardiac arrest with restoration of spontaneous circulation treated with therapeutic mild hypothermia in an academic emergency department. Methods: Temperature data between April 1995 and June 2008 were collected from 588 patients and analyzed in a retrospective cohort study by observers blinded to outcome. The time needed to achieve an esophageal temperature of less than 34°C was recorded. Survival and neurological outcomes were determined within six months after cardiac arrest. Results: The median time from restoration of spontaneous circulation to reaching a temperature of less than 34°C was 209 minutes (interquartile range [IQR]: 130-302) in patients with favorable neurological outcomes compared to 158 min (IQR: 101-230) (P < 0.01) in patients with unfavorable neurological outcomes. The adjusted odds ratio for a favorable neurological outcome with a longer time to target temperature was 1.86 (95% CI 1.03 to 3.38, P = 0.04). Conclusions: In comatose cardiac arrest patients treated with therapeutic hypothermia after return of spontaneous circulation, a faster decline in body temperature to the 34°C target appears to predict an unfavorable neurologic outcome.

Introduction: Glycemic variability as a marker of endogenous and exogenous factors, and glucose complexity as a marker of endogenous glucose regulation are independent predictors of mortality in critically ill patients. We evaluated the impact of real time continuous glucose monitoring (CGM) on glycemic variability in critically ill patients on intensive insulin therapy (IIT), and investigated glucose complexity - calculated using detrended fluctuation analysis (DFA) - in ICU survivors and non-survivors. Methods: Retrospective analysis were conducted of two prospective, randomized, controlled trials in which 174 critically ill patients either received IIT according to a real-time CGM system (n = 63) or according to an algorithm (n = 111) guided by selective arterial blood glucose measurements with simultaneously blinded CGM for 72 hours. Standard deviation, glucose lability index and mean daily delta glucose as markers of glycemic variability, as well as glucose complexity and mean glucose were calculated. Results: Glycemic variability measures were comparable between the real time CGM group (n = 63) and the controls (n = 111). Glucose complexity was significantly lower (higher DFA) in ICU non-survivors (n = 36) compared to survivors (n = 138) (DFA: 1.61 (1.46 to 1.68) versus 1.52 (1.44 to 1.58); P = 0.003). Diabetes mellitus was significantly associated with a loss of complexity (diabetic (n = 33) versus non-diabetic patients (n = 141) (DFA: 1.58 (1.48 to 1.65) versus 1.53 (1.44 to 1.59); P = 0.01). Conclusions: IIT guided by real time CGM did not result in significantly reduced glycemic variability. Loss of glucose complexity was significantly associated with mortality and with the presence of diabetes mellitus.