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1. Promotive and preventive interventions for mental health and well-being in adult populations: a systematic umbrella review

Author

Maija Saijonkari, Elsa Paronen, Timo Lakka, Tommi Tolmunen, Ismo Linnosmaa, Johanna Lammintakanen, Jenni Isotalo, Hanna Rekola, and Tomi Mäki-Opas

Subjects
mental health, mental wellbeing, alcohol, promotion, prevention, cognitive behavioral therapy, Public aspects of medicine, RA1-1270
Abstract

IntroductionMental health disorders are increasing worldwide, leading to significant personal, economic, and social consequences. Mental health promotion and prevention have been the subject of many systematic reviews. Thus, decision makers likely face the problem of going through literature to find and utilize the best available evidence. Therefore, this systematic umbrella review aims to evaluate the effectiveness of interventions for promoting mental health and mental well-being, as well as for the primary prevention of mental health disorders.MethodsLiterature searches were performed in APA PsycInfo, Medline, and Proquest Social Science databases from January 2000 to December 2021. The search results were screened for eligibility using pre-defined criteria. The methodological quality of the included reviews was evaluated using the AMSTAR 2 tool. The key findings of the included reviews were narratively synthesized and reported with an emphasis on reviews achieving higher methodological quality.ResultsOut of the 240 articles found, 16 systematic reviews and four systematic umbrella reviews were included. The methodological quality of included reviews was low or critically low.DiscussionThis review suggests that interventions using cognitive-behavioral therapy and those developing resilience, mindfulness, or healthy lifestyles can be effective in the promotion of mental health and well-being in adult populations. Motivational interviewing may reduce alcohol consumption in young adults. Indicated or selective prevention is likely to be cost-effective compared to universal prevention. Parenting interventions and workplace interventions may be cost-effective in terms of promoting mental health. Due to the low methodological quality of the included reviews and substantial heterogeneity among the reported results, the findings from the reviews we summarized should be interpreted with caution. There is a need for further rigorous, high-quality systematic reviews.

Published
2023
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2. Decision making about healthcare-related tests and diagnostic test strategies. Paper 5: a qualitative study with experts suggests that test accuracy data alone is rarely sufficient for decision making

Author

Bell, Hanan, Bettmann, Michael, Bossuyt, Patrick, Browman, George, Brozek, Jan, Bühler, Diedrich, Chou, Roger, Don-Wauchope, Andrew, Elwyn, Glyn, Garg, Amit X., Ghersi, Davina, Gion, Massimo, Glasziou, Paul, Horvath, Andrea Rita, Kopp, Ina, Krahn, Murray, Leipzig, Rosanne M., Lelgemann, Monika, Lloyd, Nancy, Maija, Saijonkari, Mäkelä, Marjukka, Mendelson, Richard, Mujoomdar, Michelle, Reed, Martin, Remedios, Denis, Santesso, Nancy, Sauerland, Stefan, Saijonkari, Maija, Steingart, Karen, Tan, Toni, Qaseem, Amir, Mustafa, Reem A., Wiercioch, Wojtek, Ventresca, Matthew, and Schünemann, Holger J.

Published
2017
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3. Decision making about healthcare-related tests and diagnostic test strategies. Paper 5

Author

Jan Brozek, Nancy Santesso, Paul Glasziou, Rosanne M. Leipzig, Andrew C. Don-Wauchope, Patrick M.M. Bossuyt, Maija Saijonkari, Glyn Elwyn, Hanan Bell, Andrea R. Horvath, Holger J. Schünemann, Martin H. Reed, Massimo Gion, Reem A. Mustafa, Marjukka Mäkelä, Richard M Mendelson, Saijonkari Maija, Murray Krahn, Roger Chou, Wojtek Wiercioch, George P. Browman, Stefan Sauerland, Toni Tan, Matthew Ventresca, Denis Remedios, Nancy S. Lloyd, Amir Qaseem, Monika Lelgemann, Davina Ghersi, Amit X. Garg, Michael A. Bettmann, Ina Kopp, Diedrich Bühler, Michelle Mujoomdar, Karen R Steingart, Epidemiology and Data Science, APH - Methodology, and APH - Personalized Medicine

Subjects
Male, Knowledge management, Epidemiology, Process (engineering), Decision Making, 03 medical and health sciences, 0302 clinical medicine, Health care, Diagnosis, Medicine, Humans, 030212 general & internal medicine, Qualitative Research, Quality of Health Care, Evidence-Based Medicine, Quality of evidence and recommendations, business.industry, Management science, Diagnostic Tests, Routine, Critical factors, Diagnostic test, Test accuracy data, Evidence-based medicine, Health Services, Test (assessment), Data Accuracy, Practice Guidelines as Topic, Female, business, 030217 neurology & neurosurgery, Qualitative research, Decision analysis, Experts
Abstract

Objectives The objective of the study was to identify the critical factors that determine recommendations and other decisions about healthcare-related tests and diagnostic strategies (HCTDS). Methods We used a qualitative descriptive approach and conducted semi-structured in-depth interviews with 24 international experts (informants) in evidence and decisions about HCTDS. Results Although test accuracy (TA) was the factor most commonly considered by organizations when developing recommendations about HCTDS, informants agreed that TA is necessary but rarely, if ever, sufficient and may be misleading when solely considered. The informants identified factors that are important for developing recommendations about HCTDS. Informants largely agreed that laying out the potential care pathways based on the test result is an essential early step but is rarely done in developing recommendations about HCTDS. Most informants also agreed that decision analysis could be useful for organizing the clinical, cost, and preference data relevant to the use of tests in the absence of direct evidence. However, they noted that using models is limited by the lack of resources and expertise required. Conclusion Developing guidelines about HCTDS requires consideration of factors beyond TA, but implementing this may be challenging. Further development and testing of “frameworks” that can guide this process is a priority for decision makers.

Published
2017

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