A Personal Experience of Performing a Systematic Literature Review.

This paper describes the personal experience of two novice reviewers in developing and conducting a systematic litera¬ture review (SLR) in the field of medical ultrasound. The review was performed as part of a PhD study by the first author, which required the researcher to critically review all relevant studies in their specific research area. The review was conducted using a formal, scientific process and high¬lighted 20 relevant papers. Among the lessons learnt, undertaking an SLR was a time-consuming process. The search produced 1,987 papers, and screening the search yield was facilitated by using a pre-defined protocol. Extraction of data from each study was standardised and generated a 1-page summary of the key findings and methodology to facilitate comparisons of the included studies. The Critical Appraisal Skills Programme (CASP) tool was used for quality assessment. In the critical appraisal process, it is essential that reviewers have good baseline knowledge in the research subject, a solid under¬standing of the fundamentals of a robust research study including potential bias in research. With the great amount of information that a critical appraisal produces, good information management was key throughout the review to ensure the process was explicit and replicable and so that reviewers could justify their decisions. The methods and processes detailed in this report, as well as its lessons, are relevant to an SLR for any research subject.

Deep vein thrombosis resolution, recurrence and post-thrombotic syndrome: a prospective observational study protocol.

BACKGROUND: Reasons for the variation in response of deep vein thrombosis (DVT) to anticoagulation treatment are not known. Some patients develop complications such as post-thrombotic syndrome or recurrent DVT but others make a full recovery. The aim of the study is to identify the level of variation in response to anticoagulation treatment and provide more precise and quantitative disease characterisation in response to treatment. METHODS: A prospective observational study using duplex ultrasound to examine changes in thrombus characterisation, evolution and resolution over a 2 year period in patients with a confirmed DVT. Logistic regression analysis will be used to seek associations between characteristics present at baseline and the outcomes of DVT resolution, recurrence and the development of post-thrombotic syndrome (PTS). DISCUSSION: This research into the response to treatment of lower limb DVT and predictive factors for DVT resolution, recurrence and PTS could inform a more tailored approach to anticoagulation therapy for the future management of DVT. UKCRN ID: 16016. Registered on 20 January 2014.

The effect of body position on developing ultrasound criteria for the assessment of the internal jugular vein.

Recent studies investigating chronic cerebrospinal venous insufficiency highlighted that intracranial venous return has not yet been routinely investigated by ultrasound in the normal population. This creates an absence of a reference standard and raises concerns that the approach introduces variations into the results. The primary objective of this study was to develop reference standards for the assessment of the internal jugular vein in a normal population. A prospective small-scale study was conducted. Internal jugular veins of 31 normal candidates were examined using B-Mode and PW Doppler. Measurements at proximal and mid-point internal jugular vein were taken in sitting (90°) and supine (0°) positions. Area measurements were taken during passive respiration in cm(2). Time average velocity measurements were taken during passive respiration over a 3-second period. Reflux measurements were taken after apnoea and reflux was recorded from any reversed flow. Measurements were taken three times; an average was calculated and statically analysed. Of the 31 participants, one was excluded from the study and 30 were suitable. The Mann-Whitney U test was used to analyse the results; all results (area, time average velocity and reflux) showed that there was a significant difference between the two positions with p < 0.05 (two-tailed). This pilot study does suggest that there is a significant difference in area, time average velocity and reflux measurements of the internal jugular vein when taken in the sitting and supine position, which could affect the outcome of chronic cerebrospinal venous insufficiency. A further large-scale study is required to validate and standardise the assessment of the internal jugular vein.