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      Systematic Review With Meta‐Analysis of Patient‐Centered Outcomes, Comparing International Guideline–Recommended Enteral Protein Delivery With Usual Care

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          Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range

          Background In systematic reviews and meta-analysis, researchers often pool the results of the sample mean and standard deviation from a set of similar clinical trials. A number of the trials, however, reported the study using the median, the minimum and maximum values, and/or the first and third quartiles. Hence, in order to combine results, one may have to estimate the sample mean and standard deviation for such trials. Methods In this paper, we propose to improve the existing literature in several directions. First, we show that the sample standard deviation estimation in Hozo et al.’s method (BMC Med Res Methodol 5:13, 2005) has some serious limitations and is always less satisfactory in practice. Inspired by this, we propose a new estimation method by incorporating the sample size. Second, we systematically study the sample mean and standard deviation estimation problem under several other interesting settings where the interquartile range is also available for the trials. Results We demonstrate the performance of the proposed methods through simulation studies for the three frequently encountered scenarios, respectively. For the first two scenarios, our method greatly improves existing methods and provides a nearly unbiased estimate of the true sample standard deviation for normal data and a slightly biased estimate for skewed data. For the third scenario, our method still performs very well for both normal data and skewed data. Furthermore, we compare the estimators of the sample mean and standard deviation under all three scenarios and present some suggestions on which scenario is preferred in real-world applications. Conclusions In this paper, we discuss different approximation methods in the estimation of the sample mean and standard deviation and propose some new estimation methods to improve the existing literature. We conclude our work with a summary table (an Excel spread sheet including all formulas) that serves as a comprehensive guidance for performing meta-analysis in different situations. Electronic supplementary material The online version of this article (doi:10.1186/1471-2288-14-135) contains supplementary material, which is available to authorized users.
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            ESPEN guideline on clinical nutrition in the intensive care unit

            Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to start and how to progress in the administration of adequate provision of nutrients is also described. The best determination of amount and nature of carbohydrates, fat and protein are suggested. Special attention is given to glutamine and omega-3 fatty acids. Particular conditions frequently observed in intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery, sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy. Monitoring of this nutritional therapy is discussed in a separate document.
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              Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.).

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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
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                Journal
                Journal of Parenteral and Enteral Nutrition
                Journal of Parenteral and Enteral Nutrition
                Wiley
                0148-6071
                1941-2444
                May 2020
                October 15 2019
                May 2020
                : 44
                : 4
                : 610-620
                Affiliations
                [1 ]Allied Health (Clinical Nutrition)Royal Melbourne Hospital Melbourne Australia
                [2 ]Department of MedicineThe University of Melbourne Parkville Australia
                [3 ]Discipline of Acute Care MedicineSchool of MedicineUniversity of Adelaide Adelaide South Australia Australia
                [4 ]Intensive Care ResearchRoyal Adelaide Hospital Adelaide South Australia Australia
                [5 ]Intensive Care UnitRoyal Melbourne Hospital Parkville Australia
                Article
                10.1002/jpen.1725
                31617220
                200eb6a9-0cea-4157-9f5d-44e015c9ba63
                © 2020

                http://onlinelibrary.wiley.com/termsAndConditions#vor

                http://doi.wiley.com/10.1002/tdm_license_1.1

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