1. PubMed Search using MeSH headings and keywords:
(("Antipsychotic Agents"[Mesh] OR ("antipsychotic agents"[MeSH Terms] OR ("antipsychotic"[All Fields] AND "agents"[All Fields]) OR "antipsychotic agents"[All Fields] OR "antipsychotic"[All Fields] OR "antipsychotic
agents"[Pharmacological Action]) OR ("antipsychotic agents"[MeSH Terms] OR ("antipsychotic"[All Fields] AND "agents"[All Fields]) OR "antipsychotic agents"[All Fields] OR "antipsychotics"[All Fields] OR "antipsychotic agents"[Pharmacological Action])) AND (atypical[All Fields] OR "second generation"[All Fields])) AND ("Metabolic Syndrome X"[Mesh] OR "metabolic syndrome"[All Fields]) AND (English[lang])
2. CINAHL via EBSCO host:
Boolean/Phrase: (MH “Antipsychotic Agents +”) AND (MH “Metabolic Syndrome X+”)
3. BIOSIS and The Cochrane Library:
Appendix 2. Evidence table of included studies
Author De Hert 19 Meyer 20
Year Published 2008 2008
Study Design 2 cohorts- prospective RCT
Selection bias Dropouts: Historic: 26 Current: 40 Historic: older and longer
Current: younger, and shorter duration Did not collect exact drugs, switches over time between agents or eventual
polypharmacy in historic cohort
Did not conduct intention to treat analysis
Baseline demographics and characteristics between treatment arms were not discussed in the study
Measurement bias Used a conversion to calculate waist circumference from BMI for Historic cohort.
Lab techniques have changed over time. We are more careful now about
metabolic syndrome and so we look for it more
For all classifiable cohort: Modified criteria for impaired fasting glucose and triglycerides
The duration of baseline
antipsychotic use was not measured- important as those with longer exposure to more metabolically offending agents might have been randomized unequally to the different treatment arms.
Internal validity (Good, Fair, Poor)
Fair Poor
External validity Fair:
>95% Caucasian and of native Belgian origin
One hospital center Small sample size
Fair
57 sites in US. Large study.- generalizable
Small sample size of treatment groups in fasting cohort
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