Correction

校正
  • 文章类型: Journal Article
    目的:缺乏治疗某些疾病的证据,包括并发症处理,初始体重减轻次优,经常性的体重增加,或一次吻合胃旁路术(OAGB)后严重肥胖并发症恶化。这项研究旨在通过采用专家修改的德尔菲共识方法来应对现有的缺乏共识,并为临床医生提供宝贵的资源。
    方法:来自28个国家的48名公认的减肥外科医生参加了改良的德尔菲共识,在两轮中对64项声明进行了投票。≥70.0%的专家之间的同意/分歧被认为表明共识。
    结果:对46个陈述达成共识。对于OAGB后复发性体重增加或严重肥胖并发症的恶化,超过85%的专家达成共识,认为延长胆胰肢(BPL)是一种可接受的选择,并且在延长BPL期间必须进行总肠长度测量,以保留至少300~400cm的共同通道肢体长度,以避免营养缺乏.此外,超过85%的专家就转换为Roux-en-Y胃旁路术(RYGB)(无论是否缩小囊袋)作为OAGB术后持续性胆汁反流的可接受治疗方案达成共识,并建议在转换为RYGB期间检测和修复任何大小的食管裂孔疝.
    结论:虽然专家们就OAGB后的修订/转换手术的几个方面达成了共识,仍然存在挥之不去的分歧。这突出了今后进行进一步研究以解决这些悬而未决的问题的重要性。
    OBJECTIVE: There is a lack of evidence for treatment of some conditions including complication management, suboptimal initial weight loss, recurrent weight gain, or worsening of a significant obesity complication after one anastomosis gastric bypass (OAGB). This study was designed to respond to the existing lack of agreement and to provide a valuable resource for clinicians by employing an expert-modified Delphi consensus method.
    METHODS: Forty-eight recognized bariatric surgeons from 28 countries participated in the modified Delphi consensus to vote on 64 statements in two rounds. An agreement/disagreement among ≥ 70.0% of the experts was regarded to indicate a consensus.
    RESULTS: A consensus was achieved for 46 statements. For recurrent weight gain or worsening of a significant obesity complication after OAGB, more than 85% of experts reached a consensus that elongation of the biliopancreatic limb (BPL) is an acceptable option and the total bowel length measurement is mandatory during BPL elongation to preserve at least 300-400 cm of common channel limb length to avoid nutritional deficiencies. Also, more than 85% of experts reached a consensus on conversion to Roux-en-Y gastric bypass (RYGB) with or without pouch downsizing as an acceptable option for the treatment of persistent bile reflux after OAGB and recommend detecting and repairing any size of hiatal hernia during conversion to RYGB.
    CONCLUSIONS: While the experts reached a consensus on several aspects regarding revision/conversion surgeries after OAGB, there are still lingering areas of disagreement. This highlights the importance of conducting further studies in the future to address these unresolved issues.
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  • 文章类型: Journal Article
    目的:调查系统评价(SRs)和临床实践指南(CPGs)中是否以及何时在纳入随机对照试验(RCTs)的情况下进行纠正。
    方法:在这项元流行病学研究中,我们包括SRs和CPG,引用了缩回观察数据库中缩回的RCT。我们调查了在SR和CPG中引用撤回的RCT的频率。我们还调查了这些SRs和CPG是否以及何时自我纠正。
    结果:我们确定了587篇文章(525份SR和62份CPG),引用了撤回的RCT。在587篇文章中,252(43%)在撤回后发表,和335(57%)在撤回前发表。在发表的127篇文章中,引用了在证据综合中已经撤回的RCT,而没有谨慎,没有人在出版后纠正自己。在撤回之前发表的335篇文章中,239包括RCT,后来在其证据合成中被撤回。其中,只有5%的SR(9/196)和5%的CPG(2/43)纠正或撤回了他们的结果。
    结论:许多SR和CPG包括已经或以后撤回的RCT,没有谨慎。他们中的大多数从未得到纠正。科学界,包括出版商和研究人员,应做出系统和一致的努力,以消除撤回的RCT的影响。
    To investigate whether and when the correction is done in Systematic Reviews (SRs) and Clinical Practice Guidelines (CPGs) when included Randomized Controlled Trials (RCTs) have been retracted.
    In this meta-epidemiological study, we included SRs and CPGs citing the retracted RCTs from the Retraction Watch Database. We investigated how often the retracted RCTs were cited in SRs and CPGs. We also investigated whether and when such SRs and CPGs corrected themselves.
    We identified 587 articles (525 SRs and 62 CPGs) citing retracted RCTs. Among the 587 articles, 252 (43%) were published after retraction, and 335 (57%) were published before retraction. Among 127 articles published citing already retracted RCTs in their evidence synthesis without caution, none corrected themselves after publication. Of 335 articles published before retraction, 239 included RCTs that were later retracted in their evidence synthesis. Among them, only 5% of SRs (9/196) and 5% of CPGs (2/43) corrected or retracted their results.
    Many SRs and CPGs included already or later retracted RCTs without caution. Most of them were never corrected. The scientific community, including publishers and researchers, should make systematic and concerted efforts to remove the impact of retracted RCTs.
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