SR

SR
  • 文章类型: Journal Article
    背景:与系统综述(SRs)相比,快速综述(RRs)为文献综述提供了一种不太严格和有条理的方法,这是目前的黄金标准。
    方法:三种不同的方法,审查过程的快速策略是在不同的范围内设计的,已经在Cochrane的SRs中进行了审查。然后,将我们的文献检索结果和研究选择过程与来自SR的结果进行了比较.最后一步是评估一些研究失败对荟萃分析最终结果的影响。
    结果:在RR1中,要审查的参考文献的初始数量减少了一半,并以84%的效率重新创建了包含列表。19项研究中有3项被错过了,都有很高的偏见风险。在RR1中遗漏的研究包括在Cochrane的meta分析中,对23个不同的结局,他们的缺乏对最终结果产生了重大影响,或者进行荟萃分析的可能性,在四个案例中。在RR2中,包含在SR中的89%的试验被捕获(24/27);缺少三项研究并不影响荟萃分析的最终结果。在RR3中,纳入研究的列表与Cochrane完全重叠,尽管工作量大大降低。
    结论:快速且具有成本效益的方法可能会导致识别支持医疗保健政策的相关证据;但是,必须认真考虑分析中的潜在偏见。
    BACKGROUND: Rapid reviews (RRs) offer a less rigorous and methodical approach to the process of reviewing literature in comparison to systematic reviews (SRs), which are currently a gold standard.
    METHODS: Three different, expedited strategies of the review process were designed in the different scopes, already reviewed in Cochrane\'s SRs. Then, the results of our literature searches and the study selection process were compared to the ones from SRs. The final step was assessing the impact of losing some studies on the final results of meta-analyses.
    RESULTS: In RR1, the initial number of references to be reviewed was reduced by half, and the inclusion list was recreated with 84% efficiency. Three out of 19 studies were missed, all having high risk of bias. Studies missed in RR1 were included in Cochrane\'s meta-analyses for 23 separate outcomes, and their lack impacted significantly the final results, or the possibility to run meta-analyses, in four cases. In RR2, 89% of trials included in the SR were captured (24/27); missing the three studies did not impact the final results of the meta-analyses. In RR3, the list of included studies overlapped completely with Cochrane\'s, despite a significantly lower workload.
    CONCLUSIONS: A prompt and cost-effective methodology may lead to the identification of pertinent evidence in support of healthcare policy; however, it is essential to conscientiously account for potential biases in the analysis.
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  • 文章类型: Meta-Analysis
    目的:大原发性肝细胞癌(HCC)死亡率高,治疗方法多样。手术和经导管动脉化疗栓塞(TACE)是重要的治疗方法。哪个可以更好地保持争议。该研究的目的是比较大肝癌患者手术切除(SR)和使用TACE的长期总生存率。
    方法:我们通过PubMed评估临床试验,Medline,Embase,和Cochrane图书馆直到2022年3月。两名研究人员独立筛选文章,提取的数据,并根据PRISMA(系统评价和荟萃分析的首选报告项目)指南评估研究质量。主要结果是总生存期(OS)。次要结果是倾向评分匹配(PSM)后的OS和无进展生存期(PFS)。
    结果:共14项研究,包括3609名病人,纳入荟萃分析。荟萃分析表明,1年OS有显著改善,3年操作系统,和5年OS倾向于SR优于TACE(OR=2.19,95%CI1,60-3.00;OR=3.47,95%CI2.47-4.88;OR=2.72,95%CI2.03-3.64,p<0.001,随机模型)。结果在肿瘤大小和肿瘤数量的亚组之间是一致的(p>0.05)。汇总结果表明,1年OS,3年操作系统,与TACE组相比,SR组PSM后5年OS较高(p<0.001)。
    结论:这项荟萃分析表明,在大型原发性肝癌患者中,手术切除患者的总生存率高于TACE患者.
    Large primary hepatocellular carcinoma (HCC) has a high mortality rate and a variety of treatments. Surgery and transcatheter arterial chemoembolization (TACE) are important treatments. Which could be better remain debatable. The objective of the study is to compare the long-term overall survival of surgical resection (SR) and the use of TACE in patients with large hepatocellular carcinoma.
    We assessed clinical trials through PubMed, Medline, Embase, and the Cochrane Library up to March 2022. Two researchers independently screened articles, extracted data, and assessed the study quality according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)guidelines. The primary outcome was overall survival (OS). The secondary outcomes were OS after propensity scores matching (PSM) and progression-free survival (PFS).
    A total of 14 studies, including 3609 patients, were enrolled in the meta-analysis. The meta-analysis indicated a significant improvement in the 1-year OS, 3-year OS, and 5-year OS favoring SR over TACE (OR = 2.19, 95% CI 1,60-3.00; OR = 3.47, 95% CI 2.47-4.88; OR = 2.72, 95% CI 2.03-3.64, p < 0.001, random model). The results were consistent across subgroups of tumor size and tumor numbers (p > 0.05). The pooled outcome indicated that 1-year OS, 3-year OS, and 5-year OS after PSM were higher in the SR group than in the TACE group (p < 0.001).
    This meta-analysis indicates that among patients with large primary hepatocellular carcinoma, the overall survival rate of patients undergoing surgical resection was higher than that of patients undergoing TACE.
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