Evidence synthesis

证据综合
  • 文章类型: Journal Article
    已经有许多关于NMDA受体作为抑郁症的治疗靶标的研究。然而,到目前为止,没有对这一领域进行全面的科学计量学分析。因此,我们进行了科学计量学分析,目的是更好地阐明该领域的研究热点和未来趋势。
    从WebofScienceCoreCollection(WoSCC)数据库检索了2004年至2023年抑郁症中有关NMDAR的出版物。然后,VOSviewer,CiteSpace,ScimagoGraphica,和R-bibliometrix-用于科学计量分析和可视化。
    5,092份合格文件被确定为进行科学计量分析。在过去的20年里,年度出版物数量呈上升趋势。美国在国际合作方面领先世界,出版物,和引用。从共同引用的参考文献分析中鉴定出15个主要簇,具有显着的模块化(Q值=0.7628)和轮廓得分(S值=0.9171)。根据关键词和共同引用的参考文献分析,治疗抗性抑郁症氯胺酮(NMDAR拮抗剂),氧化应激,突触可塑性,神经可塑性相关下游因子脑源性神经营养因子是近年来的研究热点。
    作为抑郁症中NMDAR的第一个科学计量学分析,这项研究揭示了发展,趋势,以及全球抑郁症NMDAR研究的热点。氯胺酮在重度抑郁障碍(MDD)治疗中的应用及潜在作用机制仍是目前研究的热点。然而,NMDAR拮抗剂如氯胺酮的副作用促使人们研究新的速效抗抑郁药.
    UNASSIGNED: There have been numerous studies on NMDA receptors as therapeutic targets for depression. However, so far, there has been no comprehensive scientometric analysis of this field. Thus, we conducted a scientometric analysis with the aim of better elucidating the research hotspots and future trends in this field.
    UNASSIGNED: Publications on NMDAR in Depression between 2004 and 2023 were retrieved from the Web of Science Core Collection (WoSCC) database. Then, VOSviewer, CiteSpace, Scimago Graphica, and R-bibliometrix-were used for the scientometric analysis and visualization.
    UNASSIGNED: 5,092 qualified documents were identified to scientometric analysis. In the past 20 years, there has been an upward trend in the number of annual publications. The United States led the world in terms of international collaborations, publications, and citations. 15 main clusters were identified from the co-cited references analysis with notable modularity (Q-value = 0.7628) and silhouette scores (S-value = 0.9171). According to the keyword and co-cited references analysis, treatment-resistant depression ketamine (an NMDAR antagonist), oxidative stress, synaptic plasticity, neuroplasticity related downstream factors like brain-derived neurotrophic factor were the research hotspots in recent years.
    UNASSIGNED: As the first scientometric analysis of NMDAR in Depression, this study shed light on the development, trends, and hotspots of research about NMDAR in Depression worldwide. The application and potential mechanisms of ketamine in the treatment of major depressive disorder (MDD) are still a hot research topic at present. However, the side effects of NMDAR antagonist like ketamine have prompted research on new rapid acting antidepressants.
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  • 文章类型: Journal Article
    背景:大量文献表明,运动可以逆转阿尔茨海默病(AD)患者的认知障碍并改善躯体功能。系统评价(SRs),一种常见的循证医学方法,专注于研究领域的特定问题。这项工作的目的是提供关于运动干预对AD患者影响的现有证据的概述,并通过回顾SRs报告相关的健康结果。
    方法:从PubMed检索AD患者运动干预的SRs,Cochrane图书馆,CBMdisc,Scopus,WebofScience,Embase(通过Ovid),中国国家知识基础设施,和万方数据库从成立到2023年2月。使用A测量工具评估系统评价2(AMSTAR2)清单评估SR的质量。根据人口干预比较结果(PICO)框架报告结果,并在表格和气泡图中说明了相应的证据映射。
    结果:共有26个SR符合资格标准。在方法质量方面,10个SR被评为“极低”,13个SR被评为“低”,3个SR被评为“中等”。运动被发现对认知功能产生有益的影响,功能独立,物理功能,AD患者的神经精神症状。
    结论:运动干预主要通过改善认知功能使AD患者受益。物理功能,功能独立,神经精神症状.然而,由于本分析中包含的大多数SR的低到中等的方法,我们需要进一步的调查来支持我们目前的调查结果。
    BACKGROUND: A significant body of literature suggests that exercise can reverse cognitive impairment and ameliorate somatic function in patients with Alzheimer\'s disease (AD). Systematic reviews (SRs), a common approach of evidence-based medicine, concentrate on a specific issue of a research area. The objective of this work is to provide an overview of existing evidence on the effects of exercise intervention in AD patients and report related health outcomes by reviewing SRs.
    METHODS: SRs on exercise intervention in AD patients were retrieved from the PubMed, the Cochrane Library, CBMdisc, Scopus, Web of Science, Embase (via Ovid), China National Knowledge Infrastructure, and WanFang databases from the time of inception to February 2023. The quality of the SRs was evaluated utilizing the A Measurement Tool to Assess Systematic Review 2 (AMSTAR 2) checklist. The results were reported according to the population-intervention-comparison-outcome (PICO) framework and the corresponding evidence mapping was illustrated in tables and bubble plots.
    RESULTS: A total of 26 SRs met the eligibility criteria. In terms of methodological quality, 10 SRs were rated as \"critically low\", 13 SRs were rated as \"low\", and 3 SRs were rated as \"moderate\". Exercise was found to exert a beneficial effect on cognitive function, functional independence, physical function, and neuropsychiatric symptoms in patients with AD.
    CONCLUSIONS: Exercise intervention benefits AD patients mainly by improving cognitive function, physical function, functional independence, and neuropsychiatric symptoms. However, due to the low-to-moderate methodology of most SRs included in this analysis, further investigations are required to support our current findings.
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  • 文章类型: Journal Article
    背景:鉴于全球老年人口的增长,e-Health在多种疾病的慢性病管理中起着不可或缺的作用。然而,目前缺乏综合使用电子健康服务的多患病老年人经验的定性证据。目的是探索多患病老年人在社区环境中进行电子医疗保健的经验和看法。方法:包括PubMed在内的七个电子数据库,科克伦图书馆,护理和相关健康文献的累积指数,Embase,WebofScience,中国国家知识基础设施,检索了中国生物医学文献,搜索仅限于从开始到2023年9月1日的研究。筛选,数据提取,质量评估由两名审查人员独立进行。托马斯和哈登的主题综合方法被用来综合原始主题。纳入研究的方法学质量使用乔安娜·布里格斯研究所定性研究关键评估清单进行评估,综合主题的信心是通过对定性研究方法审查的证据的信心来评估的。结果:10项方法学质量中等的研究符合资格标准,最终被纳入。研究在四个国家进行,有235名患有多种慢性病的参与者。在纳入的10项研究中,提取了37项可信的发现,并将其解释为3个综合主题和12个次主题:(1)电子健康服务期间感知到的优势和益处,(2)电子医疗服务带来的多层面挑战和负面经验,和(3)偏好,建议,以及对未来电子健康改善的期望。对三个最终合成主题中的大多数的信心被评为“低”和“中等”尺度之间。结论:这项研究的结果为多病患者实施量身定制的电子医疗保健提供了新的见解。进一步的研究应强调基于用户的需求和观点来实现电子健康服务的潜在价值,以促进老年实践中的年龄友好性。
    Background: Given the growing population of older adults globally, e-Health plays an indispensable role in the chronic disease management of multimorbidity. However, qualitative evidence that synthesizes the experiences of older adults with multimorbidity using e-Health service is currently lacking. The objective was to explore the experiences and perceptions of e-Health care in community-based settings among the older adults with multimorbidity. Methods: Seven electronic databases including PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, China National Knowledge Infrastructure, and Chinese BioMedical Literature were searched, and the search was limited to studies from inception to September 1, 2023. Screening, data extraction, and quality appraisal were conducted independently by two reviewers. Thomas and Harden\'s thematic synthesis methodology was applied to synthesize the original themes. The methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the confidence of synthesized themes was evaluated by the Confidence in the Evidence from Reviews of Qualitative Research approaches. Results: Ten studies with moderate methodological quality met eligibility criteria and were included finally. Studies were conducted in four countries with 235 participants who were living with multiple chronic conditions. Among the 10 included studies, 37 credible findings were extracted and interpreted into 3 synthesized themes and 12 subthemes: (1) advantages and benefits perceived during e-Health service, (2) multidimensional challenges and negative experience posed by e-Health service, and (3) preferences, suggestions, and expectations for future e-Health improvement. The confidence in the majority of the three final synthesized themes was rated between \"low\" and \"moderate\" scales. Conclusions: The findings of this study provide new insights into implementing tailored e-Health care for older adults with multimorbidity. Further research should emphasize on realizing the potential value of e-Health service based on users\' needs and perspectives to promote age-friendliness in geriatric practice.
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  • 文章类型: Journal Article
    标准方案项目的影响:2018年中医介入试验(SPIRIT-TCM)扩展建议关于中医随机对照试验(RCT)方案报告质量的声明不清楚。这篇综述旨在评估涉及中草药配方(CHMF)等干预措施的RCT方案的报告特征和质量,针灸,和艾灸发表在过去的3年。
    我们在多个数据库中进行了广泛的搜索,包括所有EBM评论,联合和补充医学(AMED),Embase,OvidMEDLINE(R),PubMed,WebofScience,谷歌学者,和ClinicalTrials.gov为2020年1月1日至2023年8月10日的英文出版物。两名审稿人独立评估出版物的资格,提取的预定信息,并根据2018年SPIRIT-TCM扩展检查表对报告进行评估。
    在420个符合条件的方案中(包括163个关于CHMF的研究,239针灸,和艾灸18),平均报告依从率仅为35.4%.大约一半的评估项目属于报告不佳的类别,显示符合率低于65%。值得注意的是,针灸干预研究的依从性报告得分高于CHMF研究的依从性.
    续,一致,期刊需要协调努力,编辑,审稿人,和研究人员改善SPIRIT-TCM扩展2018报告指南的应用和推广。
    UNASSIGNED: The impact of the Standard Protocol Items: Recommendations for Interventional Trials of Traditional Chinese Medicine (SPIRIT-TCM) Extension 2018 statement on the reporting quality of randomized controlled trial (RCT) protocols in traditional Chinese medicine (TCM) is not clear. This review aimed to assess the reporting characteristics and quality of RCT protocols involving interventions such as Chinese herbal medicine formulas (CHMF), acupuncture, and moxibustion published in the last 3 years.
    UNASSIGNED: We conducted an extensive search among multiple databases, including All EBM Reviews, Allied and Complementary Medicine (AMED), Embase, Ovid MEDLINE(R), PubMed, Web of Science, Google Scholar, and ClinicalTrials.gov for publications in English from 1 January 2020 to 10 August 2023. Two reviewers independently assessed the eligibility of the publications, extracted predetermined information, and evaluated the reporting based on the SPIRIT-TCM Extension 2018 checklist.
    UNASSIGNED: Of the 420 eligible protocols (comprising 163 studies on CHMF, 239 on acupuncture, and 18 on moxibustion), the average reporting compliance rate was only 35.4%. Approximately half of the assessed items fell into the category of poorly reported, demonstrating a compliance rate below 65%. Notably, reporting compliance in acupuncture and moxibustion interventional studies exhibited higher scores than compliance in CHMF studies.
    UNASSIGNED: Continued, concerted, and coordinated efforts are required by journals, editors, reviewers, and investigators to improve the application and promotion of the SPIRIT-TCM Extension 2018 reporting guideline.
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  • 文章类型: Journal Article
    快速审查(RR)可以通过使用各种快捷方式简化或省略步骤来加速传统的系统审查(SR)过程。随着RR的日益普及,出现了许多捷径,但是在如何选择最合适的问题上没有达成共识。本研究从开始到2023年12月21日,在PubMed进行了文献检索,使用诸如“快速审查”“快速评估”“快速系统审查”和“快速评估”等术语。我们还扫描了参考列表,并对纳入影响研究进行了引文跟踪,以获得更多纳入研究。我们对所有RR方法进行了叙述性综合,快捷方式和研究评估它们在每个阶段的效果。根据目前的证据,我们提供了在RR中使用某些快捷方式的建议。最终,我们确定了185项研究,重点是总结RR方法和捷径,或评估其影响。有相对充分的证据支持在RR中使用以下快捷方式:将研究限制为以英语发表的研究;进行缩写的数据库搜索(例如,仅搜索PubMed/MEDLINE,Embase,和CENTRAL);省略灰色文献的检索;将搜索时间限制在最近20年的医疗干预时间和最近15年的诊断测试准确性审查时间;由经验丰富的筛选员进行一次筛选。在某种程度上,上述捷径也适用于SRs。本研究为未来RR研究人员选择捷径提供了参考。它也为方法学家提出了一个潜在的研究课题。
    Rapid review (RR) could accelerate the traditional systematic review (SR) process by simplifying or omitting steps using various shortcuts. With the increasing popularity of RR, numerous shortcuts had emerged, but there was no consensus on how to choose the most appropriate ones. This study conducted a literature search in PubMed from inception to December 21, 2023, using terms such as \"rapid review\" \"rapid assessment\" \"rapid systematic review\" and \"rapid evaluation\". We also scanned the reference lists and performed citation tracking of included impact studies to obtain more included studies. We conducted a narrative synthesis of all RR approaches, shortcuts and studies assessing their effectiveness at each stage of RRs. Based on the current evidence, we provided recommendations on utilizing certain shortcuts in RRs. Ultimately, we identified 185 studies focusing on summarizing RR approaches and shortcuts, or evaluating their impact. There was relatively sufficient evidence to support the use of the following shortcuts in RRs: limiting studies to those published in English-language; conducting abbreviated database searches (e.g., only searching PubMed/MEDLINE, Embase, and CENTRAL); omitting retrieval of grey literature; restricting the search timeframe to the recent 20 years for medical intervention and the recent 15 years for reviewing diagnostic test accuracy; conducting a single screening by an experienced screener. To some extent, the above shortcuts were also applicable to SRs. This study provided a reference for future RR researchers in selecting shortcuts, and it also presented a potential research topic for methodologists.
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  • 文章类型: Journal Article
    The Environmental Impact Classification for Alien Taxa (EICAT) is an important tool for biological invasion policy and management and has been adopted as an International Union for Conservation of Nature (IUCN) standard to measure the severity of environmental impacts caused by organisms living outside their native ranges. EICAT has already been incorporated into some national and local decision-making procedures, making it a particularly relevant resource for addressing the impact of non-native species. Recently, some of the underlying conceptual principles of EICAT, particularly those related to the use of the precautionary approach, have been challenged. Although still relatively new, guidelines for the application and interpretation of EICAT will be periodically revisited by the IUCN community, based on scientific evidence, to improve the process. Some of the criticisms recently raised are based on subjectively selected assumptions that cannot be generalized and may harm global efforts to manage biological invasions. EICAT adopts a precautionary principle by considering a species\' impact history elsewhere because some taxa have traits that can make them inherently more harmful. Furthermore, non-native species are often important drivers of biodiversity loss even in the presence of other pressures. Ignoring the precautionary principle when tackling the impacts of non-native species has led to devastating consequences for human well-being, biodiversity, and ecosystems, as well as poor management outcomes, and thus to significant economic costs. EICAT is a relevant tool because it supports prioritization and management of non-native species and meeting and monitoring progress toward the Kunming-Montreal Global Biodiversity Framework (GBF) Target 6.
    Uso de la Clasificación de Impacto Ambiental de los Taxones Exóticos de la UICN para la toma de decisiones Resumen La Clasificación de Impacto Ambiental de los Taxones Exóticos (EICAT, en inglés) es una herramienta importante para las políticas y manejo de las invasiones biológicas y ha sido adoptada como un estándar de la Unión Internacional para la Conservación de la Naturaleza (UICN) para medir la seriedad del impacto ambiental causado por los organismos que viven fuera de su extensión nativa. La EICAT ya ha sido incorporada a algunos procedimientos locales y nacionales de toma de decisiones, lo que la vuelve un recurso particularmente relevante para abordar el impacto de las especies no nativas. Algunos principios conceptuales subyacentes de la EICAT han sido cuestionados recientemente, en particular aquellos relacionados con el uso del principio de precaución. Aunque todavía son relativamente nuevas, las directrices para la aplicación e interpretación de la EICAT tendrán una revisión periódica, basada en evidencia científica, por parte de la comunidad de la UICN para mejorar el proceso. Algunas de las críticas recientes están basadas en suposiciones seleccionadas subjetivamente que no pueden generalizarse y podrían perjudicar los esfuerzos globales para manejar las invasiones biológicas. La EICAT adopta un principio de precaución cuando considera el historial de impacto de una especie en cualquier otro lugar ya que algunos taxones tienen características que podrían volverlos más dañinos. Además, las especies no nativas suelen ser factores de pérdida de bidiversidad, incluso bajo otras presiones. Cuando ignoramos el principio de precaución al abordar el impacto de las especies no nativas, hay consecuencias devastadoras para el bienestar humano, la biodiversidad y los ecosistemas, así como resultados pobres de conservación, y por lo tanto con costos económicos importantes. La EICAT es una herramienta relevante porque respalda la priorización y el manejo de las especies no nativas y ayuda con el cumplimiento y monitoreo del progreso para llegar al objetivo 6 del Marco Mundial de Biodiversidad Kunming‐Montreal.
    外来生物环境影响分类 (Environmental impact classification for alien taxa, EICAT) 是生物入侵政策和管理的重要工具, 已被世界自然保护联盟 (International Union for Conservation of Nature, IUCN) 作为标准来衡量生活在原产地以外的生物对环境影响的严重程度。一些国家和地区的决策程序也整合了 EICAT, 将其作为应对外来生物影响的一项重要的相关资源。然而, 近期 EICAT 的一些基本概念原则, 特别是关于使用预防性方法的原则受到了质疑。这一工具目前仍比较新颖, 而 IUCN 将根据科学证据, 定期重新审查其应用和说明指南, 以改进 EICAT 的流程。最近提出的一些批评是基于主观选择的假设, 不能一概而论, 且可能会破坏管理生物入侵的全球努力。由于某些类群的特性可能使其本身具有更大的危害性, 因此, EICAT 采用了预防性原则, 考虑了物种历史上在其他地方造成的影响。此外, 即使存在其他压力, 外来物种往往也是造成生物多样性丧失的重要因素。在应对外来物种的影响时忽视预防性原则, 已经给人类福祉、生物多样性和生态系统带来了灾难性后果, 并导致管理效果不佳, 因而也产生了巨大的经济损失。而 EICAT 是一个适用的工具, 因为它可以支持对外来物种进行优先排序和管理, 以及实现昆明‐蒙特利尔全球生物多样性框架 (GBF) 目标6并监测其进展情况。【翻译: 胡怡思; 审校: 聂永刚】.
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  • 文章类型: Journal Article
    痴呆的行为和心理症状(BPSD)在痴呆中被广泛研究,而不是其前驱阶段,称为轻度认知障碍(MCI)。MCI中BPSD的科学计量学研究对于综合现有的研究体系和提供对趋势的见解将是有价值的,网络,和这个地区的影响者。我们在WebofScience数据库中搜索了相关文献,并提取了每个出版物的完整文本和引文记录。主要目标是绘制MCI中BPSD的研究演变图,并突出主要研究主题。次要目标是确定研究网络特征(作者,期刊,国家,和机构)和丰富。在1980年至2022年间发表的总共12,369项研究被纳入分析。我们从共同引用的参考网络中发现了51个不同的簇,它们具有高度的可靠性,具有显着的模块化(Q=0.856)和轮廓得分(S=0.932)。确定了五个主要研究领域:症状,诊断,大脑基质,生化途径,和干预。近年来,该领域的研究重点一直是肠道菌群,e-health,COVID-19,认知,和谵妄.总的来说,这项科学计量学分析的结果可以帮助澄清未来研究和临床实践的范围和方向。
    Behavioral and psychological symptoms of dementia (BPSD) have been extensively studied in dementia than its prodromal stage, known as mild cognitive impairment (MCI). A scientometric study on BPSD in MCI would be valuable in synthesizing the existing body of research and providing insights into the trends, networks, and influencers within this area. We searched for related literature in the Web of Science database and extracted complete text and citation records of each publication. The primary objective was to map the research evolution of BPSD in MCI and highlight dominant research themes. The secondary objective was to identify research network characteristics (authors, journals, countries, and institutions) and abundances. A total of 12,369 studies published between 1980 and 2022 were included in the analysis. We found 51 distinct clusters from the co-cited reference network that were highly credible with significant modularity (Q = 0.856) and silhouette scores (S = 0.932). Five major research domains were identified: symptoms, diagnosis, brain substrates, biochemical pathways, and interventions. In recent years, the research focus in this area has been on gut microbiota, e-health, COVID-19, cognition, and delirium. Collectively, findings from this scientometric analysis can help clarify the scope and direction of future research and clinical practices.
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  • 文章类型: Systematic Review
    目的:在COVID-19大流行期间,已经发表了许多基于24小时运动指南(24HMG)的24小时运动行为的研究。然而,没有综合综述总结和综合有关使用24HMG的研究的证据.本范围审查的目的是综合大流行期间发表的24HMG研究的证据。
    方法:三个电子数据库(WebofScience,PubMed,EBSCO)被用来进行文献检索。搜索程序符合系统审查和荟萃分析(PRISMA)首选报告项目设定的指南。最初,共筛选了发表在同行评审期刊上的1339篇研究文章.消除461个重复项之后,仍有878条。然后对这些文章的标题和/或摘要进行交叉检查,包括25篇文章。随后,两位作者根据预先定义的纳入和排除标准独立评估文章全文,最终选出16篇符合纳入标准的文章。研究特征(例如,研究人群,研究设计,测量)进行提取,然后进行总结。根据时间利用研究(VIRTUE)流行病学可行的综合研究,纳入的研究进一步分为不同但相互关联的研究领域(例如,composition,决定因素,健康结果)。
    结果:纳入的大部分文章关注儿童和青少年作为研究人群。这项研究主要表明,在COVID-19大流行期间,儿童和青少年中达到24HMG的患病率较低。与COVID-19之前相比,达到24HMG的个人比例有所下降。大多数纳入的研究集中在社会人口统计学因素,当检查与24HMG的相关性时,虽然一些研究评估了其他领域的因素,如社会,文化,和环境方面。
    结论:COVID-19大流行对儿童和青少年健康的24小时运动行为产生了影响。结合COVID-19大流行期间进行的研究,我们鼓励更多的研究来探索在更广泛人群中满足24HMG和相关健康益处的相关性.
    Many studies examining 24-hour movement behaviours based on the 24-Hour Movement Guidelines (24HMG) have been published during the COVID-19 pandemic. However, no comprehensive reviews summarized and synthesized the evidence concerning studies using 24HMG. The aim of this scoping review was to synthesize the evidence from the 24HMG studies published during the pandemic.
    Three electronic databases (Web of Science, PubMed, EBSCO) were utilized to conduct a literature search. The search procedure adhered to the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Initially, a total of 1339 research articles published in peer-reviewed journals were screened. After eliminating 461 duplicates, 878 articles remained. The titles and/or abstracts of these articles were then cross-checked, and 25 articles were included. Subsequently, two authors independently assessed full-text of articles based on the pre-defined inclusion and exclusion criteria, resulting in the final selection of 16 articles that met the inclusion criteria. Study characteristics (e.g., study population, study design, measurement) were extracted and then summarized. According to the Viable Integrative Research in Time-use Research (VIRTUE) epidemiology, the included studies were further classified into different but interrelated study domains (e.g., composition, determinants, health outcomes).
    The majority of included articles focused on children and adolescents as study population. This study primarily demonstrated that a low prevalence of meeting the 24HMG among children and adolescents during the COVID-19 pandemic. There has been a decline in the percentage of individuals meeting the 24HMG compared to the pre-COVID-19 period. The majority of included studies focused on sociodemographic factors when examining the correlates of meeting the 24HMG, while a few studies assessed factors of other domains, such as social, cultural, and environmental aspects.
    The COVID-19 pandemic had an impact on healthy 24-hour movement behaviours in children and adolescents. In conjunction with the studies conducted during the COVID-19 pandemic, more studies were encouraged to explore the correlates of meeting the 24HMG and the associated health benefits in wider ranges of populations.
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  • 文章类型: Journal Article
    证据综合在促进医疗保健实践中的明智决策方面发挥着重要作用。证据综合的一个关键问题是处理罕见不良事件的方法和解决伤害影响偏差的方法。经验数据对于帮助方法学家和统计学家解决不良事件证据综合问题至关重要。出于这个原因,我们建立了智能安全数据集,不良事件荟萃分析的最大经验数据集。该数据集包含151个系统评价和629个关于安全性结果的荟萃分析,涵盖超过2300项随机对照试验和362项危害结果,包含10069行和45列的试用级别信息。所有信息都经过双重甚至四度检查,并通过引用原始来源进一步验证(例如,纳入的随机试验的全文),以确保数据的高有效性。
    Evidence synthesis serves an important role to promote informed decision-making in healthcare practice. A key issue of evidence synthesis is the approach to deal with rare adverse events and the methods to address bias of harm effects. Empirical data is essential to help methodologists and statisticians to solve the issues in evidence synthesis of adverse events. For this reason, we have established SMART Safety dataset, the largest empirical dataset of meta-analyses of adverse events. The dataset contains 151 systematic reviews with 629 meta-analyses on safety outcomes, which covers more than 2,300 randomized controlled trials and 362 harm outcomes, with 10,069 rows and 45 columns of trial level information. All information was double- or even quadra-checked and further verified by referring the original source (e.g., the full-text of the included randomized trials) to ensure high validity of the data.
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  • 文章类型: Systematic Review
    背景与目的:重症肺炎是一种危重的呼吸系统疾病,死亡率高。中医药辅助治疗重症肺炎的有效性和安全性证据不足。本研究旨在确定,描述,评估,并总结目前已有的关于重症肺炎中医辅助治疗的高质量设计证据,利用证据图谱方法找出证据缺口。方法:在中英文在线数据库(PubMed,EMBASE,科克伦图书馆,WebofScience,CNKI,万方数据,CQVIP,和SinoMed)确定从成立到2023年8月的论文,以纳入评论。随机对照试验(RCT),系统评价(SRs),纳入了有关成人重症肺炎或其并发症的中医辅助治疗的荟萃分析。使用Cochrane手册ROB工具评估RCT中的偏倚风险。多重系统评价2(AMSTAR-2),系统评价中的偏差风险(ROBIS)工具,和建议评估的分级,开发和评估(GRADE)系统用于评估方法学质量,偏见的风险,和SR或荟萃分析的证据质量,分别。然后,气泡图被设计为在四个维度上直观地显示信息。结果:共有354项RCT和17项SR或meta分析符合纳入标准。出版的RCT有几个缺陷,如不合理的设计,样本量有限,对非药物治疗研究和辨证分型重视不够,结果指标选择或使用不当,未能提供高质量的证据。16个SRs或方法学质量的荟萃分析评分为“极低”信心。12份SR或荟萃分析被评为“高风险”。大多数结果被评为“低”证据质量。我们发现中医结合常规治疗可以提高临床总有效率和中医证候疗效。联合方法还可以缩短机械通气时间,感染控制时间,以及住院时间和ICU住院时间;显着降低温度,呼吸频率,心率,白细胞计数,C反应蛋白水平,降钙素原,血液炎症因子,细菌学反应,和D-二聚体;降低CPIS,APACHEII得分,和PSI评分;改善肺部影像学特征,动脉血气指标(包括动脉血氧压,动脉血氧饱和度,和氧指数),与常规治疗相比,重症肺炎的肺功能(包括第1秒的用力肺活量和用力呼气量)(p<0.05)。不良反应和不良事件发生率差异无统计学意义(p>0.05)。此外,与仅常规治疗相比,大多数SR或荟萃分析得出结论,中医与常规治疗相结合是“有益的”或“可能有益的”。结论:中医结合常规治疗在疗效上具有优势,临床体征,实验室结果,和重症肺炎的生活质量结果,与常规治疗相比,安全性结局无差异。清金化痰汤是最有前途的靶点,宣白承气汤有“可能有益”的结论。血必净注射液和痰热清注射液是治疗重症肺炎的两种常用中药注射剂,两者都是\"可能有益的。\"然而,未来需要大样本量和高方法学质量的多中心随机对照试验.此外,应改进SR或荟萃分析的方法设计和质量,以形成高质量的,循证医学证据,为中医辅助治疗重症肺炎的有效性和安全性提供依据。
    Background and Objective: Severe pneumonia is a critical respiratory disease with high mortality. There is insufficient evidence on the efficacy and safety of traditional Chinese medicine (TCM) adjuvant therapy for severe pneumonia. This study aims to identify, describe, assess, and summarize the currently available high-quality design evidence on TCM adjuvant therapy for severe pneumonia to identify evidence gaps using the evidence mapping approach. Methods: Systematic searches were performed on English and Chinese online databases (PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, WanFang Data, CQVIP, and SinoMed) to identify papers from inception until August 2023 for inclusion into the review. Randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses concerning TCM adjuvant therapy for severe pneumonia or its complications in adults were included. The risk of bias in RCTs was evaluated by using the Cochrane Handbook ROB tool. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Review (ROBIS) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the methodological quality, risk of bias, and evidence quality of SRs or meta-analyses, respectively. Then, a bubble plot was designed to visually display information in four dimensions. Results: A total of 354 RCTs and 17 SRs or meta-analyses met the inclusion criteria. The published RCTs had several flaws, such as unreasonable design, limited sample size, insufficient attention to non-drug therapy studies and syndrome differentiation, improper selection or use of outcome indicators, and failure to provide high-quality evidence. Sixteen SRs or meta-analyses of methodological quality scored \"Critically Low\" confidence. Twelve SRs or meta-analyses were rated as \"High Risk.\" Most outcomes were rated as \"Low\" evidence quality. We found that TCM combined with conventional treatment could improve the clinical total effective rate and the TCM syndromes efficacy. The combined approach could also shorten mechanical ventilation time, infection control time, and length of hospital and ICU stay; significantly reduce temperature, respiratory rate, heart rate, white blood cell counts, levels of C-reactive protein, procalcitonin, blood inflammatory factors, bacteriological response, and D-dimer; decrease CPIS, APACHE II score, and PSI score; improve pulmonary imaging features, arterial blood gas indicators (including arterial oxygen pressure, arterial oxygen saturation, and oxygen index), and lung function (including forced vital capacity and forced expiratory volume in the first second) for severe pneumonia compared with conventional treatment only (p < 0.05). There was no significant difference in adverse reactions and incidence of adverse events (p > 0.05). In addition, compared with conventional treatment only, most SRs or meta-analyses concluded that TCM combined with conventional treatment was \"Beneficial\" or \"Probably beneficial.\" Conclusion: TCM combined with conventional treatment had advantages in efficacy, clinical signs, laboratory results, and life quality outcomes of severe pneumonia, with no difference in safety outcomes compared with conventional treatment only. QingJin Huatan decoction is the most promising target, and Xuanbai Chengqi decoction has a \"Probably beneficial\" conclusion. XueBiJing injection and TanReQing injection are two commonly used Chinese herbal injections for treating severe pneumonia, and both are \"Probably beneficial.\" However, there was a need for multicenter RCTs with large sample sizes and high methodological quality in the future. In addition, the methodological design and quality of SRs or meta-analyses should be improved to form high-quality, evidence-based medical evidence and provide evidence for the effectiveness and safety of TCM adjuvant therapy for severe pneumonia.
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