Pub Date : 2025-02-10DOI: 10.1002/14651858.CD014999.pub2
Dennis Zetner, Ida Roost, Jacob Rosenberg, Kristoffer Andresen
<p><strong>Background: </strong>Bleeding peptic ulcer is a serious condition that often requires immediate endoscopic or surgical intervention to stop the bleeding (haemostasis). Following haemostasis, patients are at risk of rebleeding, leading to reintervention and risk of morbidity or mortality. In order to prevent rebleeding and associated complications, prophylactic measures have been developed and investigated. Prophylactic transarterial embolization (TAE), where the blood vessel leading to the site of the bleeding ulcer is closed via embolization (e.g. using coils to stop blood flow), has emerged as a potential therapeutic approach to address this challenge. However, a comprehensive evaluation of its efficacy and impact on patient outcomes is essential.</p><p><strong>Objectives: </strong>To assess the effects of prophylactic transarterial embolization after successful endoscopic treatment compared with endoscopic haemostasis only on the risk of rebleeding after bleeding peptic ulcer, in patients where endoscopic haemostasis has been successful.</p><p><strong>Search methods: </strong>In August 2023 we searched CENTRAL, MEDLINE, Embase, PubMed Central, Clinicaltrials.gov and the International Clinical Trials Registry Platform (ICTRP). There were no language or publication status constraints.</p><p><strong>Selection criteria: </strong>This review included prospective randomized controlled trials that evaluated prophylactic TAE in patients with bleeding peptic ulcers. The selection process involved meticulous screening, full-text reviews, and considerations of study design, intervention, and patient populations.</p><p><strong>Data collection and analysis: </strong>Two review authors extracted data and conducted risk of bias assessments. The outcomes of interest were rebleeding within 30 days, need for reintervention within 30 days, 30-day mortality, complications within 30 days, duration of hospitalization and success rate of the embolization. We contacted authors of included studies for missing and more detailed data, allowing us to carry out sensitivity analyses. We used GRADE to assess the certainty of evidence.</p><p><strong>Main results: </strong>The review includes two studies involving 346 participants. Prophylactic TAE may not reduce the odds of rebleeding within 30 days (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.18 to 1.83; 2 studies, 346 participants; low-certainty evidence). There may be little or no effect on reintervention rates per event (OR 0.68, 95% CI 0.35 to 1.35; 2 studies, 346 participants; low-certainty evidence) or per participant (OR 0.65, 95% CI 0.25 to1.69; 2 studies, 346 participants; low-certainty evidence), and there may be no reduction in 30-day mortality (OR 0.41, 95% CI 0.14 to 1.21; 2 studies, 346 participants; low-certainty evidence). Unfortunately, we were unable to analyze complications other than rebleeding, reintervention and mortality, as data for these outcomes were not available in the include
{"title":"Prophylactic transarterial embolization in patients with bleeding peptic ulcers following endoscopic control of bleeding.","authors":"Dennis Zetner, Ida Roost, Jacob Rosenberg, Kristoffer Andresen","doi":"10.1002/14651858.CD014999.pub2","DOIUrl":"10.1002/14651858.CD014999.pub2","url":null,"abstract":"<p><strong>Background: </strong>Bleeding peptic ulcer is a serious condition that often requires immediate endoscopic or surgical intervention to stop the bleeding (haemostasis). Following haemostasis, patients are at risk of rebleeding, leading to reintervention and risk of morbidity or mortality. In order to prevent rebleeding and associated complications, prophylactic measures have been developed and investigated. Prophylactic transarterial embolization (TAE), where the blood vessel leading to the site of the bleeding ulcer is closed via embolization (e.g. using coils to stop blood flow), has emerged as a potential therapeutic approach to address this challenge. However, a comprehensive evaluation of its efficacy and impact on patient outcomes is essential.</p><p><strong>Objectives: </strong>To assess the effects of prophylactic transarterial embolization after successful endoscopic treatment compared with endoscopic haemostasis only on the risk of rebleeding after bleeding peptic ulcer, in patients where endoscopic haemostasis has been successful.</p><p><strong>Search methods: </strong>In August 2023 we searched CENTRAL, MEDLINE, Embase, PubMed Central, Clinicaltrials.gov and the International Clinical Trials Registry Platform (ICTRP). There were no language or publication status constraints.</p><p><strong>Selection criteria: </strong>This review included prospective randomized controlled trials that evaluated prophylactic TAE in patients with bleeding peptic ulcers. The selection process involved meticulous screening, full-text reviews, and considerations of study design, intervention, and patient populations.</p><p><strong>Data collection and analysis: </strong>Two review authors extracted data and conducted risk of bias assessments. The outcomes of interest were rebleeding within 30 days, need for reintervention within 30 days, 30-day mortality, complications within 30 days, duration of hospitalization and success rate of the embolization. We contacted authors of included studies for missing and more detailed data, allowing us to carry out sensitivity analyses. We used GRADE to assess the certainty of evidence.</p><p><strong>Main results: </strong>The review includes two studies involving 346 participants. Prophylactic TAE may not reduce the odds of rebleeding within 30 days (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.18 to 1.83; 2 studies, 346 participants; low-certainty evidence). There may be little or no effect on reintervention rates per event (OR 0.68, 95% CI 0.35 to 1.35; 2 studies, 346 participants; low-certainty evidence) or per participant (OR 0.65, 95% CI 0.25 to1.69; 2 studies, 346 participants; low-certainty evidence), and there may be no reduction in 30-day mortality (OR 0.41, 95% CI 0.14 to 1.21; 2 studies, 346 participants; low-certainty evidence). Unfortunately, we were unable to analyze complications other than rebleeding, reintervention and mortality, as data for these outcomes were not available in the include","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD014999"},"PeriodicalIF":8.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-10DOI: 10.1002/14651858.CD015790.pub2
Alexis Malkin, Ashley Deemer, Melissa Contreras, Heather Edmonds, Adrienne C Quan, Jenna Koskey, Mary Kate Walters, Sueko M Ng, John G Lawrenson
<p><strong>Rationale: </strong>Visual impairment is a major health concern that predominantly impacts older adults due to age-related ocular diseases. Visual impairment affects more than 2200 million people worldwide and may lead to functional and psychological decline, emphasizing the need for effective self-management interventions. Self-management interventions aim to enhance individuals' abilities to manage their condition, maintain activities of daily living, and improve overall well-being.</p><p><strong>Objectives: </strong>To assess the effects of self-management interventions on quality of life in adults with visual impairment compared with inactive or active (usual care) control interventions.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, two other databases, and two trial registries, together with reference checking and contact with study authors to identify studies that are included in the review. The latest search date was on 19 May 2024.</p><p><strong>Eligibility criteria: </strong>We included parallel-group randomized controlled trials (RCTs) comparing multifaceted self-management interventions in adults with acquired visual impairment (including dual sensory impairment).</p><p><strong>Outcomes: </strong>Outcomes assessed were overall and subscores of health-related quality of life (HRQoL) and vision-related quality of life (VRQoL) scores at the end of follow-up, adverse events during the study period, and vision-related living performance measures at the end of follow-up.</p><p><strong>Risk of bias: </strong>We assessed the risk of bias for three outcomes reported in a summary of findings table using the Cochrane RoB 2 tool.</p><p><strong>Synthesis methods: </strong>We synthesized results for each outcome using meta-analysis where possible, by calculating standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval (CI) for continuous outcomes and risk ratio (RR) with 95% CIs for dichotomous outcomes. Where this was not possible due to the nature of the data, we provided a narrative summary of the results. We used GRADE to assess certainty of evidence for prespecified outcomes.</p><p><strong>Included studies: </strong>We included 20 parallel-group RCTs that enrolled 3151 participants. The size of studies ranged from 30 to 323 participants with a median of 153 participants. Studies were conducted in Asia (two studies), Australia (two), Europe (six), and North America (10) in academic medical centers, hospitals, low-vision clinics, private practice, rehabilitation centers, and Veterans Affairs medical facilities. The participants were older adults with a mean age across the included studies ranging from 60 to 84 years. The mean logarithm of the minimum angle of resolution (logMAR) visual acuity ranged from 0.15 to 1.11. Age-related macular degeneration was the predominant cause of low vision in 15 studies. We did not identify any eligible studies for adults with dual sensory i
{"title":"Self-management interventions for quality of life in adults with visual impairment.","authors":"Alexis Malkin, Ashley Deemer, Melissa Contreras, Heather Edmonds, Adrienne C Quan, Jenna Koskey, Mary Kate Walters, Sueko M Ng, John G Lawrenson","doi":"10.1002/14651858.CD015790.pub2","DOIUrl":"10.1002/14651858.CD015790.pub2","url":null,"abstract":"<p><strong>Rationale: </strong>Visual impairment is a major health concern that predominantly impacts older adults due to age-related ocular diseases. Visual impairment affects more than 2200 million people worldwide and may lead to functional and psychological decline, emphasizing the need for effective self-management interventions. Self-management interventions aim to enhance individuals' abilities to manage their condition, maintain activities of daily living, and improve overall well-being.</p><p><strong>Objectives: </strong>To assess the effects of self-management interventions on quality of life in adults with visual impairment compared with inactive or active (usual care) control interventions.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, two other databases, and two trial registries, together with reference checking and contact with study authors to identify studies that are included in the review. The latest search date was on 19 May 2024.</p><p><strong>Eligibility criteria: </strong>We included parallel-group randomized controlled trials (RCTs) comparing multifaceted self-management interventions in adults with acquired visual impairment (including dual sensory impairment).</p><p><strong>Outcomes: </strong>Outcomes assessed were overall and subscores of health-related quality of life (HRQoL) and vision-related quality of life (VRQoL) scores at the end of follow-up, adverse events during the study period, and vision-related living performance measures at the end of follow-up.</p><p><strong>Risk of bias: </strong>We assessed the risk of bias for three outcomes reported in a summary of findings table using the Cochrane RoB 2 tool.</p><p><strong>Synthesis methods: </strong>We synthesized results for each outcome using meta-analysis where possible, by calculating standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval (CI) for continuous outcomes and risk ratio (RR) with 95% CIs for dichotomous outcomes. Where this was not possible due to the nature of the data, we provided a narrative summary of the results. We used GRADE to assess certainty of evidence for prespecified outcomes.</p><p><strong>Included studies: </strong>We included 20 parallel-group RCTs that enrolled 3151 participants. The size of studies ranged from 30 to 323 participants with a median of 153 participants. Studies were conducted in Asia (two studies), Australia (two), Europe (six), and North America (10) in academic medical centers, hospitals, low-vision clinics, private practice, rehabilitation centers, and Veterans Affairs medical facilities. The participants were older adults with a mean age across the included studies ranging from 60 to 84 years. The mean logarithm of the minimum angle of resolution (logMAR) visual acuity ranged from 0.15 to 1.11. Age-related macular degeneration was the predominant cause of low vision in 15 studies. We did not identify any eligible studies for adults with dual sensory i","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015790"},"PeriodicalIF":8.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-10DOI: 10.1002/14651858.CD015003.pub2
Arturo J Martí-Carvajal, Mario A Gemmato-Valecillos, Diana Monge Martín, Juan Bautista De Sanctis, Cristina Elena Martí-Amarista, Ricardo Hidalgo, Eduardo Alegría-Barrero, Ricardo J Riera Lizardo, Andrea Correa-Pérez
<p><strong>Background: </strong>Atherosclerotic cardiovascular diseases (ACVDs), a condition characterised by lipid accumulation in arterial walls, which is often exacerbated by chronic inflammation disorders, is the major cause of mortality and morbidity worldwide. Colchicine, with its first medicinal use in ancient Egypt, is an inexpensive drug with anti-inflammatory properties. However, its role in primary prevention of ACVDs in the general population remains unknown.</p><p><strong>Objectives: </strong>To assess the clinical benefits and harms of colchicine as primary prevention of cardiovascular outcomes in the general population.</p><p><strong>Search methods: </strong>We searched the Cochrane Heart Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase, Web of Science, and LILACS. We searched ClinicalTrials.gov and WHO ICTRP for ongoing and unpublished studies. We also scanned the reference lists of relevant included studies, reviews, meta-analyses, and health technology reports to identify additional studies. There were no limitations on language, date of publication, or study setting. The search results were updated on 31 May 2023.</p><p><strong>Selection criteria: </strong>Randomised controlled trials (RCTs) in any setting, recruiting adults without pre-existing cardiovascular disease. We included trials that compared colchicine versus placebo, non-steroidal anti-inflammatory drugs, corticosteroids, immunomodulating drugs, or usual care. Our primary outcomes were all-cause mortality, non-fatal myocardial infarction, stroke, and adverse events.</p><p><strong>Data collection and analysis: </strong>Two or more review authors independently selected studies, extracted data, and performed risk of bias and GRADE assessments.</p><p><strong>Main results: </strong>We identified 15 RCTs (1721 participants randomised; 1412 participants analysed) with follow-up periods ranging from 4 to 728 weeks. The intervention was oral colchicine compared with placebo, immunomodulating drugs, or usual care or no treatment. Due to biases and imprecision, the evidence was very uncertain for all outcomes. All trials but one had a high risk of bias. Five out of seven meta-analyses included fewer than six trials (71.4%). The objectives of the review were to assess cardiovascular outcomes in the general population, but many of the included trials focused on liver disease. Colchicine compared to placebo Colchicine may reduce all-cause mortality compared to placebo in primary prevention, but the evidence is very uncertain (risk ratio (RR) 0.68, 95% confidence interval (CI) 0.51 to 0.91; 6 studies, 463 participants; very low-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 6 to 67). Colchicine may result in little to no difference in non-fatal myocardial infarction, but the evidence is very uncertain (RR 0.87, 95% CI 0
{"title":"Colchicine for the primary prevention of cardiovascular events.","authors":"Arturo J Martí-Carvajal, Mario A Gemmato-Valecillos, Diana Monge Martín, Juan Bautista De Sanctis, Cristina Elena Martí-Amarista, Ricardo Hidalgo, Eduardo Alegría-Barrero, Ricardo J Riera Lizardo, Andrea Correa-Pérez","doi":"10.1002/14651858.CD015003.pub2","DOIUrl":"10.1002/14651858.CD015003.pub2","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular diseases (ACVDs), a condition characterised by lipid accumulation in arterial walls, which is often exacerbated by chronic inflammation disorders, is the major cause of mortality and morbidity worldwide. Colchicine, with its first medicinal use in ancient Egypt, is an inexpensive drug with anti-inflammatory properties. However, its role in primary prevention of ACVDs in the general population remains unknown.</p><p><strong>Objectives: </strong>To assess the clinical benefits and harms of colchicine as primary prevention of cardiovascular outcomes in the general population.</p><p><strong>Search methods: </strong>We searched the Cochrane Heart Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase, Web of Science, and LILACS. We searched ClinicalTrials.gov and WHO ICTRP for ongoing and unpublished studies. We also scanned the reference lists of relevant included studies, reviews, meta-analyses, and health technology reports to identify additional studies. There were no limitations on language, date of publication, or study setting. The search results were updated on 31 May 2023.</p><p><strong>Selection criteria: </strong>Randomised controlled trials (RCTs) in any setting, recruiting adults without pre-existing cardiovascular disease. We included trials that compared colchicine versus placebo, non-steroidal anti-inflammatory drugs, corticosteroids, immunomodulating drugs, or usual care. Our primary outcomes were all-cause mortality, non-fatal myocardial infarction, stroke, and adverse events.</p><p><strong>Data collection and analysis: </strong>Two or more review authors independently selected studies, extracted data, and performed risk of bias and GRADE assessments.</p><p><strong>Main results: </strong>We identified 15 RCTs (1721 participants randomised; 1412 participants analysed) with follow-up periods ranging from 4 to 728 weeks. The intervention was oral colchicine compared with placebo, immunomodulating drugs, or usual care or no treatment. Due to biases and imprecision, the evidence was very uncertain for all outcomes. All trials but one had a high risk of bias. Five out of seven meta-analyses included fewer than six trials (71.4%). The objectives of the review were to assess cardiovascular outcomes in the general population, but many of the included trials focused on liver disease. Colchicine compared to placebo Colchicine may reduce all-cause mortality compared to placebo in primary prevention, but the evidence is very uncertain (risk ratio (RR) 0.68, 95% confidence interval (CI) 0.51 to 0.91; 6 studies, 463 participants; very low-certainty evidence; number needed to treat for an additional beneficial outcome (NNTB) 11, 95% CI 6 to 67). Colchicine may result in little to no difference in non-fatal myocardial infarction, but the evidence is very uncertain (RR 0.87, 95% CI 0","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015003"},"PeriodicalIF":8.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1002/14651858.CD015783
Hugues Sultana, Tom De Vos, Reem Malouf, François Calais, Corynne Marchal, Guillaume Eberst, Virginie Westeel, Cindy Barnig
Objectives: This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To assess the prognostic value of measuring pretreatment baseline blood eosinophil levels in adults receiving systemic treatment for any stage of non-small cell lung cancer.
{"title":"Prognostic value of blood eosinophils for predicting survival and treatment outcomes in people with non-small cell lung cancer.","authors":"Hugues Sultana, Tom De Vos, Reem Malouf, François Calais, Corynne Marchal, Guillaume Eberst, Virginie Westeel, Cindy Barnig","doi":"10.1002/14651858.CD015783","DOIUrl":"10.1002/14651858.CD015783","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To assess the prognostic value of measuring pretreatment baseline blood eosinophil levels in adults receiving systemic treatment for any stage of non-small cell lung cancer.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015783"},"PeriodicalIF":8.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1002/14651858.CD015865
Amy Belba, Thibaut Vanneste, Luc E Vanlinthout, Jan Kallewaard, Sander Mj Van Kuijk, Merel Kimman, Pieter Emans, Koen Van Boxem, Maria Milagrosa Santana Pineda, Kristof Thevissen, Jan Van Zundert, Patrik Vankrunkelsven, Anne-Catherine Vanhove
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of radiofrequency treatment of the genicular nerves in people with chronic knee pain due to knee osteoarthritis.
{"title":"Radiofrequency treatment for chronic knee pain in people with knee osteoarthritis.","authors":"Amy Belba, Thibaut Vanneste, Luc E Vanlinthout, Jan Kallewaard, Sander Mj Van Kuijk, Merel Kimman, Pieter Emans, Koen Van Boxem, Maria Milagrosa Santana Pineda, Kristof Thevissen, Jan Van Zundert, Patrik Vankrunkelsven, Anne-Catherine Vanhove","doi":"10.1002/14651858.CD015865","DOIUrl":"10.1002/14651858.CD015865","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of radiofrequency treatment of the genicular nerves in people with chronic knee pain due to knee osteoarthritis.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015865"},"PeriodicalIF":8.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD008469.pub3
Antonia O'Connor, Maryam Hasan, Krishna Bajee Sriram, Kristin V Carson-Chahhoud
<p><strong>Background: </strong>Asthma is a chronic airway condition with a global prevalence of 262.4 million people. Asthma education is an essential component of management and includes provision of information on the disease process and self-management skills development such as trigger avoidance. Education may be provided in various settings. The home setting allows educators to reach populations (e.g. financially poor) that may experience barriers to care (e.g. transport limitations) within a familiar environment, and allows for avoidance of attendance at healthcare settings. However, it is unknown if education delivered in the home is superior to usual care or the same education delivered elsewhere. There are large variations in asthma education programmes (e.g. patient-specific content versus broad asthma education, number/frequency/duration of education sessions). This is an update of the 2011 review with 14 new studies added.</p><p><strong>Objectives: </strong>To assess the effects of educational interventions for asthma, delivered in the home to children, their caregivers, or both, on asthma-related outcomes.</p><p><strong>Search methods: </strong>We searched Cochrane Airways Group Trials Register, CENTRAL, MEDLINE, two additional databases and two clinical trials registries. We searched reference lists of included trials/review articles (last search October 2022), and contacted authors of included studies.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials of education delivered in the home to children and adolescents (aged two to 18 years) with asthma, their caregivers or both. We included self-management programmes, delivered face-to-face and aimed at changing behaviour (e.g. medication/inhaler technique education). Eligible control groups were usual care, waiting list or less-intensive education (e.g. shorter, fewer sessions) delivered outside or within the home. We excluded studies with mixed-disease populations and without a face-to-face component (e.g. telephone only).</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected trials, assessed trial quality, extracted data and used GRADE to rate the certainty of the evidence. We contacted study authors for additional information. We pooled continuous data with mean difference (MD) and 95% confidence intervals (CI). We used a random-effects model and performed sensitivity analyses with a fixed-effect model. When combining dichotomous and continuous data, we used generic inverse variance, using a Peto odds ratio (OR) and fixed-effect model. Primary outcomes were exacerbations leading to emergency department visits and exacerbations requiring a course of oral corticosteroids. Six months was the primary time point for outcomes. The summary of findings tables reported on the primary outcomes, and quality of life, daytime symptoms, days missed from school and exacerbations leading to hospitalisations.</p><p><strong>M
{"title":"Home-based educational interventions for children with asthma.","authors":"Antonia O'Connor, Maryam Hasan, Krishna Bajee Sriram, Kristin V Carson-Chahhoud","doi":"10.1002/14651858.CD008469.pub3","DOIUrl":"10.1002/14651858.CD008469.pub3","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a chronic airway condition with a global prevalence of 262.4 million people. Asthma education is an essential component of management and includes provision of information on the disease process and self-management skills development such as trigger avoidance. Education may be provided in various settings. The home setting allows educators to reach populations (e.g. financially poor) that may experience barriers to care (e.g. transport limitations) within a familiar environment, and allows for avoidance of attendance at healthcare settings. However, it is unknown if education delivered in the home is superior to usual care or the same education delivered elsewhere. There are large variations in asthma education programmes (e.g. patient-specific content versus broad asthma education, number/frequency/duration of education sessions). This is an update of the 2011 review with 14 new studies added.</p><p><strong>Objectives: </strong>To assess the effects of educational interventions for asthma, delivered in the home to children, their caregivers, or both, on asthma-related outcomes.</p><p><strong>Search methods: </strong>We searched Cochrane Airways Group Trials Register, CENTRAL, MEDLINE, two additional databases and two clinical trials registries. We searched reference lists of included trials/review articles (last search October 2022), and contacted authors of included studies.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials of education delivered in the home to children and adolescents (aged two to 18 years) with asthma, their caregivers or both. We included self-management programmes, delivered face-to-face and aimed at changing behaviour (e.g. medication/inhaler technique education). Eligible control groups were usual care, waiting list or less-intensive education (e.g. shorter, fewer sessions) delivered outside or within the home. We excluded studies with mixed-disease populations and without a face-to-face component (e.g. telephone only).</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected trials, assessed trial quality, extracted data and used GRADE to rate the certainty of the evidence. We contacted study authors for additional information. We pooled continuous data with mean difference (MD) and 95% confidence intervals (CI). We used a random-effects model and performed sensitivity analyses with a fixed-effect model. When combining dichotomous and continuous data, we used generic inverse variance, using a Peto odds ratio (OR) and fixed-effect model. Primary outcomes were exacerbations leading to emergency department visits and exacerbations requiring a course of oral corticosteroids. Six months was the primary time point for outcomes. The summary of findings tables reported on the primary outcomes, and quality of life, daytime symptoms, days missed from school and exacerbations leading to hospitalisations.</p><p><strong>M","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD008469"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD016122
Stina Öberg, Jason Joe Baker, Jacob Rosenberg
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of penetrating versus non-penetrating mesh fixation in adults receiving laparoscopic groin hernia repair.
{"title":"Penetrating versus non-penetrating mesh fixation in laparoscopic groin hernia repair.","authors":"Stina Öberg, Jason Joe Baker, Jacob Rosenberg","doi":"10.1002/14651858.CD016122","DOIUrl":"10.1002/14651858.CD016122","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of penetrating versus non-penetrating mesh fixation in adults receiving laparoscopic groin hernia repair.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016122"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD016168
Caitlin R Williams, Hanna E Huffstetler, Angelo S Nyamtema, Eva Larkai, Magdalena Lyimo, Afroditi Kanellopoulou, Lindsay Robertson, Leslie Choi, Fadhlun M Alwy Al-Beity
<p><strong>Rationale: </strong>Postpartum haemorrhage (PPH) is commonly defined as blood loss of 500 mL or greater within 24 hours after birth. Intravenous transfusions of whole blood, red blood cells (RBC), or other blood components collected from a donor may be administered to manage PPH. Key questions remain regarding optimal timing for initiating blood and blood product transfusion in managing PPH and whether the use of fractionated blood products, either as replacement for or in addition to whole blood transfusion, could improve maternal outcomes. No systematic review has examined appropriate transfusion strategies for managing PPH.</p><p><strong>Objectives: </strong>To assess the benefits and harms of transfusion of whole blood or other blood products for preventing morbidity and mortality among women with PPH.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and two trials registers, together with reference checking, citation searching, and contact with study authors to identify studies for inclusion in the review. The latest search was 18 July 2024.</p><p><strong>Eligibility criteria: </strong>We considered randomised controlled trials (RCTs), cluster-randomised trials, or controlled non-randomised studies of interventions (NRSI) evaluating the efficacy and safety of blood transfusion for managing PPH, regardless of the mode of birth.</p><p><strong>Outcomes: </strong>Our critical outcomes were maternal death, severe maternal morbidity, and adverse effects.</p><p><strong>Risk of bias: </strong>We assessed risk of bias in included studies using the Cochrane RoB 2 tool and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool.</p><p><strong>Synthesis methods: </strong>We synthesised results for each outcome within each comparison using meta-analysis where possible, and used GRADE to assess the certainty of evidence for each outcome.</p><p><strong>Included studies: </strong>We included 12 studies with 17,868 participants. We excluded five NRSIs from outcome analyses due to critical risk of bias related to confounding.</p><p><strong>Synthesis of results: </strong>One threshold for initiating transfusion versus another threshold for initiating transfusion None of the studies assessed this comparison. One- to two-unit RBCs versus no transfusion Among women with moderate blood loss, low-certainty evidence from one NRSI found that transfusing 1 to 2 units of RBCs to treat PPH may increase severe maternal morbidity - composite excluding intensive care unit (ICU) admission (risk ratio (RR) 7.00, 95% confidence interval (CI) 2.75 to 17.80; 2130 women) and severe maternal morbidity - ICU admission (RR 2.12, 95% CI 1.20 to 3.75; 2130 women), though we have substantial concerns about the potential bias due to confounding as the volume of blood lost was not controlled for in the analysis. The study did not report maternal death or adverse effects. Packed RBCs versus whole blood versus combination of blood
{"title":"Transfusion of blood and blood products for the management of postpartum haemorrhage.","authors":"Caitlin R Williams, Hanna E Huffstetler, Angelo S Nyamtema, Eva Larkai, Magdalena Lyimo, Afroditi Kanellopoulou, Lindsay Robertson, Leslie Choi, Fadhlun M Alwy Al-Beity","doi":"10.1002/14651858.CD016168","DOIUrl":"10.1002/14651858.CD016168","url":null,"abstract":"<p><strong>Rationale: </strong>Postpartum haemorrhage (PPH) is commonly defined as blood loss of 500 mL or greater within 24 hours after birth. Intravenous transfusions of whole blood, red blood cells (RBC), or other blood components collected from a donor may be administered to manage PPH. Key questions remain regarding optimal timing for initiating blood and blood product transfusion in managing PPH and whether the use of fractionated blood products, either as replacement for or in addition to whole blood transfusion, could improve maternal outcomes. No systematic review has examined appropriate transfusion strategies for managing PPH.</p><p><strong>Objectives: </strong>To assess the benefits and harms of transfusion of whole blood or other blood products for preventing morbidity and mortality among women with PPH.</p><p><strong>Search methods: </strong>We searched CENTRAL, MEDLINE, Embase, and two trials registers, together with reference checking, citation searching, and contact with study authors to identify studies for inclusion in the review. The latest search was 18 July 2024.</p><p><strong>Eligibility criteria: </strong>We considered randomised controlled trials (RCTs), cluster-randomised trials, or controlled non-randomised studies of interventions (NRSI) evaluating the efficacy and safety of blood transfusion for managing PPH, regardless of the mode of birth.</p><p><strong>Outcomes: </strong>Our critical outcomes were maternal death, severe maternal morbidity, and adverse effects.</p><p><strong>Risk of bias: </strong>We assessed risk of bias in included studies using the Cochrane RoB 2 tool and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool.</p><p><strong>Synthesis methods: </strong>We synthesised results for each outcome within each comparison using meta-analysis where possible, and used GRADE to assess the certainty of evidence for each outcome.</p><p><strong>Included studies: </strong>We included 12 studies with 17,868 participants. We excluded five NRSIs from outcome analyses due to critical risk of bias related to confounding.</p><p><strong>Synthesis of results: </strong>One threshold for initiating transfusion versus another threshold for initiating transfusion None of the studies assessed this comparison. One- to two-unit RBCs versus no transfusion Among women with moderate blood loss, low-certainty evidence from one NRSI found that transfusing 1 to 2 units of RBCs to treat PPH may increase severe maternal morbidity - composite excluding intensive care unit (ICU) admission (risk ratio (RR) 7.00, 95% confidence interval (CI) 2.75 to 17.80; 2130 women) and severe maternal morbidity - ICU admission (RR 2.12, 95% CI 1.20 to 3.75; 2130 women), though we have substantial concerns about the potential bias due to confounding as the volume of blood lost was not controlled for in the analysis. The study did not report maternal death or adverse effects. Packed RBCs versus whole blood versus combination of blood","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016168"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD006606.pub5
Charalampos S Siristatidis, Michail Papapanou, Abha Maheshwari, Dennis Vaidakis
<p><strong>Background: </strong>Polycystic ovarian syndrome (PCOS) occurs in 8% to 13% of all women of reproductive age and 50% of women presenting with infertility (i.e. inability to reach a pregnancy after 12 months or more of regular unprotected sexual intercourse). A proportion of these women ultimately need assisted reproductive technology. In vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) are assisted reproduction techniques used to raise the chances of a pregnancy. In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome (OHSS). A potentially effective intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes at the germinal-vesicle stage followed by in vitro maturation (IVM). This is the third update of this Cochrane review on the subject (after the last update on 27 June 2018).</p><p><strong>Objectives: </strong>To assess the benefits and harms of IVM followed by IVF or ICSI versus conventional IVF or ICSI among women with PCOS.</p><p><strong>Search methods: </strong>On 27 February 2023, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, and the Open Grey database. We further searched the National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We also searched reference lists of relevant papers and Google Scholar for any additional trials.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCTs) comparing IVM before IVF or ICSI with conventional IVF or ICSI for infertile women with PCOS, irrespective of language and country of origin.</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected studies, assessed the risk of bias, extracted data from studies, and, where needed, attempted to contact the authors for missing data. Our primary outcomes were live birth per woman randomised and miscarriage. We performed statistical analysis using Review Manager. We assessed the certainty of the evidence using GRADE and the risk of bias using the Cochrane RoB 2 tool.</p><p><strong>Main results: </strong>We found four published trials suitable for inclusion in this update. The studies involved 810 subfertile women undergoing assisted reproductive technology. Two of four were already included in the previous version of the review, were published as abstracts in international conferences, and were at high risk of bias. The two new studies were at low risk of bias in all domains and in terms of all outcomes. We implemented the random-effects model for the quantitative analyses and restricted the primary analysis to studies at l
{"title":"In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction.","authors":"Charalampos S Siristatidis, Michail Papapanou, Abha Maheshwari, Dennis Vaidakis","doi":"10.1002/14651858.CD006606.pub5","DOIUrl":"10.1002/14651858.CD006606.pub5","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovarian syndrome (PCOS) occurs in 8% to 13% of all women of reproductive age and 50% of women presenting with infertility (i.e. inability to reach a pregnancy after 12 months or more of regular unprotected sexual intercourse). A proportion of these women ultimately need assisted reproductive technology. In vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) are assisted reproduction techniques used to raise the chances of a pregnancy. In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome (OHSS). A potentially effective intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes at the germinal-vesicle stage followed by in vitro maturation (IVM). This is the third update of this Cochrane review on the subject (after the last update on 27 June 2018).</p><p><strong>Objectives: </strong>To assess the benefits and harms of IVM followed by IVF or ICSI versus conventional IVF or ICSI among women with PCOS.</p><p><strong>Search methods: </strong>On 27 February 2023, we searched the Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase, and the Open Grey database. We further searched the National Institute for Health and Care Excellence (NICE) fertility assessment and treatment guidelines. We also searched reference lists of relevant papers and Google Scholar for any additional trials.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCTs) comparing IVM before IVF or ICSI with conventional IVF or ICSI for infertile women with PCOS, irrespective of language and country of origin.</p><p><strong>Data collection and analysis: </strong>Two review authors independently selected studies, assessed the risk of bias, extracted data from studies, and, where needed, attempted to contact the authors for missing data. Our primary outcomes were live birth per woman randomised and miscarriage. We performed statistical analysis using Review Manager. We assessed the certainty of the evidence using GRADE and the risk of bias using the Cochrane RoB 2 tool.</p><p><strong>Main results: </strong>We found four published trials suitable for inclusion in this update. The studies involved 810 subfertile women undergoing assisted reproductive technology. Two of four were already included in the previous version of the review, were published as abstracts in international conferences, and were at high risk of bias. The two new studies were at low risk of bias in all domains and in terms of all outcomes. We implemented the random-effects model for the quantitative analyses and restricted the primary analysis to studies at l","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD006606"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1002/14651858.CD016096
Therese K Dalsbø, Rakel Aasheim Greve, Ingrid L Jørgensen, Marita S Fønhus
Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.
{"title":"Education and training interventions for healthcare workers to prevent sexual harassment.","authors":"Therese K Dalsbø, Rakel Aasheim Greve, Ingrid L Jørgensen, Marita S Fønhus","doi":"10.1002/14651858.CD016096","DOIUrl":"10.1002/14651858.CD016096","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness of education and training interventions on improving knowledge and skills for managing sexual harassment, and to assess their impact on the incidence of sexual harassment towards healthcare workers in healthcare settings. We will include all forms of sexual harassment committed by patients, visitors, and co-workers.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016096"},"PeriodicalIF":8.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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