Cochrane Database of Systematic Reviews最新文献

{"title":"Corticosteroids and antiviral treatment for Bell's palsy (idiopathic facial paralysis).","authors":"Peter Konstantin Kurotschka, Fergus Daly, Ildiko Gagyor, Maria Bauer, Franz E Babl, Virginia Hernandez Santiago, Maria Chiara Bassi, Dhruvashree Somasundara, Simon W Lowe, Frank Sullivan","doi":"10.1002/14651858.CD015563","DOIUrl":"10.1002/14651858.CD015563","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To evaluate the benefits and harms of corticosteroids, antiviral agents, and their combination, when given at onset for Bell's palsy. Secondary objective To explore whether equity-related factors, particularly age, influence the benefits or harms of those treatments.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015563"},"PeriodicalIF":8.8,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12930351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282606","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}

{"title":"Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.","authors":"Yan Ping Qi, Krista S Crider, Julie Gutman, Elizabeth Centeno-Tablante, Amy Fothergill, Kelicia Daniels, Lorraine F Yeung, Cara T Mai, Saurabh Mehta, Jennifer L Williams, Julia L Finkelstein","doi":"10.1002/14651858.CD014217.pub2","DOIUrl":"10.1002/14651858.CD014217.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Malaria is an infectious disease transmitted by female Anopheles mosquitoes, with ongoing transmission in over 80 countries. The malaria parasite requires folate for survival and growth; antifolate antimalarial medications used for prevention and treatment target enzymes in folate metabolism as their mechanism of action. Periconceptional folic acid (synthetic form of folate) supplementation (400 μg/day) is the standard of care for neural tube defect prevention. Concerns have been raised about the potential effects of folic acid (including above the tolerable upper intake level (UL) &gt;1.0 mg/day) in the context of malaria prevention and treatment, including the efficacy of antimalarial medications. Examining the potential impact of folic acid on malaria risk and severity amongst people taking antifolate antimalarial medications may inform public health programmes in malaria-endemic areas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To examine the effects of folic acid supplementation on the risk and severity of malaria infection amongst people taking antifolate antimalarials and living in areas with malaria endemicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Prevention: &lt;/strong&gt;Amongst uninfected people taking antifolate antimalarial medications for malaria prevention, does folic acid supplementation increase susceptibility or severity of malaria infection?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Treatment: &lt;/strong&gt;Amongst people with malaria infection who are being treated with antifolate antimalarial drugs, does folic acid supplementation reduce parasite clearance or increase the risk of treatment failure?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched databases including CENTRAL, MEDLINE, Embase, CINAHL, Scopus, and trial registries (September 13, 2024), grey literature, and reference searches to identify additional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Randomised trials evaluating the effects of folic acid supplementation (alone or in combination with iron or other vitamins and minerals) amongst individuals taking antifolate antimalarial medications in malaria-endemic areas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Primary outcomes included uncomplicated malaria or severe malaria, parasite clearance, and treatment failure. Cochrane RoB 2 was used to evaluate the risk of bias. Certainty of evidence was assessed using GRADE for primary outcomes. We performed meta-analyses using random-effects models for all outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Eight trials with 3486 participants were included: three malaria prevention trials and five malaria treatment trials. Most treatment trials included folic acid doses above the UL (&gt; 1.0 mg/d); one trial included 400 μg per day. Antifolate antimalarials included sulfadoxine-pyrimethamine (SP; five trials), sulfisoxazole plus pyrimethamine (one trial), atovaquone-proguanil (one trial), and proguanil (one trial). Some studies had unclear or high risk of bias due to missing outcome data. Malaria pr","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD014217"},"PeriodicalIF":8.8,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218654","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}

{"title":"Screening for osteoporosis with bone densitometry in adults with risk factors for fractures.","authors":"Gisela Oltra, Mariana Andrea Burgos, Diego Ivaldi, Camila Micaela Escobar Liquitay, Juan Va Franco, Luis I Garegnani","doi":"10.1002/14651858.CD015847","DOIUrl":"10.1002/14651858.CD015847","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of screening for osteoporosis with bone mineral density (BMD) measurement for the prevention of osteoporotic fractures in adults with risk factors for fractures, compared with no BMD screening.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015847"},"PeriodicalIF":8.8,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218676","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}

{"title":"Exercise for multidirectional instability of the shoulder.","authors":"Masaki Karasuyama, Takaki Imai, Masafumi Gotoh, Junichi Kawakami, Takashi Ariie, Shuhei Yamamoto","doi":"10.1002/14651858.CD015450.pub2","DOIUrl":"10.1002/14651858.CD015450.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Multidirectional shoulder instability is characterised by symptomatic subluxation or dislocation in at least two directions, often affecting young, active individuals. Although exercise therapy is commonly recommended as a first-line treatment, its benefits and harms remain uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of exercise therapy in people with multidirectional instability of the shoulder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database), Clinicaltrials.gov and the World Health Organization Clinical Trials Registry Platform (ICTRP), unrestricted by date or language until May 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We planned to include randomised controlled trials involving participants with traumatic or nontraumatic multidirectional instability and assessing the effects of exercise therapy compared with placebo, no treatment, waiting list, or usual care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcomes were planned to include overall pain, shoulder disability (measured by validated self-reported scores), participant-rated global assessment of treatment success, health-related quality of life, withdrawals due to adverse events, and the occurrence of adverse events. We planned to extract data at the end of the intervention (primary time point) and at the last follow-up after the end of the intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We planned to independently assess the risk of bias for each study using the RoB 2 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We planned to synthesise results for each outcome within each comparison using a meta-analysis where possible. We planned to use GRADE to assess the certainty of the evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We screened 1899 records after removing duplicates. After title and abstract screening, we excluded 1882 records and assessed 17 full-text articles for eligibility. Of these, we excluded 16 articles for the following reasons: ineligible intervention (n = 13), ineligible study design (n = 2), and ineligible population (n = 1). Therefore, we did not identify any completed randomised controlled trials that met our inclusion criteria. An ongoing study that aims to compare an exercise intervention with a waiting-list control in individuals with multidirectional shoulder instability may provide evidence regarding the benefits and harms of exercise therapy in this population in the future. We contacted the investigators of the ongoing study and received a response indicating that the study had recently commenced; however, no results were yet available.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;We did not find any randomised controlled trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Authors' conclusions: &lt;/strong&gt;As there","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD015450"},"PeriodicalIF":8.8,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218592","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}

{"title":"KRAS G12C inhibitors versus chemotherapy in second line and beyond in adults with advanced or metastatic non-small cell lung cancer (NSCLC) harbouring the KRAS G12C mutation.","authors":"Anneloes Noordhof, Oke Dimas Asmara, Kim de Jong, Rolof Gp Gijtenbeek, Ymkje Ma Huitema, Femke Hm van Vollenhoven, Ben Jw Venmans, Lizza Hendriks, Wouter H van Geffen","doi":"10.1002/14651858.CD016054","DOIUrl":"10.1002/14651858.CD016054","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 G12C-inhibitors compared to chemotherapy in second line and beyond in adults with advanced/metastatic non-small cell lung cancer (NSCLC) with a Kirsten rat sarcoma (KRAS) G12C mutation.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016054"},"PeriodicalIF":8.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212283","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}

{"title":"Respiratory support during endotracheal intubation to improve intubation success in neonates.","authors":"Poonam Singh, Mayank Priyadarshi, Suman Chaurasia, Michelle Fiander, Jane Cracknell, Sriparna Basu","doi":"10.1002/14651858.CD016332","DOIUrl":"10.1002/14651858.CD016332","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of respiratory support during ETI in improving the rate of successful intubation in preterm and term neonates undergoing intubation in the NICU, delivery room, or emergency room compared to room air.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016332"},"PeriodicalIF":8.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212294","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}

{"title":"Intravenous chemotherapy versus intra-arterial chemotherapy for retinoblastoma.","authors":"Alexander C Rokohl, Nikola Lohmann, Niklas Reinking, Nicole Skoetz, Ludwig M Heindl","doi":"10.1002/14651858.CD013695.pub2","DOIUrl":"10.1002/14651858.CD013695.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intra-arterial chemotherapy (IAC), intravenous chemotherapy (IVC), and the combination of both (IVC + IAC) are among the most important treatment options for retinoblastoma, a rare form of childhood cancer. The outcomes of previous studies evaluating the success rates of these methods have been discrepant due to the varying quality of the research as well as the different study types, sample sizes, and definitions of outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of IAC, IVC, and the combination of both, in people with retinoblastoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, and Embase in September 2025. No search filters or restrictions regarding language or year of publication were used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) comparing either first-line IAC versus IVC or IVC + IAC versus IAC in children and adults with a confirmed diagnosis of retinoblastoma, irrespective of disease severity, gender, or ethnicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We followed standard Cochrane methodology. We assessed the certainty of the evidence using GRADE. Our main outcomes were tumor control with the avoidance of enucleation or external beam radiation therapy (EBRT), globe salvage (overall), overall survival, secondary neoplasms, tumor recurrence, development of metastasis, and the number of grade 3 and grade 4 adverse events at the end of short-term (&lt; 1 year), medium-term (&lt; 3 years), and long-term (&gt; 3 years) follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included six studies, of which three compared IAC with IVC (one RCT and two NRSIs) in 210 participants and 214 eyes. The other three studies compared IVC + IAC with IAC (three NRSIs) in 599 participants and 681 eyes. All participants in the included studies were children. The main results presented refer to a medium-term follow-up (up to three years). IAC versus IVC Findings of the RCT IAC compared to IVC probably increases globe salvage (overall) (hazard ratio (HR) 2.01, 95% confidence interval (CI) 1.17 to 3.45; IVC: 260 per 1000; IAC: 454 per 1000 (95% CI 297 to 646/1000); 1 RCT, 143 eyes; moderate-certainty evidence). IAC compared to IVC probably results in little to no difference in overall survival (HR 0.97, 95% CI 0.20 to 4.80; IVC: 950 per 1000; IAC: 951 per 1000 (95% CI 769 to 989/1000); 1 RCT, 143 eyes; moderate-certainty evidence). IAC compared to IVC may result in little to no difference in tumor recurrence (RR 0.91, 95% CI 0.45 to 1.86; IVC: 180 per 1000; IAC: 164 per 1000 (95% CI 81 to 335/1000); 1 RCT, 143 eyes; low-certainty evidence). IAC compared to IVC may result in little to no difference in the number of grade 3 and grade 4 adverse events (1 RCT, 143 eyes; low-certainty evidence). Limitations of the evidence are a high risk of bias and serious imprecision. No other pr","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD013695"},"PeriodicalIF":8.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212239","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}

{"title":"Preoperative interventions for reducing anxiety in school-age children undergoing surgery: a network meta-analysis.","authors":"Inês Martins Esteves, Rita Pires, Márcia Pestana-Santos, Filipa Sampaio, Margarida Reis Santos","doi":"10.1002/14651858.CD016330","DOIUrl":"10.1002/14651858.CD016330","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To compare the benefits and harms of pharmacological and non-pharmacological preoperative interventions (alone or in combination) for reducing anxiety in school-age children undergoing elective surgery under general anaesthesia, and to rank the interventions according to their efficacy and safety.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016330"},"PeriodicalIF":8.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212256","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}

{"title":"Risk scoring for the primary prevention of cardiovascular disease.","authors":"Adrian V Hernandez, Carlos Diaz-Arocutipa, German Valenzuela, Valery Feigin, Susan Banda, Joshuan J Barboza, Frank Mayta-Tovalino, Manuel André Virú Loza, Stephen Persell, Eileen Wafford, Donald M Lloyd-Jones, Gillian E Mead","doi":"10.1002/14651858.CD016333","DOIUrl":"10.1002/14651858.CD016333","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of evaluating and providing cardiovascular disease (CVD) risk scores in adults without prevalent CVD on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD016333"},"PeriodicalIF":8.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212281","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}

{"title":"Interventions for fatigue management after traumatic brain injury.","authors":"Hugh E Senior, Joan H Leung, Brigette Meehan, Sylvia Leao, Vanessa Jordan, Suzanne Barker-Collo, Sarah Crummey, Suzanne C Purdy","doi":"10.1002/14651858.CD006448.pub2","DOIUrl":"10.1002/14651858.CD006448.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Despite the high prevalence and medico-social significance of fatigue in post-traumatic brain injury (post-TBI) populations, there are no validated management strategies to control this condition. It is timely to provide clinicians and patients with the best available evidence of the efficacy of current pharmacological and non-pharmacological fatigue management practices.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effectiveness of pharmacological and non-pharmacological interventions for fatigue in people who have experienced a TBI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;For this review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO. We also searched relevant conference proceedings, and we searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) for ongoing trials. The most recent searches were conducted on 12 February 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Eligible study designs were randomised controlled trials (RCTs) and randomised cross-over trials (for pharmacological interventions only). Studies with participants of all ages (children and adults) with a TBI (of any severity) were included, where at least 75% of participants had a TBI. Any type of treatment for fatigue was considered. Four categories of interventions were prioritised: pharmacological, cognitive, stimulation/biofeedback, and psychoeducational. These interventions were compared to placebo groups, no treatment, or groups receiving other interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcome was fatigue. Important outcomes include fatigue-related outcomes of psychological functioning (depression and anxiety), cognitive functioning (processing speed), general quality of life, and daytime sleepiness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed risk of bias using the original Cochrane risk of bias tool for RCTs (RoB 1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised the results for each outcome by meta-analysis where possible using mean differences (MDs) and standardised mean differences (SMDs) and a fixed-effect model. Where meta-analysis was not possible due to the nature of the data, we narratively reported the results. We used GRADE to assess the certainty of evidence for each outcome. We performed all statistical analyses using RevMan and presented results with 95% confidence intervals (CI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included a total of 3518 trial participants (at baseline) across 40 studies, described in 49 publications. The 40 included studies are grouped by type of intervention. There were seven categories of interventions: pharmacological, cognitive, physical activity, stimulation/biofeedback, health visits, psychoeducational, and a final category for trials with multiple interventions (multi-interventions). Four published studies identified in the most recent search are awaiting cla","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"2 ","pages":"CD006448"},"PeriodicalIF":8.8,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146212258","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}