Pub Date : 2023-12-01Epub Date: 2023-12-21DOI: 10.1111/jebm.12578
Jiansheng Li, Rongchang Chen, Xueqing Yu, Huiguo Liu
Chronic obstructive pulmonary disease (COPD), with high prevalence rate, mortality, disability rate, and heavy disease burden, has become a critical chronic disease seriously threatening public health worldwide. Traditional Chinese medicine and Western medicine both have shown advantages in diagnosing and treating COPD, which has been widely applied in the clinics. In order to improve the diagnostic and treatment level for COPD with integrated traditional Chinese and Western medicine, the Guidelines of Integrated Chinese and Western Medicine for Diagnosis and Treatment of COPD were developed by the Internal Medicine Committee of the World Federation of Chinese Medicine Societies. First, a multidisciplinary working group was established. Development methods and processes of international clinical practice guidelines were adopted in the whole research. In final, a total of 13 recommendations for the diagnosis and treatment of COPD were established based on available evidence with the best quality. Meanwhile, characteristics of integrated traditional Chinese and Western medicine in treating COPD were taken into account with pros and cons of each intervention. The guidelines could be used as a reference for physicians in respiratory medicine departments (traditional Chinese medicine, integrated traditional Chinese and Western medicine, and Western medicine) at various levels of medical institutions in their diagnosis and treatment.
{"title":"Guidelines of integrated Chinese and western medicine for diagnosis and treatment of chronic obstructive pulmonary disease (2022).","authors":"Jiansheng Li, Rongchang Chen, Xueqing Yu, Huiguo Liu","doi":"10.1111/jebm.12578","DOIUrl":"10.1111/jebm.12578","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD), with high prevalence rate, mortality, disability rate, and heavy disease burden, has become a critical chronic disease seriously threatening public health worldwide. Traditional Chinese medicine and Western medicine both have shown advantages in diagnosing and treating COPD, which has been widely applied in the clinics. In order to improve the diagnostic and treatment level for COPD with integrated traditional Chinese and Western medicine, the Guidelines of Integrated Chinese and Western Medicine for Diagnosis and Treatment of COPD were developed by the Internal Medicine Committee of the World Federation of Chinese Medicine Societies. First, a multidisciplinary working group was established. Development methods and processes of international clinical practice guidelines were adopted in the whole research. In final, a total of 13 recommendations for the diagnosis and treatment of COPD were established based on available evidence with the best quality. Meanwhile, characteristics of integrated traditional Chinese and Western medicine in treating COPD were taken into account with pros and cons of each intervention. The guidelines could be used as a reference for physicians in respiratory medicine departments (traditional Chinese medicine, integrated traditional Chinese and Western medicine, and Western medicine) at various levels of medical institutions in their diagnosis and treatment.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-12-21DOI: 10.1111/jebm.12575
Nannette Baltes, Andrea Icks, Charalabos-Markos Dintsios
{"title":"Treatment response in hemato-oncology in the context of the German early benefit assessment of drugs compared to clinical practice.","authors":"Nannette Baltes, Andrea Icks, Charalabos-Markos Dintsios","doi":"10.1111/jebm.12575","DOIUrl":"10.1111/jebm.12575","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138830133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of statins and risk of uterine leiomyoma: A cohort study in the UK Biobank.","authors":"Xue-Feng Jiao, Hailong Li, Linan Zeng, Lu Han, Huazhen Yang, Yao Hu, Yuanyuan Qu, Wenwen Chen, Yajing Sun, Wei Zhang, Donghao Lu, Lingli Zhang","doi":"10.1111/jebm.12559","DOIUrl":"10.1111/jebm.12559","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-11-30DOI: 10.1111/jebm.12563
Fidan Turk, Jennifer Sweetman, Gail Allsopp, Michael Crooks, Dan J Cuthbertson, Mark Gabbay, Lyth Hishmeh, Gregory Y H Lip, W David Strain, Nefyn Williams, Dan Wootton, Amitava Banerjee, Christina van der Feltz-Cornelis
{"title":"Pathways to care for Long COVID and for long-term conditions from patients' and clinicians' perspective.","authors":"Fidan Turk, Jennifer Sweetman, Gail Allsopp, Michael Crooks, Dan J Cuthbertson, Mark Gabbay, Lyth Hishmeh, Gregory Y H Lip, W David Strain, Nefyn Williams, Dan Wootton, Amitava Banerjee, Christina van der Feltz-Cornelis","doi":"10.1111/jebm.12563","DOIUrl":"10.1111/jebm.12563","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138460346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-12-26DOI: 10.1111/jebm.12574
Jiaying Yang, Guochun Li
Aim: Utilizing external information in clinical trials enhances validity by including a wider population and expedites the implementation of adaptive designs, ultimately improving research efficiency. However, current research focused on scenarios in which only the control group benefited from the utilization of external information, while trials involving external information in both experimental and control arms were more complex and might pose challenges when applied in real-world settings.
Methods: To address these concerns, our study pioneered the application of test-then-pool, normalized power prior, calibrated power prior, and elastic prior to a two-arm information borrowing framework and systematically compared their operating characteristics through a series of simulation studies under most and least desirable scenarios.
Results: In the most desirable scenarios of information borrowing, all methods managed to control the mean of type I error rates within 5%, among which the normalized power prior, calibrated power prior and elastic prior approaches increased the mean of power from 85.94% to 95%. In the least desirable scenarios, the mean type I error rates for normalized power prior, calibrated power prior and elastic prior approaches exceeded 20%, while the mean power decreased to around 80%.
Conclusions: Our findings reveal that the normalized power prior, calibrated power prior and elastic prior approaches are suitable for situations with minimal heterogeneity between historical and current data, whereas the test-then-pool approach emerges as a more prudent choice when facing substantial discrepancies between historical and current information for trials consider information borrow in both arms.
目的：在临床试验中利用外部信息可纳入更广泛的人群，从而提高有效性，并加快适应性设计的实施，最终提高研究效率。然而，目前的研究主要集中在只有对照组从利用外部信息中获益的情况，而涉及实验组和对照组外部信息的试验则更为复杂，在实际环境中应用时可能会面临挑战：为了解决这些问题，我们的研究率先在双臂信息借用框架中应用了检验池、归一化功率先验、校准功率先验和弹性先验，并通过一系列模拟研究系统地比较了它们在最理想和最不理想情况下的运行特征：在最理想的信息借用情景下，所有方法都能将 I 类错误率的平均值控制在 5%以内，其中归一化功率先验法、校准功率先验法和弹性先验法将功率的平均值从 85.94% 提高到了 95%。在最不理想的情况下，归一化功率先验法、校准功率先验法和弹性先验法的平均 I 类错误率超过了 20%，而平均功率则下降到了 80% 左右：我们的研究结果表明，归一化功率先验法、校准功率先验法和弹性先验法适用于历史数据和当前数据之间异质性极小的情况，而对于两臂均考虑信息借用的试验，当面临历史信息和当前信息之间的巨大差异时，池试验法是一种更为审慎的选择。
{"title":"Enhancing generalizability and efficiency in clinical trials through dynamic information borrowing for both experimental and control arms: A simulation study.","authors":"Jiaying Yang, Guochun Li","doi":"10.1111/jebm.12574","DOIUrl":"10.1111/jebm.12574","url":null,"abstract":"<p><strong>Aim: </strong>Utilizing external information in clinical trials enhances validity by including a wider population and expedites the implementation of adaptive designs, ultimately improving research efficiency. However, current research focused on scenarios in which only the control group benefited from the utilization of external information, while trials involving external information in both experimental and control arms were more complex and might pose challenges when applied in real-world settings.</p><p><strong>Methods: </strong>To address these concerns, our study pioneered the application of test-then-pool, normalized power prior, calibrated power prior, and elastic prior to a two-arm information borrowing framework and systematically compared their operating characteristics through a series of simulation studies under most and least desirable scenarios.</p><p><strong>Results: </strong>In the most desirable scenarios of information borrowing, all methods managed to control the mean of type I error rates within 5%, among which the normalized power prior, calibrated power prior and elastic prior approaches increased the mean of power from 85.94% to 95%. In the least desirable scenarios, the mean type I error rates for normalized power prior, calibrated power prior and elastic prior approaches exceeded 20%, while the mean power decreased to around 80%.</p><p><strong>Conclusions: </strong>Our findings reveal that the normalized power prior, calibrated power prior and elastic prior approaches are suitable for situations with minimal heterogeneity between historical and current data, whereas the test-then-pool approach emerges as a more prudent choice when facing substantial discrepancies between historical and current information for trials consider information borrow in both arms.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siyi Zhu, Zhuo Wang, Qiu Liang, Yuting Zhang, Sheyu Li, Lin Yang, Chengqi He, Chinese Society of Physical Medicine and Rehabilitation, West China Hospital
Background
Knee osteoarthritis (KOA) is the most common degenerative joint disease in China, causing a huge economic burden on patients, families, and society. Standardized KOA rehabilitation treatment is an important means to prevent and treat the disease and promote the development of high-quality medical services. This guideline is updated on the basis of the 2016 and 2019 editions.
Methods
Clinical questions regarding rehabilitation assessment and treatment were selected through clinical questions screening and deconstruction, and multiple rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to grade the quality of evidence and recommendations.
Results
The reporting of this guideline followed the standard of Reporting Items for Practice Guidelines in Healthcare (RIGHT). Taking into account patients' preferences and values and the needs of Chinese clinical practice, a total of 11 clinical questions and 28 recommendations were established. The clinical questions were grouped into two categories: KOA assessment (body function, body structure, activity and participation, quality of life, and environmental factors and clinical outcomes assessment, resulting in 9 recommendations) and KOA treatment (health education, therapeutic exercise, therapeutic modalities, occupational therapy, assistive devices, and regenerative rehabilitation approaches, resulting in 19 recommendations).
Conclusion
This is the first evidence-based guideline for KOA rehabilitation in China utilizing the ICF framework. This guideline provides key guidance for developing systematic, standardized, and precise rehabilitation protocols for KOA across various healthcare settings.
{"title":"Chinese guidelines for the rehabilitation treatment of knee osteoarthritis: An CSPMR evidence-based practice guideline","authors":"Siyi Zhu, Zhuo Wang, Qiu Liang, Yuting Zhang, Sheyu Li, Lin Yang, Chengqi He, Chinese Society of Physical Medicine and Rehabilitation, West China Hospital","doi":"10.1111/jebm.12555","DOIUrl":"10.1111/jebm.12555","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Knee osteoarthritis (KOA) is the most common degenerative joint disease in China, causing a huge economic burden on patients, families, and society. Standardized KOA rehabilitation treatment is an important means to prevent and treat the disease and promote the development of high-quality medical services. This guideline is updated on the basis of the 2016 and 2019 editions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical questions regarding rehabilitation assessment and treatment were selected through clinical questions screening and deconstruction, and multiple rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to grade the quality of evidence and recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The reporting of this guideline followed the standard of Reporting Items for Practice Guidelines in Healthcare (RIGHT). Taking into account patients' preferences and values and the needs of Chinese clinical practice, a total of 11 clinical questions and 28 recommendations were established. The clinical questions were grouped into two categories: KOA assessment (body function, body structure, activity and participation, quality of life, and environmental factors and clinical outcomes assessment, resulting in 9 recommendations) and KOA treatment (health education, therapeutic exercise, therapeutic modalities, occupational therapy, assistive devices, and regenerative rehabilitation approaches, resulting in 19 recommendations).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first evidence-based guideline for KOA rehabilitation in China utilizing the ICF framework. This guideline provides key guidance for developing systematic, standardized, and precise rehabilitation protocols for KOA across various healthcare settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41125101","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}
Faith Chesire, Michael Mugisha, Ronald Ssenyonga, Christopher J. Rose, Allen Nsangi, Margaret Kaseje, Nelson K. Sewankambo, Matt Oxman, Sarah E. Rosenbaum, Jenny Moberg, Astrid Dahlgren, Simon Lewin, Andrew D. Oxman
Aim
The aim of this prospective meta-analysis was to synthesize the results of three cluster-randomized trials of an intervention designed to teach lower-secondary school students (age 14–16) to think critically about health choices.
Methods
We conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2- to 3-day teacher training workshop, digital resources, and ten 40-min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple-choice questions answered correctly). We performed random effects meta-analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers.
Results
Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0–10.2; p < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25–40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score. The overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6–40.4; p < 0.0001), corresponding to 32% (95% CI: 6%–57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score.
Conclusions
The intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score.
{"title":"Effects of the Informed Health Choices secondary school intervention: A prospective meta-analysis","authors":"Faith Chesire, Michael Mugisha, Ronald Ssenyonga, Christopher J. Rose, Allen Nsangi, Margaret Kaseje, Nelson K. Sewankambo, Matt Oxman, Sarah E. Rosenbaum, Jenny Moberg, Astrid Dahlgren, Simon Lewin, Andrew D. Oxman","doi":"10.1111/jebm.12552","DOIUrl":"10.1111/jebm.12552","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this prospective meta-analysis was to synthesize the results of three cluster-randomized trials of an intervention designed to teach lower-secondary school students (age 14–16) to think critically about health choices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted the trials in Kenya, Rwanda, and Uganda. The intervention included a 2- to 3-day teacher training workshop, digital resources, and ten 40-min lessons. The lessons focused on nine key concepts. We did not intervene in control schools. The primary outcome was a passing score on a test (≥9 of 18 multiple-choice questions answered correctly). We performed random effects meta-analyses to estimate the overall adjusted odds ratios. Secondary outcomes included effects of the intervention on teachers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether, 244 schools (11,344 students) took part in the three trials. The overall adjusted odds ratio was 5.5 (95% CI: 3.0–10.2; <i>p</i> < 0.0001) in favor of the intervention (high certainty evidence). This corresponds to 33% (95% CI: 25–40%) more students in the intervention schools passing the test. Overall, 3397 (58%) of 5846 students in intervention schools had a passing score. The overall adjusted odds ratio for teachers was 13.7(95% CI: 4.6–40.4; <i>p</i> < 0.0001), corresponding to 32% (95% CI: 6%–57%) more teachers in the intervention schools passing the test (moderate certainty evidence). Overall, 118 (97%) of 122 teachers in intervention schools had a passing score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The intervention led to a large improvement in the ability of students and teachers to think critically about health choices, but 42% of students in the intervention schools did not achieve a passing score.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134057","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}
Chenyu Sun, Yue Chen, Shaodi Ma, Mengqing Liu, Vicky Yau, Na Hyun Kim, Sujatha Kailas, Scott Lowe, Rachel Bentley, Shuya Chen, Jie Liu, Muzi Meng, Yuting Huang, Qin Zhou, Yuyan Wu
Background
Participation in colonoscopies is an essential aspect of endoscopic training. The purpose of this study was to explore the impact of fellow/trainee participation on colonoscopy outcomes.
Methods
This meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). From database inception to July 2022, studies investigating fellow involvement and colonoscopy outcomes were searched across Cochrane library, PubMed, and other databases. The random-effects model was applied to generate more conservative estimates. Sensitive analysis was conducted to explore whether the result would depend on a particular study. Egger's test and Begg's test were used to estimate the potential for publication bias.
Results
Seventeen studies including 30,062 participants were included. We found that fellow/trainee involvement enhanced the overall rates of adenoma detection and polyp detection (OR = 1.26, 95% CI = 1.14–1.40, p < 0.001; OR = 1.29, 95% CI = 1.02–1.63, p = 0.020, respectively). The mean number of adenoma/polyps per colonoscopy was also higher with fellow/trainee participation (MD = 0.12, 95% CI = 0.08–0.17, p < 0.001; MD = 0.15, 95% CI = 0.02–0.28, p = 0.020, respectively).
Conclusion
In addition to its educational purpose, fellow or trainee involvement is associated with beneficial effects on colonoscopy outcomes.
{"title":"You are not lab rats at teaching hospitals: A systematic review of resident and fellow participation leads to improved colonoscopy","authors":"Chenyu Sun, Yue Chen, Shaodi Ma, Mengqing Liu, Vicky Yau, Na Hyun Kim, Sujatha Kailas, Scott Lowe, Rachel Bentley, Shuya Chen, Jie Liu, Muzi Meng, Yuting Huang, Qin Zhou, Yuyan Wu","doi":"10.1111/jebm.12554","DOIUrl":"10.1111/jebm.12554","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Participation in colonoscopies is an essential aspect of endoscopic training. The purpose of this study was to explore the impact of fellow/trainee participation on colonoscopy outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO). From database inception to July 2022, studies investigating fellow involvement and colonoscopy outcomes were searched across Cochrane library, PubMed, and other databases. The random-effects model was applied to generate more conservative estimates. Sensitive analysis was conducted to explore whether the result would depend on a particular study. Egger's test and Begg's test were used to estimate the potential for publication bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen studies including 30,062 participants were included. We found that fellow/trainee involvement enhanced the overall rates of adenoma detection and polyp detection (OR = 1.26, 95% CI = 1.14–1.40, <i>p</i> < 0.001; OR = 1.29, 95% CI = 1.02–1.63, <i>p</i> = 0.020, respectively). The mean number of adenoma/polyps per colonoscopy was also higher with fellow/trainee participation (MD = 0.12, 95% CI = 0.08–0.17, <i>p</i> < 0.001; MD = 0.15, 95% CI = 0.02–0.28, <i>p</i> = 0.020, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In addition to its educational purpose, fellow or trainee involvement is associated with beneficial effects on colonoscopy outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":7.3,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号