Fibromyalgia is a prevalent chronic condition marked by widespread pain, fatigue, and other debilitating symptoms. This guideline provides evidence-based recommendations for nonpharmacological treatments, developed by a multidisciplinary expert group, including specialists in rheumatology, rehabilitation, pain management, traditional Chinese medicine (TCM), and evidence-based medicine. The guideline follows the RIGHT checklist and is registered with the International Practice Guideline Registry Platform. The literature review incorporates systematic reviews, meta-analyses, and randomized controlled trials (RCTs) up to March 2023, focusing on the effects of nonpharmacological interventions on pain intensity, fatigue, sleep quality, mood, and quality of life. A total of 57 studies were included, with findings supporting acupuncture and health education as core therapies. These interventions significantly reduce pain, alleviate fatigue, and improve sleep quality, and are strongly recommended based on moderate-quality evidence. Additionally, aerobic exercise and resistance training are recommended for their proven effectiveness in reducing pain, enhancing physical function, and providing long-term benefits. Emerging therapies, such as transcranial magnetic stimulation (TMS) and nutritional supplements, show promise but require further research due to low-certainty evidence.
{"title":"Guidelines on Treating Fibromyalgia With Nonpharmacological Therapies in China","authors":"Xuanlin Li, Hejing Pan, Liaoyao Wang, Qi Zhou, Yanfang Ma, Qi Wang, Mingzhu Wang, Zhijun Xie, Haichang Li, Lu Chen, Lin Huang, Yaolong Chen, Chengping Wen","doi":"10.1111/jebm.70044","DOIUrl":"https://doi.org/10.1111/jebm.70044","url":null,"abstract":"<p>Fibromyalgia is a prevalent chronic condition marked by widespread pain, fatigue, and other debilitating symptoms. This guideline provides evidence-based recommendations for nonpharmacological treatments, developed by a multidisciplinary expert group, including specialists in rheumatology, rehabilitation, pain management, traditional Chinese medicine (TCM), and evidence-based medicine. The guideline follows the RIGHT checklist and is registered with the International Practice Guideline Registry Platform. The literature review incorporates systematic reviews, meta-analyses, and randomized controlled trials (RCTs) up to March 2023, focusing on the effects of nonpharmacological interventions on pain intensity, fatigue, sleep quality, mood, and quality of life. A total of 57 studies were included, with findings supporting acupuncture and health education as core therapies. These interventions significantly reduce pain, alleviate fatigue, and improve sleep quality, and are strongly recommended based on moderate-quality evidence. Additionally, aerobic exercise and resistance training are recommended for their proven effectiveness in reducing pain, enhancing physical function, and providing long-term benefits. Emerging therapies, such as transcranial magnetic stimulation (TMS) and nutritional supplements, show promise but require further research due to low-certainty evidence.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144264525","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}
The demand for high-quality clinical evidence supporting acupuncture remains urgent, necessitating the establishment of a suitable methodological framework to promote its generation.
Methods
Following internal deliberations and extensive online discussions with experts in the IDEAL Collaboration, we proposed the IDEAL-Acu framework specifically for acupuncture, based on the surgery-focused IDEAL model with necessary modifications to accommodate the characteristics of acupuncture. To ensure consensus on recommendations, a panel of external experts and internal research team members was convened, and any disagreements were iteratively resolved through expert review.
Results
This article introduces an IDEAL-Acu framework with five stages for evaluating acupuncture outcome and improving practice to optimize treatment. The framework includes Idea (proposal of an acupuncture regime), Development (optimization or standardization of the acupuncture regime), Exploration (feasibility assessment for conducting a definitive RCT), Assessment (evaluation of effects through comparison with standard therapy or sham acupuncture), and Long-term monitoring (examination of long-term efficacy and safety) stages. We provide clear recommendations for each stage along with specific examples.
Conclusion
The framework highlights the importance of conducting studies at each stage in acupuncture evaluation process and can serve as a helpful guide for assessing its effects and promoting evidence-based practice in acupuncture.
{"title":"IDEAL-Acu: A Methodological Framework for Evaluating the Effects of Acupuncture","authors":"Jiali Liu, Xiaochao Luo, Yemeng Chen, Ling Zhao, Minghong Yao, Jiajie Yu, Jiahui Yang, Ling Li, Xin Sun","doi":"10.1111/jebm.70043","DOIUrl":"https://doi.org/10.1111/jebm.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The demand for high-quality clinical evidence supporting acupuncture remains urgent, necessitating the establishment of a suitable methodological framework to promote its generation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following internal deliberations and extensive online discussions with experts in the IDEAL Collaboration, we proposed the IDEAL-Acu framework specifically for acupuncture, based on the surgery-focused IDEAL model with necessary modifications to accommodate the characteristics of acupuncture. To ensure consensus on recommendations, a panel of external experts and internal research team members was convened, and any disagreements were iteratively resolved through expert review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This article introduces an IDEAL-Acu framework with five stages for evaluating acupuncture outcome and improving practice to optimize treatment. The framework includes Idea (proposal of an acupuncture regime), Development (optimization or standardization of the acupuncture regime), Exploration (feasibility assessment for conducting a definitive RCT), Assessment (evaluation of effects through comparison with standard therapy or sham acupuncture), and Long-term monitoring (examination of long-term efficacy and safety) stages. We provide clear recommendations for each stage along with specific examples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The framework highlights the importance of conducting studies at each stage in acupuncture evaluation process and can serve as a helpful guide for assessing its effects and promoting evidence-based practice in acupuncture.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244864","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}
Ying Tao, Yi Yang, Bingxing Luo, Dai Lian, Junling Weng, Fuming Li, Juntao Yan, Yingyao Chen
Aim
This study seeks to assess the reporting quality of published health economic evaluations (HEEs) on vaccination and pharmaceuticals for Coronavirus Disease 2019 (COVID-19), and identify potential predictors associated with reporting quality.
Methods
A systematic literature search was performed in PubMed, Web of Science, Embase, the Cochrane Library, INAHTA, and Chinese databases (e.g., SinoMed, CNKI, and WANGFANG Database). HEEs published between January 1, 2020, and August 20, 2022, that considered both costs and outcomes of vaccination and pharmaceuticals for COVID-19 were included. The Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement scored the reporting quality for incorporated studies. A linear regression analysis was employed to characterize the impact of various features on reporting quality.
Results
Fifty-two studies were included in the analysis. The average CHEERS score was 18.54±3.41, with the scoring rate of reporting quality was 67% (±12%). The most inadequately reported items included health economic analysis plan, time horizon, valuation of outcomes, heterogeneity, uncertainty, distributional effects, and stakeholder involvement. Higher reporting compliance was associated with articles applying a longer time horizon (no less than 1 year) and those using a societal perspective (p < 0.05). The investigations that did not specify a study perspective received the lowest scores among the subgroups.
Conclusion
Overall, the included HEEs on vaccination and pharmaceuticals for COVID-19 had moderate reporting quality. Future HEEs should be transparently and sufficiently reported in accordance with standard guidelines (e.g., the CHEERS 2022 statement), to increase the interpretability of results, improve the reporting quality, and better inform the decision-making.
本研究旨在评估已发表的关于2019冠状病毒病（COVID-19）疫苗接种和药物的卫生经济评价（HEEs）的报告质量，并确定与报告质量相关的潜在预测因素。方法系统检索PubMed、Web of Science、Embase、Cochrane Library、INAHTA和中文数据库（如：中国医学信息网、中国知网、王方数据库）。纳入了2020年1月1日至2022年8月20日期间发表的HEEs，其中考虑了COVID-19疫苗接种和药物的成本和结果。综合健康经济评估报告标准2022 （CHEERS 2022）对合并研究的报告质量进行了评分。采用线性回归分析来表征各种特征对报告质量的影响。结果共纳入52项研究。平均CHEERS评分为18.54±3.41，报告质量评分率为67%（±12%）。报告最不充分的项目包括卫生经济分析计划、时间范围、结果评估、异质性、不确定性、分配效应和利益相关者参与。较高的报告依从性与应用较长时间范围（不少于1年）和使用社会视角的文章(p <；0.05)。没有指定研究视角的调查在亚组中得分最低。结论总体而言，纳入的关于COVID-19疫苗接种和药物的HEEs报告质量中等。未来的HEEs应按照标准指南（例如，干杯2022声明）透明和充分地报告，以增加结果的可解释性，提高报告质量，并更好地为决策提供信息。
{"title":"Did Economic Evaluations on Pharmaceuticals and Vaccination for COVID-19 Maintain Adequate Reporting Quality? A Systematic Review and Quantitative Analysis","authors":"Ying Tao, Yi Yang, Bingxing Luo, Dai Lian, Junling Weng, Fuming Li, Juntao Yan, Yingyao Chen","doi":"10.1111/jebm.70040","DOIUrl":"https://doi.org/10.1111/jebm.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study seeks to assess the reporting quality of published health economic evaluations (HEEs) on vaccination and pharmaceuticals for Coronavirus Disease 2019 (COVID-19), and identify potential predictors associated with reporting quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was performed in PubMed, Web of Science, Embase, the Cochrane Library, INAHTA, and Chinese databases (e.g., SinoMed, CNKI, and WANGFANG Database). HEEs published between January 1, 2020, and August 20, 2022, that considered both costs and outcomes of vaccination and pharmaceuticals for COVID-19 were included. The Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) statement scored the reporting quality for incorporated studies. A linear regression analysis was employed to characterize the impact of various features on reporting quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-two studies were included in the analysis. The average CHEERS score was 18.54±3.41, with the scoring rate of reporting quality was 67% (±12%). The most inadequately reported items included health economic analysis plan, time horizon, valuation of outcomes, heterogeneity, uncertainty, distributional effects, and stakeholder involvement. Higher reporting compliance was associated with articles applying a longer time horizon (no less than 1 year) and those using a societal perspective (<i>p</i> < 0.05). The investigations that did not specify a study perspective received the lowest scores among the subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, the included HEEs on vaccination and pharmaceuticals for COVID-19 had moderate reporting quality. Future HEEs should be transparently and sufficiently reported in accordance with standard guidelines (e.g., the CHEERS 2022 statement), to increase the interpretability of results, improve the reporting quality, and better inform the decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244865","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}
Liang Hong, Jiawen Wang, Tianling Feng, Hongwei Fan, Xiao Shen, Wenxiu Chen, Hong Tao, Weifeng Yao, Jianjun Zou, Min Yang
Objective
The effects of malnutrition on postoperative delirium (POD) after cardiac surgery remains understudied. We hypothesized that preoperative prognostic nutrition index (PNI) has a significant clinical role in predicting POD among mechanically ventilated patients undergoing cardiac surgery.
Methods
We conducted a multicenter retrospective study of adult patients who underwent cardiac surgery and subsequently received mechanical ventilation (MV) in the Intensive Care Unit at Nanjing First Hospital (NFH-ICU) and from Medical Information Mart for Intensive Care IV (MIMIC-IV). The relationship between PNI and POD was examined by Cox proportional hazards models, propensity score matching, mediation analysis, subgroup analysis, and sensitivity analysis.
Results
2725 participants of NFH-ICU and 3368 participants of MIMIC-IV were included in this study. Reduced PNI levels were identified as an independent risk factor for POD, and its addition enhanced the accuracy of predicting POD. After adjusting for all confounders, Cox analysis revealed that PNI≤45.5 was significantly associated with the risk of progressing to POD (NFH-ICU: HR = 1.46, 95% CI 1.01–2.11, p = 0.044; MIMIC-IV: HR = 1.53, 95% CI 1.14–2.07, p = 0.005). We also analyzed the mediating role of duration of MV on malnutrition and POD. The proportions mediated were 31.64% and 9.71% in NFH-ICU and MIMIC-IV, respectively.
Conclusion
The decreased PNI can increase the risk of POD after cardiac surgery. Meanwhile, the increased risk of POD associated with low PNI was partially mediated by prolonged duration of MV after surgery. The study highlights the preoperative nutritional management as an important intervention to prevent postoperative delirium in patients undergoing cardiac surgery.
目的营养不良对心脏术后谵妄（POD）的影响尚不清楚。我们假设术前预后营养指数（PNI）在预测机械通气心脏手术患者POD方面具有重要的临床作用。方法对南京第一医院重症监护病房（NFH-ICU）和重症监护医学信息市场（MIMIC-IV）接受心脏手术并随后接受机械通气（MV）的成年患者进行多中心回顾性研究。采用Cox比例风险模型、倾向评分匹配、中介分析、亚组分析和敏感性分析检验PNI与POD的关系。结果共纳入2725例NFH-ICU患者和3368例MIMIC-IV患者。PNI水平降低被确定为POD的独立危险因素，其增加可提高POD预测的准确性。校正所有混杂因素后，Cox分析显示PNI≤45.5与进展为POD的风险显著相关(NFH-ICU: HR = 1.46, 95% CI 1.01-2.11, p = 0.044；MIMIC-IV: HR = 1.53, 95% CI 1.14-2.07, p = 0.005)。我们还分析了MV持续时间对营养不良和POD的中介作用。NFH-ICU和MIMIC-IV中介导的比例分别为31.64%和9.71%。结论PNI降低可增加心脏手术后发生POD的风险。同时，术后MV持续时间延长部分介导了低PNI相关POD风险的增加。本研究强调术前营养管理是预防心脏手术患者术后谵妄的重要干预措施。
{"title":"Delirium in Mechanically Ventilated Patients After Cardiac Surgery: The Importance of Preoperative Nutritional Management Revealed by a Multicenter Retrospective Cohort Study","authors":"Liang Hong, Jiawen Wang, Tianling Feng, Hongwei Fan, Xiao Shen, Wenxiu Chen, Hong Tao, Weifeng Yao, Jianjun Zou, Min Yang","doi":"10.1111/jebm.70042","DOIUrl":"https://doi.org/10.1111/jebm.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The effects of malnutrition on postoperative delirium (POD) after cardiac surgery remains understudied. We hypothesized that preoperative prognostic nutrition index (PNI) has a significant clinical role in predicting POD among mechanically ventilated patients undergoing cardiac surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter retrospective study of adult patients who underwent cardiac surgery and subsequently received mechanical ventilation (MV) in the Intensive Care Unit at Nanjing First Hospital (NFH-ICU) and from Medical Information Mart for Intensive Care IV (MIMIC-IV). The relationship between PNI and POD was examined by Cox proportional hazards models, propensity score matching, mediation analysis, subgroup analysis, and sensitivity analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>2725 participants of NFH-ICU and 3368 participants of MIMIC-IV were included in this study. Reduced PNI levels were identified as an independent risk factor for POD, and its addition enhanced the accuracy of predicting POD. After adjusting for all confounders, Cox analysis revealed that PNI≤45.5 was significantly associated with the risk of progressing to POD (NFH-ICU: HR = 1.46, 95% CI 1.01–2.11, <i>p</i> = 0.044; MIMIC-IV: HR = 1.53, 95% CI 1.14–2.07, <i>p</i> = 0.005). We also analyzed the mediating role of duration of MV on malnutrition and POD. The proportions mediated were 31.64% and 9.71% in NFH-ICU and MIMIC-IV, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The decreased PNI can increase the risk of POD after cardiac surgery. Meanwhile, the increased risk of POD associated with low PNI was partially mediated by prolonged duration of MV after surgery. The study highlights the preoperative nutritional management as an important intervention to prevent postoperative delirium in patients undergoing cardiac surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232388","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}
Junqiang Niu, Xuan Tuo, Xu Hui, Man Li, Suyi Liu, Zhichun Zhang, Jianming Tang, Yongbin Lu, Kehu Yang
Objective
To evaluate the efficacy and safety of paclitaxel-based regimens, including traditional Chinese medicine (TCM) combinations, for the treatment of triple-negative BC (TNBC) using a network meta-analysis.
Methods
PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, CBM, VIP, WanFang database were searched comprehensively from inception to February 27, 2025. Eligible studies included adult TNBC patients treated with paclitaxel alone or in combination with other therapies. Outcomes included objective response rate (ORR), overall survival (OS), progression-free survival, pathologic complete response, disease-free survival, and adverse events (AEs). Statistical analyses were performed using the frequentist contrast-based method and random effects model. The Grading of Recommendations, Assessment, Development, and Evaluation approach using CINeMA application and a modified Cochrane Risk of Bias Tool were used to assess the certainty of evidence and methodological quality.
Results
93 randomized controlled trials (108 publications) involving 19,016 patients were included. Paclitaxel-based quadruple and quintuple therapies significantly improved ORR (relative risk (RR) = 1.74, 95% confidence interval (CI) [1.39–2.71], low certainty of evidence) and OS duration (weighted mean difference (WMD) = 59.16 weeks, 95% CI [28.81–89.51], low) compared to monotherapy. Paclitaxel-based monotherapy and double therapy had the least potential to cause neutropenia. Regimens incorporating TCM showed superior ORR compared to non-TCM combinations and monotherapy (18 randomized controlled trials, 1570 patients; RR = 1.29. 95% CI [1.17–1.41], moderate; RR = 1.55, 95% CI [1.37–1.75], moderate).
Conclusions
Combination therapies, especially those incorporating targeted agents or platinum-based regimens, may exhibit superior efficacy while maintaining acceptable safety profiles. Additionally, TCM may be associated with a higher ORR and a reduced risk of AEs. Further large-scale, high-quality studies are warranted to investigate the efficacy and safety of combining paclitaxel with targeted agents, platinum-based therapies, or TCM in the treatment of TNBC.
{"title":"Comparative Effectiveness of Paclitaxel-Containing Regimens for Treatment of Triple-Negative Breast Cancer: A Network Meta-Analysis","authors":"Junqiang Niu, Xuan Tuo, Xu Hui, Man Li, Suyi Liu, Zhichun Zhang, Jianming Tang, Yongbin Lu, Kehu Yang","doi":"10.1111/jebm.70037","DOIUrl":"https://doi.org/10.1111/jebm.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of paclitaxel-based regimens, including traditional Chinese medicine (TCM) combinations, for the treatment of triple-negative BC (TNBC) using a network meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, CBM, VIP, WanFang database were searched comprehensively from inception to February 27, 2025. Eligible studies included adult TNBC patients treated with paclitaxel alone or in combination with other therapies. Outcomes included objective response rate (ORR), overall survival (OS), progression-free survival, pathologic complete response, disease-free survival, and adverse events (AEs). Statistical analyses were performed using the frequentist contrast-based method and random effects model. The Grading of Recommendations, Assessment, Development, and Evaluation approach using CINeMA application and a modified Cochrane Risk of Bias Tool were used to assess the certainty of evidence and methodological quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>93 randomized controlled trials (108 publications) involving 19,016 patients were included. Paclitaxel-based quadruple and quintuple therapies significantly improved ORR (relative risk (RR) = 1.74, 95% confidence interval (CI) [1.39–2.71], low certainty of evidence) and OS duration (weighted mean difference (WMD) = 59.16 weeks, 95% CI [28.81–89.51], low) compared to monotherapy. Paclitaxel-based monotherapy and double therapy had the least potential to cause neutropenia. Regimens incorporating TCM showed superior ORR compared to non-TCM combinations and monotherapy (18 randomized controlled trials, 1570 patients; RR = 1.29. 95% CI [1.17–1.41], moderate; RR = 1.55, 95% CI [1.37–1.75], moderate).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Combination therapies, especially those incorporating targeted agents or platinum-based regimens, may exhibit superior efficacy while maintaining acceptable safety profiles. Additionally, TCM may be associated with a higher ORR and a reduced risk of AEs. Further large-scale, high-quality studies are warranted to investigate the efficacy and safety of combining paclitaxel with targeted agents, platinum-based therapies, or TCM in the treatment of TNBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206599","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}
Linan Zeng, Dan Liu, Lingli Zhang, Wei Xiao, Zhe Chen, Hailong Li, Sha Diao, Kun Zou, Qiusha Yi
{"title":"Current Situation on Application of Evidence-Based Pharmacy in National Drug Policy","authors":"Linan Zeng, Dan Liu, Lingli Zhang, Wei Xiao, Zhe Chen, Hailong Li, Sha Diao, Kun Zou, Qiusha Yi","doi":"10.1111/jebm.70033","DOIUrl":"https://doi.org/10.1111/jebm.70033","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206717","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}
Xufei Luo, Bingyi Wang, Yule Li, Shuang Liu, Haodong Li, Yaxuan Ren, Wah Yang, Kyle Lam, Stephen R Ali, Gemma Sharp, Fabio Ynoe Moraes, Ye Wang, Di Zhu, Zhenhua Yang, Daher Mohammad, Robert Fruscio, Maged N. Kamel Boulos, Zhicheng Lin, Kazuki Ide, Xuping Song, Lu Zhang, Yih Chung Tham, Hui Liu, Long Ge, Yaolong Chen, Zhaoxiang Bian, the GAMER working group and ADVANCED working group
Objective
To assess the knowledge, attitudes, and practices (KAP) of medical stakeholders regarding the use of generative artificial intelligence (GAI) tools.
Methods
A cross-sectional survey was conducted among stakeholders in medicine. Participants included researchers, clinicians, and medical journal editors with varying degrees of familiarity with GAI tools. The survey questionnaire comprised 40 questions covering four main dimensions: basic information, knowledge, attitudes, and practices related to GAI tools. Descriptive analysis, Pearson's correlation, and multivariable regression were used to analyze the data.
Results
The overall awareness rate of GAI tools was 93.3%. Participants demonstrated moderate knowledge (mean score 17.71 ± 5.56), positive attitudes (mean score 73.32 ± 15.83), and reasonable practices (mean score 40.70 ± 12.86). Factors influencing knowledge included education level, geographic region, and attitudes (p < 0.05). Attitudes were influenced by work experience and knowledge (p < 0.05), while practices were driven by both knowledge and attitudes (p < 0.001). Participants from outside China scored higher in all dimensions compared to those from China (p < 0.001). Additionally, 74.0% of participants emphasized the importance of reporting GAI usage in research, and 73.9% advocated for naming the specific tool used.
Conclusion
The findings highlight a growing awareness and generally positive attitude toward GAI tools among medical stakeholders, alongside the recognition of their ethical implications and the necessity for standardized reporting practices. Targeted training and the development of clear reporting guidelines are recommended to enhance the effective use of GAI tools in medical research and practice.
{"title":"Knowledge and Awareness of Generative Artificial Intelligence Use in Medicine Among International Stakeholders: A Cross-Sectional Study","authors":"Xufei Luo, Bingyi Wang, Yule Li, Shuang Liu, Haodong Li, Yaxuan Ren, Wah Yang, Kyle Lam, Stephen R Ali, Gemma Sharp, Fabio Ynoe Moraes, Ye Wang, Di Zhu, Zhenhua Yang, Daher Mohammad, Robert Fruscio, Maged N. Kamel Boulos, Zhicheng Lin, Kazuki Ide, Xuping Song, Lu Zhang, Yih Chung Tham, Hui Liu, Long Ge, Yaolong Chen, Zhaoxiang Bian, the GAMER working group and ADVANCED working group","doi":"10.1111/jebm.70034","DOIUrl":"https://doi.org/10.1111/jebm.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the knowledge, attitudes, and practices (KAP) of medical stakeholders regarding the use of generative artificial intelligence (GAI) tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted among stakeholders in medicine. Participants included researchers, clinicians, and medical journal editors with varying degrees of familiarity with GAI tools. The survey questionnaire comprised 40 questions covering four main dimensions: basic information, knowledge, attitudes, and practices related to GAI tools. Descriptive analysis, Pearson's correlation, and multivariable regression were used to analyze the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall awareness rate of GAI tools was 93.3%. Participants demonstrated moderate knowledge (mean score 17.71 ± 5.56), positive attitudes (mean score 73.32 ± 15.83), and reasonable practices (mean score 40.70 ± 12.86). Factors influencing knowledge included education level, geographic region, and attitudes (<i>p</i> < 0.05). Attitudes were influenced by work experience and knowledge (<i>p</i> < 0.05), while practices were driven by both knowledge and attitudes (<i>p</i> < 0.001). Participants from outside China scored higher in all dimensions compared to those from China (<i>p</i> < 0.001). Additionally, 74.0% of participants emphasized the importance of reporting GAI usage in research, and 73.9% advocated for naming the specific tool used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings highlight a growing awareness and generally positive attitude toward GAI tools among medical stakeholders, alongside the recognition of their ethical implications and the necessity for standardized reporting practices. Targeted training and the development of clear reporting guidelines are recommended to enhance the effective use of GAI tools in medical research and practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197410","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}
To evaluate the relationship between socioeconomic status (SES), lifestyle factors, and their combined impact on chronic respiratory diseases (CRDs).
Methods
Participants were from the UK Biobank and were categorized into SES groups using latent class analysis based on family income, education, and employment status. Lifestyle factors were assessed via 24-hour dietary recalls and structured questionnaires. Each criterion scored 1 (healthy) or 0 (unhealthy), creating a total score from 0 to 4. Multivariable Cox proportional hazards models, interaction analyses, and mediation analyses were conducted.
Results
Among 296,731 participants, 12,128 (4.1%) participants were diagnosed with CRDs. Among low SES groups, healthy lifestyle groups with scores 2, 1, and 0 showed significantly increased hazard ratios of 1.32 (95% CI: 1.21–1.44), 1.77 (95% CI: 1.63–1.93) and 2.36 (95% CI: 2.15–2.60) compared with the healthy lifestyle scores ≥3. The combined effect of SES and healthy lifestyle increased the risk of CRDs by 15% over the risk expected from simply adding their respective effects. The proportion of SES on CRDs incidence mediated by healthy lifestyle factors was statistically significant (p < 0.001), accounting for about 2%.
Conclusions
The risk of incident CRDs in the low SES population with an unhealthy lifestyle increased by 32%–136%. Unhealthy lifestyles significantly affect the incidence of CRDs in different SES subgroups. About 2% of the risk between SES and incident CRDs was mediated by lifestyle factors. These findings highlight the importance of addressing socioeconomic disparities and unhealthy lifestyle behaviors in public health strategies aimed at preventing CRDs.
{"title":"Associations of Combined Socioeconomic Status and Healthy Lifestyle With Incidence of Chronic Respiratory Diseases: A Prospective Cohort Study","authors":"Jin Yang, Jilong Huang, Jian Gao, Wenfang Zhong, Peiliang Chen, Qingmei Huang, Yixin Zhang, Fangfei You, Huan Chen, Chuan Li, Weiqi Song, Dong Shen, Jiaojiao Ren, Dan Liu, Zhihao Li, Chen Mao","doi":"10.1111/jebm.70035","DOIUrl":"https://doi.org/10.1111/jebm.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the relationship between socioeconomic status (SES), lifestyle factors, and their combined impact on chronic respiratory diseases (CRDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were from the UK Biobank and were categorized into SES groups using latent class analysis based on family income, education, and employment status. Lifestyle factors were assessed via 24-hour dietary recalls and structured questionnaires. Each criterion scored 1 (healthy) or 0 (unhealthy), creating a total score from 0 to 4. Multivariable Cox proportional hazards models, interaction analyses, and mediation analyses were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 296,731 participants, 12,128 (4.1%) participants were diagnosed with CRDs. Among low SES groups, healthy lifestyle groups with scores 2, 1, and 0 showed significantly increased hazard ratios of 1.32 (95% CI: 1.21–1.44), 1.77 (95% CI: 1.63–1.93) and 2.36 (95% CI: 2.15–2.60) compared with the healthy lifestyle scores ≥3. The combined effect of SES and healthy lifestyle increased the risk of CRDs by 15% over the risk expected from simply adding their respective effects. The proportion of SES on CRDs incidence mediated by healthy lifestyle factors was statistically significant (<i>p</i> < 0.001), accounting for about 2%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The risk of incident CRDs in the low SES population with an unhealthy lifestyle increased by 32%–136%. Unhealthy lifestyles significantly affect the incidence of CRDs in different SES subgroups. About 2% of the risk between SES and incident CRDs was mediated by lifestyle factors. These findings highlight the importance of addressing socioeconomic disparities and unhealthy lifestyle behaviors in public health strategies aimed at preventing CRDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191100","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}
Hamidreza Ashayeri, Hanieh Salehi-Pourmehr, Ali Jafarizadeh
{"title":"Calculation of the Overlap in Umbrella Reviews Based on the Sample Size of Primary Studies","authors":"Hamidreza Ashayeri, Hanieh Salehi-Pourmehr, Ali Jafarizadeh","doi":"10.1111/jebm.70038","DOIUrl":"https://doi.org/10.1111/jebm.70038","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171721","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}
Qi Kang, Yuk Kam Yau, Zhuoran Hu, Jianchao Quan, David Chi Leung Lam, Ivy Lynn Mak, Ian Chi Kei Wong, David Vai Kiong Chao, Welchie Wai Kit Ko, Chak Sing Lau, Cindy Lo Kuen Lam, Eric Yuk Fai Wan
Purpose
This study aimed to investigate COVID-19's indirect influence on chronic respiratory disease (CRD) patients for two years since the COVID-19 pandemic began.
Methods
Using population-based data in Hong Kong, we included CRD patients diagnosed from January 2011 to December 2021. Interrupted Time Series Analysis were applied to assess mortality, complications, and healthcare utilization rates during the “pre-COVID-19 pandemic” (January 2012–January 2020), “initial COVID-19 pandemic” (February 2020–February 2021), and “post-initial COVID-19 pandemic” (March 2021–December 2021) periods.
Results
Among 587,049 patients with CRD, all-cause mortality had an increasing trend during the post-initial COVID-19 pandemic period (incidence rate ratio (95% CI): 1.019 (1.005, 1.034); p = 0.007), compared with pre-COVID-19 pandemic period. Nonrespiratory mortality had an increasing trend in the initial COVID-19 pandemic period (1.020 (1.006, 1.033); p = 0.004) and was higher than the pre-pandemic level in the post-initial COVID-19 pandemic. We observed abrupt declines in the incidence rates of asthma exacerbation, acute exacerbation of chronic obstructive pulmonary disease, pneumonia, and acute respiratory failure in the first month of initial COVID-19 pandemic period, remaining below pre-COVID-19 pandemic levels throughout the initial pandemic period.
Conclusion
The disruption of usual healthcare impacts mortality rates among patients with CRD without COVID-19, particularly nonrespiratory mortality. Contingency plans on continuing follow-up and monitoring of CRD patients are needed, for example, teleconsultations, shared primary care, and tele-reminders on red-flag symptoms for patients with CRD, when healthcare services may be disrupted during public health crises.
{"title":"The Indirect Impact of COVID-19 Pandemic on Mortality, Complications, and Healthcare Utilization Among Patients With Chronic Respiratory Diseases in Hong Kong: An Interrupted Time Series Analysis","authors":"Qi Kang, Yuk Kam Yau, Zhuoran Hu, Jianchao Quan, David Chi Leung Lam, Ivy Lynn Mak, Ian Chi Kei Wong, David Vai Kiong Chao, Welchie Wai Kit Ko, Chak Sing Lau, Cindy Lo Kuen Lam, Eric Yuk Fai Wan","doi":"10.1111/jebm.70039","DOIUrl":"https://doi.org/10.1111/jebm.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to investigate COVID-19's indirect influence on chronic respiratory disease (CRD) patients for two years since the COVID-19 pandemic began.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using population-based data in Hong Kong, we included CRD patients diagnosed from January 2011 to December 2021. Interrupted Time Series Analysis were applied to assess mortality, complications, and healthcare utilization rates during the “pre-COVID-19 pandemic” (January 2012–January 2020), “initial COVID-19 pandemic” (February 2020–February 2021), and “post-initial COVID-19 pandemic” (March 2021–December 2021) periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 587,049 patients with CRD, all-cause mortality had an increasing trend during the post-initial COVID-19 pandemic period (incidence rate ratio (95% CI): 1.019 (1.005, 1.034); <i>p</i> = 0.007), compared with pre-COVID-19 pandemic period. Nonrespiratory mortality had an increasing trend in the initial COVID-19 pandemic period (1.020 (1.006, 1.033); <i>p</i> = 0.004) and was higher than the pre-pandemic level in the post-initial COVID-19 pandemic. We observed abrupt declines in the incidence rates of asthma exacerbation, acute exacerbation of chronic obstructive pulmonary disease, pneumonia, and acute respiratory failure in the first month of initial COVID-19 pandemic period, remaining below pre-COVID-19 pandemic levels throughout the initial pandemic period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The disruption of usual healthcare impacts mortality rates among patients with CRD without COVID-19, particularly nonrespiratory mortality. Contingency plans on continuing follow-up and monitoring of CRD patients are needed, for example, teleconsultations, shared primary care, and tele-reminders on red-flag symptoms for patients with CRD, when healthcare services may be disrupted during public health crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171722","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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