Systematic Reviews最新文献

Background: Myocardial infarction (MI) poses a formidable health challenge, frequently necessitating management through percutaneous coronary intervention (PCI). However, PCI comes with potential complications that can impact patient outcomes. Traditional Chinese medicine (TCM), particularly the utilization of Chinese patent medicines with blood-activating and stasis-resolving properties, offers another approach to enhance PCI efficacy and improve patient quality of life. The aim of this study is to assess the comparative efficacy and safety of blood activating and stasis removing Chinese patent medicines for the perioperative period of PCI for MI.

Methods: This systematic review and network meta-analysis will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search strategy will be implemented across seven electronic databases to identify relevant studies. Eligible studies will be limited to randomized controlled trials that compare any Chinese patent medicine (added to standard care) with standard care or another treatment in patients in the perioperative period of PCI after MI. Two independent reviewers will screen all retrieved citations, extract pertinent data, and assess the risk of bias. We will conduct Bayesian random-effects network meta-analysis and network meta-regression. To elucidate whether the intervention has an important impact on certain outcomes within the perioperative period of PCI for MI, we will conduct a patient values and preferences survey to determine the minimum important difference for outcomes. We will assess the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.

Discussion: This study will provide new insights into the efficacy and safety of blood activating and stasis removing Chinese patent medicines for the perioperative period of PCI for MI patients, providing help for future clinical practice and research.

Ethics and dissemination: Ethical approval is not required for this review. The findings will be disseminated through publication in a peer-reviewed academic journal, presentations at scientific conferences, and outreach via various media platforms.

Background: Preventive care - asking, advising or referring patients for help with smoking, nutrition, alcohol, physical activity, and weight (SNAP-W) - is not consistently provided in routine outpatient care due to barriers such as time, other priorities, and forgetfulness. Digital health interventions (DHIs) integrated into routine care offer a promising solution and are acceptable to clinicians and patients. A systematic review is needed to synthesise existing evidence on the effectiveness of DHIs that engage patients, alongside routine care, to provide preventive care targeting SNAP-W in outpatient settings.

Methods: We will include randomised and non-randomised studies that compare a DHI supporting the provision of preventive care for SNAP-W health behaviours with usual care. The DHI must integrate with routine clinician-provided care. Participants will be adult patients/clients of any outpatient healthcare service. The primary outcomes will be provision/receipt of preventive care elements addressing the SNAP-W health behaviours. Secondary outcomes will include SNAP-W behaviour change outcomes. Eligible studies will be identified via MEDLINE, EMBASE, PsycINFO, Scopus, and CINAHL. Two reviewers will independently conduct study selection, data extraction, and risk of bias assessment, with a third resolving disagreements. Risk of bias will be assessed using Cochrane RoB-2 for randomised and ROBINS-I for non-randomised trials. If feasible, a meta-analysis will be conducted to estimate the pooled effect of DHIs by health behaviour. Exploratory sub-group (e.g., type of clinical setting, preventive care element) analyses will be conducted to determine possible causes of statistical heterogeneity. If a meta-analysis is not feasible, results will be summarised using direction of effect per the Synthesis Without Meta-analysis guidelines.

Discussion: This review will identify whether DHIs that engage patients as part of outpatient health care are effective at improving delivery of SNAP-W preventive care for adults attending these services. These findings will be of interest to service providers, policy makers and implementation researchers seeking to improve health outcomes through routine preventive care provision.

Systematic review registration: PROSPERO CRD420251067831.

Objective: Thyroid function tests are frequently overused. This systematic review aims to summarise the effectiveness of behaviour change interventions to reduce low-value thyroid testing and to identify theoretical foundations and contextual factors associated with their success.

Design: We conducted a comprehensive search of Medline, Embase, Scopus, and the Cochrane Library for randomised and non-randomised controlled trials as well as before-and-after studies. We followed PRISMA guidelines, critically appraised study quality, and applied the GRADE approach to assess certainty of evidence. We categorised interventions as soft (education, reminders, feedback, guidelines) or structural (change in funding, clinical decision support systems).

Results: We included 47 studies (54 interventions) including five randomised trials. Structural interventions, particularly clinical decision support systems, were the most common (n = 28). Most interventions reported a reduction in low-value thyroid testing (n = 52), with 40 of them having effects ≥ 20%. However, the certainty of evidence was very low to moderate. Among 49 interventions assessing volume reduction (test rates, expenditure), only two reported increased test rates. All 24 studies that measured improvement of care (appropriateness, shift in ordering pattern, coefficient of variation among physicians) indicated positive developments. Only four interventions referenced theoretical foundations or contextual factors.

Conclusions: Structural interventions, especially clinical decision support systems, were most effective in reducing thyroid testing. While most interventions showed positive effects, the certainty of evidence remains limited, highlighting the need for more high-quality studies to support robust clinical practice changes. Our results may inform targeted interventions to reduce low-value thyroid testing at national, regional, and local levels.

Cognitive development is fundamental in building children's future learning and adaptive behaviours. Children's cognitive development may be influenced by an interplay of psychosocial factors, especially in settings such as sub-Saharan Africa, where resources are limited. Despite the significance of early cognitive stimulation on children, there is a paucity of research for understanding the complex interaction of psychosocial determinants of child cognitive development in Early Childhood Development centres, particularly in sub-Saharan Africa. This review aims to synthesise existing literature on the psychosocial determinants of child cognitive development in sub-Saharan African ECDs. This proposed systematic review will be conducted according to the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). We will search for primary studies conducted using qualitative, quantitative, and mixed methods approaches on global (PubMed, PsycINFO, ProQuest) and regional databases (Sabinet African Journals, Science Direct, African Index Medicus, and sub-Saharan African institutional repositories). The included studies should report on the psychosocial determinants of child cognitive development of children aged 0-6 years registered within sub-Saharan African ECDs and conducted in English between 2014 and 2024. The quality of studies will be assessed using the Mixed Method Appraisal tool, and the data will be analysed using the content analysis method. We envision that the systematic review will enrich discussions on child cognitive development and facilitate the development of interventions aimed at improving child cognitive development in sub-Saharan African ECDs.Systematic review registration PROSPERO CRD42023470844.

Background: Despite the unknown mechanisms of coronary slow flow (CSF), several studies have investigated the role of inflammation in CSF pathogenesis and evaluated the hs-CRP levels in these patients. Our meta-analysis aims to resolve the controversy in the results and draw a conclusion.

Methods: All studies measuring hs-CRP in patients with CSF and controls were included after a systematic search. A random-effects meta-analysis was employed to calculate standardized mean differences, considering heterogeneity among the studies. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS).

Results: Out of the 299 records, 31 cross-sectional studies were included in the systematic review. The meta-analysis of these eligible cross-sectional studies revealed a significant association between CSF and hs-CRP (MD: 1.95 mg/L; 95% CI, 1.03 to 2.88; p ≤ 0.0001). The heterogeneity was considerable among studies. Additionally, sensitivity analyses indicated that the meta-analysis models were robust.

Conclusion: This meta-analysis suggests that patients with CSF exhibit significantly elevated hs-CRP levels compared to healthy controls, supporting the role of hs-CRP as a state marker of the disease.

Systematic review registration: CRD42023359516.

Background: Depression and anxiety are common mental health problems among female adolescents worldwide, with higher prevalence rates in Sub-Saharan Africa (SSA). Existing reviews indicate that psychosocial interventions can reduce depression and anxiety in adolescents in SSA. However, no review has been conducted to examine the effectiveness of these interventions for female adolescents specifically.

Aim(s): The primary aim of this study is to systematically review psychosocial interventions for depression and anxiety among female adolescents in SSA.

Method and analysis: A systematic search will be conducted across eight electronic databases-Medline, PubMed, PsycINFO, PsycArticles, Scopus, Cochrane Controlled Register of Trials (CENTRAL), Embase and Web of Science-to identify studies that meet the eligibility criteria. The study selection process will follow the PRISMA guidelines, and will be conducted in Covidence. The quality of the selected studies will be assessed using the Mixed Methods Appraisal Tool. A meta-analysis and narrative synthesis will be applied to the included studies. To complement the findings of the systematic literature review, the lived experience synthesis will be conducted. We will consult the Youth Advisory Group (YAG) composed of up to 10 young females with lived experience of depression and/or anxiety from SSA to get their perspectives, views, and suggestions on the results and dissemination of the prospective systematic review findings.

Discussion: Findings from the review will inform government policies addressing female adolescent mental health problems in Sub-Saharan Africa. It will also inform future research by identifying gaps regarding the effectiveness of psychosocial interventions for female adolescents.

Conclusion: Given the existing gender differences in adolescent mental health, it is imperative to synthesise evidence on the effectiveness of these interventions specifically for female adolescents.

Systematic review registration: PROSPERO CRD420251059110.

Introduction: Despite global efforts, progress in malaria elimination has stagnated since 2010, particularly in urban areas of sub-Saharan Africa facing rapid urbanization. Urban transmission dynamics, worsened by environmental changes and emerging threats like Anopheles stephensi, remain largely understudied. Current control strategies are predominantly based on rural data, highlighting the necessity for tailored approaches suited to urban settings. This review addresses trends in malaria indicators in Bamako to refine control strategies.

Objective: This scoping review aims to describe the trends in malaria epidemiology in urban and peri-urban Bamako, focusing on prevalence, incidence, clinical forms, mortality/morbidity, and burden from 2002 to 2025 to inform control strategies.

Inclusion criteria: Epidemiological studies on malaria in Bamako's urban and peri-urban areas from 2002 to 2025 will be included. These must cover prevalence, incidence, morbidity, mortality, transmission, manifestations, or control interventions. Studies lacking relevant data or falling outside these parameters will be excluded.

Methods: A comprehensive literature search will target databases (PubMed, Web of Science, ADHL Mali Home, and Google Scholar), National Malaria Control Program reports, and academic theses from Bamako. Data on malaria trends, clinical manifestations, and burden will be extracted and synthesized to reveal changes in transmission shifts and inform urban malaria control.

Discussion: This scoping review aims to synthesize malaria epidemiology data from urban and peri-urban Bamako between 2002 and 2025, emphasizing trends in prevalence, incidence, and transmission factors influenced by rapid urbanization. The findings will guide the adaptation of malaria control strategies to effectively address the unique challenges posed by urban environments and emerging threats like Anopheles stephensi.

Systematic review registration: osf.io/q8upv.

Background: Identity, representations individuals hold about themselves, drives health behavior change, influencing both health-promoting and health-compromising behaviors. This mixed-methods systematic review synthesizes interventions directly targeting physical activity (PA)- and/or smoking-related identities to promote PA and smoking cessation in individuals aged 12 years and over. It also examines the effects of these interventions on identity and behavior, as well as mediators or moderators of effectiveness.

Methods: A comprehensive search across nine databases identified 5801 records, with 19 reports (20 studies) being included. Two independent reviewers extracted data and assessed study quality using the Mixed Methods Appraisal Tool.

Results: Four types of identity-related interventions were identified: possible-self interventions, multi-component interventions incorporating identity components, possible-self avatar games, and identity-challenge interventions. Intervention effectiveness was mixed: nearly half of the studies reported significant positive effects on PA- and smoking-related identities and behaviors, while others found no significant differences. No significant negative effects were reported. Although results seem similar for both behaviors, more studies focused on PA, complicating direct comparisons. One study suggested that integrating PA promotion and smoking cessation into a single intervention could be beneficial, but further research is needed. Identified mediators and moderators include self-efficacy, planning, and consideration of future consequences.

Conclusions: Overall, identity-related interventions show promise for PA promotion and smoking cessation, but optimal design and operationalization remain uncertain. Tailoring these interventions to individual characteristics may enhance effectiveness and contribute to public health.

Systematic review registration: Open Science Framework https://osf.io/avtx4/.

Background: Tick bites may expose individuals to a carbohydrate not found in humans, galactose-alpha-1,3-galactose (alpha-gal). A spectrum of disorders may result from IgE-mediated hypersensitivity reactions to alpha-gal, including alpha-gal syndrome (AGS), an allergy to meat or meat-derived products usually presenting 2-6 h after consuming the product plus positive alpha-gal specific IgE testing for the oligosaccharide. Reports of anaphylaxis in group O recipients of group B plasma in the absence of other risk factors for severe allergic reactions to blood transfusion could be alpha-gal sensitization; the allergen galactose-alpha-1,3-galactose (Gal-alpha-1-3Galβ1-(3)4GlcNAc-R) is antigenically similar to the B blood group antigen (Gal-alpha-1-3(Fuc-alpha-1,2)Gal). The potential cross-reactivity of alpha-gal specific IgE to B type red blood cells may pose a safety consideration for blood donation and transfusion. This scoping review protocol will be used to research all publications on alpha-gal sensitization to (1) describe characteristics of all known cases of transfusion-related alpha-Gal syndrome (TRAGS) and hypersensitivity reactions to infusions of mammalian red meat-derived medical products besides blood components that may resemble TRAGS; (2) identify studies that explore possible relationships between alpha-gal sensitization and blood group that may be relevant to understanding TRAGS; (3) describe which clinical, laboratory, and epidemiologic parameters used to diagnose AGS food allergy are also appropriate to diagnose TRAGS; and (4) identify which diagnostic assays exist for AGS and how they are used for AGS and/or TRAGS.

Methods: Using peer-reviewed search strategies, our study team will perform a scoping review with no date or language limit of all literature relevant to the research objectives in PubMed, Scopus, Embase, Web of Science, and Cochrane Central Register of Controlled Trials, including title, abstract, full-text screening, and data collection using Covidence.

Discussion: This study involves published data predominantly from humans (and, rarely, animal) studies of diagnostic assays in development for use in humans. It does not require institutional review board or ethics approval. We intend to disseminate our findings to specialists in allergy, immunology, hematology, and blood banking and to patients or blood donors experiencing symptoms of alpha-gal sensitization.

Systematic review registration: Open Science Framework (osf.io) (DOI: https://doi.org/10.17605/OSF.IO/WDZT6).