Systematic Reviews最新文献

Background: Compassion is widely studied as a prosocial motivator with recognized mental health benefits, yet the psychosocial effects of receiving compassion remain underexplored. Interpretive frameworks-whether religious or secular-may influence how individuals perceive and emotionally respond to compassionate acts.

Objectives: To systematically review (1) the psychosocial effects of receiving compassion from others, and (2) how recipients interpret these experiences through secular or religious frameworks.

Methods: This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and is registered with the International Prospective Register of Systematic Reviews (PROSPERO). Eligible studies will be empirical, involving adult participants in any setting, and using qualitative, quantitative, or mixed-method designs. Studies will be excluded if they focus solely on self-compassion, compassion fatigue, or lack psychological outcome data related to receiving compassion. Information sources include PubMed, Psychological Information Database (PsycINFO), Web of Science, Scopus, and Google Scholar. Risk of bias will be assessed using the Risk Of Bias In Non-randomized Studies of Exposures (ROBINS-E) tool for nonrandomized studies, the Joanna Briggs Institute (JBI) checklist for quasi-experimental and qualitative designs, and the Mixed Methods Appraisal Tool (MMAT) for mixed-methods designs. Data synthesis will follow a convergent integrated approach combining thematic and narrative techniques. Where feasible, pooled effect sizes and forest plots will be presented.

Discussion: This review will explore how receiving compassion-interpreted through secular or religious lenses-affects psychological well-being and social interactions, including potential reductions in distress, increases in resilience, and prosocial behaviors. It aims to develop culturally sensitive and spiritually aware models of compassionate interaction, with relevance for clinical practice, public health ethics, and interdisciplinary education.

Systematic review registration: PROSPERO 2025 CRD420251107986. Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251107986.

Background: People living with HIV (PLWH) have a markedly increased risk of cardiovascular disease (CVD), including cardiomyopathy, due to a complex interplay of chronic inflammation, viral persistence, and antiretroviral therapy (ART) effects. Echocardiography and cardiac magnetic resonance (CMR) are key imaging tools for detecting subclinical myocardial damage, yet their comparative effectiveness and optimal use in this population remain unclear.

Objective: To systematically evaluate the effectiveness and diagnostic accuracy of echocardiography and CMR for the early detection, structural characterization, and monitoring of cardiomyopathy in PLWH, and to explore how clinical, therapeutic, and geographic factors influence imaging findings.

Methods: This protocol follows the PRISMA-P guidelines and is registered in PROSPERO (CRD420251023451). We will include observational studies and clinical trials involving adults (≥ 18 years) with confirmed HIV infection who underwent echocardiography or CMR. Two reviewers will independently perform study selection, data extraction, and risk of bias assessment using validated tools. Narrative and quantitative syntheses will be conducted, with subgroup and meta-regression analyses by ART regimen, CD4 count, and geographic region. The certainty of evidence will be rated using GRADE.

Expected impact: This review aims to generate evidence and information useful for defining rational protocols and guidelines for the use of echocardiography and CMR in the care of PLWH. By consolidating evidence on the applicability of these resources for the timely diagnosis and monitoring of cardiomyopathies in PLWH, it will provide elements for establishing individual care pathways and for improving the efficiency and coverage of respective healthcare. It is thus expected to benefit individuals and, also, health programs aimed at PLWH.

Systematic review registration: PROSPERO CRD420251023451.

Background: Cochrane reviews on nutrition and physical activity (PA) are highly relevant to scientists, practitioners, and the general public. It is important to investigate the dissemination patterns of these reviews to improve the uptake of their findings in practice. The aims of this study were (1) to describe the online and scientific attention towards Cochrane reviews on nutrition and PA using Altmetric data and (2) to investigate the associations between Altmetric data and review characteristics.

Methods: This cross-sectional, bibliographic study used data from 249 Cochrane reviews on nutrition and PA for healthy or at-risk populations that were published in the Cochrane Database of Systematic Reviews from inception until May 2024. Review characteristics and open-access Altmetric data were extracted and analysed using relative frequencies. The associations among Altmetric Attention Scores (a measure of online attention), Dimensions Citations Scores (a measure of scientific attention), and review characteristics were computed using binary logistic regression analysis.

Results: The 249 Cochrane reviews were published over a period of 25 years (1999-2024), included 0-195 studies, conducted a meta-analysis (80%), and had a plain language summary (PLS) available in 2-17 languages. Dissemination occurred via social media, including predominantly Twitter/X (n = 242), Facebook (n = 210), and Wikipedia (n = 172). Online attention based on the Altmetric Attention Scores ranged between 3 and 4111 (51% of reviews had scores between 3 and 48). Scientific attention based on the Dimensions Citations Scores ranged between 0 and 2700 (50% of reviews had scores between 0 and 81). Higher online attention was associated with higher scientific attention (odds ratio, OR = 11.14, 95% confidence interval, CI: 5.08-24.40) and more PLS languages (OR = 1.38, CI: 1.22-1.57). Higher scientific attention was associated with higher online attention (OR = 11.06, CI: 4.96-24.64), older publication year (OR = 0.12, CI: 0.06-0.27), more studies included in the review (OR = 4.13, CI: 1.90-8.98), and a meta-analysis conducted in the review (OR = 6.32, CI: 2.42-16.53).

Conclusions: There was generally high online and scientific attention towards Cochrane reviews on nutrition and PA, mainly due to mentions in the social media and academic citations. Future studies need to investigate if higher online and scientific attention could enhance evidence uptake from Cochrane reviews in practice.

Systematic reviews are crucial for synthesizing evidence, but their manual processes, particularly abstract screening, are labor-intensive and prone to error. Advances in machine learning (ML) offer solutions to enhance efficiency and accuracy. Using a learning analytics (LA) in higher education review as a case study, this tutorial provides a step-by-step guide to implementing two ML solutions to streamline abstract screening. One solution is ASReview, an active learning-based ML framework. We detailed data preparation, ASReview setup, and its active learning capabilities, which significantly reduce manual workloads while maintaining high recall rates. The second solution is ChatGPT, a GPT-4 powered large language model (LLM), to demonstrate optimizing prompts and parameters in Python's Google Colab environment for accurate and consistent screening results. We present performance metrics, including sensitivity, specificity, and accuracy, to evaluate each tool's strengths and limitations. ASReview excels in handling large datasets, while ChatGPT enhances screening precision with well-designed prompts. This tutorial empowers researchers to integrate ML into systematic reviews, ensuring rigor, transparency, and efficiency while addressing the growing complexity of evidence synthesis.

Background: A few randomized controlled trials (RCTs) have investigated endovascular aneurysm repair (EVAR) and open surgical repair (OSR) in patients with intact aortic abdominal aneurysm (AAA).

Objective: We aimed to evaluate the efficacy of EVAR vs OSR in patients with intact AAA.

Methods: We included RCTs and searched MEDLINE and the Cochrane Library on 28 December 2024 without limits. The beneficial primary outcome was overall survival, and the adverse primary outcome was reintervention. In both cases, the outcome measure was the hazard ratio (HR). Two people independently selected studies and extracted data. Management of missing data included deducing time-to-event data from published survival curves and contacting study authors.

Results: We retrieved 723 references from electronic databases and additional sources and included four RCTs. The pooled HR on overall survival favors neither EVAR nor OSR (HR = 1.02 [95% CI 0.93 to 1.12]), but the pooled HR on reintervention favors OSR (HR = 2.14 [95% CI 1.70 to 2.70]). Statistical heterogeneity was low, and the risk of bias had no noteworthy impact on the results.

Conclusions: Pooled data from four randomized controlled trials on intact aortic abdominal aneurysm favor not EVAR regarding overall survival but favor OSR with respect to reintervention.

Systematic review registration: PROSPERO CRD42024539841.

Background: Older adults (≥60 years) are one of the fastest-growing age groups, with a rising prevalence of chronic conditions such as inflammatory bowel disease (IBD). Mental health conditions are common among people living with IBD; however, the burden of depression, anxiety, and stress/psychological distress, specifically among older adults with IBD, remains poorly characterized. Most available evidence comes from younger or mixed-age cohorts, underscoring the need to synthesize evidence explicitly focused on older adults to address this gap.

Methods/design: We will conduct a systematic review and, where applicable, a meta-analysis following PRISMA-P guidance. The protocol is registered in PROSPERO (ID: (CRD420251157744)). We will include quantitative observational studies (cross-sectional, cohort, and case-control) published in English-language journals from January 2014 to the present. Eligible studies must report extractable data for older adults (≥60 years, or ≥65 years where used) with IBD (Crohn's disease, ulcerative colitis, or IBD-unclassified) and at least one eligible mental health outcome (depression, anxiety, and/or stress/psychological distress). Searches will be conducted in MEDLINE, EMBASE, PsycINFO, and CINAHL, and supplemented with reference-list screening, forward citation searching, and targeted grey literature searches using a pre-specified approach. Two reviewers will independently screen records, extract data, and assess risk of bias using design-appropriate tools. Pooled prevalence will be estimated using random-effects meta-analyses, with an appropriate transformation for proportions. Heterogeneity will be explored using I² and pre-specified subgroup/sensitivity analyses. Where pooling is not appropriate due to substantial heterogeneity, findings will be summarized using structured narrative synthesis. Where eligible longitudinal or comparative observational studies are available, association estimates (e.g., OR/RR/HR) will be synthesized and reported separately from prevalence outcomes.

Discussion: This review may provide a consolidated synthesis of international evidence on the prevalence and pooled prevalence of depression, anxiety, and stress/psychological distress among older adults with IBD. Where data allow, it may also summarize association evidence as a separate stream. Findings may inform integrated care pathways for older adults with IBD, helping to identify key sources of heterogeneity and evidence gaps that can inform future research and care planning.

Background: Heart failure (HF) remains a major cause of morbidity and mortality, highlighting the need for reliable prognostic models. This study provides a systematic review and meta-analysis of prognostic models focused on mortality, hospitalization, and their composite event.

Methods: We screened 2271 papers and reviewed 58 prognostic models from 44 studies involving 362,759 HF patients. The predictive performance of these models was assessed, and a meta-analysis was performed for the Seattle Heart Failure Model (SHFM), which focuses on mortality outcomes at 1 year. The models were evaluated via the PROBAST tool for risk of bias and applicability.

Results: Of the 58 models, 86% underwent internal and/or external validation in independent cohorts, with statistical models (88%) being more common than machine learning approaches (12%). Clinical data were used in 79% of the models, whereas the remaining models used electronic health records (EHR) or mixed sources of data. Mortality models (n = 40) revealed a 1-year discrimination range between 0.66 and 0.89. The most common predictors included age, renal function, blood pressure, coronary artery disease, and serum sodium. A meta-analysis of 5 studies that applied the SHFM at 1 year revealed a pooled C-statistic of 0.71 (95% CI: 0.64-0.78), with relatively low heterogeneity (τ² = 0.003). Hospitalization models (n = 9) demonstrated discrimination up to 0.86, and composite event models (n = 9) showed similar predictive power. The risk of bias was high in 88% of the models, largely due to univariable predictor selection and handling/reporting of missing values.

Conclusions: This systematic review highlighted the heterogeneity of HF prognostic models and patient populations in terms of severity and symptoms, emphasizing challenges in developing commonly applicable tools. Most studies enrolled patients with reduced ejection fraction (EF), whereas evidence for HF with preserved EF was limited. Despite widespread research, few HF prognostic models meet current standards for clinical implementation. The large majority of the studies did not report calibration and had a poor alignment with contemporary therapies. Future model development should prioritize transparency, methodological rigor, and external validation.

Systematic review registration: PROSPERO CRD42023488017.

Background: Health Technology Assessment (HTA) is a cornerstone of evidence for informing health policy and resource allocation globally. Rapid advancements and the proliferation of digital health technologies and artificial intelligence (AI) have prompted the re-examination of HTA processes and methods. While traditional approaches are manual and labor-intensive, HTA processes are now exploring the use of AI and other digital technologies for automation, decision support, and evidence synthesis. To date, however, there have been very limited studies that map the innovative technological solutions of HTA, the models of integration, and the associated barriers, facilitators, and governance considerations. As such, this scoping review aims to address this critical gap by mapping the landscape of the global knowledge and practices related to AI and DTs used in and for HTA and identifying the key barriers and enablers influencing their adoption, integration, and effective application within HTA processes.

Methods: A scoping review will be conducted between August and November 2025, following the Arksey and O'Malley framework, enhanced by Joanna Briggs Institute (JBI) recommendations, and reported according to Preferred Reporting Items for Systematic Reviews and Meta‑Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Literature searches will be performed in electronic databases such as Medline (Ovid), Embase (Ovid), Global Health (Ovid), CINAHL (Ebsco), Scopus, Web of Science, and all regional indexes in the World Health Organization's Global Index Medicus, and other region-specific sources for studies published between 2020 and 2025. Eligible studies will include peer-reviewed articles and grey literature describing the integration of digitization, automation, and AI in global HTA processes. Dual independent screening, data extraction, and quality appraisal will be employed.

Discussion: Findings from this review will provide a map of how digitization, automation, and AI are integrated into HTA practice, highlighting key enablers, barriers, and knowledge gaps. The insights will be used to better guide researchers, policymakers, HTA agencies, and AI developers, further supporting future research and implementation strategies for better informed decision-making.

Aim: No consensus exists on the ideal nutrition for preterm infants. This leads to significant practice variation. Fortification of expressed breast milk (EBM) and nutrient supplementation of the preterm infant's diet have become common practices to enhance growth. This systematic review aims to review the comparative effectiveness of oral macro- and micronutrient supplements in enhancing post-natal growth for preterm infants. Additionally, to identify critical gaps in the current recommendations for nutrient supplements.

Methods: We will conduct a systematic review and network meta-analysis (NMA). Websites and databases will be searched for randomised controlled trials and prospective observational studies investigating oral macro and micro-nutrient supplementation to improve in-hospital somatic growth for premature very low birth weight infants (VLBWIs, < 1500 g). Two review authors will assess full-text English publications between 2010-2024 for potentially relevant studies for inclusion, independently and in duplicate, utilising an eligibility form based on the inclusion criteria. The selection process will be demonstrated graphically utilising a PRISMA flow diagram. Details and characteristics of excluded studies will be provided. A network meta-analysis (NMA) will be done using a frequentist approach and multivariate meta-analysis. Random-effect models will be employed to estimate all relative treatment effects. Stata will be used for data analysis. All possible comparisons, containing the effect size and 95% CIs, will be reported in tabular form. If the assumptions that preserve the validity of the NMA are not met, a pairwise meta-analysis will be done. If the criteria for pair-wise meta-analysis are not met, only direct comparisons will be made, and a narrative description of the findings will be presented employing the synthesis without meta-analysis guidelines. The GRADE approach will be used to review the certainty of the evidence. For each comparison, the overall certainty of evidence for the primary outcomes will be evaluated. Estimates of the direct and/or indirect evidence of the NMA will be provided.

Results: The NMA will generate comparative rankings of nutrient supplementation interventions and evaluate their effectiveness in improving in-hospital growth. Results will be presented as summary tables and SUCRA rankings.

Conclusion: This NMA will provide evidence-based guidance on optimal nutrient supplementation strategies to enhance postnatal growth in VLBWIs, addressing a critical knowledge gap in neonatal nutrition practices.

Systematic review registration: This protocol has been registered with PROSPERO.

Registration number: CRD420250650341.