Systematic Reviews最新文献_第6页

Mapping the evaluation of the electronic health system PEC e-SUS APS in Brazil: a scoping review protocol 绘制巴西电子医疗系统 PEC e-SUS APS 的评估图：范围界定审查协议

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-18 DOI: 10.1186/s13643-024-02648-4

Mariano Felisberto, Júlia Meller Dias de Oliveira, Eduarda Talita Bramorski Mohr, Daniel Henrique Scandolara, Ianka Cristina Celuppi, Miliane dos Santos Fantonelli, Raul Sidnei Wazlawick, Eduardo Monguilhott Dalmarco

The Brazilian Ministry of Health has developed and provided the Citizen’s Electronic Health Record (PEC e-SUS APS), a health information system freely available for utilization by all municipalities. Given the substantial financial investment being made to enhance the quality of health services in the country, it is crucial to understand how users evaluate this product. Consequently, this scoping review aims to map studies that have evaluated the PEC e-SUS APS. This scoping review is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) framework, as well as by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Checklist extension for scoping reviews (PRISMA-ScR). The research question was framed based on the “CoCoPop” mnemonic (Condition, Context, Population). The final question posed is, “How has the Citizen’s Electronic Health Record (PEC e-SUS APS) been evaluated?” The search strategy will be executed across various databases (LILACS, PubMed/MEDLINE, Scopus, Web of Science, ACM Digital Library, and IEEE Digital Library), along with gray literature from ProQuest Dissertation and Theses Global and Google Scholar, with assistance from a professional healthcare librarian skilled in supporting systematic reviews. The database search will encompass the period from 2013 to 2024. Articles included will be selected by three independent reviewers in two stages, and the findings will undergo a descriptive analysis and synthesis following a “narrative review” approach. Independent reviewers will chart the data as outlined in the literature. The implementation process for the PEC e-SUS APS can be influenced by the varying characteristics of the over 5500 Brazilian municipalities. These factors and other challenges encountered by health professionals and managers may prove pivotal for a municipality’s adoption of the PEC e-SUS APS system. With the literature mapping to be obtained from this review, vital insights into how users have evaluated the PEC will be obtained. The protocol has been registered prospectively at the Open Science Framework platform under the number 10.17605/OSF.IO/NPKRU.

巴西卫生部开发并提供了公民电子健康记录 (PEC e-SUS APS)，这是一个供所有城市免费使用的卫生信息系统。鉴于巴西为提高医疗服务质量投入了大量资金，了解用户如何评价这一产品至关重要。因此，本次范围界定审查旨在对评估 PEC e-SUS APS 的研究进行摸底。本范围界定综述以系统综述和元分析协议的首选报告项目 (PRISMA-P) 框架以及范围界定综述的系统综述和元分析首选报告项目清单扩展版 (PRISMA-ScR) 为指导。研究问题是根据 "CoCoPop "记忆法（条件、背景、人群）提出的。提出的最后一个问题是："如何对市民电子健康记录（PEC e-SUS APS）进行评估？搜索策略将在各种数据库（LILACS、PubMed/MEDLINE、Scopus、Web of Science、ACM 数字图书馆和 IEEE 数字图书馆）以及 ProQuest Dissertation and Theses Global 和 Google Scholar 的灰色文献中执行，并由擅长支持系统综述的专业医疗保健图书管理员提供协助。数据库搜索的时间跨度为 2013 年至 2024 年。收录的文章将由三位独立审稿人分两个阶段进行筛选，并按照 "叙事性综述 "方法对研究结果进行描述性分析和综合。独立审稿人将按照文献中的概述绘制数据图表。PEC e-SUS APS 的实施过程可能会受到巴西 5500 多个城市不同特点的影响。这些因素以及卫生专业人员和管理人员遇到的其他挑战可能会对一个城市采用 PEC e-SUS APS 系统起到关键作用。通过本次审查所获得的文献图谱，我们可以深入了解用户是如何评价 PEC 的。本协议已在开放科学框架平台上进行了前瞻性注册，注册号为 10.17605/OSF.IO/NPKRU。

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引用次数: 0

Comparing subjective quality of recovery between remimazolam- and propofol-based total intravenous anesthesia for surgical procedures: a meta-analysis 比较基于咪唑安定和异丙酚的手术全静脉麻醉的主观恢复质量：一项荟萃分析

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-17 DOI: 10.1186/s13643-024-02660-8

Kuo-Chuan Hung, Wei-Ting Wang, Wei-Cheng Liu, Chih-Wei Hsu, Yen-Ta Huang, Jheng-Yan Wu, I-Wen Chen

Remimazolam is a novel ultra-short-acting benzodiazepine that has been recently introduced as an alternative to propofol for general anesthesia. While both agents have been compared in terms of safety and efficacy, their relative effects on postoperative quality of recovery (QoR) remain unclear. Therefore, this meta-analysis aimed to compare the effects of remimazolam and propofol on subjective QoR in surgical patients who underwent general anesthesia. Medline, Embase, Google Scholar, and the Cochrane Central Register of Controlled Trials were searched from inception to May 28, 2024 to identify randomized controlled trials comparing remimazolam and propofol in terms of postoperative QoR. The Cochrane risk-of-bias tool (RoB 2) was used to assess study quality. QoR score on postoperative day (POD) 1 (primary outcome), QoR scores on PODs 2–3, QoR dimensions, time to loss of consciousness, other recovery characteristics, and rescue analgesia requirement were evaluated using random-effects meta-analyses. This meta-analysis included 13 studies published between 2022 and 2024 involving 1,418 patients. QoR was evaluated using either the QoR-15 (10 studies) or QoR-40 (3 studies) questionnaire. The pooled results indicated no significant difference in the QoR scores on POD 1 (standardized mean difference: 0.02, 95% confidence interval [CI]: − 0.20, 0.23, P = 0.88, I2 = 73%) and PODs 2–3 between remimazolam and propofol. Furthermore, no significant differences were observed in QoR dimensions, length of postanesthesia care unit (PACU) stay, and time to extubation as well as in the risks of agitation and postoperative nausea and vomiting. Patients administered remimazolam exhibited slower anesthetic induction (mean difference (MD): 32.27 s) but faster recovery of consciousness (MD: − 1.60 min) than those administered propofol. Moreover, remimazolam was associated with a lower risk of rescue analgesia requirement in the PACU (risk ratio: 0.62, 95% CI: 0.43, 0.89, P = 0.009, I2 = 0%) but not in the ward. Remimazolam is a potential alternative to propofol for general anesthesia as it offers similar QoR to the latter and has advantages in terms of consciousness recovery and immediate postoperative analgesia requirement.

雷马唑仑是一种新型超短效苯二氮卓类药物，最近被引入作为异丙酚的替代品用于全身麻醉。虽然两种药物在安全性和有效性方面都进行了比较，但它们对术后恢复质量（QoR）的相对影响仍不明确。因此，本荟萃分析旨在比较瑞马唑仑和异丙酚对接受全身麻醉的手术患者主观恢复质量的影响。研究人员检索了 Medline、Embase、Google Scholar 和 Cochrane Central Register of Controlled Trials 中从开始到 2024 年 5 月 28 日的所有文献，以确定在术后 QoR 方面比较瑞马唑仑和异丙酚的随机对照试验。科克伦偏倚风险工具（RoB 2）用于评估研究质量。使用随机效应荟萃分析评估了术后第 1 天 (POD) 的 QoR 评分（主要结果）、第 2-3 天的 QoR 评分、QoR 维度、意识丧失时间、其他恢复特征和镇痛抢救需求。该荟萃分析纳入了 2022 年至 2024 年间发表的 13 项研究，涉及 1418 名患者。QoR采用QoR-15（10项研究）或QoR-40（3项研究）问卷进行评估。汇总结果显示，POD 1 的 QoR 评分无明显差异（标准化平均差异为 0.02，95% 置信区间为 0.01）：0.02，95% 置信区间 [CI]：- 0.20, 0.23, P = 0.88, I2 = 73%）和 POD 2-3 的 QoR 分数在瑞马唑仑和异丙酚之间无明显差异。此外，在QoR维度、麻醉后监护室（PACU）停留时间、拔管时间以及躁动和术后恶心呕吐风险方面均未观察到明显差异。与使用异丙酚的患者相比，使用雷马唑仑的患者麻醉诱导速度较慢（平均差（MD）：32.27 秒），但意识恢复速度较快（MD：- 1.60 分钟）。此外，在 PACU（风险比：0.62，95% CI：0.43，0.89，P = 0.009，I2 = 0%）中，雷马唑仑与较低的镇痛抢救需求风险相关，但在病房中则不相关。雷马唑仑是异丙酚全身麻醉的潜在替代品，因为它的QoR与异丙酚相似，而且在意识恢复和术后即时镇痛需求方面具有优势。

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引用次数: 0

Mapping health-related quality of life of children and families receiving pediatric invasive home mechanical ventilation: a scoping review protocol 绘制接受儿科有创家庭机械通气的儿童和家庭的健康相关生活质量图：范围界定审查协议

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-17 DOI: 10.1186/s13643-024-02658-2

Keisha White Makinde, Maysara Mitchell, Alexandra F. Merz, Michael Youssef

Children utilizing invasive home mechanical ventilation (administered via tracheostomy tube) receive intensive care at home without the support of trained staff typically present in an intensive care unit; within the context of worsening home nursing shortages, much of the 24/7 care burden falls to families which are likely under supported. Prior reviews have explored the quality of life of children receiving various forms of mechanical ventilation, without addressing the impact on the family. Additionally, the literature inconsistently differentiates the unique experience of families with children using invasive home mechanical ventilation from non-invasive, which has lower morbidity and mortality and requires less nursing care in the home. Therefore, our study aims to explore and map the existing literature regarding the impact of invasive home mechanical ventilation on the child and family’s quality of life. Identified gaps will inform future research focused on improving the family quality of life of children with invasive home mechanical ventilation. Five databases will be searched using keywords and controlled vocabulary to identify relevant studies: Ovid Medline, Embase, Scopus, and Cochrane Library. English language studies will meet inclusion criteria if they include primary research studies of children or families of children utilizing invasive home mechanical ventilation at home and assess quality of life. Children and young adults aged 0–25 years will be included. We exclude studies of hospitalized children, studies focused solely on healthcare professional experiences or clinical outcomes, and those focused on the period surrounding discharge from admission for tracheostomy placement. Two independent reviewers will screen studies at the title/abstract and full-text levels. Two independent reviewers will extract data from relevant studies. Disagreements will be resolved by an independent third reviewer. A targeted grey literature search will be performed utilizing ProQuest, clinicaltrials.gov, WHO trial registry, Google Scholar, and professional societies. Findings will be presented in tables and figures along with a narrative summary. This scoping review seeks to map the literature and provide a descriptive report of the health-related quality of life of children using invasive home mechanical ventilation and their families. Open Science Framework https://doi.org/10.17605/OSF.IO/6GB84 Date of Registration: November 29, 2023.

使用侵入性家庭机械通气（通过气管造口术置管）的患儿在家中接受重症监护，没有重症监护病房中训练有素的医护人员提供支持；在家庭护理人员短缺日益严重的情况下，全天候护理的重担大多落在了家庭身上，而这些家庭很可能得不到足够的支持。之前的综述探讨了接受各种形式机械通气的儿童的生活质量，但没有涉及对家庭的影响。此外，文献对使用有创家庭机械通气和无创家庭机械通气的患儿家庭的独特经历的区分并不一致，无创家庭机械通气的发病率和死亡率较低，需要的家庭护理也较少。因此，我们的研究旨在探索和绘制关于有创家庭机械通气对儿童和家庭生活质量影响的现有文献。所发现的不足将为未来的研究提供参考，这些研究的重点是改善有创家庭机械通气患儿的家庭生活质量。将使用关键词和控制词汇对五个数据库进行检索，以确定相关研究：Ovid Medline、Embase、Scopus 和 Cochrane Library。只要是对在家中使用有创家用机械通气的儿童或其家人进行的初级研究，并对生活质量进行评估的英语研究均符合纳入标准。我们将纳入 0-25 岁的儿童和青少年。我们将排除针对住院儿童的研究、仅关注医护人员经验或临床结果的研究，以及关注因气管造口术入院而出院前后的研究。两名独立审稿人将从标题/摘要和全文两个层面对研究进行筛选。两名独立审稿人将从相关研究中提取数据。如有异议，将由独立的第三位审稿人解决。将利用 ProQuest、clinicaltrials.gov、WHO 试验登记、Google Scholar 和专业学会进行有针对性的灰色文献检索。研究结果将以图表和叙述性摘要的形式呈现。本范围界定综述旨在绘制文献地图，并就使用有创家庭机械通气的儿童及其家人的健康相关生活质量提供描述性报告。开放科学框架 https://doi.org/10.17605/OSF.IO/6GB84 注册日期：2023 年 11 月 29 日。

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引用次数: 0

Role of sex and training characteristics on exercise effects on cardiovascular aging: protocol for a systematic review with meta-analysis of randomized trials 性别和训练特点对运动影响心血管衰老的作用：随机试验荟萃分析系统综述方案

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-14 DOI: 10.1186/s13643-024-02644-8

Emmanuel Gomes Ciolac, Jana Babjakova, Raphael Martins de Abreu, Su-Jie Mao, Guoping Qian, Vanessa Teixeira do Amaral, Bartlomiej Wrzesinski, Artur Junio Togneri Ferron, Zbigniew Ossowski, Fabiane Valentini Francisqueti-Ferron, Seda Cansu Yeniğün, Bianca Fernandes, Luis Monteiro Rodrigues, Rahima Gabulova

Cardiovascular diseases remain a leading global cause of mortality worldwide especially in older adults. Although it is known that regular exercise reduces cardiovascular diseases incidence, its effects on specific cardiovascular aging parameters considering the influence of sex and different exercise designs are still not fully understood. Therefore, this systematic review and meta-analysis aims to evaluate the effects of different physical exercise protocols on age-related cardiovascular outcomes in older adults. This systematic review and meta-analysis will be reported in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Articles will be eligible if they are randomized controlled trials with a primary objective of evaluating the chronic effects of exercise interventions on cardiovascular aging parameters. Search strategy will be performed from the inception to September 30th, 2023, in the following electronic databases: MEDLINE (Ovid), SCOPUS (Elsevier), Embase, Sport Discus (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science Core Collection (Clarivate Analytics). Data will be extracted and managed through Research Electronic Data Capture (REDCap) software. The Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX) will be used to assess the methodological quality of included studies. Additionally, the quality of the findings will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) profiler. Meta-analysis based on the random-effects model will be performed (if deemed suitable, considering the methodological and clinical heterogeneity of the studies) to estimate the effects of exercise training on cardiovascular aging variables (i.e., cardiac output; arterial stiffness; stroke volume; endothelial function; and carotid intima-media thickness). Heterogeneity will be assessed with the I2 statistics, while the publication bias will be assessed based on Egger’s test. To the best of our knowledge, this will be the first systematic review and meta-analysis to investigate the impact of sex and training protocols on the cardiovascular aging parameters. Moreover, the findings of this systematic review and meta-analysis will provide evidence for health professionals in the management of elderly patients in order to optimize the exercise prescription to face the cardiovascular alterations related to the aging process, considering the effects of different protocols according to sex. PROSPERO CRD42023441015 .

心血管疾病仍然是全球尤其是老年人死亡的主要原因。尽管众所周知，定期锻炼可降低心血管疾病的发病率，但考虑到性别和不同锻炼设计的影响，锻炼对特定心血管衰老参数的影响仍未得到充分了解。因此，本系统综述和荟萃分析旨在评估不同体育锻炼方案对老年人与年龄相关的心血管结果的影响。本系统综述和荟萃分析将按照《系统综述和荟萃分析首选报告项目》（PRISMA）声明进行报告。只要是以评估运动干预对心血管衰老参数的慢性影响为主要目标的随机对照试验，均符合条件。检索策略将从开始至 2023 年 9 月 30 日在以下电子数据库中进行：MEDLINE (Ovid), SCOPUS (Elsevier), Embase, Sport Discus (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science Core Collection (Clarivate Analytics)。数据将通过研究电子数据采集（REDCap）软件进行提取和管理。运动研究质量和报告评估工具（TESTEX）将用于评估纳入研究的方法学质量。此外，还将使用建议评估、发展和评价分级（GRADE）剖析器评估研究结果的质量。考虑到研究的方法学和临床异质性，如果认为合适，将基于随机效应模型进行 Meta 分析，以估计运动训练对心血管衰老变量（即心输出量、动脉僵化、每搏量、内皮功能和颈动脉内膜中层厚度）的影响。异质性将通过 I2 统计量进行评估，而发表偏倚将通过 Egger 检验进行评估。据我们所知，这将是首个研究性别和训练方案对心血管衰老参数影响的系统综述和荟萃分析。此外，本系统综述和荟萃分析的结果将为医护人员管理老年患者提供证据，以便优化运动处方，应对与衰老过程有关的心血管变化，同时考虑到不同方案对不同性别的影响。PERCOMO CRD42023441015 .

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引用次数: 0

Prognostic value of tumour-associated regulatory T-cells as a biomarker in non-small cell lung cancer: a systematic review and meta-analysis 肿瘤相关调节性 T 细胞作为非小细胞肺癌生物标志物的预后价值：系统综述和荟萃分析

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-14 DOI: 10.1186/s13643-024-02642-w

Kapil Khambholja, Manish Gehani, Rushabh Kothari, Sachin Marulkar

Tumour, nodes, and metastases (TNM) staging has been deficient in prognosticating in patients suffering from non-small cell lung cancer (NSCLC). To supplement TNM staging, this systematic review and meta-analysis aimed to evaluate the prognostic value of the regulatory T cells (Treg). A keyword search was conducted in MEDLINE and EMBASE for full-text original human studies from any region published in English during the last 12 years. Eligible for inclusion were studies evaluating the prognostic value of the number of Treg cells in NSCLC except case studies, case series, systematic reviews, and meta-analyses. Two reviewers (one reviewer used an automation tool) independently screened the studies and assessed risk-of-bias using the Quality in Prognosis Studies (QUIPS) tool. Meta-analysis was done for studies reporting significant multivariate hazard ratio (HR). Out of 809 retrievals, 24 studies were included in the final review. The low number of Treg cells was found significantly associated with improved overall survival (pooled log OR, 1.646; 95% CI, 1.349, 1.944; p (2-tailed) < .001; SE, 0.1217), improved recurrence-free survival (HR, 1.99; 95% CI, 1.15, 3.46; p = .01), improved progression-free survival (pooled log OR, 2.231; 95% CI, 0.424, 4.038; p (2-tailed) .034; SE, 0.4200), and worse disease-free survival (pooled log OR, 0.992; 95% CI, 0.820, 1.163; p (2-tailed) .009; SE, 0.0135), especially when identified by forkhead box P3 (FOXP3), in any stage or non-metastatic NSCLC. A low number of Treg cells indicated better survival, suggesting its potential use as a prognostic biomarker in NSCLC. The protocol of this review was prospectively registered on PROSPERO on August 28, 2021, and was assigned the registration number CRD42021270598. The protocol can be accessed from PROSPERO website.

肿瘤、结节和转移灶（TNM）分期在预测非小细胞肺癌（NSCLC）患者的预后方面一直存在缺陷。作为对 TNM 分期的补充，本系统综述和荟萃分析旨在评估调节性 T 细胞（Treg）的预后价值。我们在 MEDLINE 和 EMBASE 中检索了过去 12 年间在任何地区以英语发表的人类原始研究全文，并进行了关键词检索。除病例研究、系列病例、系统综述和荟萃分析外，评估Treg细胞数量对NSCLC预后价值的研究均可纳入。两名审稿人（其中一名审稿人使用自动化工具）独立筛选研究，并使用预后研究质量（QUIPS）工具评估偏倚风险。对报告了显著多变量危险比（HR）的研究进行了 Meta 分析。在 809 项检索中，有 24 项研究被纳入最终审查。研究发现，Treg细胞数量少与总生存期改善（集合对数OR，1.646；95% CI，1.349，1.944；P（2尾）< .001；SE，0.1217）、无复发生存期改善（HR，1.99；95% CI，1.15，3.46；P = .01）、无进展生存期改善（集合对数OR，2.231；95% CI，0.424，4.038；p（2-tailed）.034；SE，0.4200），无病生存期更差（集合对数OR，0.992；95% CI，0.820，1.163；p（2-tailed）.009；SE，0.0135），尤其是在任何分期或非转移性NSCLC中通过叉头盒P3（FOXP3）识别时。Treg细胞数量越少，生存率越高，这表明它有可能被用作NSCLC的预后生物标志物。本综述方案于2021年8月28日在PROSPERO上进行了前瞻性注册，注册号为CRD42021270598。该方案可在 PROSPERO 网站上查阅。

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引用次数: 0

The impact of chiropractic care on prescription opioid use for non-cancer spine pain: protocol for a systematic review and meta-analysis 脊骨神经治疗对非癌症脊柱疼痛处方阿片类药物使用的影响：系统回顾和荟萃分析方案

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-12 DOI: 10.1186/s13643-024-02654-6

Peter C. Emary, Kelsey L. Corcoran, Brian C. Coleman, Amy L. Brown, Carla Ciraco, Jenna DiDonato, Li Wang, Rachel J. Couban, Abhimanyu Sud, Jason W. Busse

In recent studies, receipt of chiropractic care has been associated with lower odds of receiving prescription opioids and, among those already prescribed, reduced doses of opioids among patients with non-cancer spine pain. These findings suggest that access to chiropractic services may reduce reliance on opioids for musculoskeletal pain. To assess the impact of chiropractic care on initiation, or continued use, of prescription opioids among patients with non-cancer spine pain. We will search for eligible randomized controlled trials (RCTs) and observational studies indexed in MEDLINE, Embase, AMED, CINAHL, Web of Science, and the Index to Chiropractic Literature from database inception to June 2024. Article screening, data extraction, and risk-of-bias assessment will be conducted independently by pairs of reviewers. We will conduct separate analyses for RCTs and observational studies and pool binary outcomes (e.g. prescribed opioid receipt, long-term opioid use, and higher versus lower opioid dose) as odds ratios (ORs) with associated 95% confidence intervals (CIs). When studies provide hazard ratios (HRs) or relative risks (RRs) for time-to-event data (e.g. time-to-first opioid prescription) or incidence rates (number of opioid prescriptions over time), we will first convert them to an OR before pooling. Continuous outcomes such as pain intensity, sleep quality, or morphine equivalent dose will be pooled as weighted mean differences with associated 95% CIs. We will conduct meta-analyses using random-effects models and explore sources of heterogeneity using subgroup analyses and meta-regression. We will evaluate the certainty of evidence of all outcomes using the GRADE approach and the credibility of all subgroup effects with ICEMAN criteria. Our systematic review will follow the PRISMA statement and MOOSE guidelines. Our review will establish the current evidence informing the impact of chiropractic care on new or continued prescription opioid use for non-cancer spine pain. We will disseminate our results through peer-reviewed publication and conference presentations. The findings of our review will be of interest to patients, health care providers, and policy-makers. Systematic review registration: PROSPERO CRD42023432277.

在最近的研究中，接受脊骨神经治疗与非癌症脊柱疼痛患者接受阿片类药物处方的几率降低，以及在已开具处方的患者中减少阿片类药物的剂量有关。这些研究结果表明，接受脊骨神经治疗可减少肌肉骨骼疼痛患者对阿片类药物的依赖。目的：评估脊骨神经治疗对非癌症脊柱疼痛患者开始或继续使用处方阿片类药物的影响。我们将检索符合条件的随机对照试验（RCT）和观察性研究，这些研究将在 MEDLINE、Embase、AMED、CINAHL、Web of Science 和《脊骨神经医学文献索引》（Index to Chiropractic Literature）中收录，检索期从数据库开始至 2024 年 6 月。文章筛选、数据提取和偏倚风险评估将由一对审稿人独立完成。我们将对研究性临床试验和观察性研究分别进行分析，并将二元结果（如处方阿片类药物接收、长期使用阿片类药物、阿片类药物剂量高与低等）汇总为几率比（OR）及相关的 95% 置信区间（CI）。如果研究提供了时间到事件数据（如首次开具阿片类药物处方的时间）的危险比（HRs）或相对危险度（RRs）或发病率（一段时间内开具阿片类药物处方的数量），我们将首先将其转换为 OR，然后再进行汇总。疼痛强度、睡眠质量或吗啡当量剂量等连续性结果将以加权平均差及相关 95% CI 的形式进行汇总。我们将使用随机效应模型进行荟萃分析，并使用亚组分析和元回归探讨异质性的来源。我们将采用 GRADE 方法评估所有结果的证据确定性，并采用 ICEMAN 标准评估所有亚组效应的可信度。我们的系统综述将遵循 PRISMA 声明和 MOOSE 指南。我们的综述将建立当前的证据，说明脊骨神经治疗对非癌症脊柱疼痛的新处方或持续处方阿片类药物使用的影响。我们将通过同行评议刊物和会议演讲传播我们的研究成果。我们的研究结果将引起患者、医疗服务提供者和政策制定者的兴趣。系统综述注册：ProCORMBERCO CRD42023432277.

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引用次数: 0

Adult co-creators’ emotional and psychological experiences of the co-creation process: a Health CASCADE scoping review protocol 成人共同创作者在共同创作过程中的情感和心理体验：健康 CASCADE 范围界定审查协议

IF 3.7 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-11 DOI: 10.1186/s13643-024-02643-9

Lauren McCaffrey, Bryan McCann, Maria Giné-Garriga, Qingfan An, Greet Cardon, Sebastien François Martin Chastin, Rabab Chrifou, Sonia Lippke, Quentin Loisel, Giuliana Raffaella Longworth, Katrina Messiha, Mira Vogelsang, Emily Whyte, Philippa Margaret Dall

There is a growing investment in the use of co-creation, reflected by an increase in co-created products, services, and interventions. At the same time, a growing recognition of the significance of co-creators’ experience can be detected but there is a gap in the aggregation of the literature with regard to experience. Therefore, the purpose of this scoping review is to uncover the breadth of existing empirical research on co-creation experience, how it has been defined and assessed, and its key emotional and psychological characteristics in the context of co-created products, services, or interventions among adults. The development of the search strategy was guided by the research question, Arksey, and O’Malley’s scoping review methodology guidelines, and through collaboration with members of the Health CASCADE consortium. The results of the search and the study inclusion process will be reported in full and presented both narratively and by use of the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram. Comprehensive searches of relevant electronic databases (e.g. Scopus) will be conducted to identify relevant papers. Snowball searches to identify additional papers through included full-text papers will be done using the artificial intelligence tool, namely, Connected Papers. All review steps will involve at least two reviewers. Studies in English, Dutch, Chinese, Spanish, and French, published from the year 1970 onwards, will be considered. Microsoft Excel software will be used to record and chart extracted data. The resulting scoping review could provide useful insights into adult co-creators’ experience of participating in the co-creation process. An increased understanding of the role of emotional and psychological experiences of participating in co-creation processes may help to inform the co-creation process and lead to potential benefits for the co-creators and co-created outcome. 10.5281/zenodo.7665851.

共同创造的产品、服务和干预措施越来越多，这反映出人们对利用共同创造的投入越来越大。与此同时，人们也越来越认识到共同创造者经验的重要性，但有关经验的文献汇总却存在空白。因此，本次范围界定综述的目的是揭示现有关于共创体验的实证研究的广度，如何定义和评估共创体验，以及在成人共创产品、服务或干预措施背景下共创体验的主要情感和心理特征。在研究问题、Arksey 和 O'Malley 的范围界定综述方法指南的指导下，并通过与 Health CASCADE 联合体成员的合作，制定了检索策略。我们将全面报告检索结果和研究纳入过程，并采用 "系统性综述和荟萃分析首选报告项目"（Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Review，PRISMA-ScR）流程图进行叙述和展示。将对相关电子数据库（如 Scopus）进行全面检索，以确定相关论文。将使用人工智能工具 "连接论文"（Connected Papers）进行 "滚雪球 "式搜索，通过已收录的全文论文找出更多论文。所有审稿步骤都将至少有两名审稿人参与。将考虑 1970 年以后发表的英文、荷兰文、中文、西班牙文和法文研究报告。将使用 Microsoft Excel 软件对提取的数据进行记录和制表。由此产生的范围综述可以为成人共同创作者参与共同创作过程的经验提供有用的见解。进一步了解参与共同创造过程的情感和心理体验的作用可能有助于为共同创造过程提供信息，并为共同创造者和共同创造的成果带来潜在的益处。10.5281/zenodo.7665851.

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引用次数: 0

A case study of the informative value of risk of bias and reporting quality assessments for systematic reviews. 系统性综述的偏倚风险和报告质量评估的信息价值案例研究。

IF 6.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-07 DOI: 10.1186/s13643-024-02650-w

Cathalijn H C Leenaars, Frans R Stafleu, Christine Häger, André Bleich

While undisputedly important, and part of any systematic review (SR) by definition, evaluation of the risk of bias within the included studies is one of the most time-consuming parts of performing an SR. In this paper, we describe a case study comprising an extensive analysis of risk of bias (RoB) and reporting quality (RQ) assessment from a previously published review (CRD42021236047). It included both animal and human studies, and the included studies compared baseline diseased subjects with controls, assessed the effects of investigational treatments, or both. We compared RoB and RQ between the different types of included primary studies. We also assessed the "informative value" of each of the separate elements for meta-researchers, based on the notion that variation in reporting may be more interesting for the meta-researcher than consistently high/low or reported/non-reported scores. In general, reporting of experimental details was low. This resulted in frequent unclear risk-of-bias scores. We observed this both for animal and for human studies and both for disease-control comparisons and investigations of experimental treatments. Plots and explorative chi-square tests showed that reporting was slightly better for human studies of investigational treatments than for the other study types. With the evidence reported as is, risk-of-bias assessments for systematic reviews have low informative value other than repeatedly showing that reporting of experimental details needs to improve in all kinds of in vivo research. Particularly for reviews that do not directly inform treatment decisions, it could be efficient to perform a thorough but partial assessment of the quality of the included studies, either of a random subset of the included publications or of a subset of relatively informative elements, comprising, e.g. ethics evaluation, conflicts of interest statements, study limitations, baseline characteristics, and the unit of analysis. This publication suggests several potential procedures.

对纳入研究的偏倚风险进行评估是进行系统综述（SR）最耗时的部分之一，这一点毋庸置疑，而且也是任何系统综述（SR）的一部分。在本文中，我们介绍了一项案例研究，其中包括对之前发表的一篇综述（CRD42021236047）的偏倚风险（RoB）和报告质量（RQ）评估的广泛分析。该研究既包括动物研究，也包括人体研究，所纳入的研究将基线患病对象与对照组进行了比较，或评估了研究性治疗的效果，或两者兼而有之。我们比较了纳入的不同类型主要研究的 RoB 和 RQ。我们还评估了每项独立要素对元研究者的 "信息价值"，因为元研究者认为报告中的差异可能比一致的高分/低分或已报告/未报告得分更有意义。一般来说，实验细节的报告较少。这导致偏倚风险评分经常不明确。我们在动物研究和人体研究中，以及在疾病对照比较和实验治疗调查中都发现了这种情况。曲线图和探索性的卡方检验表明，与其他研究类型相比，人类试验性治疗研究的报告情况略好。根据目前报告的证据，对系统综述进行偏倚风险评估的信息价值很低，只能反复表明在所有类型的体内研究中，实验细节的报告都需要改进。特别是对于不直接为治疗决策提供信息的综述，对所纳入研究的质量进行全面但不全面的评估可能会很有效，评估可以是对所纳入出版物的随机子集进行评估，也可以是对相对有参考价值的要素的子集进行评估，这些要素包括伦理评估、利益冲突声明、研究限制、基线特征和分析单位等。本出版物提出了几种可能的程序。

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引用次数: 0

Antimicrobial prescription pattern and appropriateness for respiratory tract infection in outpatients: a systematic review and meta-analysis. 门诊患者呼吸道感染的抗菌药处方模式和适宜性：系统回顾和荟萃分析。

IF 6.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-06 DOI: 10.1186/s13643-024-02649-3

Gashaw Enbiyale Kasse, Suzanne M Cosh, Judy Humphries, Md Shahidul Islam

Background: Millions of people die every year as a result of antimicrobial resistance worldwide. An inappropriate prescription of antimicrobials (e.g., overuse, inadequate use, or a choice that diverges from established guidelines) can lead to a heightened risk of antimicrobial resistance. This study aimed to determine the rate and appropriateness of antimicrobial prescriptions for respiratory tract infections.Methods: This review was conducted in accordance with the PRISMA guidelines. Web of Science, PubMed, ProQuest Health and Medicine, and Scopus were searched between October 1, 2023, and December 15, 2023, with no time constraints. Studies were independently screened by the first author and the co-authors. We included original studies reporting antimicrobial prescription patterns and appropriateness for respiratory tract infections. The quality of included studies' was assessed via the Joanna Briggs Institute's Critical Appraisal Checklists for Cross-Sectional Studies. The assessment of publication bias was conducted using a funnel plot and Egger's regression test. A random effect model was employed to estimate the pooled antibiotic prescribing and inappropriate rates. Subgroup analysis was conducted by country, study period, data source, and age group.Results: Of the total 1220 identified studies, 36 studies were included in the review. The antimicrobial prescribing rate ranged from 25% (95% CI 0.24-0.26) to 90% (95% CI 0.89-0.91). The pooled antimicrobial prescription rate was 66% (95% CI 0.57 to 0.73). Subgroup analysis by region revealed that the antimicrobial prescription rate was highest in Africa (79%, 95% CI 0.48-0.94) and lowest in Europe (47%, 95% CI 0.32-0.62). Amoxicillin and amoxicillin-clavulanate antimicrobials from the Access group, along with azithromycin and erythromycin from the Watch group, were the most frequently used antimicrobial agents. This study revealed that the major reasons for antimicrobial prescription were acute bronchitis, pharyngitis, sinusitis, and the common cold. The pooled inappropriate antimicrobial prescription rate was 45% (95% CI 0.38-0.52). Twenty-eight of the included studies reported that prescribing antimicrobials without proper indications was the main cause of inappropriate antimicrobial prescriptions. Additionally, subgroup analysis by region showed a higher inappropriate antimicrobial prescription rate in Asia at 49% (95% CI 0.38-0.60). The result of the funnel plot and Egger's tests revealed no substantial publication bias (Egger's test: p = 0.268).Conclusion: The prescribing rate and inappropriate use of antimicrobials remain high and vary among countries. Further studies should be conducted to generate information about factors contributing to unnecessary antimicrobial prescriptions in outpatients.Systematic review registration: Systematic review registration: CRD42023468353.

背景：全球每年有数百万人死于抗菌药耐药性。抗菌药处方不当（如过度使用、使用不足或选择偏离既定指南）会导致抗菌药耐药性风险增加。本研究旨在确定呼吸道感染抗菌药物处方的使用率和适当性：本综述按照 PRISMA 指南进行。在 2023 年 10 月 1 日至 2023 年 12 月 15 日期间，不受时间限制地检索了 Web of Science、PubMed、ProQuest Health and Medicine 和 Scopus。研究由第一作者和共同作者独立筛选。我们纳入了报告呼吸道感染抗菌药物处方模式和适宜性的原创研究。纳入研究的质量通过乔安娜-布里格斯研究所（Joanna Briggs Institute）的《横断面研究批判性评估检查表》进行评估。采用漏斗图和 Egger 回归检验对发表偏倚进行了评估。采用随机效应模型来估算抗生素的汇总处方率和不当使用率。按照国家、研究时间、数据来源和年龄组进行了分组分析：在总共 1220 项已确定的研究中，有 36 项研究被纳入综述。抗菌药物处方率从 25% (95% CI 0.24-0.26) 到 90% (95% CI 0.89-0.91) 不等。汇总的抗菌药物处方率为 66%（95% CI 0.57 至 0.73）。按地区进行的分组分析显示，抗菌药物处方率最高的地区是非洲（79%，95% CI 0.48-0.94），最低的地区是欧洲（47%，95% CI 0.32-0.62）。Access组的阿莫西林和阿莫西林-克拉维酸酯抗菌药以及Watch组的阿奇霉素和红霉素是最常用的抗菌药。这项研究显示，开具抗菌药处方的主要原因是急性支气管炎、咽炎、鼻窦炎和普通感冒。不适当抗菌药处方的汇总率为 45%（95% CI 0.38-0.52）。所纳入的研究中有 28 项报告称，开具无适当适应症的抗菌药物处方是导致抗菌药物处方不当的主要原因。此外，按地区进行的分组分析表明，亚洲的抗菌药物处方不当率较高，为 49%（95% CI 0.38-0.60）。漏斗图和 Egger 检验的结果显示没有实质性的发表偏倚（Egger 检验：P = 0.268）：结论：抗菌药物的处方率和不当使用率仍然很高，而且各国之间存在差异。应开展进一步研究，以了解导致门诊患者不必要使用抗菌药物处方的因素：系统综述注册CRD42023468353。

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引用次数: 0

Is artificial intelligence for medical professionals serving the patients? : Protocol for a systematic review on patient-relevant benefits and harms of algorithmic decision-making. 医疗专业人员的人工智能是在为患者服务吗？算法决策对患者的利弊系统综述协议》。

IF 6.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Systematic Reviews

Pub Date : 2024-09-06 DOI: 10.1186/s13643-024-02646-6

Christoph Wilhelm, Anke Steckelberg, Felix G Rebitschek

Background: Algorithmic decision-making (ADM) utilises algorithms to collect and process data and develop models to make or support decisions. Advances in artificial intelligence (AI) have led to the development of support systems that can be superior to medical professionals without AI support in certain tasks. However, whether patients can benefit from this remains unclear. The aim of this systematic review is to assess the current evidence on patient-relevant benefits and harms, such as improved survival rates and reduced treatment-related complications, when healthcare professionals use ADM systems (developed using or working with AI) compared to healthcare professionals without AI-related ADM (standard care)-regardless of the clinical issues.

Methods: Following the PRISMA statement, MEDLINE and PubMed (via PubMed), Embase (via Elsevier) and IEEE Xplore will be searched using English free text terms in title/abstract, Medical Subject Headings (MeSH) terms and Embase Subject Headings (Emtree fields). Additional studies will be identified by contacting authors of included studies and through reference lists of included studies. Grey literature searches will be conducted in Google Scholar. Risk of bias will be assessed by using Cochrane's RoB 2 for randomised trials and ROBINS-I for non-randomised trials. Transparent reporting of the included studies will be assessed using the CONSORT-AI extension statement. Two researchers will screen, assess and extract from the studies independently, with a third in case of conflicts that cannot be resolved by discussion.

Discussion: It is expected that there will be a substantial shortage of suitable studies that compare healthcare professionals with and without ADM systems concerning patient-relevant endpoints. This can be attributed to the prioritisation of technical quality criteria and, in some cases, clinical parameters over patient-relevant endpoints in the development of study designs. Furthermore, it is anticipated that a significant portion of the identified studies will exhibit relatively poor methodological quality and provide only limited generalisable results.

Systematic review registration: This study is registered within PROSPERO (CRD42023412156).

背景：算法决策（ADM算法决策（ADM）利用算法来收集和处理数据，并开发模型以做出或支持决策。人工智能（AI）的进步促进了支持系统的发展，在某些任务中，这些系统可以优于没有人工智能支持的医疗专业人员。然而，患者是否能从中受益仍不清楚。本系统性综述旨在评估目前与患者相关的益处和危害方面的证据，如与不使用人工智能相关ADM（标准护理）的医疗专业人员相比，医疗专业人员使用ADM系统（使用人工智能开发或与人工智能合作）可提高存活率并减少与治疗相关的并发症--无论临床问题如何：按照 PRISMA 声明，将使用标题/摘要中的英文自由文本术语、医学主题词表（MeSH）术语和 Embase 主题词表（Emtree 字段）检索 MEDLINE 和 PubMed（通过 PubMed）、Embase（通过 Elsevier）以及 IEEE Xplore。其他研究将通过联系纳入研究的作者和参考文献目录来确定。灰色文献检索将在谷歌学术中进行。对于随机试验，将使用 Cochrane's RoB 2 评估偏倚风险；对于非随机试验，将使用 ROBINS-I 评估偏倚风险。将使用 CONSORT-AI 扩展声明对纳入研究的透明报告进行评估。两名研究人员将独立筛选、评估和摘录研究内容，如果出现无法通过讨论解决的冲突，将由第三名研究人员进行处理：预计在与患者相关的终点方面，对使用和未使用 ADM 系统的医护人员进行比较的合适研究将非常缺乏。这可能是由于在制定研究设计时优先考虑了技术质量标准，在某些情况下优先考虑了临床参数，而不是与患者相关的终点。此外，预计在已确定的研究中，有相当一部分研究的方法学质量相对较差，只能提供有限的可推广结果：本研究已在 PROSPERO 注册（CRD42023412156）。

{"title":"Is artificial intelligence for medical professionals serving the patients? : Protocol for a systematic review on patient-relevant benefits and harms of algorithmic decision-making.","authors":"Christoph Wilhelm, Anke Steckelberg, Felix G Rebitschek","doi":"10.1186/s13643-024-02646-6","DOIUrl":"10.1186/s13643-024-02646-6","url":null,"abstract":"Background: Algorithmic decision-making (ADM) utilises algorithms to collect and process data and develop models to make or support decisions. Advances in artificial intelligence (AI) have led to the development of support systems that can be superior to medical professionals without AI support in certain tasks. However, whether patients can benefit from this remains unclear. The aim of this systematic review is to assess the current evidence on patient-relevant benefits and harms, such as improved survival rates and reduced treatment-related complications, when healthcare professionals use ADM systems (developed using or working with AI) compared to healthcare professionals without AI-related ADM (standard care)-regardless of the clinical issues.Methods: Following the PRISMA statement, MEDLINE and PubMed (via PubMed), Embase (via Elsevier) and IEEE Xplore will be searched using English free text terms in title/abstract, Medical Subject Headings (MeSH) terms and Embase Subject Headings (Emtree fields). Additional studies will be identified by contacting authors of included studies and through reference lists of included studies. Grey literature searches will be conducted in Google Scholar. Risk of bias will be assessed by using Cochrane's RoB 2 for randomised trials and ROBINS-I for non-randomised trials. Transparent reporting of the included studies will be assessed using the CONSORT-AI extension statement. Two researchers will screen, assess and extract from the studies independently, with a third in case of conflicts that cannot be resolved by discussion.Discussion: It is expected that there will be a substantial shortage of suitable studies that compare healthcare professionals with and without ADM systems concerning patient-relevant endpoints. This can be attributed to the prioritisation of technical quality criteria and, in some cases, clinical parameters over patient-relevant endpoints in the development of study designs. Furthermore, it is anticipated that a significant portion of the identified studies will exhibit relatively poor methodological quality and provide only limited generalisable results.Systematic review registration: This study is registered within PROSPERO (CRD42023412156).","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"13 1","pages":"228"},"PeriodicalIF":6.3,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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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