Systematic Reviews最新文献

Background: Systematic reviews are fundamental to evidence-based medicine, but the process of screening studies is time-consuming and prone to errors, especially when conducted by a single reviewer. False exclusions of relevant studies can significantly impact the quality and reliability of reviews. Artificial intelligence (AI) tools have emerged as secondary reviewers in detecting these false exclusions, yet empirical evidence comparing their performance is limited.

Methods: This study protocol outlines a comprehensive evaluation of four AI tools (ASReview, DistillerSR Artificial Intelligence System [DAISY], Evidence for Policy and Practice Information [EPPI]-Reviewer, and Rayyan) in their capacity to act as secondary reviewers during single-reviewer title and abstract screening for systematic reviews. Utilizing a database of single-reviewer screening decisions from two published systematic reviews, we will assess how effective AI tools are at detecting false exclusions while assisting single-reviewer screening compared to the dual-reviewer reference standard. Additionally, we aim to determine the overall screening performance of AI tools in assisting single-reviewer screening.

Discussion: This research seeks to provide valuable insights into the potential of AI-assisted screening for detecting falsely excluded studies during single screening. By comparing the performance of multiple AI tools, we aim to guide researchers in selecting the most effective assistive technologies for their review processes.

Systematic review registration: (Open Science Framework): https://osf.io/dky26.

Background: Advancements in artificial intelligence (AI) are transforming employment and working conditions in ways that shape the safety, health, and well-being of workers. We describe a protocol for a living systematic review (LSR) that will examine the interrelationship between AI systems, employment and working conditions, and worker safety, health, and well-being. Research questions are: 1. What types of AI systems are being used within workplaces and how do their design and adoption impact worker safety, health, and well-being? 2. How do a worker's employment and working conditions affect the relationship between the adoption of AI systems and worker safety, health, and well-being? 3. How does a worker's social position (e.g., age, gender, race, disability) shape the interrelationship between AI systems at work, employment and working conditions, and their safety, health, and well-being?

Methods: A comprehensive search of primary qualitative and quantitative research will be conducted. MEDLINE, Embase (OVID), PsycINFO (OVID), and Web of Science will be searched every six to twelve months using database-specific terms and keywords. Title/abstract and full-text screening will be completed independently by two reviewers. Relevant articles will be quality appraised using a mixed method assessment tool adapted for studies of AI. Medium and high-quality studies will be synthesized using a best evidence synthesis approach. To ensure relevancy, applied workplace and AI stakeholders will provide feedback at all stages of the LSR process through dissemination excluding quality appraisal. Annually, we will evaluate the appropriateness of the review process (e.g., frequency of searches, requirement to refine research questions, utility of continuing LSR). Any amendments to protocols will be documented.

Discussion: This LSR will provide timely and evolving evidence on the implications of AI in the workplace that will be disseminated through a publicly available living review dashboard. We will capture the emerging impact AI has on workers. Findings can be used to develop strategies to minimize AI's potential workplace harms while amplifying its potential benefits, address emerging worker inequities, and inform ongoing discussions regarding responsible and safe AI adoption.

Systematic review registration: PROSPERO CRD42024625501.

Background: Advanced practice nurses play a vital role in healthcare innovation, delivering high-quality care and improving patient outcomes. Leadership is a core competency of advanced practice nurses, empowering them to drive systemic improvements and foster collaboration. However, these master-level educated nurses often encounter challenges in assuming leadership roles, including limited recognition and competing demands on their time. The growing volume of healthcare-related research, combined with the lack of a comprehensive evidence base on the determinants and outcomes of their leadership behaviours, complicates the development of effective programmes. This protocol outlines a systematic approach to addressing these challenges, using an AI tool to efficiently manage the expanding evidence base and provide a detailed understanding of the factors influencing advanced practice nurses' leadership behaviours.

Methods: This protocol follows the PRISMA-P 2015 guidelines to outline a systematic review investigating the determinants and outcomes of advanced practice nurses' leadership behaviours. It employs the SPIDER tool for eligibility criteria, encompassing studies that explore advanced practice nursing leadership behaviours and their determinants and outcomes. Eligible studies include quantitative, qualitative and mixed-methods research, focusing on advanced practice nursing roles. The protocol also outlines a workflow for AI-aided title and abstract screening using ASReview LAB, incorporating multi-phase human validation to ensure accuracy and reliability. Data synthesis will utilise narrative synthesis for quantitative data and meta-aggregation for qualitative findings, integrating results through narrative weaving.

Discussion: This protocol addresses a critical gap in nursing research by systematically exploring the determinants influencing advanced practice nurses' leadership behaviours and their outcomes. It provides evidence to inform the development of tailored programmes aimed at empowering advanced practice nurses to maximise their leadership potential. Additionally, the protocol demonstrates how AI tools can enhance systematic review efficiency while maintaining methodological rigour. The findings will not only contribute to advancing nursing practice but also highlight the transformative potential of AI in research synthesis, ensuring timely and robust evidence generation amidst the expanding volume of healthcare-related research.

Systematic review registration: PROSPERO CRD42025644174.

Background: Breast cancer is the fourth leading cause of cancer mortality worldwide. New drugs, such as cyclin-dependent kinase 4/6 inhibitors (CDKIs), increase the life expectancy of receptor-positive (HR+) and human epidermal growth factor receptor 2 negative (HER2-) breast cancer patients. This class acts to limit the G1/S transition in tumor cells, inducing tumor cell death. Owing to the basic nature of CDKIs, their solubilities are pH dependent and could be influenced by the concurrent use of acid-reducing agents such as proton pump inhibitors (PPIs). This meta-analysis aims to assess the impact of co-administering PPIs on the pharmacokinetics and clinical efficacy of CDKIs in breast cancer patients.

Methods: Four databases with English-language restriction were searched for concomitant CDKIs and PPIs keywords from their inception date to 2024 March 7th. Prospective, retrospective, randomized or nonrandomized clinical studies and observational longitudinal studies with at least one outcome of interest were included. The outcomes included pharmacokinetic variables, progression-free survival (PFS), and overall survival (OS).

Results: We included three pharmacokinetic studies conducted in patients enrolled in clinical trials and seven clinical studies evaluating survival outcomes. When coadministered with palbociclib, PPIs significantly reduced the serum maximum concentration (Cmax) (MD -35.37 ng/mL; 95%CI from -67.59 to -3.16) and increased the clearance (CL/F) (MD 61.24 L/h; 95%CI from 14.66 to 107.82). Ribociclib Cmax and AUC did not significantly differ among the PPIs users. However, the overall PFS favored PPIs non-users (HR 1.74; 95%CI from 1.28 to 2.37). Consistently, coadministration of PPIs with CDKIs significantly increased the likelihood of reduced OS (HR 1.99; 95%CI from 1.18 to 3.33). The effect was confirmed only for the palbociclib subgroup (HR 2.11; 95%CI from 1.17 to 3.81). No data were available for OS evaluation with ribociclib. A single study on abemaciclib revealed nonsignificant differences (HR 1.30; 95%CI from 0.53 to 3.19), with similar results for OS.

Conclusions: PPI use in HR + /HER2- breast cancer patients treated with palociclib should be avoided. When strictly necessary, ribociclib may be preferred to palbociclib, even though closer monitoring is strongly advised.

Systematic review registration: PROSPERO identifier number CRD42024506456.

Introduction: The prevalence and mortality rates of type 2 diabetes mellitus (T2DM) are increasing, making it a significant public health concern. Effective self-management of T2DM requires external factors, such as medical interventions and social support, and internal factors, including self-efficacy. However, during humanitarian emergencies, such as the COVID-19 pandemic, healthcare system disruptions limit external factors, making internal factors even more critical. Nonetheless, existing reviews have primarily focused on external factors and clinical outcomes during the pandemic, with no comprehensive review examining internal factors. Therefore, this review aims to systematically synthesize evidence on the internal factors supporting T2DM self-management during the COVID-19 pandemic and identify research gaps.

Methods: This scoping review follows the Joanna Briggs Institute guidelines and is conducted according to the PRISMA-P framework. A comprehensive search strategy will be employed to systematically explore multiple databases, including PubMed (MEDLINE), CINAHL, Web of Science, Scopus, ERIC, PsycINFO, and the Cochrane Library, as well as gray literature platforms, such as Google, Google Scholar, and Semantic Scholar. The search will include both published and gray literature without language restrictions. Studies that utilize quantitative and qualitative methodologies will also be included. Two independent reviewers will screen titles, abstracts, and full texts for eligibility, and discrepancies will be resolved through discussion or consultation with a third reviewer. The outcomes related to the internal factors contributing to the improvement of self-management among T2DM patients will be extracted and summarized. The findings will be presented descriptively and in tabular form, emphasizing key insights and identifying research gaps in the literature.

Discussion: The findings will be actively disseminated through academic conferences and peer-reviewed journals to provide valuable insights into the internal factors that contribute to the improvement of self-management in T2DM patients. These results are expected to contribute to the development of innovative strategies for sustaining and improving self-management in T2DM patients during future humanitarian emergencies and major public health challenges.

Background: Phosphodiesterase type-5 inhibitors (PDE5is) are used for the treatment of erectile dysfunction (ED) and have potential cardioprotective effects. The impacts of PDE5is on cardiovascular parameters, which may be associated with the occurrence and progression of subclinical cardiovascular diseases, remain uncertain. In this study, we evaluated the effects of PDE5is on vascular parameters.

Methods: Randomized controlled trials (RCTs) that compared the effects of PDE5is and placebo on vascular parameters and were published from 1998 to 2022 were identified from PubMed, Scopus and Web of Science. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled. A sensitivity analysis was conducted to confirm the robustness of the pooled results. The keywords that were searched in the databases are as follows: ((systolic blood pressure) OR (SBP) OR (diastolic blood pressure) OR (DBP) OR (mean arterial pressure) OR (MAP) OR (Pulse Wave Velocity) OR (PWV) OR (intima-media thickness) OR (cIMT) OR (augmentation Index) OR (AI) OR (FMD) OR (flow-mediated dilation) OR (reactive hyperemia index) OR (RHI) OR (Endothelial microparticles) OR (EMP) OR (EPCs) OR (Endothelial Progenitor Cells) OR (PSV) OR (peak systolic velocity)) AND ((PDE5 Inhibitors) OR (PDE5i) OR (Sildenafil) OR (Vardenafil) OR (Tadalafil) OR (Lodenafil) OR (Udenafil) OR (Avanafil)).

Results: Sixty-three studies involving 3242 subjects were included. Overall, PDE5is decreased systolic blood pressure (MD: -2.80 mmHg, 95% CI: -4.24, -1.37, P < 0.001), diastolic blood pressure (MD: -1.80 mmHg, 95% CI: -2.37, -1.22, P < 0.001), carotid intima‒media thickness (MD: -0.01 mm, 95% CI: -0.02, -0.01, P < 0.001), and pulse wave velocity (MD: -0.75 cm/s, 95% CI: -1.01, -0.49, P < 0.001). In addition, PDE5is increased the peak systolic velocity (MD: 3.70 cm/s, 95% CI: 3.52, 3.88, P < 0.001), flow-mediated dilation (MD: 2.47%, 95% CI: 1.24, 3.71, P < 0.001), concentration of endothelial progenitor cells (MD: 475.29 cells/mL, 95% CI: 51.38, 899.20, P = 0.03), and concentration of endothelial microparticles (MD: 4.86%, 95% CI: 0.65, 9.07, P = 0.02). However, the effects of PDE5is on the augmentation index, brachial artery diameter and reactive hyperemia index were not statistically significant.

Conclusion: Compared with the placebo, PDE5is improved vascular parameters, indicating the potential of PDE5is for treating subclinical cardiovascular diseases. Further research is needed to confirm the role of the improvement on vascular parameters by PDE5isin preventing and treating cardiovascular diseases.

Systematic review registration: The present study protocol was reviewed and approved by PROSPERO. The title is "Associations between PDE5is and vascular parameters: A systematic review and meta-analysis" ( https://www.crd.york.ac.uk/PROSPERO/ ) (Reg. No. CRD42023387924).

Introduction: Food insecurity is the violation of this right to regular and permanent access to quality food in sufficient quantity without compromising other essential needs and is associated with an increase in non-communicable chronic diseases (NCDs). Recyclable waste collectors' vulnerable social groups face a high risk of food insecurity due to low income, precarious working conditions, and a lack of public policies targeting them.

Objective: This systematic review aimed to investigate the prevalence of food insecurity as well as changes in nutritional status among recyclable waste collectors.

Methods: The review followed the Cochrane guidelines and was registered in PROSPERO. Five databases were searched and observational studies (cross-sectional, case--control, and cohort) were included. The primary outcome was the prevalence of food insecurity and secondary outcomes were nutritional status such as underweight, overweight, and obese. Meta-analysis was performed using the pooled crude proportions (PRAW) method and random effects in software R version 4.1.1.

Results: The search identified 10 studies involving 788 waste collectors. The prevalence of food insecurity was high, reaching 71% with Brazil showing the highest prevalence (77%). Overweight affected 47% of participants, with higher rates in Brazil (52%) compared to South Africa (25%). Additionally, 29% of the collectors were obese.

Conclusion: The high prevalence of food insecurity and overweight among recyclable waste collectors highlights the urgent need for specific public policies for this group.

Systematic review registration: PROSPERO CRD42025645499.

Background: This scoping review protocol aims to examine the current evidence base on the experiences, barriers, and facilitators of infant and young child feeding (IYCF) among adolescent mothers in sub-Saharan Africa (SSA). The review will help to identify the nature and extent of available research in this area and highlight evidence and knowledge gaps for future research. The work is significant because of the urgent need to understand the unique challenges faced by adolescent mothers in SSA and inform the development of evidence-based interventions to improve IYCF practices.

Methods: The review will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search strategy will be employed to identify relevant studies from electronic databases, grey literature, and additional sources. Four independent reviewers will conduct study selection, data extraction, and quality appraisal. Bronfenbrenner's bioecological model system levels will be used as a guiding framework to code, interpret and frame the results by identifying experiences, barriers, and enablers influencing IYCF practices at microsystem, mesosystem, exosystem, and macrosystem levels. Furthermore, the review will highlight gaps in existing literature, providing valuable insights for future research and evidence-based interventions.

Discussion: The study is aligned with global efforts to address child malnutrition and emphasizes the importance of evidence-based interventions in SSA and findings will be disseminated through publication in a peer-reviewed journal and presentation at national and international conferences. The protocol has been registered prospectively on the Open Science Framework ( https://osf.io/h7kzw ).

Background: The global shortage of organs and tissues highlights the need to strengthen and monitor the quality of deceased donor programs. Evaluating each stage of this process using quality-sensitive indicators is essential to ensure transparency, efficiency, safety, and effectiveness. However, there is still no consensus on which indicators best reflect the quality of organ and tissue donation processes, highlighting the need to map and analyze existing evidence. The aim of this study was to map and analyze international literature on indicators for monitoring the quality of the process of deceased organ and tissue donation for transplantation.

Methods: This review will be conducted following the methodology proposed by the JBI and guidelines for scope reviews. The databases, portals, and directories to be searched included MEDLINE (via PubMed), CINAHL (EBSCO), Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), Business Source Complete (EBSCO), VHL Virtual Health Library; gray literature will be sought on Google Scholar, OpenGrey (GreyNet), CAPES Theses and Dissertations, Global ETD Search (formerly the Union Catalog), Open Access Theses and Dissertations, and websites of organ and tissue donation and transplant organizations. Studies in any language and published after 1980 will be considered for inclusion. A wide range of study designs will be included, encompassing quantitative, qualitative, and mixed-methods research, as well as relevant gray literature on organ and tissue donation and transplantation. Two reviewers will screen the studies, paying attention to the eligibility criteria. The data will be extracted by means of specific variables and presented in categories according to the evaluative triad structure, process, and result, and by the pillars of quality proposed by Avedis Donabedian in the form of diagrams, tables, charts, and narrative synthesis.

Discussion: The evidence on quality indicators for organ and tissue donation processes is conceptually diverse. This scoping review will provide an overview of existing studies, identify gaps in current knowledge, and guide future research on the development and validation of quality indicators.

Systematic review registration: Open Science Framework osf.io/ymuvj/.

Objective: The study aimed to systematically review the evidence on the association between smoking and the risk of diabetic neuropathy, with a particular emphasis on the risk of peripheral neuropathy among individuals with diabetes mellitus.

Design and methods: MEDLINE, EMBASE, SCOPUS, and CENTRAL databases were searched for studies published before August 2024. Cross-sectional, case-control, and cohort studies that assessed the association between smoking and diabetic neuropathy in individuals diagnosed with diabetes mellitus (type 1 or type 2), reported smoking as an exposure, and any type of diabetic neuropathy as an outcome were included in the study. The risk of bias of the included studies was evaluated using the modified risk of bias in non-randomized studies-of exposures (ROBINS-E).

Results: Seventy-five articles, including 228,699 individuals with diabetes met the inclusion criteria. Fifty-four cross-sectional, 8 case-control, and 13 cohort studies provided data for the meta-analyses. Cohort studies demonstrated a significantly increased risk of diabetic peripheral neuropathy (RR 1.28; 95% CI 1.05, 1.51), the most prevalent subtype of diabetic neuropathy. Meta-analyses of cross-sectional and case-control revealed an increased risk of diabetic neuropathy (all types combined) among smokers with diabetes ([OR 1.29; 95% CI 1.17, 1.41], [OR 1.48; 95% CI 1.23, 1.72]). Meta-regression showed no statistically significant impact of total sample size and type of effect estimates on pooled effect estimates for cross-sectional, case-control, and cohort studies.

Conclusion: Smoking is associated with an increased risk of diabetic neuropathy, peripheral neuropathy in particular. Future research should evaluate the precise dynamics of neuropathy pathogenesis among individuals with diabetes to prevent such complications.

Systematic review registration: PROSPERO CRD42022363380.