Cochrane Database of Systematic Reviews最新文献

{"title":"Interventions for fertility preservation in women with cancer undergoing chemotherapy.","authors":"Maria Aj Weterings, Elizabeth Glanville, Rik van Eekelen, Cindy Farquhar","doi":"10.1002/14651858.CD012891.pub2","DOIUrl":"https://doi.org/10.1002/14651858.CD012891.pub2","url":null,"abstract":"<p><strong>Background: </strong>Anti-cancer drugs can be toxic to healthy cells in the body and have the potential to cause irreversible damage to ovarian tissue. This may lead to premature ovarian insufficiency. There are two main strategies to preserve fertility in women undergoing chemotherapy treatment for cancer. One is controlled ovarian hyperstimulation with gonadotropins and a protective agent for safety, followed by freezing of oocytes or embryos; the other is ovarian suppression using gonadotropin-releasing hormone agonists (GnRH agonists). This review aims to gain an understanding of the best way to support women with cancer to preserve their fertility. As breast cancer is the most common cancer in women worldwide, it is the primary focus of this review.</p><p><strong>Objectives: </strong>To determine the effectiveness and safety of the two main fertility preservation strategies used in premenopausal women with cancer undergoing chemotherapy. One strategy is controlled ovarian hyperstimulation with gonadotropins and a protective agent followed by freezing of oocytes/embryos, and the other is ovarian suppression using GnRH agonists.</p><p><strong>Search methods: </strong>We searched the Cochrane Gynaecology and Fertility (CGF) Specialised Register of Controlled Trials, CENTRAL, MEDLINE, Embase and PsycINFO on 27 November 2023. To identify additional studies, we also checked reference lists and contacted study authors and experts in the field.</p><p><strong>Selection criteria: </strong>We included randomised controlled trials (RCTs) that evaluated protective agents used in combination with controlled ovarian hyperstimulation with gonadotropins and followed by freezing of oocytes or embryos, and RCTs that evaluated the use of GnRH agonists to suppress the ovaries. The comparator could be placebo, usual care, no treatment or another agent in the same group (e.g. ovarian suppression using goserelin versus using leuprolide acetate). We also looked for studies that compared the two main fertility preservation methods against each other.</p><p><strong>Data collection and analysis: </strong>We used the standard methodological procedures recommended by Cochrane. The primary review outcomes were ovarian insufficiency, live birth and overall survival. We had a number of secondary outcomes, including non-pregnancy-related adverse events.</p><p><strong>Main results: </strong>We included 23 RCTs (2647 women analysed). We judged the certainty of the evidence to be very low to moderate. The main limitations in the evidence were serious risk of bias in multiple domains for several studies, publication bias due to early termination of three studies and very serious imprecision. Controlled ovarian hyperstimulation with gonadotropins and a protective agent followed by freezing of oocytes or embryos versus placebo, usual care, no treatment or another agent in the same group in breast cancer patients There was no evidence available for our primary outcomes: ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD012891"},"PeriodicalIF":8.8,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cupping therapy for chronic non-specific low back pain.","authors":"Bruno T Saragiotto, Hugo Jario Almeida Silva, Junior V Fandim, Wesley Rios, Germanna Medeiros Barbosa, Rodrigo Scattone Silva, Luke C Jenkins, Marcelo Cardoso de Souza","doi":"10.1002/14651858.CD015269","DOIUrl":"https://doi.org/10.1002/14651858.CD015269","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of cupping therapy for people with chronic non-specific LBP.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD015269"},"PeriodicalIF":8.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for helping people recognise early signs of recurrence in bipolar disorder.","authors":"Sumeet Gupta, Laurence Astill Wright, Ogba Onwuchekwa, Nicholas Meader, Ryan Pw Kenny, Rachel Steele, Richard K Morriss, Lakshmi Ramana Alla, Nitin Gupta","doi":"10.1002/14651858.CD015343.pub2","DOIUrl":"https://doi.org/10.1002/14651858.CD015343.pub2","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness of EWS plus TAU or EWS plus psychological therapy versus TAU alone or psychological treatment (without EWS) independently on time to recurrence of any bipolar episode and hospitalisation, and other clinically relevant outcome measures. To evaluate the effectiveness of intermittent medication used on recognition of EWS without continued mood-stabilising medication versus TAU involving continued mood-stabilising medication on time to recurrence of any bipolar episodes.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD015343"},"PeriodicalIF":8.8,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesh for immediate implant-based prepectoral breast reconstruction following mastectomy.","authors":"Rachel Rolph, Akriti Nanda, Timothy Martyn Hill, Lauren Chong, Pankaj G Roy, Michael Douek","doi":"10.1002/14651858.CD015961","DOIUrl":"https://doi.org/10.1002/14651858.CD015961","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of mesh (biological and synthetic) in immediate prosthetic (implant or expander) prepectoral breast reconstruction following mastectomy for women with breast cancer or breast cancer risk-reduction surgery.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD015961"},"PeriodicalIF":8.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgens for genitourinary and vasomotor symptoms associated with menopause.","authors":"Lucia A Lara, Denisse Cartagena-Ramos, Debora Cantelli, Carla M F Dias, Sarah Armstrong, Vanessa Jordan, Miguel Fuentealba-Torres","doi":"10.1002/14651858.CD016052","DOIUrl":"https://doi.org/10.1002/14651858.CD016052","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of androgens compared to placebo or no intervention, or another active treatment for genitourinary and vasomotor symptoms in perimenopausal or postmenopausal women.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD016052"},"PeriodicalIF":8.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for glaucoma.","authors":"Kalyan Vemulapalli, Rishikesh Gandhewar, Atika Safitri, Sueko M Ng, Manuele Michelessi, Augusto Azuara-Blanco, Su-Hsun Liu, Gianni Virgili, Kuang Hu","doi":"10.1002/14651858.CD016114","DOIUrl":"https://doi.org/10.1002/14651858.CD016114","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (diagnostic). The objectives are as follows: To determine the accuracy of artificial intelligence (AI) algorithms as a diagnostic tool for glaucoma compared with human graders in a community or secondary care setting. Secondary objectives To compare the performance of different AI algorithms in the diagnosis of glaucoma To explore other potential causes of heterogeneity in the diagnostic performance compared with human graders, using subgroup analysis of the following characteristics: Clinical setting in which the test is used (the general population in the community versus people referred to secondary care); Study design (studies enroling consecutive participants in the same setting versus multicentre registries and public databases); Characteristics of the population (age according to quartiles, sex, symptomatic versus asymptomatic), when sufficient data are available; Prevalence of glaucoma in the training and test sets (< 5% versus ≥ 5%), since sensitivity and specificity may depend on disease prevalence [17]; Severity of glaucoma; Core AI method used (neural networks, random forests, support vector machines, or others); Size of the dataset from which performance data were collected (< 1000 versus ≥ 1000 total unique participants); Modalities of input data for the AI algorithms (imaging data, visual fields, clinical parameters, or any combination), particularly as their accessibility and affordability may vary across different settings.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD016114"},"PeriodicalIF":8.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium salt substitution for blood pressure in adults with diabetes.","authors":"Ambrish Singh, Salman Hussain, Mark Nelson, Liping Huang, Benny Antony","doi":"10.1002/14651858.CD014721","DOIUrl":"https://doi.org/10.1002/14651858.CD014721","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effect on blood pressure - measured as changes in systolic and diastolic blood pressure (mmHg) using standardised measurement methods - of substituting sodium salt with other edible salts (e.g. potassium chloride, magnesium chloride) in people with diabetes mellitus.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD014721"},"PeriodicalIF":8.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint inhibitors for advanced oesophageal cancer treated with surgery, radiotherapy or chemotherapy.","authors":"Ning Cai, Yi Fung Chau, Yurou Xu, Yajing Sun, Hao Dong, Huan Song, Xingdong Chen, Chen Suo","doi":"10.1002/14651858.CD014621","DOIUrl":"10.1002/14651858.CD014621","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the effectiveness and safety of immune checkpoint inhibitors (ICIs) for people with advanced, unresectable or metastatic oesophageal cancer.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD014621"},"PeriodicalIF":8.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions for central serous chorioretinopathy: a network meta-analysis.","authors":"Clemens Ak Lange, Riaz Qureshi, Laurenz Pauleikhoff","doi":"10.1002/14651858.CD011841.pub3","DOIUrl":"10.1002/14651858.CD011841.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Central serous chorioretinopathy (CSC) is characterized by a thickened and dysfunctional choroid which is accompanied by a serous detachment of the neural retina. The effects on the retina are usually self-limiting, although some people are left with irreversible vision loss due to progressive and permanent photoreceptor damage or atrophy of the retinal pigment epithelium (RPE). There has been a variety of interventions used in CSC, including, but not limited to, laser treatment, photodynamic therapy (PDT), and drug therapy with mineralocorticoid receptor antagonists or intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents. However, it is not known whether these treatments offer significant long-term advantages over observation or each other. At present, there is no evidence-based consensus on the management of CSC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This is an update of a Cochrane review first published in 2015 where 25 studies with 1098 participants were included. Since then, many trials have been conducted and reports published. Our primary objective was to assess the comparative effectiveness of multiple interventions for CSC. The secondary objective was to provide the relative ranking of the interventions for CSC using network meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, and three trial registries in 29 March 2024, together with reference checking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Randomized controlled trials (RCTs) that compared any intervention for CSC with any other intervention for CSC or control.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors (CL, LP) independently selected studies and extracted data. Our outcomes of interest were best corrected visual acuity (BCVA), recurrence of CSC, persistent CSC, contrast sensitivity, central retinal subfield thickness, quality of life, and adverse events. We used standard methodological procedures expected by Cochrane. We used Cochrane's statistical software, Review Manager, to perform pairwise analyses and Stata to perform network meta-analysis (NMA). For pairwise comparisons, we pooled data from studies using fixed or random-effects models if there were fewer or more than three studies, respectively. We conducted NMAs using a multivariate meta-analyses approach and ranked interventions using the surface under the cumulative ranking (SUCRA). We used the Confidence in Network Meta-Analysis (CINeMA) approach to assess and present the certainty of evidence for NMA results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;This review includes 4015 participants from 67 RCTs in total. Additionally, we identified 31 ongoing clinical trials. Trials compared aflibercept, crocin, lutein, eplerenone, spironolactone, prednisolone eye drops, PDT, subthreshold micropulse laser (SML) (577 nm) between each other or respective control groups (e.g. observation, sham injection, or pla","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD011841"},"PeriodicalIF":8.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probiotics in infants for prevention of allergic disease.","authors":"Hang Zhen Wang, Elizabeth H Hayles, Michelle Fiander, John Kh Sinn, David A Osborn","doi":"10.1002/14651858.CD006475.pub3","DOIUrl":"10.1002/14651858.CD006475.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;This is an update of a Cochrane review first published in 2007. Allergic disease and food allergy are prevalent, and contribute to a significant burden of disease on the individual, their family and the healthcare system. Probiotics are live bacteria that colonise the gastrointestinal tract, and have been studied in many clinical trials for preventing allergic conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of a probiotic, or a probiotic with added prebiotic ('synbiotic'), compared with control (placebo or no treatment) for preventing allergic diseases (asthma, eczema, allergic rhinitis) and dietary allergies in infants by two years of age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase and trial registries in December 2023. We reviewed the reference lists of studies selected for inclusion in this review, and systematic reviews on similar topics. We manually searched conference abstracts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials that compared a probiotic to a control, or a probiotic added to a prebiotic ('synbiotic'). We included enterally fed infants in the first six months of life without clinical evidence of allergic disease. We included probiotics added to human milk or infant formula, added in the manufacturing process or given separately.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Infant incidence by two years of age and childhood incidence (up to 10 years of age or up to the age of latest report between 2 and 10 years) of specific allergic diseases, including: asthma, eczema, allergic rhinitis, immunoglobulin E (IgE)-mediated food allergy, IgE-mediated cow's milk protein allergy. Events of anaphylaxis and potential harms including adverse effects, harms or infection with probiotic bacteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane RoB 2 tool to assess bias in the studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We used the random-effects (Mantel-Haenszel) model for meta-analysis where possible. Where this was not possible due to the nature of the data, we synthesised and interpreted individual studies separately. We used GRADE to assess the certainty of evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 24 studies (7077 mother-infant pairs). The studies were conducted in many parts of the world, including the USA, Europe, South Korea, Japan, Singapore and Australia, with most being conducted in Europe. Studies were published between 2001 and 2020. As some studies measured outcomes such as eczema using different criteria, we made assumptions to allow us to combine data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Probiotics may result in little to no difference in asthma (risk ratio (RR) 0.96, 95% confidence interval (CI) 0.65 to 1.44; 4 studies, 954 participants; low-certainty evidence), allergic rhinitis (RR 0.89, 95% CI 0.45 to 1.77; 5 studies, 1045 participants;","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD006475"},"PeriodicalIF":8.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}