Cochrane Database of Systematic Reviews最新文献

{"title":"Pharmacological interventions for peripartum cardiomyopathy.","authors":"Michail Papapanou, Dennis Vaidakis, Themistoklis Paraskevas, Theodoros N Sergentanis, Charalampos S Siristatidis","doi":"10.1002/14651858.CD014851","DOIUrl":"10.1002/14651858.CD014851","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of available pharmacological interventions for the care of women diagnosed with PPCM.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544141","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":"Improving adverse drug event reporting by healthcare professionals.","authors":"Gloria Shalviri, Niayesh Mohebbi, Fariba Mirbaha, Reza Majdzadeh, Bahareh Yazdizadeh, Kheirollah Gholami, Liesl Grobler, Christopher J Rose, Weng Yee Chin","doi":"10.1002/14651858.CD012594.pub2","DOIUrl":"10.1002/14651858.CD012594.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adverse drug events, encompassing both adverse drug reactions and medication errors, pose a significant threat to health, leading to illness and, in severe cases, death. Timely and voluntary reporting of adverse drug events by healthcare professionals plays a crucial role in mitigating the morbidity and mortality linked to unexpected reactions and improper medication usage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effectiveness of different interventions aimed at healthcare professionals to improve the reporting of adverse drug events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, Embase, MEDLINE and several other electronic databases and trials registers, including ClinicalTrials.gov and WHO ICTRP, from inception until 14 October 2022. We also screened reference lists in the included studies and relevant systematic reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised trials, non-randomised controlled studies, controlled before-after studies, interrupted time series studies (ITS) and repeated measures studies, assessing the effect of any intervention aimed at healthcare professionals and designed to increase adverse drug event reporting. Eligible comparators were healthcare professionals' usual reporting practice or a different intervention or interventions designed to improve adverse drug event reporting rate. We excluded studies of interventions targeted at adverse event reporting following immunisation. Our primary outcome measures were the total number of adverse drug event reports (including both adverse drug reaction reports and medication error reports) and the number of false adverse drug event reports (encompassing both adverse drug reaction reports and medication error reports) submitted by healthcare professionals. Secondary outcomes were the number of serious, high-causality, unexpected or previously unknown, and new drug-related adverse drug event reports submitted by healthcare professionals. We used GRADE to assess the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We followed standard methods recommended by Cochrane and the Cochrane Effective Practice and Organisation of Care (EPOC) Group. We extracted and reanalysed ITS study data and imputed treatment effect estimates (including standard errors or confidence intervals) for the randomised studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 15 studies (eight RCTs, six ITS, and one non-randomised cross-over study) with approximately 62,389 participants. All studies were conducted in high-income countries in large tertiary care hospitals. There was a high risk of performance bias in the controlled studies due to the nature of the interventions. None of the ITS studies had a control arm, so we could not be sure of the detected effects being independent of other changes. None of the studies reported on the number of false adverse drug event reports submitted. There is low-cer","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521218","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":"Omega-3 fatty acids for intermittent claudication.","authors":"Mina Mohammady, Tamara Brown, Maryam Radmehr, Erfan Shamsoddin, Leila Janani","doi":"10.1002/14651858.CD003833.pub5","DOIUrl":"10.1002/14651858.CD003833.pub5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Peripheral artery disease (PAD) is a progressive disorder characterised by stenosis or occlusion of arteries, or both, due to arteriosclerosis. Intermittent claudication (IC) and diminished walking ability are often present as the main symptoms of PAD. Omega-3 fatty acids have been used in the treatment and prevention of coronary artery disease, although current evidence suggests they may be of limited benefit. Peripheral arterial disease and coronary artery disease share a similar pathogenesis. It is uncertain whether omega-3 fatty acids benefit people with IC. This is an update of the review first published in 2004 and updated in 2013.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of omega-3 fatty acid supplementation in people with intermittent claudication.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We used standard, extensive Cochrane search methods, and searched the Cochrane Vascular Specialised Register via the Cochrane Register of Studies, CENTRAL, MEDLINE Ovid, Embase Ovid, and two trials registers on 19 April 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) of omega-3 fatty acids versus placebo or non-omega-3 fatty acids in people with intermittent claudication.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We used standard Cochrane methods. Our primary outcomes were quality of life, pain-free walking distance, and maximal walking distance. Secondary outcomes were ankle-brachial index, revascularisation procedures in the lower limb, amputation rate/frequency, lipid levels, blood pressure, all-cause and vascular mortality, non-fatal vascular events, and adverse effects of therapy. We used GRADE to assess the certainty of the evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 15 RCTs (1830 participants) comparing omega-3 fatty acid supplementation with placebo or alternative therapies. The follow-up was four weeks to six years. The majority of the studies had unclear risk of bias, and many could not be included in our meta-analysis, so were reported narratively. The evidence is very uncertain about the effect of omega-3 fatty acids on quality of life. One study measured quality of life but did not present any data. The study authors reported there was no improvement in any of the eight self-reported quality-of-life parameters in the SF-36 questionnaire between entry and 16 weeks for the intervention group. No results were presented for the control group (very low-certainty evidence). Omega-3 fatty acids may result in little to no effect on pain-free walking distance (mean difference (MD) 1.01 metre (m), 95% confidence interval (CI) -34.23 to 36.24; 3 studies, 147 participants; very low-certainty evidence), or maximal walking distance (MD -4.18 m, 95% CI -37.10 to 28.74; 3 studies, 164 participants; very low-certainty evidence). Omega-3 compared with a control may have little to no effect on ankle-brachial ind","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521219","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":"Conservative, physical and surgical interventions for managing faecal incontinence and constipation in adults with central neurological diseases.","authors":"Claire L Todd, Eugenie E Johnson, Fiona Stewart, Sheila A Wallace, Andrew Bryant, Sue Woodward, Christine Norton","doi":"10.1002/14651858.CD002115.pub6","DOIUrl":"10.1002/14651858.CD002115.pub6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;People with central neurological disease or injury have a much higher risk of both faecal incontinence (FI) and constipation than the general population. There is often a fine line between the two symptoms, with management intended to ameliorate one risking precipitating the other. Bowel problems are observed to be the cause of much anxiety and may reduce quality of life in these people. Current bowel management is largely empirical, with a limited research base. The review is relevant to individuals with any disease directly and chronically affecting the central nervous system (post-traumatic, degenerative, ischaemic or neoplastic), such as multiple sclerosis, spinal cord injury, cerebrovascular disease, Parkinson's disease and Alzheimer's disease. This is an update of a Cochrane Review first published in 2001 and subsequently updated in 2003, 2006 and 2014.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of conservative, physical and surgical interventions for managing FI and constipation in people with a neurological disease or injury affecting the central nervous system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Incontinence Specialised Register (searched 27 March 2023), which includes searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, ClinicalTrials.gov, WHO ICTRP as well as handsearching of journals and conference proceedings; and all reference lists of relevant articles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised, quasi-randomised (where allocation is not strictly random), cross-over and cluster-randomised trials evaluating any type of conservative, physical or surgical intervention against placebo, usual care or no intervention for the management of FI and constipation in people with central neurological disease or injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;At least two review authors independently assessed the risk of bias in eligible trials using Cochrane's 'Risk of bias' tool and independently extracted data from the included trials using a range of prespecified outcome measures. We produced summary of findings tables for our main outcome measures and assessed the certainty of the evidence using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 25 studies with 1598 participants. The studies were generally at high risk of bias due to lack of blinding of participants and personnel to the intervention. Half of the included studies were also at high risk of bias in terms of selective reporting. Outcomes were often reported heterogeneously across studies, making it difficult to pool data. We did not find enough evidence to be able to analyse the effects of interventions on individual central neurological diseases. Additionally, very few studies reported on the primary outcomes of self-reported improvement in FI or constipation, or Neurogenic Bowel Dysfu","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521217","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":"Perineal techniques during the second stage of labour for reducing perineal trauma and postpartum complications.","authors":"Kerry Dwan, Tilly Fox, Vittoria Lutje, Tina Lavender, Tracey A Mills","doi":"10.1002/14651858.CD016148","DOIUrl":"10.1002/14651858.CD016148","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Postpartum haemorrhage (PPH) is responsible for around 27% of global maternal deaths. Perineal tears are common in vaginal births and a significant contributor to excessive blood loss. A diversity of perineal techniques are utilised to prevent perineal trauma and reduce the incidence of PPH; however, they lack evidence-based comparisons to understand their effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effect of perineal techniques during the second stage of labour on the incidence of and morbidity associated with perineal trauma to prevent postpartum complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched four databases and two trial registers up to 16 April 2024. We checked references, searched citations and contacted study authors to identify additional studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) of women in the second stage of labour who intended to give birth vaginally, comparing any perineal techniques with control or another perineal technique. We excluded studies that performed perineal techniques outside the second stage of labour.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were second-, third- and fourth-degree tears measured immediately after birth, and PPH ≥ 500 mL measured within 24 hours after birth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias 2 tool to assess bias in the included RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome within each comparison using meta-analysis where possible. Where this was not possible due to the nature of the data, we synthesised results narratively. 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 a total of 17 studies with 13,695 participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Hands off (or poised) versus hands on Hands off (poised) may result in little to no difference in second-degree tears (risk ratio (RR) 0.73, 95% confidence interval (CI) 0.32 to 1.64; 2 studies; low-certainty evidence) and third- or fourth-degree tears when data are combined (RR 1.27, 95% CI 0.81 to 1.99; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of hands off (poised) on third-degree tears and fourth-degree tears when reported separately (RR 0.50, 95% CI 0.05 to 5.27; 1 study; very low-certainty evidence and RR 3.00, 95% CI 0.13 to 71.22; 1 study; very low-certainty evidence). Hands off (poised) may result in little to no difference in PPH ≥ 500 mL (RR 1.16, 95% CI 0.92 to 1.47; 1 study; low-certainty evidence). Hands off (poised) probably results in little to no difference in breastfeeding two days after birth (RR 1.02, 95% CI 0.99 to 1.06; 1 study; moderate-certainty evidence) and perineal pain (RR 0.98, 95% CI 0.94 to 1.01; 1 study; moderate-certainty evidence). Vocalisation versus control Vocalisation may result in a ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496393","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":"Uterotonics for management of retained placenta.","authors":"Jen Sothornwit, Chetta Ngamjarus, Porjai Pattanittum, Termtem Waidee, Nampet Jampathong, Apiwat Jongjakapun, Kiattisak Kongwattanakul, Pisake Lumbiganon","doi":"10.1002/14651858.CD016147","DOIUrl":"10.1002/14651858.CD016147","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Retained placenta is a significant cause of maternal death from postpartum haemorrhage. Traditionally, it is managed by manual removal under anaesthesia, which carries risks of haemorrhage, infection, and uterine perforation. Uterotonics may offer an alternative for delivering the retained placenta since they induce uterine contractions. However, evidence regarding uterotonic agents for retained placenta is still limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of uterotonics for women with retained placenta after vaginal delivery for preventing postpartum haemorrhage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, CINAHL, ClinicalTrials.gov, and WHO ICTRP; and checked references of included studies and pertinent systematic reviews to identify additional studies. The latest search date was 25 April 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) and non-randomised studies of interventions in women who underwent vaginal delivery with retained placenta comparing one uterotonic with another uterotonic, placebo, or no treatment. We excluded studies that compared different uterotonics administered by umbilical vein injection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our main outcomes were manual removal of the placenta; postpartum haemorrhage of 1000 mL or more; adverse effects, such as shivering; blood transfusion; maternal death; severe morbidity (admission to the intensive care unit); and blood loss in millilitres. The primary time point of interest for all outcomes was the end of the study period.&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 RCTs and the ROBINS-I tool to assess bias in non-randomised studies of interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using a random-effects meta-analysis, where possible, employing Mantel-Haenszel with risk ratio (RR) or inverse variance with mean difference (MD), as appropriate. Where this was not possible due to the nature of the data, we synthesised results using narrative synthesis methods. 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 five studies with 560 women, comprising four RCTs and one non-randomised study. The studies were conducted in the Netherlands, Tanzania, and Egypt. Three RCTs compared uterotonics (sulprostone or misoprostol) with placebo or no treatment. One RCT compared oxytocin, intravenous carbetocin, and sublingual misoprostol. One non-randomised study compared intraumbilical oxytocin to oxytocin infusion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Systemic uterotonic agents versus placebo or no treatment Sulprostone or misoprostol may result in little to no difference in the rate of manual removal of the placenta (RR 0.82, 95% confidence interval (CI) 0.54 to 1.27; 3 RCTs, 244 women; low-c","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496395","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":"Topical, light-based, and complementary interventions for acne: an overview of systematic reviews.","authors":"Yi Yuan, Yiying Wang, Jun Xia, Haibo Liu, Jian Ping Liu, Duoduo Li, Ruiting Wang, Hong Sang, Huijuan Cao","doi":"10.1002/14651858.CD014918.pub2","DOIUrl":"10.1002/14651858.CD014918.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acne is a chronic inflammatory and immune-mediated disease of the pilosebaceous unit (the skin structure consisting of a hair follicle and its associated sebaceous gland). It is characterised by non-inflammatory lesions (open and closed comedones) and inflammatory lesions (papules, pustules, nodules, and cysts). Lesions may be present on the face, thorax, and back, with variable severity. Acne exhibits a global distribution and has a growing prevalence. Acne vulgaris is the most common form. Acne gives rise to complications such as scars and can seriously affect people's mental health, especially those with severe acne. Acne has a huge impact on the quality of life and self-esteem of those affected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To synthesise the existing evidence on the efficacy and safety of non-systemic pharmacological interventions and non-pharmacological interventions (physical therapy and complementary therapies) in the treatment of acne vulgaris and related skin complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We searched the Cochrane Database of Systematic Reviews, Epistemonikos, MEDLINE, and Embase to 2 December 2021, and checked the reference lists of included reviews. At least two authors were responsible for screening, data extraction, and critical appraisal. We excluded reviews with high risk of bias as assessed with the ROBIS tool. We evaluated the overall certainty of the evidence according to GRADE (as carried out by the authors of the included reviews or ourselves). We provide comprehensive evidence from the review data, including summary of findings tables, summary of results tables, and evidence maps.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We retrieved and assessed a total of 733 records; however, only six reviews (five Cochrane reviews and one non-Cochrane review) with low risk of bias met the overview inclusion criteria. The six reviews involved 40,910 people with acne from 275 trials and 1316 people with acne scars from 37 trials. The age of the participants ranged from 10 to 59 years, with an average age range from 9.8 to 30 years. Four reviews included original trials involving only female participants and three reviews included original trials with only male participants. Main results for clinically important comparisons: Benzoyl peroxide versus placebo or no treatment: In two trials involving 1012 participants over 12 weeks, benzoyl peroxide may reduce the total (mean difference (MD) -16.14, 95% confidence interval (CI) -26.51 to -5.78), inflammatory (MD -6.12, 95% CI -11.02 to -1.22), and non-inflammatory lesion counts (MD -9.69, 95% CI -15.08 to -4.29) when compared to placebo (long-term treatment), but the evidence is very uncertain (very low-certainty evidence). Two trials including 1073 participants (time point: 10 and 12 weeks) suggested benzoyl peroxide may have little to no effect in improving participants' global self-assessment compared to placebo (long-term treatment), but the ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496394","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":"Artificial intelligence for diagnosing exudative age-related macular degeneration.","authors":"Chaerim Kang, Jui-En Lo, Helen Zhang, Sueko M Ng, John C Lin, Ingrid U Scott, Jayashree Kalpathy-Cramer, Su-Hsun Alison Liu, Paul B Greenberg","doi":"10.1002/14651858.CD015522.pub2","DOIUrl":"10.1002/14651858.CD015522.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Age-related macular degeneration (AMD) is a retinal disorder characterized by central retinal (macular) damage. Approximately 10% to 20% of non-exudative AMD cases progress to the exudative form, which may result in rapid deterioration of central vision. Individuals with exudative AMD (eAMD) need prompt consultation with retinal specialists to minimize the risk and extent of vision loss. Traditional methods of diagnosing ophthalmic disease rely on clinical evaluation and multiple imaging techniques, which can be resource-consuming. Tests leveraging artificial intelligence (AI) hold the promise of automatically identifying and categorizing pathological features, enabling the timely diagnosis and treatment of eAMD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine the diagnostic accuracy of artificial intelligence (AI) as a triaging tool for exudative age-related macular degeneration (eAMD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, three clinical trials registries, and Data Archiving and Networked Services (DANS) for gray literature. We did not restrict searches by language or publication date. The date of the last search was April 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;Included studies compared the test performance of algorithms with that of human readers to detect eAMD on retinal images collected from people with AMD who were evaluated at eye clinics in community or academic medical centers, and who were not receiving treatment for eAMD when the images were taken. We included algorithms that were either internally or externally validated or both.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Pairs of review authors independently extracted data and assessed study quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool with revised signaling questions. For studies that reported more than one set of performance results, we extracted only one set of diagnostic accuracy data per study based on the last development stage or the optimal algorithm as indicated by the study authors. For two-class algorithms, we collected data from the 2x2 table whenever feasible. For multi-class algorithms, we first consolidated data from all classes other than eAMD before constructing the corresponding 2x2 tables. Assuming a common positivity threshold applied by the included studies, we chose random-effects, bivariate logistic models to estimate summary sensitivity and specificity as the primary performance metrics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We identified 36 eligible studies that reported 40 sets of algorithm performance data, encompassing over 16,000 participants and 62,000 images. We included 28 studies (78%) that reported 31 algorithms with performance data in the meta-analysis. The remaining nine studies (25%) reported eight algorithms that lacked usable performance data; we reported them in the qualitative synthesis. Study characteristics and ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459712","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":"Risk of fracture in users of hormonal contraception.","authors":"Shaalini Ramanadhan, Jillian T Henderson, Amy Cantor, Robin A Paynter, Alison Edelman","doi":"10.1002/14651858.CD015972","DOIUrl":"https://doi.org/10.1002/14651858.CD015972","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 hormonal contraception used for pregnancy prevention on fracture risk in individuals who are currently or were previously capable of becoming pregnant.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459733","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":"Alpha 1 antitrypsin augmentation for alpha 1 antitrypsin deficiency associated lung disease.","authors":"Patrick Glaister, Nichola Hindle Robinson, Amy Ward, Chloe Bentham, Iain Crossingham","doi":"10.1002/14651858.CD015930","DOIUrl":"10.1002/14651858.CD015930","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 alpha 1 antitrypsin augmentation therapy on respiratory disease in people with alpha 1 antitrypsin deficiency.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":8.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459711","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}