Cochrane Database of Systematic Reviews最新文献

{"title":"Acupuncture for insomnia.","authors":"Lin Ang, Myeong Soo Lee, Tae-Young Choi, Ji Hee Jun, Eunhye Song, Hye Won Lee, Boram Lee, Jingyi Zhang, Liujiao Cao, Chan-Young Kwon, Qi Wang, Liang Yao","doi":"10.1002/14651858.CD015974","DOIUrl":"10.1002/14651858.CD015974","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 acupuncture in the treatment of insomnia.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD015974"},"PeriodicalIF":8.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583269","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":"Advance care planning for children with life-limiting and life-threatening conditions.","authors":"Noyuri Yamaji, Katherine Kelly, Pamela Hinds, Erika Ota, Katsuhiro Hiratsuka, Takeshi Hasegawa, Hisashi Noma, Daichi Suzuki, Olukunmi O Balogun, Mari Ikeda","doi":"10.1002/14651858.CD016106","DOIUrl":"10.1002/14651858.CD016106","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 ACP for children with LLCs and LTCs.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD016106"},"PeriodicalIF":8.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559424","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":"Rituximab for myasthenia gravis.","authors":"Katherine C Dodd, Fiona J Clay, Anne-Marie Forbes, Joel Handley, Ryan Yann Shern Keh, James Al Miller, Karen Storms, Laura M White, James B Lilleker, Jon Sussman","doi":"10.1002/14651858.CD014574.pub2","DOIUrl":"10.1002/14651858.CD014574.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Myasthenia gravis (MG) is an autoimmune disease which causes muscle weakness due to disruption in neuromuscular transmission. Rituximab is a medication increasingly used in the treatment of MG, but its potential benefits, and optimal use in terms of patient subgroup and dosing, are unclear. It is important to bring together high-quality evidence to determine how rituximab would be best used in treatment algorithms for MG.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess: - the effects of rituximab (including biosimilar variants) for the treatment of MG in adults; and - the benefits and harms of rituximab in different patient subgroups, and treatment strategies, in order to aid treatment choice for individuals, and inform policymakers about those most likely to benefit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, and two trials registries (Clinicaltrials.gov and the World Health Organization trials registry) up to November 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) or quasi-RCTs in adults (aged 16 years and over) with MG (all subtypes and severity), comparing rituximab (any dosing regimen) with placebo, no treatment, or alterative therapy. We excluded cluster-RCTs and nonrandomised studies, studies in those previously treated with rituximab, and studies analysing juvenile MG (under 16 years of age).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were improvement in symptom severity or functional ability (as measured by Quantitative MG (QMG) and MG-Activities of Daily Living (ADL) scores), reduction in the burden of alternative treatment (steroid-sparing effect and relapse requiring rescue therapy), and serious adverse events (SAEs) in the long term (beyond nine months). Important outcomes included MG Composite (MGC) score, quality of life, hospital admissions and antibody titre, at short-term (two months or less), medium-term (two to nine months), and long-term (beyond nine months) time points. Achievement of a clinically significant improvement in QMG, MG-ADL and MGC scores was analysed dichotomously. We examined safety by looking at adverse events (AEs), treatment-related AEs, and AEs leading to discontinuation of treatment. We also analysed critical outcome measures at the short- and medium-term time points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias 1 tool RoB 1 to assess potential bias.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised results for each outcome using meta-analysis where possible, with random-effects models to calculate mean difference (MD) or risk ratios (RRs) and 95% confidence intervals (CI). Where this was not possible due to the nature of the data, we synthesised results by summarising effect estimates. Data were analysed on an intention-to-treat basis. We used GRADE to assess the certainty of evidence for each outcome. Sensitivity analysis examined whether a fixed-effec","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD014574"},"PeriodicalIF":8.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552456","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":"Heat as a prognostic factor for the development and progression of diabetes: a systematic review and meta-analysis.","authors":"Alexander Lang, Thaddäus Tönnies, Janett Barbaresko, Sebastian Friedrich Petry, Manfred Krüger, Lutz Heinemann, Ruediger Landgraf, Juan Va Franco, Brenda Bongaerts, Maria-Inti Metzendorf, Sabrina Schlesinger","doi":"10.1002/14651858.CD016289","DOIUrl":"10.1002/14651858.CD016289","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To assess the prognostic value of ambient heat exposures as a risk factor for diabetes and diabetes progression. This objective can be framed in two syntheses following the PICOTS scheme as demonstrated in Table 1. Table 1. PICOTS for the review questions Synthesis 1: Heat as a prognostic factor for the development of diabetes Synthesis 2: Heat as a prognostic factor for outcomes in people living with diabetes Population Persons of any age without diabetes Persons of any age with type 1 diabetes, type 2 diabetes, gestational diabetes mellitus, or other types of diabetes Index prognostic factor Different ambient heat exposures, including heatwaves, increasing temperatures, and seasonal variations of temperatures Comparator Persons exposed to non-extreme lower temperatures Outcomes Incidence of diabetes Diabetes progression Including all-cause mortality, hospital admissions, CVD incidence, nephropathy incidence, retinopathy incidence, neuropathy incidence, health-related quality of life, glycaemic control, blood lipids, blood pressure, renal and inflammatory biomarkers, acute complications, progression of neuropathy, and mental and cognitive disorders Timing Ambient heat exposures, including heatwaves, increasing temperatures, and seasonal variations of temperatures as defined by the original studies, ranging from a few hours to several years depending on the prognostic factor and study design Setting No restrictions on setting, including data from both high-income countries and low- and middle-income countries.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD016289"},"PeriodicalIF":8.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539227","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 improving adherence to amblyopia treatments in children.","authors":"Debora Ml Chen, Silvia Han, Allison Summers, Jingyun Wang, Melissa Rice, Jenelle Mallios, Louis Leslie, Elise N Harb, Riaz Qureshi","doi":"10.1002/14651858.CD015820.pub2","DOIUrl":"10.1002/14651858.CD015820.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Amblyopia is a neurodevelopmental visual disorder that can be successfully treated, particularly in younger children. However, the effectiveness of treatment is often limited by adherence. This review discusses the efficacy and harms of interventions designed to increase adherence to amblyopia treatments in children.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the efficacy and harms of various behavioral interventions for improving children's objective adherence to amblyopia treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase.com, LILACS, ClinicalTrials.gov, and ICTRP. We did not use any date or language restrictions in the electronic searches for trials. The latest search date was 24 May 2024. We also searched the bibliographies of the included trials and any relevant systematic reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) and quasi-RCTs in children aged three to 18 years old at the start of the trial. We included participants with bilateral or unilateral amblyopia, comparing interventions to improve treatment adherence. Interventions were categorized as behavioral (e.g. rewards, informational videos), digital (e.g. video games), and different approaches to patching (e.g. different types of patches). We excluded participants with deprivation amblyopia or with a history of ocular diseases, unrelated to amblyopia, that could affect visual acuity (VA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcome was adherence to treatment using objective adherence measures from one week up to three months. 'Adherence' was defined as the percentage of hours of actual treatment undertaken by the participant compared with the hours of prescribed treatment. Our important outcomes were measured at two time intervals, one week to three months and four to six months: 1. Adherence to prescribed treatment using subjective measures 2. Total hours of adherence 3. Change in recognition VA in the amblyopic eye from baseline 4. Change in random dot stereoacuity We also assessed harms, such as adverse effects and the burden of adherence monitoring, in studies that reported them by the end of the study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias (RoB 2) tools for parallel and cross-over trials to assess the risk of bias in the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesized results for each outcome using meta-analyses of mean differences (MD), when data were available, using fixed-effect inverse variance models when fewer than three studies were available and random-effects models if three or more studies were available. Where this was not possible due to the nature of the data, we synthesized the results qualitatively. We used GRADE to assess the certainty of the evidence for prespecified outcomes that were reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included a total of 18 studies wi","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD015820"},"PeriodicalIF":8.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539229","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":"Antiseizure medications for preventing a first seizure in adults with a brain tumour.","authors":"Laura White, Nicole Mooney, Mohammad A Mustafa, Matthew G Stovell, Michael D Jenkinson, Anthony G Marson, Rasheed Zakaria, Sarah J Nevitt, Gashirai K Mbizvo","doi":"10.1002/14651858.CD015155","DOIUrl":"10.1002/14651858.CD015155","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the efficacy and tolerability of antiseizure medications (ASMs) in preventing a first seizure in people with brain tumours compared with placebo or no active treatment.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD015155"},"PeriodicalIF":8.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539223","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":"De-escalation of radiotherapy in the treatment of human papillomavirus-associated oropharyngeal cancer.","authors":"Anna K Lawless, Esther Duruchukwu, Sarah Bergamin, Dasantha T Jayamanne, Michael Back, Adrian Lee","doi":"10.1002/14651858.CD016160","DOIUrl":"10.1002/14651858.CD016160","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 de-escalation of radiotherapy compared with standard radiotherapy in the treatment of human papillomavirus-associated oropharyngeal squamous cell carcinoma.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD016160"},"PeriodicalIF":8.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539225","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":"Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A) for detecting anxiety disorders in adults.","authors":"Alexey Fomenko, Daniel Dümmler, Zekeriya Aktürk, Stefanie Eck, Clara Teusen, Siranush Karapetyan, Sarah Dawson, Bernd Löwe, Alexander Hapfelmeier, Klaus Linde, Antonius Schneider","doi":"10.1002/14651858.CD015456","DOIUrl":"10.1002/14651858.CD015456","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite being highly prevalent mental health conditions, anxiety disorders frequently go undiagnosed, prompting the use of questionnaires for anxiety screening as a potential solution. This review summarises the test accuracy of the Hospital Anxiety and Depression Scale Anxiety subscale (HADS-A) for screening purposes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the test accuracy of the HADS-A in screening for any anxiety disorder (AAD), generalised anxiety disorder (GAD) and panic disorder in adults, and to investigate how the test accuracy varies by sources of heterogeneity and across all cutoffs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched Embase, MEDLINE, PubMed-not-MEDLINE subset and PsycINFO from 1990 to 10 July 2024. We checked the reference lists of included studies and review articles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included studies in adults in which the HADS-A was administered cross-sectionally alongside structured or semi-structured clinical interviews, allowing the creation of 2x2 tables. We excluded case-control studies, studies with a time gap exceeding four weeks between administering the HADS-A and the reference standard, and studies with diagnostic criteria based on the Diagnostic and Statistical Manual of Mental Disorders Third Edition or earlier versions. We also excluded studies involving people who were recruited based on mental health symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;At least two review authors independently decided on the eligibility of the articles, extracted data, and assessed the methodological quality of the included studies using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). For each target condition, we present the sensitivity and specificity of each study along with 95% confidence intervals (CIs). For the primary analyses, we used bivariate models to obtain summary estimates for the recommended HADS-A cutoff score of 8 or higher (≥ 8); if the bivariate models did not converge, we used multiple thresholds models. For the secondary analyses, we obtained summary estimates for all cutoffs using bivariate and multiple thresholds models. From the multiple thresholds model, we derived the summary estimates of all available cutoffs from the summary receiver operating characteristic (SROC) curve and the area under the curve (AUC) as a measure of overall accuracy. We explored sources of heterogeneity using meta-regression models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We identified 67 studies, encompassing data from 18,467 participants that were available for the analyses. Fifty-four studies contributed to the analyses of HADS-A for detecting AAD, 35 for GAD, and 10 for panic disorder. The median prevalence of AAD, GAD and panic disorder was 17%, 7% and 6%, respectively. The included studies showed a wide spectrum of clinical and methodological differences. We considered the overall risk of bias to be low in 19 studies. The most","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD015456"},"PeriodicalIF":8.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539228","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":"Endometrial receptivity testing for assisted reproductive technologies.","authors":"Penelope Cappas, Nikka Milani, Jack Wilkinson, Mohan S Kamath, Sarah F Lensen","doi":"10.1002/14651858.CD016209","DOIUrl":"10.1002/14651858.CD016209","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 endometrial receptivity testing in women undergoing assisted reproductive technologies.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD016209"},"PeriodicalIF":8.8,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12216806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539226","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":"Controlled ovarian stimulation protocols for assisted reproduction: a network meta-analysis.","authors":"Pedro Melo, Abey Eapen, Yealin Chung, Yadava Jeve, Malcolm J Price, Sesh Kamal Sunkara, Nick S Macklon, Yacoub Khalaf, Aurelio Tobias, Frank J Broekmans, Mohammed K Khairy, Ioannis D Gallos, Arri Coomarasamy","doi":"10.1002/14651858.CD012586.pub2","DOIUrl":"10.1002/14651858.CD012586.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Controlled ovarian stimulation (COS) is an essential step in most assisted conception cycles. Different treatment combinations (termed protocols) exist in COS, yet there is no consensus on their relative effectiveness and safety.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to assess the relative effectiveness and safety of COS protocols in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We followed standard Cochrane methodology to conduct extensive electronic searches to 11 June 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) comparing at least two COS protocols using any form of pituitary suppression (gonadotrophin-releasing hormone (GnRH) agonists, antagonists or progestogens) and human menopausal gonadotropin (hMG), urinary or recombinant follicle-stimulating hormone (u/rFSH), with or without luteinising hormone (LH) and/or oral medications (e.g. clomifene or letrozole), for ovarian stimulation. The primary outcomes were the rates of live birth or ongoing pregnancy (LBR or OPR) and ovarian hyperstimulation syndrome (OHSS) per participant after one stimulation cycle. The secondary outcomes were the rates of clinical pregnancy, miscarriage, multiple pregnancy, ectopic pregnancy and cycle cancellation per participant, and the number of oocytes, cleavage-stage embryos, blastocyst-stage embryos and cryopreserved embryos per participant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two review authors independently selected studies and extracted data. We conducted pairwise and network meta-analyses (NMA) according to participants' predicted response to COS (normal/unselected, high or low). For each outcome and subgroup of women, we grouped treatment protocols into the following different networks: all pituitary suppression methods; all long GnRH agonist protocols; all short GnRH antagonist protocols; all GnRH agonist flare protocols; all protocols using progestogens for pituitary suppression; and all protocols using ovarian stimulation in the absence of pituitary suppression. Using the Cochrane RoB 1 tool, we restricted our primary analyses to RCTs at low risk of 'selection' and 'other' biases. We presented effect estimates as risk ratios (RR) for dichotomous outcomes, or mean difference (MD) for continuous outcomes, with 95% confidence intervals (CI). We used Review Manager and Stata 18 for the meta-analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included 338 studies investigating a total of 15 pairwise comparisons between different COS protocols in 59,086 women. Of these, 226 trials included only women with predicted normal response or whose predicted response was unstated, 31 trials included only women with predicted high response and 81 trials included only women with predicted low response. Primary outcome (effectiveness) - LBR or OPR per woman randomised Pituitary suppression methods In women with predicted normal response, short antagonist prot","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD012586"},"PeriodicalIF":8.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539224","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}