Cochrane Database of Systematic Reviews最新文献

{"title":"Near point-of-care nucleic acid amplification tests (NPOC-NAATs) using respiratory specimens for detection of pulmonary tuberculosis.","authors":"David J Horne, Jerry S Zifodya, Ermias Diro Ejara, Taylor D Coston, Adrienne E Shapiro, Mikashmi Kohli, Samuel G Schumacher, Patricia Hall-Eidson, Alexei Korobitsyn, Yemisi Takwoingi","doi":"10.1002/14651858.CD016396","DOIUrl":"10.1002/14651858.CD016396","url":null,"abstract":"<p><strong>Rationale: </strong>Near point-of-care nucleic acid amplification tests (NPOC-NAATs) are a new class of diagnostics that can be used for tuberculosis diagnosis. NPOC-NAATs are suitable for use in peripheral levels of healthcare systems as they are battery-operated instrument-based tests without special infrastructure requirements and can be performed by health care workers with basic technical skills. We evaluated the accuracy of NPOC-NAATs in diagnosing pulmonary tuberculosis using respiratory samples.</p><p><strong>Objectives: </strong>To assess the diagnostic accuracy of NPOC-NAATs for detecting pulmonary tuberculosis using respiratory samples from adults, adolescents, and children with presumptive tuberculosis based on signs or symptoms or a positive diagnostic screening result. Secondary objectives included: 1) to compare the diagnostic accuracy of NPOC-NAATs versus smear microscopy or low complexity, automated nucleic acid amplification tests (LC-aNAATs) for detecting pulmonary tuberculosis using respiratory samples from adults, adolescents, and children; 2) to investigate potential sources of heterogeneity such as smear status, Xpert MTB/RIF Ultra semi-quantitative category, HIV status, age groups, and history of tuberculosis; 3) to summarise the frequency of inconclusive (invalid, error, no result, and indeterminate) index test results.</p><p><strong>Search methods: </strong>We searched seven databases including CENTRAL, MEDLINE, and Embase, plus two trial registers (ClinicalTrials.gov and the WHO ICTRP) between 21 and 25 July 2025, without language restrictions. A World Health Organization (WHO) Public Call for ongoing and unpublished studies was made between 29 May and 15 July 2025. In consultation with the WHO, we searched for studies published since 2024 to reflect the development dates of relevant tests.</p><p><strong>Eligibility criteria: </strong>We included studies that provided data on the diagnostic accuracy of NPOC-NAATs that met our criteria using respiratory specimens in children (less than 10 years old), adolescents (aged 10 to 14 years), and adults (aged 15 years and older) with presumptive pulmonary tuberculosis. The reference standards were culture and a composite reference standard that included culture or the clinical decision to treat.</p><p><strong>Risk of bias and applicability: </strong>We assessed the risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy - Revised (QUADAS-2) and QUADAS-C tools.</p><p><strong>Synthesis methods: </strong>Working in pairs, we independently extracted data using a standardised form. We used a bivariate model for the meta-analyses to estimate summary sensitivities and specificities for pulmonary tuberculosis detection. We performed subgroup analyses by smear status and HIV status. We conducted head-to-head comparisons of the accuracy of NPOC-NAATs with those of LC-aNAATs and sputum smear microscopy.</p><p><strong>Included studies: </strong>We included fiv","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016396"},"PeriodicalIF":11.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134759","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":"Daily sedation interruption versus no daily sedation interruption for critically ill adults and children requiring invasive mechanical ventilation.","authors":"Louise Rose, David R Williamson, Iain J McCullagh, Becky Skidmore, Dean A Fergusson, Marc M Perreault, Lisa D Burry","doi":"10.1002/14651858.CD009176.pub3","DOIUrl":"10.1002/14651858.CD009176.pub3","url":null,"abstract":"<p><strong>Rationale: </strong>Daily sedation interruption (DSI) aims to limit drug accumulation and promote a more awake state, thereby reducing the duration of mechanical ventilation and its associated complications. This is an update of a Cochrane review first published in 2014.</p><p><strong>Objectives: </strong>To assess the effects of DSI versus sedation management without DSI on the duration of invasive mechanical ventilation, mortality, intensive care unit (ICU) length of stay, adverse events related to under- or oversedation (including accidental removal of endotracheal tube and tracheostomy), total doses of sedative and analgesic drug administered, and health-related quality of life, for critically ill people requiring intravenous sedation.</p><p><strong>Search methods: </strong>We used CENTRAL, MEDLINE All, Embase Classic+Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Core Collection, and two trial registers, together with reference checking, citation searching, and contact with study authors to identify the studies included in the review. The latest search date was 8 October 2025.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials (RCTs) comparing DSI with sedation strategies that did not include DSI (protocolised sedation, non-protocolised usual care (clinician discretion), or analgesia first/no sedation) in mechanically ventilated, critically ill people (adults and infants or children under 18 years of age).</p><p><strong>Outcomes: </strong>Our critical outcomes were duration of mechanical ventilation (from randomisation to successful extubation or death), mortality, and ICU length of stay (LOS). Our important outcomes included hospital LOS, adverse events related to under- or oversedation (e.g. accidental removal of endotracheal tube or other lines or catheters, tracheostomy, new onset of delirium occurrence, use of physical restraint, and cardiac events), total drug doses, and health-related quality of life (HRQoL).</p><p><strong>Risk of bias: </strong>We used the original Cochrane tool, RoB 1, to assess bias in the RCTs.</p><p><strong>Synthesis methods: </strong>We synthesised results for each outcome using meta-analysis (random-effects modelling). We conducted subgroup and sensitivity analyses according to pre-defined criteria. We used GRADE to assess the certainty of evidence.</p><p><strong>Included studies: </strong>This update included 23 trials (one cluster-randomised trial; 18 RCTs in adults, five in children) with 5987 (4910 adjusted) participants (3238 adults, 2750 (1673 adjusted) children). Nine trials used a sedation protocol comparator, nine used 'usual sedation practices' with sedative and analgesic drugs at the clinical team's discretion, and five used analgesia-first or no-sedation comparators.</p><p><strong>Synthesis of results: </strong>Daily sedation interruption may reduce the duration of mechanical ventilation compared with sedation s","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD009176"},"PeriodicalIF":11.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127002","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":"Diagnostic accuracy of ultrasound, computed tomography, and magnetic resonance imaging for the evaluation of thyroid nodules.","authors":"Fabian Lunger, Luis Burillo, Nicolás Meza, Juan Va Franco, Tania Rivero, Reto M Kaderli","doi":"10.1002/14651858.CD016398","DOIUrl":"10.1002/14651858.CD016398","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane review (diagnostic). The objectives are as follows: To assess the diagnostic accuracy of US, CT, and MRI - each considered separately - in identifying malignant thyroid nodules, using histopathological examination as the reference standard. Each modality will be evaluated within its established role in the preoperative diagnostic pathway. This includes estimating the sensitivity and specificity of each imaging modality for differentiating malignant from benign thyroid nodules (the ability to correctly identify cancerous and non-cancerous nodules). A clearer understanding of each modality's accuracy is intended to support patient and clinician decisions - for example, whether further imaging is warranted when ultrasound is inconclusive, and whether surgery can be avoided in nodules reliably classified as benign. Secondary objectives Comparative accuracy: To compare the diagnostic performance of US, CT, and MRI for detecting thyroid malignancy, restricted to direct comparisons within studies that evaluated two or more of these tests in the same participants. Indirect comparisons across separate studies will not be performed for inference, as differing clinical roles, case-mix, and selection make them vulnerable to confounding by indication; any such observation will be reported descriptively and regarded as exploratory. Sources of heterogeneity: To investigate potential sources of variation (heterogeneity) in diagnostic accuracy. Specifically, we will examine whether factors such as nodule size, use of contrast media (for CT or MRI), variations in imaging protocols (e.g. ultrasound risk stratification systems, MRI sequence parameters), study design (prospective vs. retrospective), and patient characteristics (e.g. endemic goitre populations, baseline prevalence of malignancy) significantly affect sensitivity or specificity.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"10 ","pages":"CD016398"},"PeriodicalIF":11.1,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105030","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 treatment of herpes labialis (cold sores on the lips).","authors":"Huang-Shen Lin, Pei-Tzu Lin, I-Chieh Shih, Meng-Lin Lu, Yu-Shiun Tsai, Ching-Chi Chi","doi":"10.1002/14651858.CD015216.pub2","DOIUrl":"10.1002/14651858.CD015216.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Herpes labialis (also known as cold sores or fever blisters) is a highly prevalent recurrent infection caused by the herpes simplex virus. Recurrences arise from varied triggers. Standard treatments usually involve nucleoside antivirals. Several studies have investigated alternative treatments such as zinc, honey, and photodynamic therapy for their potential to shorten lesion duration and relieve symptoms, but most reviews exclude these therapies. We wished to address this evidence gap by evaluating both conventional and alternative approaches, synthesising evidence on efficacy and safety to inform clinical practice and guide patient decisions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of interventions for treating herpes labialis in immunocompetent people.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, and Embase on 23 September 2025, and we searched two clinical trial registries (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform) on 1 October 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) enrolling immunocompetent people with herpes labialis. Eligible interventions included topical, oral, and physical therapies (e.g. nucleoside antivirals, anti-inflammatory agents, phototherapy, photodynamic therapy). Eligible comparators were placebo, no treatment, or another active intervention. We applied no restrictions related to publication language or status (published, unpublished, in press, or in progress).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes were healing time (with healing defined as loss of crusts or all symptoms), rated by participants or investigators; and any adverse events leading to treatment cessation. Our important outcomes were participant-rated improvement of signs and symptoms (e.g. global rate of change scales), change from baseline in clinical episode severity (e.g. lesion size), change from baseline in pain severity, and any mild or moderate adverse events not leading to treatment cessation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed the risk of bias using the Cochrane RoB 2 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesised outcomes descriptively and pooled data with a random-effects meta-analysis using the inverse-variance method where appropriate. We reported dichotomous outcomes as risk ratios (RRs), continuous outcomes as mean differences (MDs), and time-to-event data as hazard ratios (HRs), all with 95% confidence intervals (CIs). For rare outcomes, we calculated the Peto odds ratio (OR). We assessed heterogeneity using the I² statistic and performed subgroup analyses by intervention or dose. We also conducted sensitivity analyses, excluding trials with high risk of bias. We rated the certainty of evidence using the GRADE approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 87 RCTs with 22,631 participants. For","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD015216"},"PeriodicalIF":11.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079690","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":"Systemic azoles for asthma with fungal sensitisation.","authors":"Yosuke Fukuda, Tetsuya Homma, Yoshihisa Miyamoto, Norio Watanabe","doi":"10.1002/14651858.CD016394","DOIUrl":"10.1002/14651858.CD016394","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 adding systemic azoles to standard asthma care for people with asthma who have evidence of fungal sensitisation (including severe asthma with fungal sensitisation and allergic bronchopulmonary aspergillosis/allergic bronchopulmonary mycosis).</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016394"},"PeriodicalIF":11.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079806","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":"Oral anticoagulant monotherapy versus oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease.","authors":"Saehyeon Kim, Hiroki Harada, Kazuteru Murakoshi, Masataka Ono, Ken Goda, Paniz Parvar, Zeyad Abdelaziz, Norio Watanabe","doi":"10.1002/14651858.CD016399","DOIUrl":"10.1002/14651858.CD016399","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 oral anticoagulant monotherapy compared with oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease requiring long-term anticoagulation.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016399"},"PeriodicalIF":11.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079727","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":"Oral appliances for obstructive sleep apnoea in adults.","authors":"Yue Chen, Liu Liu, Yubin Cao, Chunjie Li, Hu Long, Carlos Flores Mir, Xianglong Han","doi":"10.1002/14651858.CD015834","DOIUrl":"10.1002/14651858.CD015834","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 oral appliances for obstructive sleep apnoea in adults.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD015834"},"PeriodicalIF":11.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073701","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":"Treat-to-target strategies for low-density lipoprotein cholesterol and triglyceride levels for primary and secondary prevention of cardiovascular disease in adults with dyslipidaemia.","authors":"Kamyar Shokraee, Juan Va Franco, Petek Eylul Taneri, Siavosh Olfati, Ana-Mihaela Zorger, Camila Micaela Escobar Liquitay, Nicole Skoetz, Brenda Bongaerts","doi":"10.1002/14651858.CD016388","DOIUrl":"10.1002/14651858.CD016388","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 a treat-to-target (goal-directed) strategy versus a no-target strategy for lipid-lowering therapy in the primary and secondary prevention of cardiovascular disease in adults with dyslipidaemia.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016388"},"PeriodicalIF":11.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069319","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":"Blood pressure targets for hypertension in people with diabetes mellitus.","authors":"Doreen Y Larvie, Anshula Ambasta, Ciprian Jauca, Douglas Salzwedel, James Wright, Guillaume Grenet, Colleen Fuller, Wade Thompson","doi":"10.1002/14651858.CD016392","DOIUrl":"10.1002/14651858.CD016392","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane review (intervention). The objectives are as follows: To determine if lower blood pressure (BP) targets (i.e. ≤ 130/85 mmHg), compared with standard BP targets (i.e. ≤ 140 to 160/90 to 100 mmHg) are associated with reduction in mortality and morbidity in people with elevated BP and diabetes mellitus.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD016392"},"PeriodicalIF":11.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036749","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":"Zuclopenthixol acetate for acute schizophrenia and similar major mental illnesses.","authors":"Kaushadh Jayakody, Sarah Chuang, Shalmini Gunadasa, Roger Carl Gibson, Ajit Kumar, Philip Tune","doi":"10.1002/14651858.CD000525.pub4","DOIUrl":"10.1002/14651858.CD000525.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Schizophrenia is a serious mental health condition that can cause long-term disability and major disruption to daily life. People living with schizophrenia may experience psychosis, causing frightening and distressing experiences. At times, this distress may lead to aggressive or violent behaviour towards themselves or others. On such occasions, medications used for the management of aggression and agitation in psychiatric settings must have a rapid onset of action, low frequency of administration and exhibit a minimal adverse-effect profile. Zuclopenthixol acetate is reported to have these properties.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the clinical effectiveness of zuclopenthixol acetate in the management of acute behavioural disturbance in people with acute schizophrenia and similar major mental illnesses, compared with other pharmacological agents used for the treatment of similar clinical presentations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Schizophrenia Study-Based Register of Randomised Controlled Trials, CENTRAL and MEDLINE, supplemented by citation searching and contacting study authors. The date of the last search was 8 September 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Randomised controlled trials (RCTs) involving participants with major mental illnesses that compared zuclopenthixol acetate with standard pharmacological treatments were included, with predefined exclusion criteria applied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our outcomes were tranquillisation, sedation (measured between 15 minutes and 48 hours), global state (including the need for additional medications), behaviour, mental state and adverse effects (evaluated up to seven days). These outcomes were also used to compare lower doses of zuclopenthixol acetate (25 mg to 50 mg per injection) with higher doses (50 mg to 100 mg per injection).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane risk of bias tool (RoB 1).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;Data extraction and cross-checking were performed independently by the review authors, and the risk of bias in the included studies was systematically assessed. We synthesised results for each outcome using meta-analysis where possible. Review Manager and the GRADE profiler were used for data synthesis and evaluation of the certainty of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 11 studies with 714 participants. All studies were RCTs and investigated the effect of intramuscular zuclopenthixol acetate. The risk of bias was variable: two studies reported adequate random sequence generation, one confirmed allocation concealment, four reported participant blinding and five reported assessor blinding. Outcomes were clearly reported in three studies, but selective reporting was identified in 10 of 11 included studies. Overall, the certainty of evidence ranged from moderate to very low.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/st","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"9 ","pages":"CD000525"},"PeriodicalIF":11.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036772","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}