Cochrane Database of Systematic Reviews最新文献

{"title":"Interventions for preventing falls in older people in care facilities.","authors":"Suzanne M Dyer, Wing S Kwok, Jenni Suen, Rik Dawson, Dylan Kneale, Katy Sutcliffe, Lotta J Seppala, Keith D Hill, Ngaire Kerse, Geoffrey R Murray, Nathalie van der Velde, Catherine Sherrington, Ian D Cameron","doi":"10.1002/14651858.CD016064","DOIUrl":"10.1002/14651858.CD016064","url":null,"abstract":"<p><strong>Rationale: </strong>Falls in care facilities are common events, causing considerable morbidity and mortality for older people. This is an update of a review on interventions in care facilities and hospitals first published in 2010 and updated in 2012 and 2018 on interventions in care facilities and hospitals. This review has now been split into separate reviews for each setting.</p><p><strong>Objectives: </strong>To assess the benefits and harms of interventions designed to reduce the incidence of falls in older people in care facilities.</p><p><strong>Search methods: </strong>We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and two trial registers to 10 May 2024 and used reference checking, citation searching, and contact with authors to identify eligible trials and records.</p><p><strong>Eligibility criteria: </strong>We included randomised controlled trials (RCTs) of any intervention for preventing falls in older people (aged over 65 years) in care facilities with any comparator. We excluded trials conducted in places of residence that do not provide residential health-related care or rehabilitative services. We excluded trials where falls were recorded as adverse events of the intervention and those recruiting participants post-stroke or living with Parkinson's disease.</p><p><strong>Outcomes: </strong>Critical outcomes were rate of falls (number of falls per unit time) and number of fallers (risk of experiencing one or more falls). Important outcomes were risk of fracture, adverse events, and economic outcomes.</p><p><strong>Risk of bias: </strong>We assessed risk of bias in the included studies against nine items (seven items from Cochrane's RoB 1 tool, plus method of ascertaining falls and baseline imbalance).</p><p><strong>Synthesis methods: </strong>Two review authors independently performed study selection and data analysis. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) with 95% CIs for outcomes of risk of falling (number of people falling) and risk of fracture. We adjusted for clustering if not undertaken by trial authors. We grouped the results of trials with comparable interventions and participant characteristics, and pooled results where appropriate using the generic inverse variance method in RevMan. We conducted subgroup analyses according to intervention type, cognitive status, and informed by a qualitative comparative analysis where more than 10 trials were pooled and heterogeneity was high. Where pooling was precluded by the nature of the data, we presented trial data in tables for illustrative purposes or reported these in the text, or both. We used GRADE to assess the certainty of evidence. GRADE ratings of risk of bias were based on sensitivity analyses excluding trials at high risk of bias.</p><p><strong>Included studies: </strong>We included 104 trials, 56 individually randomised and 48 cluster-random","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD016064"},"PeriodicalIF":8.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945463","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":"Monoclonal antibodies for preventing respiratory syncytial virus infection in children: a network meta-analysis.","authors":"Luis Garegnani, Camila Micaela Escobar Liquitay, Ignacio Esteban, Mikaela Lenells, Chiara Russo, Matteo Bruschettini, Juan Va Franco","doi":"10.1002/14651858.CD016224","DOIUrl":"https://doi.org/10.1002/14651858.CD016224","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the comparative effectiveness of monoclonal antibodies (mAbs) for preventing respiratory syncytial virus (RSV) infection in children, and to evaluate the relative rankings for benefits and harms of mAbs for preventing RSV in children.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD016224"},"PeriodicalIF":8.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12365943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945477","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 replacing missing teeth: prostheses for the edentulous mandible.","authors":"Sarra Jawad, Sharon R Lewis, Tanya Walsh, Dwayne Boyers, Philip Riley, Owen Addison","doi":"10.1002/14651858.CD016215","DOIUrl":"10.1002/14651858.CD016215","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 removable and fixed prostheses for people with edentulous mandibles. To explore whether equity impacts the benefits and harms of removable and fixed prostheses for people with edentulous mandibles, particularly in relation to the age and economic status of wearers.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD016215"},"PeriodicalIF":8.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871733","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":"Botulinum toxin for provoked vestibulodynia.","authors":"Saehyeon Kim, John J Paliakkara, Julia Schmutz, Norio Watanabe","doi":"10.1002/14651858.CD016202","DOIUrl":"10.1002/14651858.CD016202","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The primary objective is to examine the efficacy of botulinum toxin therapy in the treatment of provoked vestibulodynia (PVD) compared with placebo or no treatment. The secondary objectives are to investigate the dose effect of botulinum toxin and the complication rates associated with botulinum toxin.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD016202"},"PeriodicalIF":8.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871732","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":"Virtual reality-related exercise for people with chronic kidney disease undergoing haemodialysis.","authors":"Hiroki Nishiwaki, William Mm Levack, Takeshi Hasegawa, Hisashi Noma, Erika Ota, Taihei Suzuki, Yoshitaka Watanabe, Naonori Tashiro, Yunan Han, Davey Li, Tanika N Kelly","doi":"10.1002/14651858.CD016138","DOIUrl":"10.1002/14651858.CD016138","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 virtual reality (VR)-based exercise for improving mental health, physical function, and quality of life (QoL), as well as assessing adverse events during dialysis, in people with chronic kidney disease (CKD) undergoing haemodialysis compared to exercise interventions without VR or standard treatment alone.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD016138"},"PeriodicalIF":8.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871736","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":"Linked color imaging versus conventional white-light colonoscopy for the detection of colorectal polyps.","authors":"Jun Watanabe, Takeshi Kanno, Eiichi Kakehi, Kazuma Rifu, Takehiro Kagaya, Kazuhiko Kotani, Yuki Kataoka","doi":"10.1002/14651858.CD015476.pub2","DOIUrl":"10.1002/14651858.CD015476.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Early detection of colorectal polyps using colonoscopy is important for preventing post-colonoscopy colorectal cancer (PCCRC) because a 1% increase in adenoma detection rate (ADR) is associated with a 3% decrease in PCCRC incidence. Linked color imaging (LCI) enhances color contrast compared to white-light imaging (WLI), potentially improving ADR. Existing reviews provide promising yet inconclusive findings on LCI's benefits, highlighting the need for this systematic review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of LCI compared to WLI colonoscopy in detecting colorectal polyps in people requiring colonoscopy for screening, symptoms, or surveillance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform from 2014 to 30 May 2025. We screened the reference lists of relevant review articles and current treatment guidelines to identify additional studies. We contacted the study authors in case of any missing data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomized controlled trials (RCTs) comparing LCI and WLI. We excluded non-RCTs. We included adults 18 years of age and older who required colonoscopy for screening, symptom assessment, and surveillance in any healthcare setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The critical outcomes were ADR during the study period, proportion of participants with PCCRC at next scheduled follow-up colonoscopy, and proportion of adverse events requiring medical treatment during the study period. Important outcomes were polyp detection rate and sessile serrated lesion detection rate during the study period, numbers of adenomas, polyps, and flat polyps per participant at the end of a single colonoscopy, and all adverse events during the study period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;Two authors assessed study risk of bias using version two of the Cochrane tool for assessing risk of bias in randomized trials (RoB 2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We synthesized results for each outcome using random-effects meta-analysis, calculating risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, each with 95% confidence intervals (CIs), using Review Manager. Where meta-analysis was not possible due to data heterogeneity or insufficient reporting, we applied the Synthesis Without Meta-analysis (SWiM) approach. We used GRADE to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 16 trials, with 12,836 participants. Nine trials focused on screening/surveillance and seven on screening and symptomatic patients. We judged six trials as being at low risk of bias overall.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Critical outcomes LCI slightly increases ADR compared to WLI (RR 1.18, 95% CI 1.10 to 1.28; 15 RCTs, 12,877 participants; high-certa","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD015476"},"PeriodicalIF":8.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871735","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":"Ketamine and other NMDA receptor antagonists for chronic pain.","authors":"Michael C Ferraro, Aidan G Cashin, Eric J Visser, Christina Abdel Shaheed, Michael A Wewege, Benedict M Wand, Sylvia M Gustin, Neil E O'Connell, James H McAuley","doi":"10.1002/14651858.CD015373.pub2","DOIUrl":"10.1002/14651858.CD015373.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;N-methyl-D-aspartate (NMDA) receptor antagonists are a group of medicines classed according to their mechanism of action. Ketamine and other NMDA receptor antagonists are used to treat chronic pain, despite uncertain benefits and harms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of ketamine and other NDMA receptor antagonists compared to placebo, usual care, or other medicines for adults with chronic non-cancer, non-headache pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, and three trial registries (with reference checking, citation searching, and contact with study authors/experts) to identify included studies. The last search was 3 June 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) in adults with chronic pain (≥ 3 months' duration), evaluating ketamine, memantine, dextromethorphan, amantadine, or magnesium versus placebo, usual care, or another medicine. We excluded studies of cancer or headache pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes were pain intensity and adverse events. Important outcomes were disability, depressive symptoms, health-related quality of life, tolerability, and opioid consumption. For adverse events and tolerability, follow-up was until the end of treatment. For all other outcomes, we were interested in treatment effects in the immediate term (48 hours-1 week), short term (&gt; 1 week-3 months), medium term (&gt; 3 months-6 months), and long term (&gt; 6 months).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed risk of bias using the Cochrane Risk of Bias tool for RCTs (RoB 2).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;We converted all continuous pain intensity scores to a 0-to-100 scale (0 = no pain; 100 = worst pain). We synthesised results using random-effects meta-analysis where possible, reporting mean differences (MDs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes, each with its 95% confidence interval (CI). We assessed the certainty of evidence with GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We found 67 RCTs (2309 participants): 30 parallel-group RCTs (1568 participants) and 37 cross-over RCTs (741 participants). Most studies (96%) were from high-income countries. Female participation ranged from 11% to 100%. The interventions were ketamine (39 studies), memantine (10 studies), dextromethorphan (9 studies), amantadine (3 studies), and magnesium (8 studies). Sixty-two studies used placebo comparators. Our quantitative synthesis included 28 studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Results are presented for pain intensity (continuous measures, at reported time points) and total adverse events. Ketamine Intravenous ketamine versus placebo There is no clear evidence that intravenous ketamine reduces pain intensity in the immediate term (MD -15.79, 95% CI -32.09 to 0.51; 3 studies, 173 participants; very low certainty), short term (","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD015373"},"PeriodicalIF":8.8,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871734","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 anal canal intraepithelial neoplasia.","authors":"Torben B Pedersen, Frederik Rønne Pachler, Jacob Rosenberg, Kristoffer Andresen","doi":"10.1002/14651858.CD009244.pub3","DOIUrl":"10.1002/14651858.CD009244.pub3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anal intraepithelial neoplasia (AIN) is a dysplasia of the anal transitional epithelium that is associated with human papillomavirus (HPV) infection. High-grade lesions have the potential to develop into anal cancer. The incidence and prevalence of AIN and anal cancer has been increasing over the last decades. Certain groups - including people living with HIV, men who have sex with men (MSM), and those with suppressed immune systems - are at high risk of developing AIN. Targeted excisions using ablative treatments such as electrocauterisation, infrared coagulation, or cryotherapy have been used as first-line therapeutic strategies. Other options include topical treatment with immunomodulators such as imiquimod or cytostatics such as fluorouracil. Ideally, treatment of AIN should have a low risk of complications and result in a low risk of recurrence. This is the first update of a review originally published in 2012.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the effects of any therapeutic intervention for anal intraepithelial neoplasia, regardless of gender, age, and comorbidity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We used CENTRAL, MEDLINE, Embase, and five trials registers, together with reference checking, citation searching and contact with study authors to identify the studies that are included in the review. The latest search date was 16 April 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) that assessed any type of intervention for AIN. We excluded cluster-randomised and cross-over trials. We excluded people with a histological diagnosis of anal carcinoma, Paget's disease, or Bowenoid papulosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We used standard methodological procedures expected by Cochrane. Our primary outcomes of interest were: AIN eradication (defined by the absence of histologic criteria OR the presence of a normal epithelium or scarring OR the complete absence of dysplasia); development of anal cancer; and human papillomavirus (HPV) eradication. We assessed the certainty of the evidence using GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;Five RCTs met our inclusion criteria, randomising a total of 4907 participants. All included participants were adults living with HIV with a CD4 cell count above 300 cells/μL. The median participant age ranged from 45 to 51 years. Most participants were male. Two studies were multicentre, both conducted in the USA. The remaining studies were conducted in outpatient clinics in Spain, the Netherlands, and the UK. We considered the overall risk of bias as high in one study and moderate in four. The main reasons for concerns of bias were open-label design and high dropout rates. All studies had different interventions and outcomes, precluding meta-analysis. The inclusion of two multi-armed studies means that we synthesised evidence for nine separate comparisons. Here, we summarise only the results from t","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD009244"},"PeriodicalIF":8.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834374","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":"First aid training for laypeople.","authors":"Irvin Kendall, Jorien Laermans, Tine D'aes, Vere Borra, Michael McCaul, Bert Aertgeerts, Emmy De Buck","doi":"10.1002/14651858.CD015538.pub2","DOIUrl":"10.1002/14651858.CD015538.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;The global burden of death and disability is significantly influenced by illness and injury, which can occur at any time and anywhere. When these conditions are acute or life-threatening, immediate care outside the hospital becomes crucial. In these situations, first aid provided by laypeople (i.e. individuals without formal healthcare education) is a vital component of the prehospital care system, playing an important role in preserving life, alleviating suffering, preventing further harm, and promoting recovery. Therefore, training laypeople in first aid is widely assumed to increase first aid-related competencies and, hence, may improve the health outcomes of suddenly ill or injured individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The main objective is to assess the effects of first aid training for laypeople compared with another type of training or no training on the health outcomes of people receiving first aid, the quality of the first aid provided, and the helping behaviour of people providing first aid. Secondary objectives are to assess the effects of first aid training for laypeople compared with another type of training or no training on first aid-related educational outcomes, including knowledge, skills, self-efficacy, and willingness to help, and adverse effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, four other databases and two trials registries, together with reference and citation checking. We handsearched the websites of organisations, journals, and conference proceedings. The latest search date was 16 December 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) and cluster-RCTs in laypeople comparing physical health first aid training with no first aid training (i.e. another type of training or no training).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Our critical outcomes are the health outcomes of people receiving first aid, the quality of the first aid provided, and the helping behaviour of people providing first aid. Our important outcomes are first aid-related knowledge, first aid-related skills, self-reported first aid-related self-efficacy, and self-reported first aid-related willingness to help.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We used the Cochrane Risk of Bias 2 tool (RoB 2) to assess bias in RCTs and its extension in cluster-RCTs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;When possible, we synthesised results for each outcome using meta-analysis of risk ratios (RR) and ratio of means (RoM) with 95% confidence intervals (CI) for dichotomous and continuous outcomes, respectively. When meta-analysis was not feasible due to the nature of the data, we followed the synthesis without meta-analysis (SWiM) principles and summarised results using vote counting based on the direction of effect. We applied GRADE to assess the certainty of the evidence for each outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 3","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD015538"},"PeriodicalIF":8.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820709","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":"Vitamin D supplementation in pregnant or breastfeeding women or young children for preventing asthma.","authors":"Bonnie K Patchen, Cora M Best, Jocelyn Boiteau, Beate Stokke Solvik, Alexander Vonderschmidt, Jiayi Xu, Robyn T Cohen, Patricia A Cassano","doi":"10.1002/14651858.CD013396.pub2","DOIUrl":"10.1002/14651858.CD013396.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Randomised controlled studies evaluating vitamin D supplementation in pregnancy or early childhood for preventing childhood asthma have yielded inconclusive results. Previous systematic reviews of vitamin D for asthma prevention focused on studies comparing vitamin D to placebo or studies intervening in pregnancy, limiting the body of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Primary: to evaluate the efficacy of any vitamin D supplementation and high-dose vitamin D supplementation in early life, including the prenatal period, for preventing asthma in children. Secondary: to assess the efficacy of vitamin D supplementation: • for preventing asthma in children at risk of vitamin D deficiency at the start of the trial or whose mothers were at risk; • by intervention timing and the cumulative dose administered; • in preventing factors associated with early childhood asthma, including atopic dermatitis, respiratory tract infections, sensitisation to allergens, and airway inflammation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, the International Clinical Trials Registry Platform, and the Cochrane Airways and Skin Trial Registers. We checked the reference lists of relevant systematic reviews and meta-analyses. We contacted authors to obtain additional study information as needed. Date of last search: October 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled studies comparing higher versus lower/standard dose vitamin D (≤ 400 international units (IU)/day) or any vitamin D versus placebo/no treatment in generally healthy pregnant or lactating women or children up to five years of age that evaluated childhood asthma, wheeze, atopic dermatitis, airway infections, allergic sensitisation, and airway inflammation. We excluded trials recruiting populations with pre-existing conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We followed standard Cochrane methodological procedures, including using Cochrane's Screen4Me workflow. We considered participants rather than events as the unit of analysis, performed fixed-effect meta-analysis, and reported risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) for four comparisons: (1) any vitamin D versus placebo/no supplementation in pregnant or breastfeeding women; (2) any vitamin D versus placebo/no supplementation in infants or children; (3) high versus low/standard dose vitamin D in pregnant or breastfeeding women; (4) high versus low/standard dose vitamin D in infants or children. Our outcomes were: asthma, wheeze, atopic dermatitis, airway infections, allergic sensitisation, airway inflammation, and adverse events. We narratively described results that could not be meta-analysed. We used the Cochrane risk of bias tool (RoB) to assess bias in the studies. We used GRADE to assess the certainty of the evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We included","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"8 ","pages":"CD013396"},"PeriodicalIF":8.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820711","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}