Cochrane Database of Systematic Reviews最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>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.</p><p><strong>Search methods: </strong>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.</p><p><strong>Selection criteria: </strong>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.</p><p><strong>Data collection and analysis: </strong>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.</p><p><strong>Main results: </strong>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}

{"title":"Non-invasive respiratory support in preterm infants as primary mode: a network meta-analysis.","authors":"Amit Mukerji, Prakeshkumar S Shah, Madhura Kadam, Sayem Borhan, Abdul Razak","doi":"10.1002/14651858.CD014895.pub2","DOIUrl":"10.1002/14651858.CD014895.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Numerous innovations in non-invasive respiratory support have been introduced, resulting in a variety of available modes. Given the many options, understanding the relative effectiveness of these strategies is important.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate the benefits and harms of various non-invasive respiratory support modes when used as primary support in preterm infants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, CINAHL, Web of Science, and trial registries (to 7 January 2024).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Randomised, quasi-randomised, and cluster-randomised controlled trials comparing two or more non-invasive respiratory support modes used as primary support for preterm infants within the first 24 hours.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Critical outcomes included treatment failure, endotracheal ventilation, and moderate-severe chronic lung disease (CLD). Important outcomes included any CLD, death, death or moderate-severe CLD, pulmonary air leak syndrome, intestinal perforation, and moderate-severe neurodevelopmental impairment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias: &lt;/strong&gt;We assessed risk of bias using the Cochrane RoB 1 tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis methods: &lt;/strong&gt;For direct treatment comparisons, we conducted standard pairwise meta-analyses of each treatment pair of non-invasive respiratory support modes using a random-effects model. The seven eligible non-invasive respiratory support modes evaluated included nasal continuous positive airway pressure (CPAP), nasal intermittent positive pressure ventilation (NIPPV), biphasic positive airway pressure (BiPAP), high-flow nasal cannula (HFNC), non-invasive high-frequency oscillatory ventilation (NIHFV), non-invasive neurally adjusted ventilatory assist (NIV-NAVA), and high nasal continuous positive airway pressure (H-CPAP). For indirect and mixed treatment comparisons, we used a random-effects model with the Bayesian approach to estimate relative treatment effects to generate a network risk ratio (nRR) and 95% credible interval (95% CrI) for each outcome. We assessed the certainty of evidence using GRADE, specifically adapted for network meta-analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Included studies: &lt;/strong&gt;We included 61 studies (7554 preterm neonates); 44 studies had a high risk of bias. No studies reported on primary use of non-invasive respiratory support with H-CPAP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;Treatment failure (47 studies, 6045 infants): NIHFV may decrease the risk of treatment failure compared to CPAP (nRR 0.41, 95% CrI 0.23 to 0.69; low-certainty evidence); compared to HFNC it may decrease the risk, but the evidence is very uncertain (nRR 0.35, 95% CrI 0.19 to 0.62; very low-certainty evidence). NIPPV may decrease the risk of treatment failure compared to CPAP (nRR 0.63, 95% CrI 0.48 to 0.82; very low-certainty evidence) and HFNC (nRR 0.54, 95% CrI 0.39 to 0.74; very low-certainty evidence), but ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"7 ","pages":"CD014895"},"PeriodicalIF":8.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539230","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":"Lightweight versus heavyweight synthetic mesh for inguinal hernia repair.","authors":"Ajay Kumar Pal, Balendra P Singh, Awanish Kumar, Harvinder Singh Pahwa, Pranita Pradhan","doi":"10.1002/14651858.CD015553","DOIUrl":"10.1002/14651858.CD015553","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 risks of lightweight mesh compared with heavyweight mesh in any open mesh-reinforced hernia repair as well as in laparoscopic repair (TAPP, TEP, or robotic TAPP) in adults with an inguinal hernia.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD015553"},"PeriodicalIF":8.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526714","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":"Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).","authors":"Patrizia Natale, Suetonia C Green, Marinella Ruospo, Jonathan C Craig, Mariacristina Vecchio, Grahame J Elder, Giovanni Fm Strippoli","doi":"10.1002/14651858.CD006023.pub4","DOIUrl":"10.1002/14651858.CD006023.pub4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Phosphate binders lower serum phosphate levels for people with chronic kidney disease (CKD). This is an updated review, previously published in 2011 and 2018. New studies have been published and an update of the current evidence is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of phosphate binders for people with CKD and whether phosphate binders have different effects compared with each other.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched the Cochrane Kidney and Transplant Register of Studies to 16 December 2024 by contacting the Information Specialist, using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, the International Clinical Trials Registry Platform Search Portal, and ClinicalTrials.gov.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) or quasi-RCTs of adults with CKD (any glomerular filtration rate; GFR) comparing a phosphate binder to placebo, usual care, or a different phosphate binder with follow-up of at least eight weeks. The key outcomes were death (all causes), cardiovascular death, hypercalcaemia, nausea, constipation, serum phosphate, and vascular calcification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two authors independently selected studies for inclusion and extracted study data. We adjudicated the risk of bias using the Cochrane RoB 1 tool, and we used GRADE to assess the evidence certainty. We estimated treatment effects using random-effects meta-analysis. We expressed the results as risk ratios (RR) for dichotomous outcomes, and mean differences (MD) or standardised MD (SMD) for continuous outcomes, together with 95% confidence intervals (CI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;This review includes 134 studies involving 20,913 adults. Thirty new studies were added to this update. We assessed the risk of bias as high or unclear for many methodological domains in the studies, and we judged the certainty of the evidence as low or very low. Most studies comparing phosphate binders with placebo/usual care were in people with CKD, while most head-to-head studies comparing two different phosphate binders involved participants on dialysis. The median study duration was 5.4 months, and the median study age was 58 years. Compared to placebo/usual care, sevelamer may have little or no effect on death from any cause (RR 0.45, 95% CI 0.13 to 1.53; 6 studies, 781 participants; low-certainty evidence), and uncertain effects on hypercalcaemia and nausea, but may increase the risk of constipation (RR 3.27, 95% CI 1.38 to 7.74; 5 studies, 632 participants; low-certainty evidence) in people with CKD. Compared to placebo/usual care, sevelamer may have little or no effect on serum phosphate (MD -0.27 mg/L, 95% CI -0.71 to 0.17; 6 studies, 671 participants; low-certainty evidence) and on coronary artery calcium score (MD -70.19, 95% CI -362.44 ","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD006023"},"PeriodicalIF":8.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504977","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":"Brexanolone, zuranolone and related neurosteroid GABA_A receptor positive allosteric modulators for postnatal depression.","authors":"Claire A Wilson, Lindsay Robertson, Karyn Ayre, Jessica L Hendon, Sarah Dawson, Charlene Bridges, Hind Khalifeh","doi":"10.1002/14651858.CD014624.pub2","DOIUrl":"10.1002/14651858.CD014624.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Postnatal depression - depression that occurs up to one year after a woman has given birth - is an important and common disorder that can have short- and long-term adverse impacts on the mother, her child and the family as a whole. Recommended treatment for postnatal depression is psychological therapy, and for more severe depression, antidepressants. However, many antidepressants are associated with limited response. Neurosteroid gamma-aminobutyric acid (GABA&lt;sub&gt;A&lt;/sub&gt;) receptor positive allosteric modulators have been developed for the treatment of depression, including postnatal depression, and have a different mechanism of action than traditional antidepressants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the benefits and harms of brexanolone, zuranolone and related neurosteroid GABA&lt;sub&gt;A&lt;/sub&gt; receptor positive allosteric modulators compared to another active treatment (pharmacological, psychological or psychosocial), placebo or treatment as usual for postnatal depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched Cochrane Common Mental Disorders' Specialised Register, CENTRAL, MEDLINE, Embase and PsycINFO in January 2024. We also searched two international trials registries and contacted experts in the field to identify the studies that are included in the review.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included randomised controlled trials (RCTs) of women with depression during the first 12 months following childbirth that compared neurosteroid GABA&lt;sub&gt;A&lt;/sub&gt; receptor positive allosteric modulators with any other treatment (pharmacological, psychological or psychosocial), placebo or treatment as usual.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;We used standard Cochrane methodological procedures. The primary outcomes were depression response, depression remission and adverse events experienced by the mother, nursing baby, or both. The secondary outcomes were depression severity, treatment acceptability, quality of life and parenting- and child-related outcomes. We grouped analyses according to whether the neurosteroid GABA&lt;sub&gt;A&lt;/sub&gt; receptor positive allosteric modulator was intravenous or oral. We assessed the certainty of the evidence using GRADE criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results: &lt;/strong&gt;We identified six RCTs (674 women); all were placebo-controlled trials. Three studies tested intravenous brexanolone; one, intravenous ganaxolone; and two studies, oral zuranolone. Sample sizes ranged from 21 to 196. All were conducted in the USA. We judged the risks of selection, performance, detection, attrition and reporting biases to mostly be low, although the risk of selection and attrition bias was unclear in two studies. The biopharmaceutical companies which made the drugs sponsored all six included studies. They appear to have had a considerable role in the design and conduct of the studies. Intravenous neurosteroid GABA&lt;sub&gt;A&lt;/sub&gt; receptor positive allosteric modulators ver","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD014624"},"PeriodicalIF":8.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495026","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":"Sorafenib with or without co-interventions for hepatocellular carcinoma.","authors":"Shanshan Chen, Jian Ping Liu, Xinyu Li, Shoutao Dang, Wei Li","doi":"10.1002/14651858.CD015851","DOIUrl":"10.1002/14651858.CD015851","url":null,"abstract":"<p><strong>Objectives: </strong>This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the beneficial and harmful effects of sorafenib, with or without co-interventions, versus placebo, no intervention, or the same co-interventions for adults, aged 18 and over, with hepatocellular carcinoma.</p>","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD015851"},"PeriodicalIF":8.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495027","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":"Low-complexity manual nucleic acid amplification tests for pulmonary tuberculosis in children.","authors":"Leeberk Raja Inbaraj, Mukesh Kumar Sathya Narayanan, Jefferson Daniel, Vignes Anand Srinivasalu, Adhin Bhaskar, Bella Devaleenal Daniel, Tephilla Epsibha, Katie Scandrett, Priya Rajendran, Winsley Rose, Alexei Korobitsyn, Nazir Ismail, Yemisi Takwoingi","doi":"10.1002/14651858.CD015806.pub2","DOIUrl":"10.1002/14651858.CD015806.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Accurate and prompt diagnosis of tuberculosis in children is challenging due to non-specific clinical presentation and the low bacillary load of samples. Low-complexity manual nucleic acid amplification tests (LC-mNAATs) such as loop-mediated isothermal amplification (TB-LAMP) are World Health Organization (WHO)-recommended rapid molecular diagnostic tests. Even in resource-limited settings, they have good diagnostic accuracy in adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To determine the diagnostic accuracy of LC-mNAATs for the detection of pulmonary tuberculosis in children (&lt; 10 years) with presumptive pulmonary tuberculosis. Secondary objectives 1. To compare the diagnostic accuracy of LC-mNAATs and Xpert MTB/RIF Ultra for the detection of pulmonary tuberculosis in children with presumptive pulmonary tuberculosis. 2. To compare the diagnostic accuracy of LC-mNAATs and smear microscopy for detecting pulmonary tuberculosis in children when TB-LAMP is considered as a replacement test for smear microscopy. 3. To determine the diagnostic accuracy of LC-mNAATs for the detection of pulmonary tuberculosis if used as an add-on test amongst sputum smear-negative children. 4. To investigate potential sources of heterogeneity in the diagnostic accuracy of LC-mNAATs due to factors such as smear status, age, HIV status, setting, and tuberculosis burden.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;We searched CENTRAL, MEDLINE, Embase, Science Citation Index, Biosis Previews, Global Index Medicus, SCOPUS, WHO ICTRP, and ClinicalTrials.gov on 2 October 2023 for published articles and trials in progress without language or time limits. We screened the reference lists of included articles, conference abstracts, tuberculosis reviews, and guidelines. We searched ProQuest Dissertations & Theses A&I for dissertations. We approached the Stop TB Partnership, FIND, and other experts on tuberculosis for ongoing and unpublished studies. A WHO public call was made between 30 November 2023 and 15 February 2024 for ongoing and unpublished studies from manufacturers and researchers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We included cross-sectional and cohort studies that evaluated LC-mNAATs in children (&lt; 10 years) against microbiological or composite reference standards. Our index test was TB-LAMP, and comparator index tests were Xpert MTB/RIF Ultra and smear microscopy. The microbiological reference standard included automated liquid culture, solid culture, or a combination of both methods. We considered only design-locked, marketed technologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Four review authors, in pairs, independently screened titles and abstracts and assessed the full texts of potentially eligible articles. A fifth review author resolved any disagreements. We tailored and applied the QUADAS-2 and QUADAS-C tools to assess the risk of bias and applicability. Six review authors, in three pairs, extracted data and perfo","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD015806"},"PeriodicalIF":8.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483421","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":"Peripheral venous blood gas analysis for the diagnosis of respiratory failure, hypercarbia and metabolic disturbance in adults.","authors":"Anthony L Byrne, Nathan L Pace, Paul S Thomas, Rebecca L Symons, Robindro Chatterji, Michael Bennett","doi":"10.1002/14651858.CD010841.pub2","DOIUrl":"10.1002/14651858.CD010841.pub2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Arterial blood gas analysis (ABGA) is the reference standard for the diagnosis of respiratory failure (RF) and metabolic disturbance (MD), but peripheral venous blood gas analysis (PVBGA) is increasingly being used for the estimation of carbon dioxide, pH, and other variables in the context of acutely unwell adults presenting to hospitals and emergency departments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The primary objective of this review is to evaluate the performance of PVBGA by comparing it with the reference standard ABGA, which is assumed to be error-free for the diagnosis of (1) respiratory failure, (2) hypercarbia, and (3) metabolic disturbance (the three target conditions) in adults. The secondary objective is to evaluate the performance of the index test to diagnose nine specific subtypes of respiratory failure and metabolic disturbance. The definitions for these additional conditions are determined by changes to one or more of the following: pH (acidity), pO&lt;sub&gt;2&lt;/sub&gt; (partial pressure of oxygen), pCO&lt;sub&gt;2&lt;/sub&gt; (partial pressure of carbon dioxide), HCO&lt;sub&gt;3&lt;/sub&gt; (bicarbonate), as stated in the Methods section of this review (target conditions). We aimed to explore the following covariates: participant demographics (e.g. age, weight, and sex); participant comorbidities (e.g. chronic lung disease, chest wall deformity, and central nervous system disorder such as spinal cord injury); and the indication for blood gas sampling (e.g. shortness of breath, critical illness, resuscitation, trauma, or whilst under general anaesthesia).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Search methods: &lt;/strong&gt;On 10 July 2024, we searched the electronic databases MEDLINE, EMBASE, CINAHL, and LILACS. We also manually searched 19 respiratory and critical care journals, and we searched ClinicalTrials.gov for ongoing trials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Selection criteria: &lt;/strong&gt;We considered consecutive series studies and case-control studies that directly compared the index test PVBGA to the reference standard ABGA for adults over the age of 16 years. The included studies contained data for any one of the target conditions of respiratory failure and metabolic disturbance, as determined by individual changes to pO&lt;sub&gt;2&lt;/sub&gt; (partial pressure of oxygen), pCO&lt;sub&gt;2&lt;/sub&gt; (partial pressure of carbon dioxide), pH (acidity), and HCO&lt;sub&gt;3&lt;/sub&gt; (bicarbonate) concentration. Studies that only provided mean values for summed data were ineligible for inclusion. However, we invited authors of such studies to provide individual patient data for inclusion in this systematic review. There are nine studies awaiting classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data collection and analysis: &lt;/strong&gt;Two authors independently evaluated the quality of the relevant studies and extracted data from them. We conducted a quality assessment using the QUADAS-2 tool. Our statistical analysis used 2 x 2 tables for the positive and negative results of each test. We estimated a bivariate meta-analysis of","PeriodicalId":10473,"journal":{"name":"Cochrane Database of Systematic Reviews","volume":"6 ","pages":"CD010841"},"PeriodicalIF":8.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483422","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}