Journal of Evidence‐Based Medicine最新文献

{"title":"From Patient-Friendly Guidelines to Conceptual Coherence: Why Future Professional Fibromyalgia Guidelines Should Develop a Biopsychosocial Multidimensional Assessment Framework.","authors":"André Pontes-Silva","doi":"10.1111/jebm.70209","DOIUrl":"https://doi.org/10.1111/jebm.70209","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149268930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baduanjin Exercise Across Clinical Conditions: An Umbrella Review.","authors":"Dongsheng Yuan, Bo Xu, Renkun Zhao, Yongsheng Cui, Kexin Yang, Zhefeng Jin, Kai Sun, Jiaming Wei, Liguo Zhu, Xiaokuan Qin, He Yin","doi":"10.1111/jebm.70196","DOIUrl":"https://doi.org/10.1111/jebm.70196","url":null,"abstract":"<p><strong>Background: </strong>Baduanjin (BDJ) is a traditional Chinese mind-body exercise increasingly evaluated in rehabilitation and chronic disease care. The growth of systematic reviews has made the literature difficult to interpret because review volume, methodological quality, certainty of evidence, and overlap of primary trials are rarely considered together. This umbrella review aimed to map the clinical condition spectrum of BDJ research and to appraise the credibility and redundancy of the existing review evidence.</p><p><strong>Methods: </strong>Eight English and Chinese databases were searched from inception to April 2026 for systematic reviews and meta-analyses in which BDJ was a standalone or separable intervention. Eligible reviews were mapped by clinical condition. Representative core reviews were selected using prespecified hierarchical criteria. Methodological quality, certainty of evidence, and primary-trial overlap were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), grading of recommendations assessment, development and evaluation (GRADE), and corrected covered area (CCA), respectively.</p><p><strong>Results: </strong>A total of 261 reviews were included. Thirty-one core reviews underwent AMSTAR 2 appraisal, 21 condition-outcome pairs underwent GRADE assessment, and 10 review clusters underwent CCA analysis. Review activity was concentrated in cardiovascular/cardiac rehabilitation, musculoskeletal pain, cognitive/neurological rehabilitation, endocrine/metabolic disorders, psychological/sleep/emotional conditions, oncology/postoperative rehabilitation, and respiratory disease. AMSTAR 2 ratings were moderate in one review, low in 18, and critically low in 12. Nineteen condition-outcome pairs were rated low certainty and 2 very low certainty. Several clusters showed high or very high primary-trial overlap.</p><p><strong>Conclusions: </strong>BDJ has been reviewed widely, but the evidence is methodologically uneven, frequently overlapping, and of low or very low certainty. Current findings should be interpreted as uncertain evidence signals rather than practice recommendations.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70196"},"PeriodicalIF":4.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Clinical Practice Guidelines on Fecal Microbiota Transplantation in Adults: A Cross-Sectional Study.","authors":"Mingjuan Zhao, Shaojie Li, Guang Fu, Tong Deng, Yinghui Jin, Yingjiang Ye, Zhiqiang Li","doi":"10.1111/jebm.70202","DOIUrl":"https://doi.org/10.1111/jebm.70202","url":null,"abstract":"<p><strong>Objective: </strong>Fecal microbiota transplantation (FMT) is an emerging multi-disease therapy, yet the quality and consistency of its available clinical practice guidelines (CPGs) remain unknown. This study aimed to systematically evaluate the quality, content coverage and recommendation consistency of FMT-related guidelines and develop an optimization framework for evidence-informed future guideline revision and standardized FMT clinical practice.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Web of Science Core Collection, The Cochrane Library, CNKI, WanFang Data, and official websites of guideline development organizations and professional societies from inception to March 11, 2026. Two reviewers independently screened and selected CPGs with actionable recommendations and conducted quality evaluation via the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. Intraclass correlation coefficient (ICC) with 95% confidence intervals (CIs) was computed for each AGREE II domain and interpreted according to Fleiss' criteria. Inter-guideline agreement was reported as the percentage of CPGs endorsing each recommendation.</p><p><strong>Results: </strong>Eighteen CPGs (3 general, 15 FMT-specific) with 191 recommendations were included. Applicability obtained the lowest AGREE II score (37.8%), followed by rigor of development (47.4%) and stakeholder involvement (49.7%). General guidelines scored higher than FMT-specific guidelines in applicability (62.5% vs. 32.9%) and stakeholder involvement (59.3% vs. 47.8%), but lower in rigor of development (38.9% vs. 49.1%). The coverage of recommendations showed marked inter‑guideline heterogeneity. Recurrent Clostridioides difficile infection (rCDI) was the most consistently recommended indication with the highest level of evidence (10/16). Over 75% of guidelines ignored transplant-center management, and non-CDI indications and key operational steps lacked sufficient high-certainty evidence. ICCs (0.86-0.97) showed excellent evaluator consistency.</p><p><strong>Conclusions: </strong>Current FMT guidelines exhibit significant methodological deficiencies, heterogeneous recommendation coverage, and limited consensus beyond rCDI. FMT-specific guidelines show better developmental rigor but poorer applicability than general guidelines. Future FMT guideline development should establish core topic sets, adopt multidisciplinary collaborative mechanisms, and develop implementation toolkits with regular update protocols.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70202"},"PeriodicalIF":4.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Social Determinants of Health and All-Cause and Cause-Specific Mortality: UK Biobank Cohort Study.","authors":"Huan Chen, Xiaolin Wang, Jian Gao, Chuan Li, Wenfang Zhong, Qingmei Huang, Jiahao Xie, Jin Yang, Weiqi Song, Dan Liu, Zhihao Li, Chen Mao","doi":"10.1111/jebm.70205","DOIUrl":"https://doi.org/10.1111/jebm.70205","url":null,"abstract":"<p><strong>Aim: </strong>Social determinants of health (SDHs) play an important role in addressing inequitable and avoidable disparities in health status within countries but lack systematic assessment in broad populations. The aim of this study was to determine the association of SDHs, individually, in combination and cumulatively, with all-cause mortality risk, cardiovascular disease (CVD) mortality, and cancer mortality.</p><p><strong>Methods: </strong>Data were obtained from 190,239 adults in the UK Biobank. Exposure variables were SDHs assessed by self-reported sociodemographic characteristics using standardized questionnaires. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models to estimate the associations of combined SDHs and cumulative number of SDHs with all-cause, CVD, and cancer mortality.</p><p><strong>Results: </strong>Over a median 12-year follow-up, 9,871 deaths occurred, including 1,673 from CVD and 5,199 from cancer. Compared to favorable SDHs, medium SDHs (HR 1.143; 95% CI 1.090-1.198) and unfavorable SDHs (HR 1.642; 95% CI 1.559-1.729) were associated with higher all-cause mortality risks. Medium and unfavorable SDHs were associated with increased risks of CVD mortality (by 16.3% and 81.5%) and cancer mortality (by 7.7% and 26.1%). Having ≥8 cumulative adverse SDHs significantly heightened all-cause mortality risk. In exploratory analyses, baseline hypertension and diabetes statistically accounted for a portion of the associations between combined SDHs and mortality outcomes.</p><p><strong>Conclusions: </strong>Unfavorable SDHs are substantially associated with increased risks of all-cause, CVD, and cancer mortality. Exploratory findings suggest that baseline hypertension and diabetes substantially explain these associations, highlighting existing disease burden as a key driver of health inequalities.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70205"},"PeriodicalIF":4.7,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149220276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Esophageal Cancer Stage at Diagnosis: A Systematic Review of Registry-Based Data.","authors":"Lanwei Guo, Chenxin Zhu, Le Wang, Jiani Yuan, Yu Qiu, Huamei Luan, Lin Cai, Hongda Chen, Yuelun Zhang, Yan Zheng, Yanyan Liu","doi":"10.1111/jebm.70198","DOIUrl":"https://doi.org/10.1111/jebm.70198","url":null,"abstract":"<p><strong>Aims: </strong>Stage at diagnosis is a key factor influencing survival in patients with esophageal cancer. This study aims to assess the distribution of esophageal cancer stage at diagnosis using registry data from multiple countries/regions.</p><p><strong>Methods: </strong>PubMed, Embase, CNKI, and WanFang Data were systematically searched, supplemented by grey literature from cancer registry reports. Population- or hospital-based registry studies reporting stage distribution at diagnosis according to tumor-node-metastasis or Surveillance, Epidemiology, and End Results systems were included. Sex-specific stage distributions, associations of the Human Development Index (HDI) and Socio-Demographic Index (SDI) with distant metastasis, and temporal trends in stage distribution were assessed.</p><p><strong>Results: </strong>Stage data from 23 countries/regions were included. Among the 22 countries/regions in the primary analysis, the proportion of cases with distant metastasis varied substantially, with a median of 26.6% (interquartile range: 18.7%-35.9%), highest in Czechia (43.7%). Among the 11 countries with sex-stratified data, males had a higher proportion of distant metastasis than females in all but Norway. Weighted ecological analyses showed no statistically significant associations of HDI or SDI with the proportion of cases with distant metastasis (p > 0.05). Temporal trends showed that the proportion of distant metastasis remained generally stable in most countries/regions, with the Republic of Korea below 20%.</p><p><strong>Conclusions: </strong>A substantial proportion of patients with esophageal cancer presented with distant metastasis at diagnosis, with marked regional and sex differences in stage distribution. Further research is needed to identify factors associated with stage variation and improve cancer registration and staging data quality.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70198"},"PeriodicalIF":4.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Early Clinical Management of Herpes Zoster to Prevent Postherpetic Neuralgia: An Evidence-Based Narrative Review.","authors":"Yupeng Guo, Xuanwei Dong, Guoqiang Chen","doi":"10.1111/jebm.70203","DOIUrl":"https://doi.org/10.1111/jebm.70203","url":null,"abstract":"<p><p>Herpes zoster (HZ), caused by the reactivation of latent varicella-zoster virus, is a common neurocutaneous disorder that predominantly affects older adults and immunocompromised populations. Postherpetic neuralgia (PHN), the most frequent and debilitating complication of HZ, is characterized by persistent neuropathic pain and is associated with substantial impairment in quality of life, functional decline, and increased healthcare utilization. Despite advances in antiviral therapy and vaccination strategies, PHN remains a major clinical challenge. Accumulating mechanistic and clinical evidence indicates that events occurring during the acute phase of HZ, including virus-induced neural injury, persistent inflammation, and central sensitization, play a critical role in the subsequent development of PHN. This evidence-based narrative review summarizes current data on early clinical management as a potential disease-modifying strategy to reduce PHN risk. It examines the pathophysiological continuum from acute HZ to chronic neuropathic pain, evaluates the effectiveness of early antiviral therapy and optimized pain management, and discusses the role of multimodal and supportive interventions during the acute phase. In addition, this review highlights the preventive value of recombinant zoster vaccination and its integration with early clinical management across the HZ-PHN continuum. Overall, current evidence supports a proactive, risk-stratified approach to HZ management that emphasizes early diagnosis, timely antiviral therapy, mechanism-based pain management, structured follow-up, and widespread vaccination. Optimizing early clinical care represents an important opportunity to reduce the incidence, severity, and long-term burden of PHN, particularly in high-risk populations.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70203"},"PeriodicalIF":4.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture and Moxibustion for Neck Pain: A Clinical Practice Guideline.","authors":"Yuhan Wang, Zihan Yin, Xin Sun, Fanrong Liang, Jiping Zhao, Luwen Zhu, Yemeng Chen, Xu Wei, Linda Zhong, Fei Yao, Liang Yao, Weilin Liu, Ling Zhao","doi":"10.1111/jebm.70204","DOIUrl":"https://doi.org/10.1111/jebm.70204","url":null,"abstract":"<p><strong>Background: </strong>Neck pain (NP) is a leading cause of disability worldwide. Pharmacological treatments often provide limited benefits and may be associated with adverse effects, highlighting the need for effective non-pharmacological options.</p><p><strong>Aim: </strong>To develop evidence-based recommendations on the effectiveness, safety, and clinical implementation of acupuncture and/or moxibustion for adults with NP.</p><p><strong>Methods: </strong>This guideline was developed in accordance with the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement for acupuncture and the BMJ Rapid Recommendations process. Recommendations were informed by a systematic review of 88 randomized controlled trials (RCTs) involving 10,172 participants. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and recommendations were formulated through an evidence-to-decision framework and multidisciplinary consensus.</p><p><strong>Results: </strong>The guideline proposed five recommendations: (1) acupuncture and/or moxibustion is suggested rather than no such treatment (weak recommendation, moderate-certainty); (2) acupuncture and/or moxibustion may be considered for patients with moderate-to-severe pain or prolonged symptoms (weak recommendation, low-certainty); (3) adding acupuncture and/or moxibustion to usual care is suggested rather than usual care alone (weak recommendation, low-certainty); (4) an initial 3-4-week course, using 5-10 acupoints/session and 3-5 sessions/week, may serve as a reference regimen (weak recommendation, low-certainty); and (5) electroacupuncture may be preferentially considered for pain relief and functional improvement, whereas manual acupuncture, warm needling, and moxibustion may be alternatives (weak recommendation, low-certainty). Adverse events were generally mild and self-limiting.</p><p><strong>Conclusions: </strong>Acupuncture and/or moxibustion may be reasonable and safe non-pharmacological options for adults with NP. Clinical use should be guided by shared decision-making that considers symptom severity, disease duration, treatment goals, patient preferences, accessibility, and practitioner expertise.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70204"},"PeriodicalIF":4.7,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Alterations at High Altitude: A Systematic Review and Meta-Analysis.","authors":"Jianwen Ma, Weijie Fu, Zhuolin Tang, Wei Wu, Fan Wu, Xuelin Yang, Huwei Nie, Feng Gao, Mei Xin, Siyi He","doi":"10.1111/jebm.70199","DOIUrl":"https://doi.org/10.1111/jebm.70199","url":null,"abstract":"<p><strong>Objectives: </strong>The patterns of cardiovascular adaptation to high-altitude (HA) exposure remain unclear. The aim of this systematic review and meta-analysis was to characterize dose-dependent cardiovascular responses across altitude gradients and to identify the adaptive patterns associated with increasing altitude exposure.</p><p><strong>Methods: </strong>We searched the MEDLINE, Embase, The Cochrane Library, WanFang Data, CNKI, VIP and CBM databases published from inception to April 2025. Studies assessing cardiovascular responses to high-altitude exposure were included. Data were synthesized using random-effects pairwise and dose-response network meta-analysis models, with standardized mean differences (SMDs) calculated for continuous outcomes. The study was prospectively registered in PROSPERO (CRD420251022814).</p><p><strong>Results: </strong>We included 121 studies involving 108,530 participants in the final analysis. Compared with low-altitude group (LAG), peripheral capillary oxygen saturation declined in a dose-dependent manner, with a marked reduction at extreme high-altitude group (EHAG) (SMD, -16.68; 95% confidence interval [CI], -18.36 to -15.00). Diastolic blood pressure showed the greatest increase (SMD, 6.09; 95% CI, 4.71 to 7.47) at EHAG. Heart rate increased from LAG to HAG, but showed no further significant increase at higher altitudes. Subgroup analyses suggested variations in cardiovascular responses according to population type and exposure duration.</p><p><strong>Conclusions: </strong>HA exposure induces altitude-dependent cardiovascular adaptations involving impaired oxygenation, hemodynamic changes, and cardiac remodeling, with more pronounced effects at EHAG. These findings offer evidence-based insights for clinical decision-making and formulation of altitude-specific healthcare policies.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70199"},"PeriodicalIF":4.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Blood Pressure Is Causally Associated With Larger Subcortical Gray Matter Structure Through Perivascular Clearance Routes.","authors":"Jing Sun, Jing Li, Xiaoshuai Li, Xinyu Zhao, Pengfei Zhao, Zhenghan Yang, Shuohua Chen, Shouling Wu, Ying Hui, Zhenchang Wang, Han Lv","doi":"10.1111/jebm.70200","DOIUrl":"https://doi.org/10.1111/jebm.70200","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the association between elevated blood pressure (BP) and subcortical gray matter structures, and to elucidate the causality and underlying mechanisms.</p><p><strong>Methods: </strong>This study enrolled 1012 participants from a multicenter, population-based cohort study in China. Generalized linear models were used to evaluate the associations between different degrees of BP and subcortical gray matter volumes. Mendelian randomization analysis based on genome-wide data was performed to investigate causal relationships. We further conducted mediation analysis to analyze whether these associations were mediated by dysfunctional brain clearance.</p><p><strong>Results: </strong>Compared with the lowest group of systolic BP (SBP) < 120 mmHg and diastolic BP (DBP) < 80 mmHg, elevated BP was associated with larger subcortical gray matter volumes, including caudate volumes (SBP/DBP 130/80-140/90 mmHg: β = 0.19), putamen volumes (SBP/DBP 130/80-140/90 mmHg: β = 0.27; SBP/DBP ≥ 140/90 mmHg: β = 0.31), and pallidum volumes (SBP/DBP 120/80-130/80 mmHg: β = 0.25; SBP/DBP 130/80-140/90 mmHg: β = 0.28; SBP/DBP ≥ 140/90 mmHg: β = 0.25). Genetically determined hypertension was causally associated with increased volumes of subcortical gray matter (left caudate: β = 1.59; right caudate: β = 1.42; left putamen: β = 0.84; right putamen: β = 0.69; left pallidum: β = 0.59). The number of basal ganglia enlarged perivascular spaces (BG-EPVS) mediated the relationship between elevated BP and larger volumes of subcortical gray matter.</p><p><strong>Conclusions: </strong>Elevated BP is associated with larger subcortical gray matter volumes, mediated by an increased burden of BG-EPVS. Our study provides novel evidence for the complex mechanisms linking higher BP levels to brain health.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70200"},"PeriodicalIF":4.7,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of ad^Writer and Human Evaluations of Guideline Reporting Quality: Performance of ChatGPT and DeepSeek.","authors":"Jie Zhang, Qianling Shi, Hui Liu, Xufei Luo, Zhenhua Yang, Zeming Li, Bingyi Wang, Yishan Qin, Honghao Lai, Yaolong Chen","doi":"10.1111/jebm.70193","DOIUrl":"https://doi.org/10.1111/jebm.70193","url":null,"abstract":"<p><strong>Aim: </strong>The proliferation of clinical practice guidelines presents significant challenges for ensuring evidence-based care, since evaluating their trustworthiness with the Reporting Items for practice Guidelines in HealThcare (RIGHT) criteria is both time-consuming and resource-intensive. To address this, the Artificial intelligence-empowered DeVelopment and AssessmeNt of healthCare guidElines and stanDards (ADVANCED) working group developed ad^Writer, an artificial intelligence system, designed to automate guideline reporting quality assessment. This study aimed to determine the agreement and reliability of ad^Writer compared with human evaluations.</p><p><strong>Methods: </strong>Guidelines were identified from four published systematic reviews, and through direct communication with the original authors, 60 were ultimately included. These guidelines were evaluated using ad^Writer with two different large language models, each performing three independent assessments. A majority rule was applied to synthesize results. Results from systematic reviews, which served as the reference standard. Agreement, consistency, and stability of the artificial intelligence-based assessments were examined using Bland-Altman plots, accuracy measures, and intraclass correlation coefficient (ICC), with a focus on identifying patterns of performance across individual RIGHT items.</p><p><strong>Results: </strong>Both models showed good agreement with human but had wide limits of agreement. DeepSeek performed better (mean difference = -1.40, standard deviation = 5.00, 95% limits of agreement ([-11.22, 8.42]) and had higher accuracy scores. Both achieved ≥ 75% accuracy on 23 items (65.71%), however, the results varied. ChatGPT showed higher consistency (ICC = 0.93) compared to DeepSeek (ICC = 0.88).</p><p><strong>Conclusions: </strong>The ad^Writer system leverages large language models to demonstrate the potential for rapid, accurate, and reproducible guideline quality assessments based on RIGHT. By serving as a supportive tool for manual evaluation, this approach enhances the efficiency of the guideline appraisal process, saving time and human resources for stakeholders.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70193"},"PeriodicalIF":4.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}