Journal of Evidence‐Based Medicine最新文献

{"title":"Calculation of the Overlap in Umbrella Reviews Based on the Sample Size of Primary Studies","authors":"Hamidreza Ashayeri, Hanieh Salehi-Pourmehr, Ali Jafarizadeh","doi":"10.1111/jebm.70038","DOIUrl":"https://doi.org/10.1111/jebm.70038","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171721","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":"The Indirect Impact of COVID-19 Pandemic on Mortality, Complications, and Healthcare Utilization Among Patients With Chronic Respiratory Diseases in Hong Kong: An Interrupted Time Series Analysis","authors":"Qi Kang,&nbsp;Yuk Kam Yau,&nbsp;Zhuoran Hu,&nbsp;Jianchao Quan,&nbsp;David Chi Leung Lam,&nbsp;Ivy Lynn Mak,&nbsp;Ian Chi Kei Wong,&nbsp;David Vai Kiong Chao,&nbsp;Welchie Wai Kit Ko,&nbsp;Chak Sing Lau,&nbsp;Cindy Lo Kuen Lam,&nbsp;Eric Yuk Fai Wan","doi":"10.1111/jebm.70039","DOIUrl":"https://doi.org/10.1111/jebm.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to investigate COVID-19's indirect influence on chronic respiratory disease (CRD) patients for two years since the COVID-19 pandemic began.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using population-based data in Hong Kong, we included CRD patients diagnosed from January 2011 to December 2021. Interrupted Time Series Analysis were applied to assess mortality, complications, and healthcare utilization rates during the “pre-COVID-19 pandemic” (January 2012–January 2020), “initial COVID-19 pandemic” (February 2020–February 2021), and “post-initial COVID-19 pandemic” (March 2021–December 2021) periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 587,049 patients with CRD, all-cause mortality had an increasing trend during the post-initial COVID-19 pandemic period (incidence rate ratio (95% CI): 1.019 (1.005, 1.034); <i>p</i> = 0.007), compared with pre-COVID-19 pandemic period. Nonrespiratory mortality had an increasing trend in the initial COVID-19 pandemic period (1.020 (1.006, 1.033); <i>p</i> = 0.004) and was higher than the pre-pandemic level in the post-initial COVID-19 pandemic. We observed abrupt declines in the incidence rates of asthma exacerbation, acute exacerbation of chronic obstructive pulmonary disease, pneumonia, and acute respiratory failure in the first month of initial COVID-19 pandemic period, remaining below pre-COVID-19 pandemic levels throughout the initial pandemic period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The disruption of usual healthcare impacts mortality rates among patients with CRD without COVID-19, particularly nonrespiratory mortality. Contingency plans on continuing follow-up and monitoring of CRD patients are needed, for example, teleconsultations, shared primary care, and tele-reminders on red-flag symptoms for patients with CRD, when healthcare services may be disrupted during public health crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171722","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":"Meta-Epidemiology: A Combination of Epidemiology and Meta-Analysis in Response to the Challenges of Systematic Reviews and Meta-Analysis","authors":"Masoud Mohammadi","doi":"10.1111/jebm.70036","DOIUrl":"https://doi.org/10.1111/jebm.70036","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140473","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":"Large Language Models in Integrative Medicine: Progress, Challenges, and Opportunities","authors":"Hiu Fung Yip,&nbsp;Zeming Li,&nbsp;Lu Zhang,&nbsp;Aiping Lyu","doi":"10.1111/jebm.70031","DOIUrl":"https://doi.org/10.1111/jebm.70031","url":null,"abstract":"<p>Integrating Traditional Chinese Medicine (TCM) and Modern Medicine faces significant barriers, including the absence of unified frameworks and standardized diagnostic criteria. While Large Language Models (LLMs) in Medicine hold transformative potential to bridge these gaps, their application in integrative medicine remains underexplored and methodologically fragmented. This review systematically examines LLMs' development, deployment, and challenges in harmonizing Modern and TCM practices while identifying actionable strategies to advance this emerging field. This review aimed to provide insight into the following aspects. First, it summarized the existing LLMs in the General Domain, Modern Medicine, and TCM from the perspective of their model structures, number of parameters and domain-specific training data. We highlighted the limitations of existing LLMs in integrative medicine tasks through benchmark experiments and the unique applications of LLMs in Integrative Medicine. We discussed the challenges during the development and proposed possible solutions to mitigate them. This review synthesizes technical insights with practical clinical considerations, providing a roadmap for leveraging LLMs to bridge TCM's empirical wisdom with modern medical systems. These AI-driven synergies could redefine personalized care, optimize therapeutic outcomes, and establish new standards for holistic healthcare innovation.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085160","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":"Limited Evidence to Fully Determine the Implementation of Evidence-Based Practice by Healthcare Providers in Africa: A Systematic Review and Meta-Analysis","authors":"Feleke H. Astawesegn,&nbsp;Kedir Y. Ahmed,&nbsp;Subash Thapa,&nbsp;Shakeel Mahmood,&nbsp;Anayochukwu Anyasodor,&nbsp;M. Mamun Huda,&nbsp;Setognal B. Aychilihum,&nbsp;Utpal K. Modal,&nbsp;Allen G. Ross","doi":"10.1111/jebm.70032","DOIUrl":"https://doi.org/10.1111/jebm.70032","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Implementing evidence-based practice (EBP) is a complex process requiring healthcare providers to integrate evidence-based medicine (EBM) into clinical practice, ultimately improving clinical outcomes. This systematic review examined the sources of information for EBP, analyzed the extent of EBP implementation by healthcare providers, and explored the factors influencing EBP in Africa.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We identified articles published between January 1992 and March 2024 by searching Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMbase, PubMed, and Scopus databases. The pooled effect sizes for the prevalence of EBP and odds ratios (ORs) were estimated using random- and fixed-effects models as appropriate. For the qualitative component of the study, we performed a thematic analysis and subsequently integrated and interpreted findings from both the quantitative and qualitative analyses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty-three studies were included in this review, involving 9722 healthcare providers: 60.3% nurses, 15.9% physicians, and 15.4% midwives. Our findings revealed a lack of detailed information on how healthcare providers utilized different forms of EBM to inform EBP and clinical outcomes in Africa. Self-reported EBP was 57.3% among nurses and 37.3% among physicians. Nigeria had the highest self-reported EBP (75.2%), whereas Egypt had the lowest (18.9%). Common sources of information reported for EBP were PubMed, UpToDate, the Cochrane Library, clinical guidelines, and training programs. Factors associated with EBP included knowledge of EBP (OR = 2.13, 95% confidence interval [CI]: 1.83–2.47), positive attitude toward EBP (OR = 1.95, 95% CI: 1.76–2.15), and having EBM training (OR = 3.08, 95% CI: 2.08–4.57), and a managerial role (OR = 2.16, 95% CI: 1.37–3.41). The availability of guidelines (OR = 1.88, 95% CI: 1.5–2.37) and internet access (OR = 1.90, 95% CI: 1.54–2.34) were also found to increase EBP. Our qualitative analysis identified common barriers to EBP, including a lack of support, resistance to change, poor communication, and failure to integrate EBP courses into the continuing education curricula.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This systematic review found limited information on the sources of EBM, how it was delivered, and its frequency of use in clinical practice. Thus, the correlation between EBM, EBP, and clinical outcomes was not fully transparent. Further studies are required to examine the medical conditions","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074694","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":"Clinical Application Guideline of Combination With Traditional Chinese Medicine and Western Medicine in the Prevention and Treatment of Chronic Obstructive Pulmonary Disease (2024)","authors":"Di Wu,&nbsp;Wei Liu,&nbsp;Jianxin Wang,&nbsp;Wei Chen,&nbsp;Mengyao Shi,&nbsp;Lu Zhang,&nbsp;Hui Wang,&nbsp;Huanzhang Ding,&nbsp;Xiao Ma,&nbsp;Yating Gao,&nbsp;Zengtao Sun,&nbsp;Jiangtao Lin,&nbsp;Hongchun Zhang,&nbsp;Suyun Li,&nbsp;Zhuying Li,&nbsp;Zhenhui Lu,&nbsp;Fuqiang Wen,&nbsp;Zegeng Li","doi":"10.1111/jebm.70024","DOIUrl":"https://doi.org/10.1111/jebm.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Chronic Obstructive Pulmonary Disease (COPD) is a common chronic airway disease that can lead to decreased lung function in patients. It places a heavy economic burden on patients and society. Traditional Chinese medicine (TCM) and Western medicine have played important roles in managing COPD. We aimed to develop an evidence-based guideline for treating COPD with Chinese and Western Medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We formed a guideline panel of multidisciplinary experts. The clinical questions were identified based on two rounds of issue solicitation and expert demonstration. We searched the literature for direct evidence on the management of COPD and assessed its certainty-generated evidence using the grading of recommendations, assessment, development, and evaluation (GRADE) approach. The recommendations and their strengths were formulated using the Delphi method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our guideline covers aspects of the diagnosis and treatment of COPD such as principles and commonly used medications for both traditional Chinese medicine and Western medicine, complications, and the high-risk populations. 9 clinical questions and 35 recommendations were identified, which covered the combinations of YuPingFeng granule, Buzhong Yiqi decoction, Gushen Dingchuan Pill, Bufei Huoxue Capsules, Runfei cream, Bailing Capsule, Tanyin Pills, etc., and nonpharmacological therapy of TCM such as combined acupoint application, electroacupuncture, and Chinese exercise techniques (Tai Chi, Baduanjin), etc. Recommendations were either high or low or in the form of ungraded consensus-based statements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is a comprehensive and systematic evidence-based guideline and we hope it can systematically and effectively guide clinicians in managing COPD and improve overall medical care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143888890","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":"An Umbrella Review of Diabetes Mellitus and Hearing Impairment","authors":"Longkun Liu,&nbsp;Qian Xu,&nbsp;Mengmeng Zhu,&nbsp;Jing Cui,&nbsp;Yanfei Liu,&nbsp;Yue Liu","doi":"10.1111/jebm.70030","DOIUrl":"https://doi.org/10.1111/jebm.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to synthesize current meta-analyses to propose a potentially existing association between diabetes and hearing impairment (HI), elevating their relationship to “high” level of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was performed in 9 databases up to March 31, 2025. The pooled results were synthesized to elucidate the direction and magnitude of the effects. We used the AMSTAR-2 scale to assess study quality and the GRADE tool to assess the certainty of the evidence. Subgroup analysis was conducted according to age (PROSPERO-ID: CRD42024606416).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This umbrella review comprehensively encompassed over 22 million participants from more than 226 studies. After screening, 21 studies were finally included. Primary outcomes showed that individuals with HI were at a higher risk of developing diabetes, referring to [odds ratio (OR) = 1.88, 95% confidence interval (CI): (1.01, 3.50)] with moderate evidence certainty. Simultaneously, participants with diabetes exhibited a more prevalent occurrence of HI. Higher pure tone audiometric thresholds, lower distortion product otoacoustic emission amplitudes, and increased auditory brainstem-evoked response latency time collectively indicated an increased risk of HI associated with diabetes. Subgroup analysis results revealed that in the younger population, the association between HI and diabetes risk is also high.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, the current body of evidence underscores a latent bidirectional association between diabetes and HI, coupled with mutually aggravating effects. Our findings suggest that HI may serve as an indicator of the risk of developing diabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143871467","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":"Chinese Expert Consensus on Integrated Chinese and Western Medicine for the Treatment of Tic Disorders","authors":"Rong Ma,&nbsp;Sumei Wang,&nbsp;Yi Zheng,&nbsp;Jian Chen,&nbsp;Wenxiong Chen,&nbsp;Xia Cui,&nbsp;Yonghua Cui,&nbsp;Yanzhao Guo,&nbsp;Fei Han,&nbsp;Xinmin Han,&nbsp;Daohan Wang,&nbsp;Fan He,&nbsp;Ping Rong,&nbsp;Yan Hu,&nbsp;Yi Huang,&nbsp;Xiaoyan Ke,&nbsp;Bo Li,&nbsp;Min Li,&nbsp;Ruiben Li,&nbsp;Huanzhong Liu,&nbsp;Jing Liu,&nbsp;Zhisheng Liu,&nbsp;Xuerong Luo,&nbsp;Bingxiang Ma,&nbsp;Ping Shi,&nbsp;Jiaxin Sun,&nbsp;Hua Wang,&nbsp;Liping Wu,&nbsp;Min Wu,&nbsp;Haihong Yan,&nbsp;Baoqing Zhang,&nbsp;Jinsong Zhang,&nbsp;Junhua Zhang,&nbsp;Xilian Zhang,&nbsp;Xin Zhang,&nbsp;the Standard Research Project Group on Prevention and Treatment Strategies of Integrated Chinese and Western Medicine","doi":"10.1111/jebm.70012","DOIUrl":"https://doi.org/10.1111/jebm.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Tic disorders are neurodevelopmental conditions that manifest in childhood or adolescence and can significantly impact the quality of life of affected children and their families to varying degrees. Integrated traditional Chinese and Western medicine treatment strategies have demonstrated more pronounced efficacy and better safety profiles. However, there is currently no standardized clinical expert consensus on this approach. To address this, the National Administration of Traditional Chinese Medicine initiated a project, and the China Association of Chinese Medicine assembled a team of authoritative domestic experts to develop this expert consensus, aiming to provide practical and feasible integrated treatment strategies for clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This consensus identified clinical issues through research, conducted literature reviews, and established evidence based on systematic evaluations. Expert surveys, two rounds of Delphi questionnaires, and expert consensus meetings were conducted to formulate a series of recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We established a multidisciplinary consensus development panel. Based on systematic literature reviews, Delphi questionnaires, and consensus meetings, ten clinical issues were identified. Ultimately, a series of recommendations were developed, considering the balance of benefits and risks, the certainty of evidence, clinical feasibility, accessibility, and clinical acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These recommendations comprehensively address key issues in the field of integrated traditional Chinese and Western medicine treatment, including indications for the use of Chinese or Western medicine alone or in combination, specific treatment protocols, methods for dose reduction and discontinuation, evaluation intervals, and the management of adverse reactions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840839","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":"Efficacy of Hypoglycemic Agents in Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD): A Systematic Review and Network Meta-Analysis","authors":"Qiao Ren,&nbsp;Yao Tan,&nbsp;Guixiang Zhang,&nbsp;Yuzhao Dai,&nbsp;Lidan Yang,&nbsp;Yunmo Wu,&nbsp;He He,&nbsp;Jie Chen","doi":"10.1111/jebm.70021","DOIUrl":"https://doi.org/10.1111/jebm.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Metabolic dysfunction associated steatotic liver disease (MASLD) is a universal hepatic disease, and many recent randomized clinical trials (RCTs) have explored whether hypoglycemic agents may be beneficial for its treatment. This study aimed to assess the relative effectiveness of each hypoglycemic agent for MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>China National Knowledge Infrastructure（CNKI）, WanFang, Weipu, PubMed, Embase, The Cochrane Library, and Web of Science Core Collection were searched for RCTs on the efficacy of hypoglycemic agents in MASLD published up to December 31, 2024. All statistical analyses were performed using R version 4.3.3. The network meta-analysis was conducted using Bayesian statistical methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 26 hypoglycemic agents for treating MASLD in 37 studies with 2406 participants were included. Empagliflozin was most effective in improving liver stiffness measurement (LSM), whereas liraglutide showed significant benefits in body weight, body mass index (BMI), and waist circumference. Both sodium-glucose co-transporter 2 (SGLT-2) inhibitors (e.g., empagliflozin) and glucagon-like peptide-1 (GLP-1) receptor agonists (e.g., liraglutide) improved liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST], gamma-glutamyltransferase [GGT]), glucose metabolism (fasting plasma glucose [FPG], and homeostasis model assessment of insulin resistance [HOMA-IR]), and lipid profiles. Pioglitazone had limited benefits in these outcomes. Secondary outcomes such as inflammatory markers and fibrosis showed minimal changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several hypoglycemic agents can improve laboratory and imaging indicators in adult patients with MASLD. Liraglutide is more effective than other agents, whereas empagliflozin emerged as the most effective for reducing LSM. However, different agents have different effects on the indicators; therefore, the relevant agents must be selected according to the specific patient condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831205","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 Randomized, Double-Blinded, Placebo-Controlled Study of the Use of Traditional Chinese Medicine for Treating Patients With Mild/Moderate Chronic Obstructive Pulmonary Disease","authors":"Jiansheng Li,&nbsp;Minghang Wang,&nbsp;Yang Xie,&nbsp;Suyun Li,&nbsp;Xueqing Yu,&nbsp;Fengsen Li,&nbsp;Hanrong Xue,&nbsp;Zegeng Li,&nbsp;Nianzhi Zhang,&nbsp;Guiying Liu,&nbsp;Wei Zhang,&nbsp;Qing Miao,&nbsp;ZiKai Sun,&nbsp;Zhenghang Ge,&nbsp;Zhanping Ma,&nbsp;Hongyan Cai,&nbsp;Zhijia Sun,&nbsp;Hailong Zhang,&nbsp;Yanfang Wang","doi":"10.1111/jebm.70023","DOIUrl":"https://doi.org/10.1111/jebm.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Chronic obstructive pulmonary disease (COPD) is a critical disease, with lung function closely linked to disease severity. This study aimed to evaluate the clinical efficacy of treatments for stable COPD in patients with pulmonary function Grades I and II.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We conducted a multicenter, randomized, double-blind, placebo-controlled trial (registration number: NCT01486186). A total of 502 patients were randomly assigned to an experimental group (<i>n </i>= 251, treated with Bufei, Bufei Jianpi, and Bufei Yishen granules based on traditional Chinese medicine [TCM] syndromes) and a control group (<i>n </i>= 251, treated with a Chinese medicine-based placebo). Acute exacerbations (AEs), lung function, clinical symptoms, 6-min walking distance (6MWD), and dyspnea were assessed over 12 months of treatment and 12 months of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 432 patients, including 214 and 218 patients in the experimental and control groups, respectively, completed the trial. The early treatment group had fewer AEs (<i>p </i>&lt; 0.05), better clinical symptom scores (<i>p </i>&lt; 0.05), longer 6MWD (<i>p</i> &lt; 0.05), and better Modified Medical Research Council (mMRC) scores than the control group (<i>p </i>&lt; 0.05). No significant differences were found in forced vital capacity (FVC) and forced expiratory volume in first second (FEV1%) between the two groups, but there was a significant difference in FEV1 and the annual rate of FEV1 decline between the groups over 2 years (<i>p </i>&lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Treatment with TCM for stable COPD significantly reduced AEs, increased the 6MWD, and alleviated dyspnea in patients with pulmonary function Grades I and II. FEV1 was improved, and the slower FEV1 decline indicates a potential benefit in mitigating disease progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143809781","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}