Journal of Evidence‐Based Medicine最新文献

{"title":"Diagnosis and management of inflammatory bowel disease","authors":"Lili Li,&nbsp;Rui Cheng,&nbsp;Yushan Wu,&nbsp;Hao Lin,&nbsp;Huatian Gan,&nbsp;Hu Zhang","doi":"10.1111/jebm.12626","DOIUrl":"10.1111/jebm.12626","url":null,"abstract":"<p>Inflammatory bowel disease (IBD) is a chronic and relapsing immune-mediated disease of the gastrointestinal tract with a gradually increasing global incidence and prevalence. A prolonged course of IBD leads to a decline in patient quality of life and the creation of a substantial economic burden on society. Owing to the lack of specific diagnostic markers, the diagnosis of IBD still needs a gold standard based on a combination of clinical manifestations, imaging, laboratory, and endoscopic results. Accordingly, the current goals of IBD treatment are to alleviate clinical symptoms and reduce recurrence rates. Therefore, it is imperative to develop a standard set of procedures to diagnose and treat IBD. In this review, we summarize prominent and emerging studies, outline classical and contemporary approaches to diagnosing and managing IBD, and integrate multiple guidelines. Furthermore, we propose the possibility of establishing an early and comprehensive diagnostic workflow and personalized management strategy in the future. We aim to enhance the quality and standardization of diagnostic and treatment procedures for IBD.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457339","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 Guidelines for use and promotion of low sodium salt in China","authors":"Yifang Yuan,&nbsp;Chao Gao,&nbsp;Xuejun Yin,&nbsp;Xianghui Zhang,&nbsp;Yufei Ji,&nbsp;Xizi Zheng,&nbsp;Qi Zhou,&nbsp;Yangfeng Wu","doi":"10.1111/jebm.12621","DOIUrl":"10.1111/jebm.12621","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Both excessive intake of sodium and inadequate intake of potassium are associated with blood pressure elevation and subsequent increase in the risk of cardiovascular disease, which accounts for the largest number of deaths in China and worldwide. Low sodium salt, a mixture of mainly sodium chloride and potassium chloride, has shown its great potential as a promising population strategy for sodium intake reduction through multiple large-scale, multicenter, randomized controlled trials among populations including patients with cardiovascular disease, individuals with and without hypertension, older and younger adults, and men and women in China and other countries. This Guidelines aims to provide expert recommendations for promotion and use of low sodium salt in China, based on the current available scientific evidence regarding the effectiveness, safety, cost-effectiveness, and acceptability of low sodium salts in various population groups and different application scenarios. The suggestions to key stakeholders are also made.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A working group, an expert review committee and an advisory committee were established to be responsible for formulating the guidelines’ scope and key questions to be addressed, for searching, synthesizing, and evaluating research evidence, proposing and reviewing the recommendations. The consensus on the final recommendations was reached using the GRADE grid method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The working group summarized current available evidence of salt substitution regarding its effectiveness, safety, cost-effectiveness, acceptability, availability, suitability, etc. The Guidelines provided six recommendations advising different populations how to use low sodium salt, four recommendations on the application of low sodium salts in different scenarios, and five suggestions for key stakeholders to promote salt substitution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The first evidence-based guidelines on promotion and use of low sodium salts covers all key questions in relevance and would play a critical role in prevention and control of hypertension and cardiovascular disease in China and worldwide.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457340","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 ethics of some placebo-controlled randomized controlled trials","authors":"Elliot M. Levine,&nbsp;Carlos M. Fernandez","doi":"10.1111/jebm.12625","DOIUrl":"10.1111/jebm.12625","url":null,"abstract":"<p>It has been well-recognized that a randomized controlled trial (RCT) represents the best investigative format to establish medical evidence. In an RCT, essential variables can be controlled and bias minimized. When testing for the efficacy and safety of a medication, it is often compared to a blinded placebo. There is little argument to challenge the role of an RCT in this regard. When a subject is enrolled in an RCT investigating the therapeutic value of a medication for the treatment of a condition, it is often compared to a placebo, so as to best measure whatever benefit this new medication can have, independent of a possible placebo or contextual effect.<span>¹</span> There are many examples of RCTs performed for the testing of a medication being measured for its efficacy in treating a condition when compared to a placebo. However, when there is a known effective medication that can be used with which that comparison can be made, it may be difficult to justify the use of a placebo in that instance, and there are many examples of this circumstance in all medical specialties, including as referenced in these gynecologic examples.<span>^{2, 3}</span> The putative medications that can be used for such a comparison (instead of placebo), have themselves been compared with placebo in prior Investigational New Drug (IND) trials performed for Federal Drug Administration (FDA) approval.</p><p>It is fair to recognize that the ethical principle of nonmaleficence (“first, do no harm”) may be violated by the physicians involved in that RCT.<span>⁴</span> Simply put, if the comparison being made in this sort of a study was between a standard medication and a newer medication (possibly being better), then that would certainly be acceptable. Many studies are not performed in that way, however. As a physician-scientist, duty-bound to provide standard-of-care medications to patients and also to see innovative medical treatment be properly tested in order to advance evidence-based medical science, a placebo-controlled investigation fails in this regard, especially for conditions with currently available therapies of proven medical benefit. To not provide available therapy to a patient presenting with a properly documented condition may be an example of harm to that patient.</p><p>According to a principle of Logic (Transitive Property of Equality), if A = B, and B = C, then A = C.<span>⁵</span> While that tenet may refer to an objective mathematical concept, it may still be useful to apply to the circumstance being described, in that if a FDA-approved medication was objectively found to be efficacious for treating a particular condition in a placebo-controlled investigation, it can itself be used (rather than a placebo) in future studies. Of course, this logical principle may only apply for those investigations showing a medication found to be either more effective or noninferior when compared with that same FDA-approve","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12625","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468540","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":"Expert-guided evaluation of medical research may promote publishing low-quality studies and increase research waste: A comparative analysis of Journal Impact Factor and Polish expert-based journal ranking list","authors":"Albert Stachura,&nbsp;Łukasz Banaszek,&nbsp;Paweł K. Włodarski","doi":"10.1111/jebm.12615","DOIUrl":"10.1111/jebm.12615","url":null,"abstract":"<p>An ever-growing amount of medical literature has created a need for evaluating scientific merit. The Journal Impact Factor (JIF) is a metric relying on citation count and may indicate the prestige of a scientific journal.<span>¹</span> A study quality is often assessed based on a publication venue—hence JIF may be indirectly used to evaluate research. Such an approach is not flawless. Using JIF as a surrogate of a journal's quality has been widely criticized.<span>²</span> In the Leiden Manifesto Hicks et al. advocated for putting more emphasis on qualitative assessment, transparency, robust locally relevant research, and accounting for variation by field of study.<span>³</span></p><p>Despite these criticisms, JIF is still used to assess scientific output.<span>⁴</span> In the United States and Canada, journal ranking is based on indicators such as JIF, CiteScore, SCImago Journal Rank, or Hirsh index. In some countries, journal rankings have been created to assess the research performance of scientists and institutions. Two main approaches are prevalent: (<span>1</span>) based solely on metrics or (<span>2</span>) determined by experts who may (or may not) take such metrics into consideration.<span>⁵</span> The first model is used, for example, in Turkey (the TÜBİTAK Incentive Program for International Scientific Publications) or China (Chinese Academy of Sciences Journal Ranking List), the second one, for example, in Finland (the Publication Forum Journal list), Norway (the Norwegian Register for Scientific Journals, Series and Publishers), Italy (the Ratings of scientific and class A journals), Denmark (the BFI List of Series), and Poland (Polish Journal Ranking).<span>⁶</span> Though both models rely to some degree on JIF, the latter is more subjective and likely to be shaped by the national science policy objectives. This significantly increases the risk of politicization, which might lead to adjusting the assigned journal rank to own professional goals of experts involved in producing rankings, potentially creating a conflict of interests.<span>⁵</span></p><p>Funding, grants, and scholarships are awarded to scientists publishing in top journals from the national ranking lists. In Poland, the evaluation system is based on points awarded by the Ministry of Education and Science (MEiN—<i>pol. Ministerstwo Edukacji i Nauki</i>). The latest edition was released on January 5, 2024, more than 1 year after the 2022 Journal Citation Report had been announced (June 2022).<span>⁷</span> Since JIF is an imperfect surrogate of journal quality, supplementing assessment systems with expert opinion may potentially help promote good research. The objective of this study is to compare the MEiN ranking system with JIF and discuss the consequences of potential discrepancies between the two models.</p><p>A total of 5326 journals appeared both in JCR Clinical Medicine categ","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468537","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":"The characteristics, development methods, reporting quality, and evidence basis of diagnostic criteria in China between 1965 and 2023: A cross-sectional study","authors":"Qi Zhou,&nbsp;Hongfeng He,&nbsp;Qinyuan Li,&nbsp;Janne Estill,&nbsp;Zhengxiu Luo,&nbsp;Kehu Yang,&nbsp;Jinling Tang,&nbsp;Yaolong Chen","doi":"10.1111/jebm.12624","DOIUrl":"10.1111/jebm.12624","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>As a large and populous country, China releases a high number of diagnostic criteria. However, the published diagnostic criteria have not yet been systematically analyzed. Therefore, the aim of this study is to investigate the characteristics, development methods, reporting quality, and evidence basis of diagnostic criteria published in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched five databases for diagnostic criteria from their inception until July 31, 2023. All diagnostic criteria were screened through abstract and full-text reading, and included if satisfying the prespecified criteria. Two researchers independently extracted data on the characteristics, development methods, reporting quality, and evidence basis of diagnostic criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 143 diagnostic criteria were included. In terms of development methods, the proportions of diagnostic criteria that involved a systematic literature search (<i>n</i> = 2; 1.4%; 95% confidence interval (CI), 0.4% to 5.0%), adoption of formal consensus methods (<i>n</i> = 4; 2.8%; 95% CI, 1.1% to 7.0%), and criteria validation (<i>n</i> = 9; 6.3%; 95% CI, 3.3% to 11.5%) were relatively low. Regarding reporting quality, the average compliance with the ACCORD checklist was 5.1%; none of the diagnostic criteria reported on registration, expert inclusion criteria, expert recruitment process, or consensus results. A majority (58.7%; 95% CI, 50.6% to 66.5%) of criteria did not cite any research, and only one (0.7%; 95% CI, 0.1% to 3.9%) criterion was derived from a systematic review. Moreover, only 16.1% (95% CI, 11.0% to 23.0%) of diagnostic criteria used evidence from the Chinese population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The diagnostic criteria developed in China exhibit serious flaws, particularly in evidence retrieval, formation of expert panels, consensus methods, and validation. Additionally, only few diagnostic criteria used a systematic synthesis of the evidence or evidence from the China. There is an urgent need to enhance the methodology for developing diagnostic criteria.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468539","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":"Impact of hormone replacement therapy on all-cause and cancer-specific mortality in colorectal cancer: A systematic review and dose‒response meta-analysis of observational studies","authors":"Kefeng Liu,&nbsp;Yazhou He,&nbsp;Qiong Li,&nbsp;Shusen Sun,&nbsp;Zubing Mei,&nbsp;Jie Zhao","doi":"10.1111/jebm.12622","DOIUrl":"10.1111/jebm.12622","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The effect of hormone replacement therapy (HRT) on colorectal cancer (CRC) mortality and all-cause mortality remains unclear. We conducted a systematic review and dose–response meta-analysis to determine the effects of HRT on CRC mortality and all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched the electronic databases of PubMed, Embase, and The Cochrane Library for all relevant studies published until January 2024 to investigate the effects of HRT exposure on survival rates for patients with CRC. Two reviewers independently extracted individual study data and evaluated the risk of bias between the studies using the Newcastle‒Ottawa Scale. We performed a two-stage random-effects dose–response meta-analysis to examine a possible nonlinear relationship between the year of HRT use and CRC mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten cohort studies with 480,628 individuals were included. HRT was inversely associated with the risk of CRC mortality (hazard ratios (HR) = 0.77, 95% CI (0.68, 0.87), <i>I</i>² = 69.5%, <i>p</i> &lt; 0.05). The pooled results of seven cohort studies revealed a significant association between HRT and the risk of all-cause mortality (HR = 0.71, 95% CI (0.54, 0.92), <i>I</i>² = 89.6%, <i>p</i> &lt; 0.05). A linear dose–response analysis (<i>p</i> for nonlinearity = 0.34) showed a 3% decrease in the risk of CRC for each additional year of HRT use; this decrease was significant (HR = 0.97, 95% CI (0.94, 0.99), <i>p</i> &lt; 0.05). An additional linear (<i>p</i> for nonlinearity = 0.88) dose–response analysis showed a nonsignificant decrease in the risk of all-cause mortality for each additional year of HRT use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that the use of HRT is inversely associated with all-cause and colorectal cancer mortality, thus causing a significant decrease in mortality rates over time. More studies are warranted to confirm this association.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468538","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":"Effectiveness of narrowband ultraviolet B monotherapy versus combination therapy with systemic agents in patients with early-stage mycosis fungoides and the association with plaque lesions","authors":"Yao Qin,&nbsp;Yuwei Lin,&nbsp;Zhuojing Chen,&nbsp;Qiuli Zhang,&nbsp;Yingyi Li,&nbsp;Yujie Wen,&nbsp;Ping Tu,&nbsp;Pei Gao,&nbsp;Yang Wang","doi":"10.1111/jebm.12623","DOIUrl":"10.1111/jebm.12623","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Narrowband ultraviolet B (NB-UVB) has been recommended as first-line therapy for early-stage mycosis fungoides (MF) in international guidelines. NB-UVB can be used as monotherapy or part of a multimodality treatment regimen. There is limited evidence on the effectiveness and optimal patients of NB-UVB in combination with systemic therapies in MF. We aimed to assess the effectiveness of the combination versus NB-UVB monotherapy in early-stage MF and if plaque lesion status was related to these effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational cohort study included 247 early-stage MF patients who had received NB-UVB combined with systemic therapies vs. NB-UVB monotherapy from 2009 to 2021. The primary outcome was partial or complete response. Overall response rate and median time to response were calculated. Hazard ratios (HRs) were estimated using the Cox model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 139 plaque-stage patients, the response rate for combination therapy group was higher than that of monotherapy group (79.0% vs. 54.3%, <i>p </i>= 0.006). The adjusted HR for combination therapy compared with NB-UVB monotherapy was 3.11 (95% CI 1.72–5.63). The combination therapy group also showed shorter time to response (4 vs. 6 months, <i>p </i>= 0.002). In 108 patch-stage patients, the response rate and time to response in two treatment groups showed no significant difference. There was therefore an observed interaction with patients’ plaque lesion status for the effect size of NB-UVB combination therapy. No serious adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adding systemic treatments to NB-UVB did not improve the treatment outcome of patch-stage patients, but it surpassed NB-UVB monotherapy for early-stage patients with plaques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427034","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":"MASTER scale for methodological quality assessment: Reliability assessment and update","authors":"Ashraf I. Ahmed,&nbsp;Muhammad Zain Kaleem,&nbsp;Amgad Mohamed Elshoeibi,&nbsp;Abdalla Moustafa Elsayed,&nbsp;Elhassan Mahmoud,&nbsp;Yaman A. Khamis,&nbsp;Luis Furuya-Kanamori,&nbsp;Jennifer C. Stone,&nbsp;Suhail A. Doi","doi":"10.1111/jebm.12618","DOIUrl":"10.1111/jebm.12618","url":null,"abstract":"<p>In evidence synthesis of analytical studies, methodological quality (mQ) assessment is necessary to determine the extent to which internal validity safeguards are implemented in the included studies against a list of selected safeguards in an assessment tool. Such mQ tools consist of internal validity safeguards that are checked against those put in place by researchers when they undertake research to guard against systematic error in the design, conduct, and analysis of a study.<span>¹</span> However, consistency or agreement among the individuals undertaking an assessment of implemented safeguards in published research against those listed in a mQ tool needs to be documented to ensure that the tool is reliable. Therefore mQ tools need to have their interrater reliability tested in order to ensure the consistency of their use in research.<span>²</span></p><p>Many existing tools are available to assess mQ or risk of bias (RoB) specific to a study design, which leads to a lack of comparability across studies of different designs when using different tools and assessment results which, as a whole, may lack meaning. For example, Cochrane's Risk of Bias (RoB2) tool is used to assess the RoB in RCTs while nonrandomized trials are assessed using the ROBINS-I tool. It is difficult to compare these scales to one another, and hence, there is a need for a unified scale that is not confined to one study design. The MASTER scale was developed to overcome some of these issues by providing a comprehensive list of methodological safeguards across analytic study designs that allow for comparative assessment between these studies. It uses an assessment approach that takes the reviewer all the way from mQ assessment through to an ability to make use of this for bias adjustment.<span>^{3, 4}</span> A drawback for reviewers using the MASTER scale is that there is a lack of information regarding its reliability, with no studies conducted to assess this metric.</p><p>The degree to which studies maintain their relative position in a list over repeated measurements is referred to as reliability.<span>⁵</span> For example, when assessing the reliability of a tool such as the MASTER scale, it would be considered reliable if you see that studies which scored well on the tool by the first rater also scored well on subsequent assessments by different raters.<span>^{5, 6}</span> The scoring system for this scale has been discussed previously.<span>⁷</span> Such consistency across the individuals undertaking mQ assessment needs to be established to ensure that the tool is reliable across different raters. Researchers trained in clinical epidemiology were chosen for this study so that they could also examine the scale item wordings to remove ambiguity and improve the readability and applicability of the wording. This study therefore serves the dual purpose of evaluating the reliability of the MASTER scale across rat","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12618","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306136","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":"Comparation of fixed-ratio (IDegLira and iGlarLixi) versus free combination of basal insulin and glucagon-like peptide-1 receptor agonist for uncontrolled type 2 diabetes: A systematic review and network meta-analysis","authors":"Junling Weng,&nbsp;Ying Tao,&nbsp;Zian Xu,&nbsp;Shanyan Zhou,&nbsp;Dunming Xiao,&nbsp;Zhixu Zhu,&nbsp;Ruizhi Zheng,&nbsp;Yi Yang,&nbsp;Yingyao Chen","doi":"10.1111/jebm.12620","DOIUrl":"10.1111/jebm.12620","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the safety and efficacy of the fixed-ratio combination (FRC) and free combination of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1RA) in patients with type 2 diabetes mellitus (T2DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Web of Science, Embase, The Cochrane Library, and four Chinese databases were searched for relevant studies from inception to April 13, 2023. Phase III clinical trials involving FRC or free combination in patients with uncontrolled T2DM were included. A network meta-analysis (NMA) was used to evaluate the effects of FRC and free combination. The Cochrane Collaboration's tool was used to evaluate the risk-of-bias. The primary outcomes were changes in hemoglobin A1c (HbA1c), body weight, and incident hypoglycemia. Secondary outcomes included changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP). This study was registered with PROSPERO (CRD42023409585).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two trials with 23,619 patients were included in the NMA, and treatments were categorized as FRC, free combination and NOINSGLP (neither FRC nor free combination). The forest plots revealed comparable HbA1c control (mean difference (MD) = 0.07%, 95% confidence interval (CI): –0.17 to –0.30) between free combination and FRC. However, there were significant differences in the body weight (MD = –2.06 kg; 95% CI: –3.34 to –0.77), SBP (MD = –1.22 mmHg; 95% CI: –2.41 to –0.04), and DBP (MD = –1.09 mmHg; 95% CI: –1.94 to –0.24) between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with uncontrolled T2DM, the safety and efficacy of FRC and free combination therapy were comparable. The use of FRC is justifiable in patients requiring free combination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300827","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":"Induced abortion and ectopic pregnancy: A systematic review and meta-analysis","authors":"Xin Wang,&nbsp;Mengcong Deng,&nbsp;Shangchun Wu,&nbsp;Qunxia Mao","doi":"10.1111/jebm.12619","DOIUrl":"10.1111/jebm.12619","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Existing evidence of the relationship between induced abortion and ectopic pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation to examine whether induced abortion (IA) can increase the rate of ectopic pregnancy (EP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, EMBASE, Web of Science, Cochrane, CNKI, WanFang, and Sinomed databases since their inception until February 2023. Eligibility criteria included case-control studies and cohort studies that analyzed induced abortion associated with ectopic pregnancy. Data analyses were conducted by using R-studio Version 1.1.383 software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 33 case-control studies and 7 cohort studies involving 132,926 participants were included. In case-control studies, there was a significant association between induced abortion and ectopic pregnancy by using single-factor analysis data (OR = 2.32, 95% CI = 1.81–2.98). Subgroup analysis by region suggested no statistical significance in the Americas (OR = 1.15, 95% CI = 0.92–1.43) and Eastern Mediterranean (OR = 3.64, 95% CI = 0.88–15.18). The relationship was significant by using multiple regression analysis data (OR = 1.97, 95% CI = 1.38–2.80). In cohort studies, statistical significance was found (OR = 1.42, 95% CI = 1.001–2.018) after omitting one study in sensitivity analysis. The combined results of the two types of studies suggested that induced abortion would increase the risk of ectopic pregnancy to some degree, but the conclusion needs to be considered with caution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicated that IA could increase the risk of EP to some degree and the times of IA had a negative impact on the risk. Safe abortion and avoiding repeat abortion due to unintended pregnancy could protect women's fertility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300828","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}