Journal of Evidence‐Based Medicine最新文献

Intervention at Circulating Homocysteine Levels >10 µmol/L for Primary Prevention of Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis. 循环同型半胱氨酸水平bbb10µmol/L对心血管疾病一级预防的干预：系统评价和剂量-反应荟萃分析

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-30 DOI: 10.1111/jebm.70080

Zihui Huang, Jiupeng Zou, Zhen Li, Mengchu Li, Ruikun He, Jing Zeng, Zhijun Yang, Huabin Li, Xiaoting Lu, Huilian Zhu

{"title":"Intervention at Circulating Homocysteine Levels >10 µmol/L for Primary Prevention of Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis.","authors":"Zihui Huang, Jiupeng Zou, Zhen Li, Mengchu Li, Ruikun He, Jing Zeng, Zhijun Yang, Huabin Li, Xiaoting Lu, Huilian Zhu","doi":"10.1111/jebm.70080","DOIUrl":"https://doi.org/10.1111/jebm.70080","url":null,"abstract":"Objective: Several studies suggested that the risk of cardiovascular disease (CVD) had increased before individuals developed hyperhomocysteinemia. This study aimed to investigate the dose-response relationship between circulating homocysteine (Hcy) levels and the risk of CVD.Methods: Observational studies examining the relationship between circulating Hcy levels and CVD risks were included. Searches were conducted on English databases (PubMed, Embase, and Web of Science) and Chinese databases (CNKI, WanFang, VIP, and SinoMed) in May 2025. Combined relative risks (RRs) or odds ratios (ORs) were calculated using random-effects models. The dose-response relationship between circulating Hcy levels and CVD risks was assessed using restricted cubic spline analysis. The risk of bias was assessed using the Newcastle-Ottawa Scale for cohort and case-control studies, and the Agency for Healthcare Research and Quality criteria for cross-sectional studies. Publication bias was assessed using funnel plots and the trim-and-fill method.Results: A total of 117 original studies (35 cohort studies, 60 case-control studies, and 22 cross-sectional studies) were included, involving 504,469 participants with 43,089 CVD cases. Elevated circulating Hcy levels were significantly associated with increased CVD risks in all study types (RRs/ORs: 1.61-2.14). A non-linear dose-response relationship was observed between circulating Hcy levels and CVD risks (all p < 0.001), with thresholds at 10.4 µmol/L for cohort studies, and 10.0 µmol/L for both case-control studies and cross-sectional studies.Conclusions: In this meta-analysis, increased Hcy levels were linked to higher CVD risks. Circulating Hcy level >10 µmol/L may implement nutritional intervention in primary prevention of CVD.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70080"},"PeriodicalIF":3.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199639","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}

引用次数: 0

Ecological and Regional Disparities in the Impact of Autoimmune Diseases on Global Labor Market Dynamics: A Cross-Sectional Study. 自身免疫性疾病对全球劳动力市场动态影响的生态和区域差异：一项横断面研究。

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-26 DOI: 10.1111/jebm.70073

Fen-Fen Li, Ke Han, Zi-Yue Fu, Bing-Yu Liang, Yan-Xun Han, Yu-Chen Liu, Ye-Hai Liu, Bu-Sheng Tong, Hai-Feng Pan

{"title":"Ecological and Regional Disparities in the Impact of Autoimmune Diseases on Global Labor Market Dynamics: A Cross-Sectional Study.","authors":"Fen-Fen Li, Ke Han, Zi-Yue Fu, Bing-Yu Liang, Yan-Xun Han, Yu-Chen Liu, Ye-Hai Liu, Bu-Sheng Tong, Hai-Feng Pan","doi":"10.1111/jebm.70073","DOIUrl":"https://doi.org/10.1111/jebm.70073","url":null,"abstract":"Aim: Climate change has intensified the prevalence of chronic diseases, particularly autoimmune diseases (ADs), which severely affect the health and labor market participation of the working-age population. While ADs are not typically fatal, their chronic nature and high disability rates lead to significant labor force attrition. This study explores the impact of ADs on the labor market, particularly in regions affected by climate change.Methods: This study integrates labor market data with re-estimated ADs burden data from 1990 to 2021. Using time series analysis, multivariate regression, and geographic variation analysis, the research examines the relationship between ADs burden and labor force participation, with a focus on the exacerbating effects of climate change. Data was sourced from the International Labour Organization (ILO) and the Global Burden of Disease (GBD) database.Results: In 2021, the global labor force with ADs was 86,295,350, with a prevalence rate of 1644.55 per 100,000. Women had a significantly higher prevalence (1841.96 per 100,000) compared to men (1448.6 per 100,000). The total disability-adjusted life Years (DALYs) for ADs was 18,513,645 person-years, with women experiencing higher DALYs (386.3 per 100,000). Regions severely affected by climate change showed increased ADs prevalence and a decline in labor force participation.Conclusion: ADs significantly contribute to global labor market decline, with climate change amplifying the health burden. Gender disparities are notable, and ADs' impact on labor force participation highlights the need for comprehensive public health policies and labor market interventions.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70073"},"PeriodicalIF":3.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176155","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}

引用次数: 0

Efficacy and Safety of Different Preoperative Sedative Regimens in Alleviating Pediatric Preoperative Anxiety: A Systematic Review and Network Meta-Analysis. 不同术前镇静方案缓解儿科术前焦虑的有效性和安全性：系统评价和网络荟萃分析。

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-24 DOI: 10.1111/jebm.70068

Hu Zhenyu, Haizhou Xiang, Zeng Ziran, Wu Jiali, Liu Li, Tang Jianwen, Long Menghong, Wang Maohua

{"title":"Efficacy and Safety of Different Preoperative Sedative Regimens in Alleviating Pediatric Preoperative Anxiety: A Systematic Review and Network Meta-Analysis.","authors":"Hu Zhenyu, Haizhou Xiang, Zeng Ziran, Wu Jiali, Liu Li, Tang Jianwen, Long Menghong, Wang Maohua","doi":"10.1111/jebm.70068","DOIUrl":"https://doi.org/10.1111/jebm.70068","url":null,"abstract":"Background: Pediatric preoperative anxiety (PPA) is a prevalent condition that exhibits significant effects on the psychological and physiological status of children both preoperatively and postoperatively.Methods: We conducted systematic review and network meta-analysis. PubMed, Embase, Web of Science Core Collection, and The Cochrane Library were searched up to December 1, 2024. RCTs of pediatric patients (0-14 years) receiving preoperative sedatives were included. Primary outcome was Parental Separation Anxiety Scale (PSAS); secondary outcomes were Mask Acceptance Scale (MAS), postoperative nausea/vomiting (PONV), and delirium/agitation (PODA).Results: Seventy studies (16,626 participants) were included. Five sedatives including midazolam, dexmedetomidine, ketamine (oral, intranasal, nebulized), clonidine (oral, intranasal), and melatonin (oral) were compared with placebo. Data from 20 interventions (5581 patients) assessed PPA. Intranasal dexmedetomidine (ID) showed highest single-drug efficacy (SUCRA: PSAS 68.1%, MAS 48.8%, PONV 65.7%, PODA 67.8%). Oral ketamine (OK) and midazolam (OM/IM) were effective alternatives. Combined regimens were promising but inconclusive.Conclusions: ID significantly alleviated PPA with minimal adverse effects in single-drug regimens (optimal dose: 1-2 µg/kg). OK, OM or IM served as potential alternative options for clinical application. While combination regimens (notably OM+OK) demonstrated superior efficacy across outcomes, small sample sizes necessitate cautious interpretation, underscoring the need for future comparative studies.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70068"},"PeriodicalIF":3.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137814","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}

引用次数: 0

Systematic Review and Network Meta-Analysis of the Comparative Effectiveness of Adherence Enhancement Strategies in Chronic Kidney Disease. 慢性肾脏疾病依从性增强策略比较效果的系统评价和网络meta分析。

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-24 DOI: 10.1111/jebm.70078

Bin Ma, Yuanmin Jia, Haixia Wang, Ou Chen

{"title":"Systematic Review and Network Meta-Analysis of the Comparative Effectiveness of Adherence Enhancement Strategies in Chronic Kidney Disease.","authors":"Bin Ma, Yuanmin Jia, Haixia Wang, Ou Chen","doi":"10.1111/jebm.70078","DOIUrl":"https://doi.org/10.1111/jebm.70078","url":null,"abstract":"Objective: To evaluate and compare the effectiveness of adherence-enhancement strategies in patients with chronic kidney disease (CKD).Methods: Nine databases (PubMed, Embase, The Cochrane Library, Web of Science, Scopus, CNKI, VIP, WanFang, and CBM) were searched for randomized controlled trials (RCTs) to April 1, 2025. Two reviewers independently screened, extracted data, and assessed risk of bias with the Cochrane Risk of Bias 2.0 tool. Certainty of evidence was appraised using the Confidence in Network Meta-Analysis (CINeMA) tool. Network meta-analysis was performed, and surface under the cumulative ranking curve (SUCRA) was calculated to rank interventions. The review was registered in PROSPERO (CRD42024604771).Results: Thirty-five RCTs with 5084 patients were included. Evidence quality was limited by high risk of bias and low certainty. For medication adherence, education plus phone follow-up with short message service education showed the greatest effect (standardized mean differences [SMD] = 2.15, 95% confidence interval [CI] 1.09-3.21; SUCRA = 98.7), followed by empowerment (SMD = 1.19, 95% CI 0.20-2.18; SUCRA = 82.1). For diet adherence, education with phone follow-up was most effective (SMD = 6.68, 95% CI 5.64-7.71; SUCRA = 100), with empowerment also beneficial (SMD = 1.83, 95% CI 1.23-2.43; SUCRA = 87.9). For fluid adherence, education with medication management and pharmacist follow-up was most effective on scale-based outcomes (SMD = 3.06, 95% CI 2.18-3.94; SUCRA = 99.8), while cognitive behavioral therapy reduced interdialytic weight gain (SMD = -0.76, 95% CI -1.30 to -0.22; SUCRA = 71.1).Conclusions: Adherence-enhancement strategies improve medication, diet, and fluid adherence in CKD. High-quality RCTs are needed to confirm these findings.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70078"},"PeriodicalIF":3.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137823","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}

引用次数: 0

Strategies for the Analysis and Elimination of Hallucinations in Artificial Intelligence Generated Medical Knowledge. 人工智能生成医学知识中的幻觉分析与消除策略

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-22 DOI: 10.1111/jebm.70075

Fengxian Chen, Yan Li, Yaolong Chen, Zhaoxiang Bian, La Duo, Qingguo Zhou, Lu Zhang

{"title":"Strategies for the Analysis and Elimination of Hallucinations in Artificial Intelligence Generated Medical Knowledge.","authors":"Fengxian Chen, Yan Li, Yaolong Chen, Zhaoxiang Bian, La Duo, Qingguo Zhou, Lu Zhang","doi":"10.1111/jebm.70075","DOIUrl":"https://doi.org/10.1111/jebm.70075","url":null,"abstract":"The application of artificial intelligence (AI) in healthcare has become increasingly widespread, showing significant potential in assisting with diagnosis and treatment. However, generative AI (GAI) models often produce \"hallucinations\"-plausible but factually incorrect or unsubstantiated outputs-that threaten clinical decision-making and patient safety. This article systematically analyzes the causes of hallucinations across data, training, and inference dimensions and proposes multi-dimensional strategies to mitigate them. Our findings reveal three critical conclusions: The technical optimization through knowledge graphs and multi-stage training significantly reduces hallucinations, while clinical integration through expert feedback loops and multidisciplinary workflows enhances output reliability. Additionally, implementing robust evaluation systems that combine adversarial testing and real-world validation substantially improves factual accuracy in clinical settings. These integrated strategies underscore the importance of harmonizing technical advancements with clinical governance to develop trustworthy, patient-centric AI systems.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70075"},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124918","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}

引用次数: 0

Disease Burden of Gastrointestinal Tumors in China From 1990 to 2021, an Analysis for the Global Burden of Disease Study 2021. 1990 - 2021年中国胃肠道肿瘤疾病负担——2021年全球疾病负担研究分析

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-20 DOI: 10.1111/jebm.70072

Lanwei Guo, Jiani Yuan, Lin Cai, Chenxin Zhu, Yan Zheng, Haiyan Yang, Yanyan Liu

{"title":"Disease Burden of Gastrointestinal Tumors in China From 1990 to 2021, an Analysis for the Global Burden of Disease Study 2021.","authors":"Lanwei Guo, Jiani Yuan, Lin Cai, Chenxin Zhu, Yan Zheng, Haiyan Yang, Yanyan Liu","doi":"10.1111/jebm.70072","DOIUrl":"https://doi.org/10.1111/jebm.70072","url":null,"abstract":"Objective: China faces a significant burden of gastrointestinal tumors driven by socioeconomic, environmental, and lifestyle factors. Using GBD2021 data, this study analyses epidemiological trends and disease burden for six major gastrointestinal tumor cancers (esophagus, gastric, colorectum, liver, pancreas, gallbladder and biliary tract) in China (1990-2021).Methods: The GBD 2021 was used to extract the incidence, mortality, and disability-adjusted life years (DALYs) data of gastrointestinal tumors in China. Age-standardized rates (ASRs) and 95% uncertainty intervals (UIs) were calculated. Temporal trends were assessed by joinpoint regression analysis, and average annual percent change (AAPC) and annual percentage change (APC) were calculated and analyzed stratified by gender and age group.Results: In 2021, China recorded 1.96 million new gastrointestinal cancer cases, with 1.35 million deaths and 33.07 million DALYs. Gastric cancer led in mortality, and colorectal cancer demonstrated the most rapid incidence growth (AAPC = 1.68). Significant reductions were observed in gastric cancer age-standardized mortality rates (ASMR) (AAPC = -2.44) and esophageal cancer age-standardized disability-adjusted life year rates (ASDR) (AAPC = -2.31). Gender disparities were particularly pronounced in esophageal cancer, with the male-to-female mortality ratio (M/F) escalating from 2.50 (1990) to 4.12 (2021). The age group with the highest mortality burden was 70-74, while the age group with the most significant loss of DALYs was 65-69.Conclusion: China has significantly reduced gastrointestinal cancer burden, but gender and age disparities persist, necessitating targeted interventions. Future efforts should focus on tertiary prevention for high-risk groups, especially males and the elderly, while enhancing molecular subtyping and regional data stratification for precision cancer control.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70072"},"PeriodicalIF":3.5,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092174","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}

引用次数: 0

Efficacy and Safety of Xiaoer Chiqiao Qingre Syrup in the Treatment of Pedo-Anemopyretic Cold With Stagnant Syndrome in Children: A Multicenter, Randomized, Double-Blind, Double-Dummy, Parallel, Positive-Controlled, Noninferiority Trial. 小儿赤翘清热糖浆治疗小儿风热寒瘀证的疗效及安全性：多中心、随机、双盲、双虚拟、平行、正对照、非劣效性试验

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-18 DOI: 10.1111/jebm.70077

Chengliang Zhong, Shengxuan Guo, Yimin Yang, Aizhen Wang, Zheng Xue, Mengqing Wang, Guihua Song, Kun Yang, Hai Wang, Wei Zhong, Ya Gao, Zhigang Liu, Minghui Wang, Yuyan Chen, Xinmin Li, Siyuan Hu

引用次数: 0

Cardiac Autonomic Dysfunction in Obstructive Sleep Apnea: The Hidden Role of Vitamin D Deficiency. 阻塞性睡眠呼吸暂停的心脏自主神经功能障碍：维生素D缺乏的隐藏作用。

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-17 DOI: 10.1111/jebm.70071

Huai Heng Loh, Siow Phing Tay, Ai Jiun Koa, Mei Ching Yong, Asri Said, Chee Shee Chai, Natasya Marliana Abdul Malik, Anselm Ting Su, Bonnie Bao Chee Tang, Florence Hui Sieng Tan, Norlela Sukor

引用次数: 0

Evaluating Evidence With AI: ChatGPT's Performance on the PEDro Scale in Physical Therapy Research. 用AI评估证据：ChatGPT在物理治疗研究中PEDro量表的表现。

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-17 DOI: 10.1111/jebm.70074

Jie Hao, Zixuan Yao, Andréas Remis, Xin Yu

引用次数: 0

Chinese Guideline for the Rehabilitation Treatment of Osteoporosis (2024 Edition). 中国骨质疏松症康复治疗指南（2024年版）

IF 3.5 2区医学

Journal of Evidence‐Based Medicine Pub Date : 2025-09-13 DOI: 10.1111/jebm.70056

Haiming Wang, Yi Li, Chengqi He

{"title":"Chinese Guideline for the Rehabilitation Treatment of Osteoporosis (2024 Edition).","authors":"Haiming Wang, Yi Li, Chengqi He","doi":"10.1111/jebm.70056","DOIUrl":"https://doi.org/10.1111/jebm.70056","url":null,"abstract":"Osteoporosis (OP) is one of the most serious health problems, causing a huge economic burden to patients, families, and society. OP rehabilitation treatment plays an important role in pain-relieving, reducing the risk of fracture, improving the ability of daily activities, and promoting the healing of OP fractures, and has been increasingly valued and recommended by domestic and foreign guidelines. This guideline was updated based on the Chinese Expert Consensus on Rehabilitation Intervention for Primary OP 2019 editions and was initiated by the Chinese Society of Physical Medicine and rehabilitation and the West China Hospital of Sichuan University. This guideline development was guided by domestic and international guideline development methods and principles and selected through clinical issue screening and deconstruction and two rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used based on the best available evidence. The guideline was developed based on the best available evidence, used the GRADE method to grade the quality of evidence and recommendations, and reported according to the Reporting Items for Practice Guidelines in Healthcare. Taking into account patients' preferences and values and the needs of Chinese clinical practice, it puts forward 22 recommendations covering seven aspects (rehabilitation assessment, therapeutic modalities, occupational therapy, assistive devices, cognitive behavior and psychological therapy, traditional Chinese medicine therapy, and health education) to systematically standardize OP rehabilitation.","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70056"},"PeriodicalIF":3.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054173","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}

引用次数: 0