Journal of Evidence‐Based Medicine最新文献

{"title":"Ontology of clinical practice guidelines for Integrated Traditional Chinese and Western Medicine","authors":"Yongbo Wang,&nbsp;Xiangying Ren,&nbsp;Kuang Gao,&nbsp;Mukun Chen,&nbsp;Qiao Huang,&nbsp;Siyu Yan,&nbsp;Yan Zhu,&nbsp;Xin Sun,&nbsp;Yaolong Chen,&nbsp;Long Ge,&nbsp;Jinguang Gu,&nbsp;Feng Gao,&nbsp;Wenbin Hu,&nbsp;Liang Hong,&nbsp;Chen Zhao,&nbsp;Hongcai Shang,&nbsp;Yinghui Jin","doi":"10.1111/jebm.12639","DOIUrl":"10.1111/jebm.12639","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Clinical practice guidelines (CPGs) for Integrated Traditional Chinese and Western Medicine (TCM and WM) are important medical documents used to assist medical decision-making and are of great significance for standardizing clinical pathways. However, due to the constraints of text format, it is difficult for Integrated TCM and WM CPGs to play a real role in medical practice. In addition, how to standardize the structure and semantic relationships between Integrated TCM and WM CPG knowledge, and realize the construction of computable, sharable and reliable CPGs, remains an urgent issue to be addressed. Therefore, we are proposing an ontology of CPGs for Integrated TCM and WM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We first initialized domain concepts and relationships to ensure the accuracy of the ontology knowledge structure. We then screened CPGs that meet the standards for Integrated TCM and WM, analyzed and classified the contents, and extracted the common structures. Based on the seven-step ontology construction method combined with inference-complement, referring to the representation methods and hierarchical relationships of terms and concepts in MeSH, ICD-10, SNOMED-CT, and other ontologies and terminology sets, we formed the concept structure and semantic relationship tables for the ontology. We also achieved the matching and mapping between the ontology and reference ontologies and term sets. Next, we defined the aspects and constraints of properties, selected multiple Integrated TCM and WM CPGs as instances to populate, and used ontology reasoning tools and formulated defined inference rules to reason and extend the ontology. Finally, we evaluated the performance of the ontology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The content of the Integrated TCM and WM CPGs is divided into nine parts: basic information, background, development method, clinical question, recommendation, evidence, conclusion, result, and reason for recommendations. The Integrated TCM and WM CPG ontology has 152 classes and defines 90 object properties and 114 data properties, with a maximum classification depth of 4 layers. The terms of disease, drug and examination item names in the ontology have been standardized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study proposes an Integrated TCM and WM CPG ontology. The ontology adopts a modular design, which has both sharing and scaling ability, and can express rich guideline knowledge. It provides important support for the semantic processing and computational application of guideline documents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"604-614"},"PeriodicalIF":3.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140278","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":"Incorrect blinding assessments are common in meta-analyses published in high impact journals","authors":"Ilari Kuitunen,&nbsp;Ville T. Ponkilainen,&nbsp;Mikko Uimonen","doi":"10.1111/jebm.12636","DOIUrl":"10.1111/jebm.12636","url":null,"abstract":"&lt;p&gt;Guidelines and best practices emphasize the importance of blinding to mitigate potential biases in clinical studies.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Randomized controlled trials are considered the be the highest form of evidence and typically the goal has been to conduct a placebo controlled double-blinded trial.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Risk of bias (RoB) assessment is a crucial part of evidence synthesis.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Typically, this evaluation is carried out using tools such as Cochrane's original RoB tool and the revised RoB 2.0 tool.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; The original RoB tool explicitly assesses blinding through separate domains for blinding of participants and personnel (performance bias), as well as blinding of outcome assessment (detection bias).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; In RoB 2.0, blinding assessment is part of the measurement of the outcome domain.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; However, both tools consider blinding within the context of the outcome's nature, whether it is objective for the patient, treating personnel, the outcome assessor, all of these, or none.&lt;/p&gt;&lt;p&gt;The objectivity of the outcome plays a pivotal role in assessing bias risk when evaluating blinding, especially concerning subjective outcomes where the absence of blinding could significantly affect effect sizes.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Previous meta-epidemiological studies have mostly reported that the blinding has influence only on subjective outcomes.&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt; Interestingly, one of the latest and largest meta-epidemiological studies did not find evidence that blinding would even have an influence on subjective outcomes neither.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Thus, it is plausible to assume that the effect of blinding on objective outcomes is either negligible or even nonexistent in medicine.&lt;/p&gt;&lt;p&gt;A key part of the evidence synthesis is to appraise the evidence certainty. The most widely used method is to assess the evidence certainty according to the Grading and Recommendations (GRADE).&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; GRADE rates each outcome according to different domains, of which one is risk of bias.&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt; Thus, to make an accurate judgment on evidence certainty, risk of bias in studies should be adequately assessed. A previous meta-epidemiological study of neonatal meta-analyses showed evidence certainties were often downgraded due to lack of blinding even in the objective outcomes.&lt;span&gt;&lt;sup&gt;11&lt;/sup&gt;&lt;/span&gt; Thus, inadequate downgrading of evidence certainty may have direct influence to treatment guidelines and patient care.&lt;span&gt;&lt;sup&gt;12&lt;/sup&gt;&lt;/span&gt; The aim of this study was to investigate how the authors of systematic reviews and meta-analyses published in top level journals and Cochrane have estimated the risk of bias due to blinding and have they noted the objectivity of the outcomes in their assessments.&lt;/p&gt;&lt;p&gt;We conducted a systematic meta-epidemiological review of systematic reviews and meta-analyses. As the RoB 2.0 too","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"471-473"},"PeriodicalIF":3.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108119","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":"Does neoadjuvant therapy contribute to increased risk in anastomotic leakage of esophageal cancer? A network meta-analysis","authors":"Da Zhou,&nbsp;Donglai Chen,&nbsp;Peidong Song,&nbsp;Zihao Hu,&nbsp;Sukai Xu,&nbsp;Rongying Zhu,&nbsp;Yongbing Chen","doi":"10.1111/jebm.12634","DOIUrl":"10.1111/jebm.12634","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Conflicting results have been reported about the impact of neoadjuvant therapy on anastomotic leakage (AL) after esophagectomy. We aimed to unravel the potential effect of neoadjuvant therapy on AL after esophagectomy through a network meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Bayesian network meta-analysis was performed by retrieving relevant literature from PubMed, EMbase, The Cochrane Library and Web of Science Core Collection. Randomized clinical trials (RCTs) and retrospective studies (RS) comparing the following treatment modalities were included: neoadjuvant chemoradiation (nCRT), neoadjuvant chemotherapy (nCT), neoadjuvant radiotherapy (nR), neoadjuvant immunochemotherapy (nICT), and surgery alone (SA). Subgroup analyses by radiation dose, examined lymph nodes (ELN), route of reconstruction, site of anastomosis, and surgical approach were also conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 62 studies with 12,746 patients were included for the present study, among which 17 were RCTs. There were no significantly statistical differences observed among the five treatment modalities in AL for both RCTs (nCRT-nICT: risk ratio 1.51, 95% confidence interval 0.52–4.4; nCT-nICT: 1.71, 0.56–5.08; nICT-nR: 0.79, 0.12–8.02; nICT-SA: 0.59, 0.2–1.84) and RS (nCRT-nICT: odds ratio 1.53, 95% confidence interval 0.84–2.84; nCT-nICT: 1.56, 0.87–2.88; nICT-SA: 0.6, 0.31–1.12; nICT-nR: 1.08, 0.09–36.02). Subgroup analysis revealed that no significant difference in AL was observed among the five treatment modalities except for the impact of nCRT versus nCT (0.21, 0.05–0.73) on AL with a radiation dose ≥41.4 Gy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Neoadjuvant therapy do not significantly increase the incidence of AL after esophagectomy. Administration of irradiation with a moderate dose is not associated with elevated risk in AL. Clinicians can be less apprehensive about prescribing nCRT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"559-574"},"PeriodicalIF":3.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004397","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":"A Bayesian bias-adjusted random-effects model for synthesizing evidence from randomized controlled trials and nonrandomized studies of interventions","authors":"Minghong Yao,&nbsp;Fan Mei,&nbsp;Kang Zou,&nbsp;Ling Li,&nbsp;Xin Sun","doi":"10.1111/jebm.12633","DOIUrl":"10.1111/jebm.12633","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>An important consideration when combining RCTs and NRSIs is how to address their potential biases in the pooled estimates. This study aimed to propose a Bayesian bias-adjusted random effects model for the synthesis of evidence from RCTs and NRSIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present a Bayesian bias-adjusted random effects model based on power prior method, which combines the likelihood contribution of the NRSIs, raised to the power parameter of alpha, with the likelihood of the RCT data, modeled with an additive bias. The method was illustrated using a meta-analysis on the association between low-dose methotrexate exposure and melanoma. We also combined RCTs and NRSIs using the naïve data synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results including only RCTs has a posterior median and 95% credible interval (CrI) of 1.18 (0.31–4.04), the posterior probability of any harm (&gt; 1.0) and a meaningful association (&gt; 1.15) were 0.61 and 0.52, respectively. The posterior median and 95% CrI based on the naïve data synthesis resulted in 1.17 (0.96–1.47), and the posterior probability of any harm and a meaningful association were 0.96 and 0.60, respectively. For the Bayesian bias-adjusted analysis, the median OR was 1.16 (95% CrI: 0.83–1.71), and the posterior probabilities of any and a meaningful clinical association were 0.88 and 0.53, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results indicated that integrating NRSIs into meta-analysis could increase the certainty of the body of evidence. However, directly combining RCTs and NRSIs in the same meta-analysis without distinction may lead to misleading conclusions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"550-558"},"PeriodicalIF":3.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897624","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":"Development and validation of the eMCI-CHD tool: A multivariable prediction model for the risk of mild cognitive impairment in patients with coronary heart disease","authors":"Qing Wang,&nbsp;Yanfei Liu,&nbsp;Shihan Xu,&nbsp;Fenglan Liu,&nbsp;Luqi Huang,&nbsp;Fengqin Xu,&nbsp;Yue Liu","doi":"10.1111/jebm.12632","DOIUrl":"10.1111/jebm.12632","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to develop and validate an eMCI-CHD tool based on clinical data to predict mild cognitive impairment (MCI) risk in patients with coronary heart disease (CHD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study prospectively collected data from 400 patients with coronary heart disease (aged 55–90 years, 62% men) from July 2022 to September 2023 and randomized (7:3 ratio) them into training and validation sets. After determining the modeling variables through least absolute shrinkage and selection operator regression analysis, four ML classifiers were developed: logistic regression, extreme gradient boosting (XGBoost), support vector machine, and random forest. The performance of the models was evaluated using area under the ROC curve, accuracy, sensitivity, specificity, and F1 score. Decision curve analysis was used to assess the clinical performance of the established models. The SHapley Additive exPlanations (SHAP) method was applied to determine the significance of the features, the predictive model was visualized with a nomogram, and an online web-based calculator for predicting CHD-MCI risk scores was developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 400 CHD patients (average age 70.86 ± 8.74 years), 220 (55%) had MCI. The XGBoost model demonstrated superior performance (AUC: 0.86, accuracy: 78.57%, sensitivity: 0.74, specificity: 0.84, F1: 0.79) and underwent validation. An online tool (https://mr.cscps.com.cn/mci/index.html) with seven predictive variables (<i>APOE</i> gene typing, age, education, TyG index, NT-proBNP, C-reactive protein, and occupation) assessed MCI risk in CHD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the potential for predicting MCI risk among CHD patients using an ML model-driven nomogram and risk scoring tool based on clinical data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"535-549"},"PeriodicalIF":3.6,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897625","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":"Effect of testosterone replacement therapy on lower urinary tract symptoms: A systematic review and network meta-analysis","authors":"Xiang Yuan,&nbsp;Xingyu Xiong,&nbsp;Jianxin Xue","doi":"10.1111/jebm.12628","DOIUrl":"10.1111/jebm.12628","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In this study, we aimed to perform a network meta-analysis (NMA) to investigate the effects of different testosterone replacement therapy (TRT) administration routes on lower urinary tract symptoms (LUTS) in aging men with late-onset hypogonadism (LOH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Embase, The Cochrane Library, CNKI, WanFang Data, and VIP was conducted to identify randomized controlled trials (RCTs) reporting data on International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA) level, or prostate volume. NMA was performed, and subgroup analysis was conducted to assess the impact of TRT duration on outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 21 RCTs involving 2453 participants were included. For pairwise meta-analysis, <i>p</i> values for TRT delivered by transdermal, intramuscular, and oral routes were as follows: IPSS: 0.93, 0.20, and 0.76; PSA level: 0.20, 0.27, and 0.98; prostate volume: 0.18, 0.04, and 0.16. There were no significant differences in IPSS, PSA level, or prostate volume between TRT routes. In subgroup analysis, long-term intramuscular TRT significantly decreased IPSS (<i>p</i> = 0.03), short-term transdermal TRT increased PSA levels (<i>p</i> &lt; 0.001), and short-term intramuscular TRT increased the prostate volume (<i>p</i> = 0.04). Other forms of TRT showed no significant change in IPSS, PSA level, and prostate volume compared with the placebo. Indirect comparison of the three administration routes demonstrated no significant differences in IPSS, PSA level, and prostate volume. Nevertheless, surface under the cumulative ranking curve analysis indicated that intramuscular TRT had an 83% probability of being the best method for decreasing IPSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results demonstrate that TRT does not worsen LUTS regardless of the administration route. Intramuscular TRT may be the preferred treatment for aging men with LOH and LUTS. Intramuscular TRT may be the preferred treatment for men with LOH and LUTS. Further research is warranted to validate these findings and optimize TRT management strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"490-502"},"PeriodicalIF":3.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616663","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":"Unveiling the detrimental vicious cycle linking skeletal muscle and COVID-19: A systematic review and meta-analysis","authors":"Qin Wang,&nbsp;Peipei Shi,&nbsp;Lu Cao,&nbsp;Haoran Li,&nbsp;Xiankai Chen,&nbsp;Peiyu Wang,&nbsp;Jianjiang Zhang","doi":"10.1111/jebm.12629","DOIUrl":"10.1111/jebm.12629","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Skeletal muscle catabolism supports multiple organs and systems during severe trauma and infection, but its role in COVID-19 remains unclear. This study investigates the interactions between skeletal muscle and COVID-19.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed, EMbase, and The Cochrane Library databases were systematically searched from January 2020 to August 2023 for cohort studies focusing on the impact of skeletal muscle on COVID-19 prevalence and outcomes, and longitudinal studies examining skeletal muscle changes caused by COVID-19. Skeletal muscle quantity (SMQN) and quality (SMQL) were assessed separately. The random-effect model was predominantly utilized for statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy studies with moderate to high quality were included. Low SMQN/SMQL was associated with an increased risk of COVID-19 infection (OR = 1.62, <i>p</i> &lt; 0.001). Both the low SMQN and SMQL predicted COVID-19-related mortality (OR = 1.53, <i>p</i> = 0.016; OR = 2.18, <i>p</i> = 0.001, respectively). Mortality risk decreased with increasing SMQN (OR = 0.979, <i>p</i> = 0.009) and SMQL (OR = 0.972, <i>p</i> = 0.034). Low SMQN and SMQL were also linked to the need for intensive care unit/mechanical ventilation, increased COVID-19 severity, and longer hospital stays. Significant skeletal muscle wasting, characterized by reduced volume and strength, was observed during COVID-19 infection and the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study reveals a detrimental vicious circle between skeletal muscle and COVID-19. Effective management of skeletal muscle could be beneficial for treating COVID-19 infections and addressing the broader pandemic. These findings have important implications for the management of future virus pandemics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Systematic review registration</h3>\u0000 \u0000 <p>PROSPERO CRD42023395476.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"503-525"},"PeriodicalIF":3.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554965","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 for ischemic heart failure with mildly reduced/preserved ejection fraction (BEAR Trial): A randomized controlled trial","authors":"Jingen Li,&nbsp;Meili Yu,&nbsp;Yanhui Wang,&nbsp;Siming Li,&nbsp;Siwei Li,&nbsp;Xue Feng,&nbsp;Ruijie Li,&nbsp;Keji Chen,&nbsp;Hao Xu","doi":"10.1111/jebm.12631","DOIUrl":"10.1111/jebm.12631","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>While Baduanjin, a traditional Chinese mind-body exercise, has shown potential health benefits, its efficacy in improving outcomes for heart failure patients with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) has not been well documented. We aimed to investigate the adjunctive impact of Baduanjin on exercise capacity and quality of life for HFmrEF/HFpEF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with HFmrEF/HFpEF were enrolled in this multicenter randomized clinical trial. All participants were randomized to conventional cardiac rehabilitation with or without an additional 12-week Baduanjin exercise. The primary endpoint was the distance covered in a 6-min walk test (6MWD), while key secondary outcomes included quality of life measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and cardiopulmonary function including anaerobic threshold (VO₂ AT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 120 patients were enrolled, and 109 completed all session and tests. The mean age of the 120 patients was 60.5 years (SD, 9.21 years), and 23 (19.2%) were women. The Baduanjin group exhibited a 6.14% improvement in 6MWD compared to a 1.32% improvement in the control group (median improvement, 25.0 vs. 5.0 m; <i>p </i>&lt; 0.001) at 12th week. The VO₂ AT increased by 25.87% in the Baduanjin group versus 3.94% in the control group (<i>p </i>&lt; 0.001). Quality of life also significantly improved in the Baduanjin group as indicated by MLHFQ score changes (–16.8% vs. –3.99%; <i>p </i>&lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adding Baduanjin to exercise-based cardiac rehabilitation for patients with ischemic HFmrEF or HFpEF are generally safe and could provide significant improvements in exercise capacity and quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"526-534"},"PeriodicalIF":3.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12631","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544885","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":"Evaluation and management of knee osteoarthritis","authors":"Siyi Zhu,&nbsp;Wenchun Qu,&nbsp;Chengqi He","doi":"10.1111/jebm.12627","DOIUrl":"10.1111/jebm.12627","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Knee osteoarthritis (KOA) significantly contributes to the global disability burden, with its incidence expected to escalate by 74.9% by 2050. The urgency to comprehend and tackle this condition is critical, necessitating an updated and thorough review of KOA. A systematic review up to February 26, 2024, has elucidated the principal aspects of KOA's pathogenesis, risk factors, clinical manifestations, and contemporary management paradigms. The origins of KOA are intricately linked to mechanical, inflammatory, and metabolic disturbances that impair joint function. Notable risk factors include age, obesity, and previous knee injuries. Diagnosis predominantly relies on clinical assessment, with radiographic evaluation reserved conditionally. The significance of rehabilitation assessments, informed by the International Classification of Functioning, Disability, and Health framework, is highlighted. Treatment strategies are diverse, prioritizing nonpharmacological measures such as patient education, exercise, and weight management, with pharmacological interventions considered adjuncts. Intra-articular injections and surgical options are contemplated for instances where conventional management is inadequate. KOA stands as a predominant disability cause globally, characterized by a complex etiology and profound effects on individuals’ quality of life. Early, proactive management focusing on nonpharmacological interventions forms the cornerstone of treatment, aiming to alleviate symptoms and enhance joint function. This comprehensive review underscores the need for early diagnosis, individualized treatment plans, and the integration of rehabilitation assessments to optimize patient outcomes. Further research is needed to refine prevention strategies and improve management outcomes for KOA patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 3","pages":"675-687"},"PeriodicalIF":3.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534556","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":"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":"17 2","pages":"409-433"},"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}