Journal of Evidence‐Based Medicine最新文献

{"title":"Risk factors for inadequate bowel preparation before colonoscopy: A meta-analysis","authors":"Lina Feng,&nbsp;Jialun Guan,&nbsp;Ruonan Dong,&nbsp;Kai Zhao,&nbsp;Mingyu Zhang,&nbsp;Suhong Xia,&nbsp;Yu Zhang,&nbsp;Liping Chen,&nbsp;Fang Xiao,&nbsp;Jiazhi Liao","doi":"10.1111/jebm.12607","DOIUrl":"10.1111/jebm.12607","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This meta-analysis aimed to comprehensively explore the risk factors for inadequate bowel preparation (IBP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched the Embase, PubMed, Web of Science, and The Cochrane Library databases up to August 24, 2023, to identify observational studies and randomized controlled trials (RCTs) that examined risk factors for IBP. A random effects model was used to pool the adjusted odds ratios and 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 125 studies (91 observational studies, 34 RCTs) were included. Meta-analyses of observational studies revealed that three preparation-related factors, namely, characteristics of last stool (solid or brown liquid), incomplete preparation intake, and incorrect diet restriction, were strong predictors of IBP. The other factors were moderately correlated with IBP incidence, including demographic variables (age, body mass index, male sex, Medicaid insurance, and current smoking), comorbidities (diabetes, liver cirrhosis, psychiatric disease, Parkinson's disease, previous IBP, poor mobility, inpatient, and Bristol stool form 1/2), medications (tricyclic antidepressants, opioids, antidepressants, narcotics, antipsychotics, and calcium channel blockers), and preparation-related factors (preparation-to-colonoscopy interval not within 3 to 5/6 h, nonsplit preparation, and preparation instructions not followed). No colonoscopy indications were found to be related to IBP. Meta-analyses of RCTs showed that education, constipation, stroke/dementia, and discomfort during preparation were also moderately associated with IBP. Most of the other findings were consistent with the pooled results of observational studies. However, primarily due to imprecision and inconsistency, the certainty of evidence for most factors was very low to moderate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We summarized five categories of risk factors for IBP. Compared to demographic variables, comorbidities, medications, and colonoscopy indications, preparation-related elements were more strongly associated with IBP. These findings may help clinicians identify high-risk individuals and provide guidance for IBP prevention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"341-350"},"PeriodicalIF":3.6,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802328","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 application of acupuncture-moxibustion therapy in perioperative period pain control","authors":"Jun Xiong,&nbsp;Yuxin Li,&nbsp;Yingping Kuang,&nbsp;Han Hu,&nbsp;Lijun Yao,&nbsp;Meng Lin","doi":"10.1111/jebm.12608","DOIUrl":"10.1111/jebm.12608","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"245-246"},"PeriodicalIF":3.6,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140611832","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":"Effects of initiation time of levothyroxine therapy in women with gestational subclinical hypothyroidism and negative thyroid peroxidase antibodies on the neurological development of offspring","authors":"Jiajia Chen,&nbsp;Zhenyao Li,&nbsp;Fengli Yin,&nbsp;Jiale Bao,&nbsp;Yuanfan Lu,&nbsp;Xiaoting Yu,&nbsp;Xianping Huang,&nbsp;Huiqiu Xiang,&nbsp;Tong Zhou,&nbsp;Jing Zhu,&nbsp;Zhangye Xu","doi":"10.1111/jebm.12592","DOIUrl":"10.1111/jebm.12592","url":null,"abstract":"&lt;p&gt;Subclinical hypothyroidism (SCH) is characterized by an elevated thyroid-stimulating hormone (TSH) with normal thyroxine (T4) levels. The 2017 American Thyroid Association (ATA) recommends that an upper reference limit of 4.0 mIU/L should be used in the absence of pregnancy-specific TSH ranges.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; It is well known that overt hypothyroidism exerts a profound effect on pregnancy outcomes; conflicting data have been reported regarding the association between SCH and the incidence of adverse pregnancy outcomes. To date, various observational studies have shown that SCH is associated with adverse pregnancy outcomes, including preterm delivery,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; gestational diabetes,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; gestational hypertension, eclampsia,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; low birth weight, low Apgar score, and lower childhood IQ.&lt;span&gt;&lt;sup&gt;5, 6&lt;/sup&gt;&lt;/span&gt; Additional studies have not demonstrated the association of adverse outcomes with SCH,&lt;span&gt;&lt;sup&gt;7, 8&lt;/sup&gt;&lt;/span&gt; although the status of antithyroid peroxidase antibodies (TPOAbs) was not differentiated in these studies. Previous studies have shown higher impairment of positive TPOAbs (TPOAb&lt;sup&gt;+&lt;/sup&gt;) on neurocognitive outcomes in offspring.&lt;span&gt;&lt;sup&gt;9&lt;/sup&gt;&lt;/span&gt; The adverse impact of negative TPOAbs in gestational SCH (SCH-TPOAb&lt;sup&gt;−&lt;/sup&gt;) on offspring development has not yet been identified.&lt;/p&gt;&lt;p&gt;No consensus has been demonstrated on the treatment of pregnant women with SCH-TPOAb&lt;sup&gt;−&lt;/sup&gt;. The Endocrine Society recommends therapy in all pregnant women with SCH, irrespective of their TPOAb status.&lt;span&gt;&lt;sup&gt;10&lt;/sup&gt;&lt;/span&gt; The 2017 ATA supports treatment for a specific subgroup of women with SCH who are TPOAb&lt;sup&gt;+&lt;/sup&gt; (SCH-TPOAb&lt;sup&gt;+&lt;/sup&gt;) or TPOAb&lt;sup&gt;−&lt;/sup&gt; and possess TSH levels greater than 10 mU/L.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The application of levothyroxine (L-T4) treatment for SCH-TPOAb&lt;sup&gt;−&lt;/sup&gt; is somewhat ambiguous (TSH cutoff 4.0–10.0 mIU/L). Moreover, a limited number of studies have investigated the influence of the time frame on the treatment effect in SCH during pregnancy. Previously, it was reported from our group that standardized treatment should be used for SCH-TPOAb&lt;sup&gt;−&lt;/sup&gt; pregnant women prior to 8 gestational weeks; their TSH levels ranged from 4.0 to 10.0 mIU/L, which might significantly improve the intellectual development of the 2-year-old offspring.&lt;span&gt;&lt;sup&gt;11&lt;/sup&gt;&lt;/span&gt; It was hypothesized that the later treatment of patients with negative TPOAb and TSH levels between 4.0 and 10.0 mlU/L (4.0 mIU/L &lt; TSH ≤ 10.0) would have greater adverse effects on the neurobehavioral development of their offspring.&lt;/p&gt;&lt;p&gt;To assess this hypothesis, electronic health records and abstracted clinical data from patients who were reviewed at the Second Affiliated Hospital of Wenzhou Medical University were retrieved from June 2016 to June 2019. Pregnant women were routinely screened at their first antenatal visit for thyroid function, s","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"239-241"},"PeriodicalIF":3.6,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586953","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 detection of circulating tumor cells indicates poor therapeutic efficacy and prognosis in patients with nonsmall cell lung cancer: A systematic review and meta-analysis","authors":"Shan Wang,&nbsp;Xiaolin Liu,&nbsp;Hongwei Lv,&nbsp;Jing Yu,&nbsp;Huihui Li","doi":"10.1111/jebm.12606","DOIUrl":"10.1111/jebm.12606","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The efficacy and prognostic value of circulating tumor cells (CTCs) in nonsmall cell lung cancer (NSCLC) are controversial based on the existing research. This systematic review and meta-analysis evaluated the significance of CTCs in NSCLC therapy monitoring and prognosis prediction, supporting their potential as clinical biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive search of PubMed, Embase, Web of Science, The Cochrane Library, WanFang Data, CNKI, and VIP through September 20, 2023. Inclusion criteria were cohort studies involving NSCLC patients, focusing on peripheral blood CTCs, and assessing outcomes such as pre- and posttreatment CTC rates or levels, progression-free survival (PFS), and overall survival (OS). Two reviewers independently extracted the data and assessed risk of bias using the Newcastle-Ottawa Scale. We utilized Review Manager 5.4.1 for meta-analysis, calculating pooled odds ratios (ORs) for dichotomous outcomes, mean differences for continuous variables and hazard ratios (HRs) for survival data, applying fixed- or random-effects models based on heterogeneity assessed by the <i>I</i>² statistic. This study was registered in PROSPERO (No. CRD42023450035).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two eligible studies with a total of 1674 NSCLC patients were included. Meta-analysis results showed that the CTCs-positive rate (OR = 0.59, 95% CI 0.45 to 0.77, <i>p = </i>0.0001) and CTCs count (mean difference = –3.10, 95% CI –5.52 to –0.69, <i>p = </i>0.01) were significantly decreased after antitumor treatment. Compared with the CTCs nonreduced group, the CTC-reduced group showed better PFS (HR = 1.71, 95% CI 1.35 to 2.17, <i>p </i>&lt; 0.00001) and OS (HR = 1.50, 95% CI 1.21 to 1.86, <i>p = </i>0.0003) after treatment. PFS and OS in CTC-positive groups were lower than those in the CTCs-negative group pretreatment (HR = 2.49, 95% CI 1.78 to 3.47, <i>p</i> &lt; 0.00001; HR = 1.80, 95% CI 1.29 to 2.52, <i>p</i> = 0.0006) and posttreatment (HR = 3.36, 95% CI 2.12 to 5.33, <i>p </i>&lt; 0.00001; HR = 3.31, 95% CI 1.75 to 6.27, <i>p = </i>0.0002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CTCs can be used as a biomarker to monitor NSCLC efficacy, predict prognosis and guide follow-up treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"329-340"},"PeriodicalIF":3.6,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586952","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":"Real-world experience of Fuzheng Yiqing granule as chemoprophylaxis against COVID-19 infection among close contacts: A prospective cohort study","authors":"Qianzi Che,&nbsp;Ruili Huo,&nbsp;Chen Zhao,&nbsp;Wei Yang,&nbsp;Xinghua Xiang,&nbsp;Shihuan Tang,&nbsp;Jiaheng Shi,&nbsp;Cheng Lu,&nbsp;Hongmei Li,&nbsp;Luqi Huang","doi":"10.1111/jebm.12591","DOIUrl":"10.1111/jebm.12591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of the current study was to evaluate whether the use of traditional Chinese medicine, Fuzheng Yiqing granule (FZYQG), was associated with a reduced infection risk of COVID-19 in close contacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research design and methods</h3>\u0000 \u0000 <p>This was a prospective cohort study across 203 quarantine centres for close contacts and secondary contacts of COVID-19 patients in Yangzhou city. FZYQG group was defined as quarantined individuals who voluntarily took FZYQG; control group did not take FZYQG. The primary outcome was the coronavirus test positive rate during quarantine period. Logistic regression with propensity score inverse probability weighting was used for adjusted analysis to evaluate independent association between FZYQG and test positive rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From July 13, 2021 to September 30, 2021, 3438 quarantined individuals took FZYQG and 2248 refused to take the granule. Test positive rate was significantly lower among quarantined individuals who took FZYQG (0.29% vs. 1.73%, risk ratio 0.17, 95% confidence interval (CI): 0.08–0.34, <i>p</i> &lt; 0.001). On logistic regression, odds for test positive were decreased in FZYQG group (odds ratio: 0.16, 95% CI: 0.08–0.32, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Close and secondary contacts of COVID-19 patients who received FZYQG had a lower test positive rate than control individuals in real-world experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial registration</h3>\u0000 \u0000 <p>This study has been registered on Chinese Clinical Trial Registry (ChiCTR2100049590) on August 5, 2021.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"269-277"},"PeriodicalIF":3.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870419","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":"Fluids in the treatment of diabetic ketoacidosis in children: A systematic review","authors":"Daniela Patino-Galarza,&nbsp;Andres Duque-Lopez,&nbsp;Ginna Cabra-Bautista,&nbsp;Jose A. Calvache,&nbsp;Ivan D. Florez","doi":"10.1111/jebm.12603","DOIUrl":"10.1111/jebm.12603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the comparative effectiveness of fluid schemes for children with diabetic ketoacidosis (DKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review with an attempt to conduct network meta-analysis (NMA). We searched MEDLINE, EMBASE, CENTRAL, Epistemonikos, Virtual Health Library, and gray literature from inception to July 31, 2022. We included randomized controlled trials (RCTs) in children with DKA evaluating any intravenous fluid schemes. We planned to conduct NMA to compare all fluid schemes if heterogeneity was deemed acceptable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve RCTs were included. Studies were heterogeneous in the population (patients and DKA episodes), interventions with different fluids (saline, Ringer's lactate (RL), and polyelectrolyte solution-PlasmaLyte^®), tonicity, volume, and administration systems. We identified 47 outcomes that measured clinical manifestations and metabolic control, including single and composite outcomes and substantial heterogeneity preventing statistical combination. No evidence was found of differences in neurological deterioration (main outcome), but differences were found among interventions in some comparisons to normalize acid-base status (∼2 h less with low vs. high volume); time to receive subcutaneous insulin (∼1 h less with low vs. high fluid rate); length of stay (∼6 h less with RL vs. saline); and resolution of the DKA (∼3 h less with two-bag vs. one-bag scheme). However, available evidence is scarce and poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is not enough evidence to determine the best fluid therapy in terms of fluid type, tonicity, volume, or administration time for DKA treatment. There is an urgent need for more RCTs, and the development of a core outcome set on DKA in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"317-328"},"PeriodicalIF":3.6,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586776","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":"Model-based meta-analysis of omalizumab in treating patients with chronic idiopathic/spontaneous urticaria","authors":"Aiping Zhao,&nbsp;Ke Zhang,&nbsp;Zhen Wang,&nbsp;Kaihe Ye,&nbsp;Zhaosi Xu,&nbsp;Xiao Gong,&nbsp;Guanghu Zhu","doi":"10.1111/jebm.12604","DOIUrl":"10.1111/jebm.12604","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"242-244"},"PeriodicalIF":3.6,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586968","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":"Step count and multiple health outcomes: An umbrella review","authors":"Zhimin Ao,&nbsp;Hongbo He,&nbsp;Hongxia Shi,&nbsp;Hong Liu","doi":"10.1111/jebm.12596","DOIUrl":"10.1111/jebm.12596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to quantify the association between step count and multiple health outcomes in a healthy population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, Web of Science, and The Cochrane Library were systematically searched for systematic reviews and meta-analyses from inception to April 1, 2022. Literature screening, data extraction, and data analysis were performed in this umbrella review. The intervention factor was daily step counts measured based on devices. Multiple health outcomes included metabolic diseases, cardiovascular diseases, all-cause mortality, and other outcomes in the healthy population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty studies with 94 outcomes were identified in this umbrella review. The increase in daily step count contributed to a range of human health outcomes. Furthermore, the special population, different age groups, countries, and cohorts should be carefully considered. Negative correlation between step counts and the following outcomes: metabolic outcomes, cardiovascular diseases, all-cause mortality, postural balance, cognitive function, and mental health. However, there was no association between participation in the outdoor walking group and the improvement of systolic blood pressure and diastolic blood pressure. Analysis of the dose–response association between increasing daily step count and the risk of cardiovascular disease events and all-cause mortality showed a substantially linear relationship.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A wide range of health outcomes can benefit from the right number of steps.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"278-295"},"PeriodicalIF":3.6,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140586770","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":"Thiazide-associated hyponatremia in arterial hypertension patients: A nationwide population-based cohort study","authors":"Soie Kwon,&nbsp;Hasung Kim,&nbsp;Jungkuk Lee,&nbsp;Jungho Shin,&nbsp;Su Hyun Kim,&nbsp;Jin Ho Hwang","doi":"10.1111/jebm.12601","DOIUrl":"10.1111/jebm.12601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Thiazides are the first-line treatment for hypertension, however, they have been associated with hospitalizations for thiazide-associated hyponatremia (TAH). The aim of this study was to evaluate the risk of TAH and other drug-associated hyponatremia in a Korean population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used big data from the National Health Insurance Sharing Service of 1,943,345 adults treated for hypertension from January 2014 to December 2016. The participants were divided into two groups based on the use of thiazides. Cox proportional hazard models were used to identify independent risk factors for the occurrence of hyponatremia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that hyponatremia-related hospitalizations were significantly higher in the thiazide group than the control group (2.19% vs. 1.45%). The risk increased further with concurrent use of other diuretics or desmopressin, and thiazide+spironolactone+desmopressin and hospitalization risk further increased (4.0 and 6.9 times). Multivariate analysis showed that hyponatremia occurrence increased with age, diabetes mellitus, depression, and thiazide use (hazard ratio = 1.436, <i>p </i>&lt; 0.001). The thiazide group had better 6-year overall survival than the control group but had more fractures and hyponatremia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Thiazide use is associated with an increased risk of hyponatremia and related complications. However, the mortality rate decreased in those who received thiazides, suggesting that thiazide use itself is not harmful and may help decrease complications and improve prognosis with proper, cautious use in high-risk patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"296-306"},"PeriodicalIF":3.6,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140602755","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 computable biomedical knowledge system: Toward rapidly building candidate-directed acyclic graphs","authors":"Yongmei Bai,&nbsp;Xuanyu Shi,&nbsp;Jian Du","doi":"10.1111/jebm.12602","DOIUrl":"10.1111/jebm.12602","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>It is essential for health researchers to have a systematic understanding of third-party variables that influence both the exposure and outcome under investigation, as shown by a directed acyclic graph (DAG). The traditional construction of DAGs through literature review and expert knowledge often needs to be more systematic and consistent, leading to potential biases. We try to introduce an automatic approach to building network linking variables of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Large-scale text mining from medical literature was utilized to construct a conceptual network based on the Semantic MEDLINE Database (SemMedDB). SemMedDB is a PubMed-scale repository of the “concept-relation-concept” triple format. Relations between concepts are categorized as Excitatory, Inhibitory, or General.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>To facilitate the use of large-scale triple sets in SemMedDB, we have developed a computable biomedical knowledge (CBK) system (https://cbk.bjmu.edu.cn/), a website that enables direct retrieval of related publications and their corresponding triples without the necessity of writing SQL statements. Three case studies were elaborated to demonstrate the applications of the CBK system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CBK system is openly available and user-friendly for rapidly capturing a set of influencing factors for a phenotype and building candidate DAGs between exposure-outcome variables. It could be a valuable tool to reduce the exploration time in considering relationships between variables, and constructing a DAG. A reliable and standardized DAG could significantly improve the design and interpretation of observational health research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"17 2","pages":"307-316"},"PeriodicalIF":3.6,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331772","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}