Journal of Evidence‐Based Medicine最新文献

{"title":"From Evidence to Recommendations With Large Language Models: A Feasibility Study.","authors":"Weilong Zhao, Danni Xia, Ziying Ye, Honghao Lai, Mingyao Sun, Jiajie Huang, Jiayi Liu, Jianing Liu, Long Ge","doi":"10.1111/jebm.70067","DOIUrl":"https://doi.org/10.1111/jebm.70067","url":null,"abstract":"<p><strong>Background: </strong>Formulating evidene-based recommendations for practice guidelines is a complex process that requires substantial expertise. Artificial intelligence (AI) is promising in accelerating the guideline development process. This study evaluates the feasibility of leveraging five large language models (LLMs)-ChatGPT-3.5, Claude-3 sonnet, Bard, ChatGLM-4, Kimi chat-to generate recommendations based on structured evidence, assesses their concordance, and explores the potential for AI.</p><p><strong>Methods: </strong>The general and specific prompts were drafted and validated. We searched PubMed to include evidence-based guidelines related to health and lifestyle. We randomly selected one recommendation from every included guideline as the sample and extracted the evidence base supporting the selected recommendations. The prompts and evidence were fed into five LLMs to generate structured recommendations.</p><p><strong>Results: </strong>ChatGPT-3.5 demonstrated the highest proficiency in comprehensively extracting and synthesizing evidence to formulate novel insights. Bard consistently adhered to existing guideline principles, aligning its algorithm with these tenets. Claude generated fewer topical recommendations, focusing instead on evidence analysis and mitigating irrelevant information. ChatGLM-4 exhibited a balanced approach, combining evidence extraction with adherence to guideline principles. Kimi showed potential in generating concise and targeted recommendations. Among the six generated recommendations, average consistency ranged from 50% to 91.7%.</p><p><strong>Conclusion: </strong>The findings of this study suggest that LLMs hold immense potential in accelerating the formulation of evidence-based recommendations. LLMs can rapidly and comprehensively extract and synthesize relevant information from structured evidence, generating recommendations that align with the available evidence.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70067"},"PeriodicalIF":3.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040250","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":"Developing and Externally Validating the Multivariable Prediction Model for White-Coat Hypertension.","authors":"Shali Hao, Xiaomei Zhang, Lingxiao Li, Libin Mo, Yangguang Liu, Jiahuan Li, Wenli Wang, Jiandi Wu, Yuli Huang","doi":"10.1111/jebm.70064","DOIUrl":"https://doi.org/10.1111/jebm.70064","url":null,"abstract":"<p><strong>Aim: </strong>The white-coat hypertension (WCH) detection by monitoring the out-of-office blood pressure (BP) consumes resources and time. This study aimed at developing the prediction model based on patients' characteristics obtained from clinical data.</p><p><strong>Methods: </strong>Individuals who participated in two large hospitals health check-up examination were screened. Participants with twice readings of elevated office blood pressure in different visits, while no history of hypertension were included. Combination with home blood pressure monitoring, participants were defined as having WCH or sustained hypertension (SH), respectively. Independent predictors were found by employing multivariate logistic regression on training set. A nomogram was built using independent predictors.</p><p><strong>Results: </strong>In total, 383 outpatients with elevated office blood pressure were enrolled. Two hundred and thirty-three of them from one hospital were included for the development of the prediction model (training sets), and 150 patients from another independent study site were included for external validation (external validation sets). We identified six predictors including office systolic blood pressure, body mass index, sex, total cholesterol, homocysteine, and heart rate being linked to WCH diagnosis. Area under receiver operating characteristic curve (AUC) for the model was 0.792 and 0.692 regarding training and external validation sets, respectively. The calibration curve and decision curve analyses further demonstrated that the model had good performance for distinguishing WCH from SH.</p><p><strong>Conclusions: </strong>This prediction model can help clinicians to identify WCH individuals from those with SH, providing an effective tool for guiding personalized recommendations of abnormal blood pressure management.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70064"},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029802","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":"Burden of Myelodysplastic Syndromes: A Literature Review of Epidemiological and Humanistic Aspects.","authors":"Shitong Xie, Jiajun Yan, Preston Tse, Brittany Humphries, Feng Xie","doi":"10.1111/jebm.70065","DOIUrl":"https://doi.org/10.1111/jebm.70065","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70065"},"PeriodicalIF":3.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029841","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":"Examining and Interpreting Doi Plot Asymmetry in Meta-Analyses of Randomized Controlled Trials.","authors":"Luis Furuya-Kanamori, Xanthoula Rousou, Polychronis Kostoulas, Suhail A R Doi","doi":"10.1111/jebm.70063","DOIUrl":"https://doi.org/10.1111/jebm.70063","url":null,"abstract":"<p><p>Systematic reviews and meta-analyses are considered the highest level of evidence, but their reliability can be undermined by publication bias. Traditional methods for assessing publication bias, such as funnel plots and p-value-based tests (e.g., Egger test), have notable limitations, including reliance on subjective interpretation and dependence on the number of studies included in a meta-analysis (k). The Doi plot and LFK index offer promising alternatives, providing improved visualization and quantification of plot asymmetry. This study revisits the application of the Doi plot and LFK index for detecting publication bias, addresses recent criticisms, and evaluates their performance compared to p-value-based methods using simulation study. Simulations included scenarios with varying study numbers (k = 5, 10, 20, 50), study sample sizes (small, large), and simulated bias level (ρ = 0, -0.3, -0.5, -0.9) generated using the Copas selection model. Diagnostic performance metrics (i.e., sensitivity and specificity) were estimated and compared for the LFK index and Egger test. The LFK index exhibited consistent higher sensitivity across varying k and simulated bias levels. In contrast, the Egger test was highly dependent on k, with sensitivity declining sharply in small meta-analyses (k < 20). Specificity of the LFK index adjusted with random error, while Egger test specificity remained fixed at ∼90%. The Doi plot and LFK index effectively address the limitations of traditional methods, offering robust k-independent performance and more reliable detection of publication bias. These findings support a transition to the Doi plot and LFK index for publication bias assessment in meta-analyses.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70063"},"PeriodicalIF":3.5,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Survey of the Optimal Strategy for Dealing With Missing Binary Outcomes in Simulation Studies of Randomized Controlled Trials.","authors":"Yanjiao Shen, Parpia Sameer, Xin Xia, Yuqing Zhang, Jinhui Ma, Qingyang Shi, Qiukui Hao, Xianlin Gu, Wenbo He, Yamin Chen, Na Zhang, Le Wang, Yating Zeng, Xiaoyi Su, Qiang Zong, Qiao Zhi, Sitong Liu, Xinyao Wang, Xinyu Zou, Ying He, Qiong Guo, Borong Wang, Liang Du, Zhengchi Li, Jin Huang, Guyatt Gordon","doi":"10.1111/jebm.70058","DOIUrl":"https://doi.org/10.1111/jebm.70058","url":null,"abstract":"<p><strong>Aim: </strong>To summarize the optimal strategies for dealing with missing binary outcome data (MBOD) in randomized controlled trials (RCTs) as informed by simulation studies, and to summarize the quality of reporting in these studies.</p><p><strong>Methods: </strong>To identify simulation studies comparing at least two strategies to deal with MBOD and evaluating their performance (bias, coverage and power), we searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials via Ovid, Web of Science, and JSTOR from their inception up to December 20, 2023. We evaluated reporting quality using established criteria for simulation studies in medical statistics. We summarized data using descriptive statistics and a narrative synthesis.</p><p><strong>Results: </strong>Our search identified 29,460 citations, of which five proved eligible. Multiple imputation (MI), investigated in five studies, showed consistently good performance in all domains tested for missing completely at random (MCAR) and missing at random (MAR) but with important limitations in missing not at random (MNAR). Complete case analysis (CCA), investigated in four studies of which three addressed model-based CCA, performed well in bias and coverage under MAR and MCAR, but less well for MNAR. One study reported that non-model-based CCA performed poorly with respect to bias under MAR. Non-model-based single imputation, investigated in two studies, showed consistently poor performance across all domains tested for MAR, MCAR and MNAR. One study reported that model-based single imputation performed well with respect to bias under MAR. Regarding reporting quality, all studies reported the aims, dependence of simulated data sets, scenarios and statistical methods evaluated, number of simulations performed, justification of data generation and criteria used to evaluate the simulation performance. None of the studies reported the starting seeds, random number generators and failures occurring during simulation.</p><p><strong>Conclusions: </strong>Simulation studies address methods to deal with MBOD in RCTs, provided evidence that the MI approach is superior with respect to bias and coverage compared with CCA. Non-model-based single imputation generally performed poorly.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70058"},"PeriodicalIF":3.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957088","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 Prophylactic Effect of Acupuncture for Migraine Without Aura: A Randomized, Sham-Controlled, Clinical Trial.","authors":"Mingsheng Sun, Chaorong Xie, Yanan Wang, Xuguang Yang, Linlin Dong, Taipin Guo, Xiaoqin Chen, Jing Luo, Yutong Zhang, Xixiu Ni, Lu Liu, Jiao Chen, Siyuan Zhou, Ling Zhao","doi":"10.1111/jebm.70059","DOIUrl":"https://doi.org/10.1111/jebm.70059","url":null,"abstract":"<p><strong>Objective: </strong>Acupuncture is recognized as an effective migraine treatment, but the comparative long-term efficacy of different acupuncture methods at identical acupoints remains unclear. This study investigates the prophylactic effects of manual acupuncture (manual penetrating acupuncture, MPA) versus sham acupuncture (non-penetrating acupuncture, NPA) at the same acupoints.</p><p><strong>Methods: </strong>In this multicenter, single-blind randomized controlled trial conducted across four Chinese clinical centers (May 2020 to September 2022), 192 migraineurs without aura (International Classification of Headache Disorders 3rd edition criteria) were randomized 1:1 to 12 sessions of MPA or NPA. Primary outcome was the change from baseline in migraine attack frequency at week 16; secondary outcomes included migraine attack frequency, responder rates, migraine days, and pain intensity (every 4 weeks), etc. Trial registration: No. ChiCTR2000032308.</p><p><strong>Results: </strong>A total of 198 participants were randomly allocated to either MPA or NPA groups, 99 in each group. At 16 weeks, the change in MPA showed a greater reduction in migraine attacks versus NPA (mean difference [MD] = -0.6, 95% confidence interval [CI] -1.5 to 0.05; p = 0.069). MPA demonstrated superior responder rates (risk difference = 17.2%, 95% CI 5.2 to 29.1; p = 0.007) and pain reduction (MD = -0.6, 95% CI -1.1 to -0.2; p = 0.003) after treatment. At follow-up, MPA improved all migraine symptoms and some quality of life compared with NPA. Adverse events occurred in 5.1% of MPA participants.</p><p><strong>Conclusions: </strong>Although MPA and NPA showed comparable preventive effects, MPA provided sustained symptom relief and quality-of-life improvements. Therefore, suitable acupoint selection establishes therapeutic potential, whereas acupuncture methods critically determine long-term clinical benefits.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70059"},"PeriodicalIF":3.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957095","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 Efficacy of Zinc Supplementation Alone or in Combination for Improving Pregnancy and Infant Outcomes: A Systematic Review and Meta-Analysis.","authors":"Sha Diao, Yuan Feng, Xue Peng, Dan Liu, Liang Huang, Linan Zeng, Lingli Zhang","doi":"10.1111/jebm.70061","DOIUrl":"https://doi.org/10.1111/jebm.70061","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate zinc supplementation's efficacy in pregnancy, addressing gaps in previous reviews regarding high-risk subgroups and combination therapies.</p><p><strong>Methods: </strong>Systematic review of six databases through March 27, 2025 for randomized controlled trials (RCTs) on prenatal zinc supplementation. Risk of bias was assessed using the Cochrane Risk of Bias 2. Stratified analyses was conducted by participant or intervention characteristics, with meta-analysis or qualitative synthesis when appropriate. Sensitivity analyses was conducted by excluding studies with high risk of bias. The systematic review was registered in PROSPERO (CRD42023440314).</p><p><strong>Results: </strong>77 RCTs were included. Compared with no zinc, zinc monotherapy among healthy pregnant women resulted in higher serum zinc level (standard mean difference (SMD) _{the second trimester} = 0.32, 95% confidence interval (CI) 0.20 to 0.44; SMD_{the third trimester} = 0.51, 95% CI 0.27 to 0.76), lower fetal intrauterine retardation rate (risk ratio = 0.23, 95% CI 0.16 to 0.35), longer neonatal birth length (SMD = 0.66, 95% CI 0.21 to 1.12), bigger birth head circumference (SMD = 0.58, 95% CI 0.08 to 1.09), higher 1-min Apgar score (SMD = 0.28, 95% CI 0.06 to 0.49) and cord blood zinc level (SMD = 0.36, 95% CI 0.17 to 0.56). No additional benefits observed with zinc-iron-folate combinations versus iron-folate alone. Qualitative synthesis of limited evidence suggested potential benefits for high-risk groups (anemia, gestational diabetes, zinc deficiency or impaired intravenous glucose tolerance test).</p><p><strong>Conclusions: </strong>Zinc monotherapy may benefit healthy pregnancies and high-risk groups, but combination regimens show no additional advantages. Further research should confirm these findings.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70061"},"PeriodicalIF":3.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957138","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":"Analysis of the Current Status and Characteristics of Health Economics Reporting in Clinical Practice Guidelines for 2021-2023.","authors":"Xin Xing, Guohua Zhang, Weize Kong, Liping Guo, Xiuxia Li, Zhipeng Wei, Yongbin Lu, Howard White, Yaolong Chen, Kehu Yang","doi":"10.1111/jebm.70062","DOIUrl":"10.1111/jebm.70062","url":null,"abstract":"<p><strong>Objective: </strong>While prior investigations into the reporting of health economics (HE) have predominantly focused on guideline analyses at singular institutional or national levels, this study extends its scope to encompass diverse guidance documents issued transnationally across multiple institutions. Specifically, we evaluated the reporting of HE evidence in international clinical practice guidelines (CPGs) and expert consensus statements published between 2021 and 2023. The findings aim to inform the future revisions and development of such documents.</p><p><strong>Methods: </strong>A systematic PubMed search identified relevant CPGs and expert consensus statements within a specified period. Two independent researchers screened the literature, extracted economic evidence integrated into these documents, and employed descriptive analysis to summarize the reporting characteristics.</p><p><strong>Results: </strong>Of the 8931 screened publications, 3119 (34.9%) reported HE evidence. Among these 3119 publications, 237 (7.6%) incorporated HE evidence in formulating recommendations, 220 (7.1%) utilized HE evidence for evidence grading, and 2581 (82.8%) referenced HE evidence in explanatory notes accompanying the recommendations.</p><p><strong>Conclusions: </strong>Current CPGs and expert consensus statements exhibit low rates of HE evidence reporting, indicating that most international guideline developers have overlooked their applications. HE evidence-through cost-effectiveness and cost-utility analyses-can optimize medical resource allocation, support clinicians in patient-centered economic decision-making, and enhance health outcomes. Future guideline development should prioritize HE evidence integration to advance the scientific rigor and clinical applicability of the recommendations.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70062"},"PeriodicalIF":3.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882918","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":"Does Sulfasalazine Still Have Therapeutic Value in the Treatment of Axial Spondyloarthritis? A Real-World Cohort Study From China.","authors":"Jiaxin Zhang, Xiaojian Ji, Lidong Hu, Yiwen Wang, Simin Liao, Jiawen Hu, Yinan Zhang, Lulu Zeng, Shiwei Yang, Jian Zhu, Feng Huang","doi":"10.1111/jebm.70055","DOIUrl":"10.1111/jebm.70055","url":null,"abstract":"<p><strong>Objective: </strong>The efficacy of sulfasalazine (SSZ) in axial spondyloarthritis (ax-SpA) patients meeting both 2009 ax-SpA and 2011 peripheral SpA (p-SpA) criteria is unclear. This study aimed to assess SSZ's clinical efficacy in pure ax-SpA and overlapping ax-SpA patients and to identify factors influencing peripheral symptom development.</p><p><strong>Methods: </strong>SpA patients from 2016 to 2023 at the First Medical Center of People's Liberation Army General Hospital were categorized into pure ax-SpA and ax-SpA with peripheral features. They received nonsteroidal anti-inflammatory drugs (NSAIDs) alone or with SSZ. The study evaluated SSZ's efficacy, peripheral symptom timing and prevalence, and factors affecting symptom onset using Cox regression.</p><p><strong>Results: </strong>Of 670 SpA patients, 469 maintained pure axial involvement throughout follow-up, while 201 developed peripheral symptoms during follow-up. had pure ax-SpA. The SSZ plus NSAIDs group demonstrated significantly lower Axial Spondyloarthritis Disease Activity Score than NSAIDs-only in both pure axial (1.2 vs. 1.8; p = 0.015) and axial-with-peripheral subgroups (1.1 vs. 1.8; p = 0.011). New peripheral symptoms occurred in 33.2% of the NSAIDs group and 15.1% of the SSZ plus NSAIDs group. SSZ reduced the risk of peripheral symptom development (hazard ratio [HR] = 0.489, p = 0.0028). In the Cox proportional hazards model adjusted for age, sex, smoking status, body mass index, and Human Leukocyte Antigen B27 status, male gender (HR = 0.64, p = 0.020) and SSZ use (HR = 0.47, p = 0.004) emerged as protective factors, whereas smoking significantly increased risk (HR = 1.97, p < 0.001).</p><p><strong>Conclusions: </strong>SSZ reduces disease activity, improves quality of life among ax-SpA patients, reduces the incidence of peripheral symptoms, and delays their onset. About one-third of ax-SpA patients develop peripheral symptoms over time, which are associated with poorer functional status and quality of life. Smoking increases this risk, while male gender and SSZ use offer protection.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70055"},"PeriodicalIF":3.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873543","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":"Cost-Effectiveness and Cost-Utility Analysis of Tongxinluo Capsules Compared With Conventional Therapy for the Treatment of Acute Myocardial Infarction.","authors":"Guoqiang Liu, Peng Liu, Sijun Yu, Xia Liu, Fan Wang, Chunhui Liu, Xiaozhen Hu, Yongquan Jing, Linqiang Liu, Xuxia Zhang, Yuzeng Xue, Guanzhong Zheng, ChangYu Wang, Zhongming Zhao, Yanjie Zheng, Wenzhai Cao, Huanyi Zhang, Feng Gao, Jing Zhou, Zidong Bie, Guoqiang Yuan, Lei Wang, Jun Qian, Xiaochen Tian, Haitao Zhang, Xiangdong Li, Zhenhua Jia, Ningxin Ding, Yuejin Yang","doi":"10.1111/jebm.70060","DOIUrl":"https://doi.org/10.1111/jebm.70060","url":null,"abstract":"<p><strong>Aim: </strong>Tongxinluo (TXL) capsule, a traditional Chinese medicine compound, has proven effective in acute myocardial infarction (AMI), but its cost-effectiveness is unclear.</p><p><strong>Methods: </strong>This economic evaluation utilized individual data from clinical trials to compare major adverse cardiac and cerebrovascular events (MACCEs) at 30 days and quality-adjusted life years (QALYs) at 1 year between an intervention group (TXL combined with conventional therapy) and the control group (placebo plus conventional therapy), from a healthcare perspective. A lifetime cost-utility analysis (CUA) was conducted using a Markov model, and sensitivity analyses were performed to evaluate the robustness of the results.</p><p><strong>Results: </strong>A total of 3777 patients (TXL: 1889; placebo: 1888) were included in the analysis. The 30-day total costs for the TXL and placebo groups were ¥38,561 ($5399) and ¥39,217 ($5490), respectively, showing no statistical difference. The 30-day MACCEs rates were 3.39% for the TXL group and 5.24% for the placebo group (p < 0.006), indicating TXL's superiority in effectiveness at 30 days. Over a lifetime, the TXL group incurred higher total costs (¥97,108 [$13,595] vs. ¥92,033 [$12,885]) and gained more QALYs (6.70 vs. 6.30). The incremental cost-effectiveness ratio for TXL was ¥12,421/QALY ($1739), below the 1 Gross Domestic Product per capital threshold which was ¥89,358 ($12,510) in 2023 in China. Sensitivity analysis confirmed robust results, revealing that TXL was more likely to be accepted over the placebo when the willingness to pay exceeds ¥12,500 ($1739).</p><p><strong>Conclusions: </strong>TXL is a cost-effective option compared to placebo in AMI.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":" ","pages":"e70060"},"PeriodicalIF":3.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862281","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}