Journal of Evidence‐Based Medicine最新文献

{"title":"Delirium in Mechanically Ventilated Patients After Cardiac Surgery: The Importance of Preoperative Nutritional Management Revealed by a Multicenter Retrospective Cohort Study","authors":"Liang Hong,&nbsp;Jiawen Wang,&nbsp;Tianling Feng,&nbsp;Hongwei Fan,&nbsp;Xiao Shen,&nbsp;Wenxiu Chen,&nbsp;Hong Tao,&nbsp;Weifeng Yao,&nbsp;Jianjun Zou,&nbsp;Min Yang","doi":"10.1111/jebm.70042","DOIUrl":"https://doi.org/10.1111/jebm.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The effects of malnutrition on postoperative delirium (POD) after cardiac surgery remains understudied. We hypothesized that preoperative prognostic nutrition index (PNI) has a significant clinical role in predicting POD among mechanically ventilated patients undergoing cardiac surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter retrospective study of adult patients who underwent cardiac surgery and subsequently received mechanical ventilation (MV) in the Intensive Care Unit at Nanjing First Hospital (NFH-ICU) and from Medical Information Mart for Intensive Care IV (MIMIC-IV). The relationship between PNI and POD was examined by Cox proportional hazards models, propensity score matching, mediation analysis, subgroup analysis, and sensitivity analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>2725 participants of NFH-ICU and 3368 participants of MIMIC-IV were included in this study. Reduced PNI levels were identified as an independent risk factor for POD, and its addition enhanced the accuracy of predicting POD. After adjusting for all confounders, Cox analysis revealed that PNI≤45.5 was significantly associated with the risk of progressing to POD (NFH-ICU: HR = 1.46, 95% CI 1.01–2.11, <i>p</i> = 0.044; MIMIC-IV: HR = 1.53, 95% CI 1.14–2.07, <i>p</i> = 0.005). We also analyzed the mediating role of duration of MV on malnutrition and POD. The proportions mediated were 31.64% and 9.71% in NFH-ICU and MIMIC-IV, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The decreased PNI can increase the risk of POD after cardiac surgery. Meanwhile, the increased risk of POD associated with low PNI was partially mediated by prolonged duration of MV after surgery. The study highlights the preoperative nutritional management as an important intervention to prevent postoperative delirium in patients undergoing cardiac surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232388","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":"Comparative Effectiveness of Paclitaxel-Containing Regimens for Treatment of Triple-Negative Breast Cancer: A Network Meta-Analysis","authors":"Junqiang Niu,&nbsp;Xuan Tuo,&nbsp;Xu Hui,&nbsp;Man Li,&nbsp;Suyi Liu,&nbsp;Zhichun Zhang,&nbsp;Jianming Tang,&nbsp;Yongbin Lu,&nbsp;Kehu Yang","doi":"10.1111/jebm.70037","DOIUrl":"https://doi.org/10.1111/jebm.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of paclitaxel-based regimens, including traditional Chinese medicine (TCM) combinations, for the treatment of triple-negative BC (TNBC) using a network meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, CBM, VIP, WanFang database were searched comprehensively from inception to February 27, 2025. Eligible studies included adult TNBC patients treated with paclitaxel alone or in combination with other therapies. Outcomes included objective response rate (ORR), overall survival (OS), progression-free survival, pathologic complete response, disease-free survival, and adverse events (AEs). Statistical analyses were performed using the frequentist contrast-based method and random effects model. The Grading of Recommendations, Assessment, Development, and Evaluation approach using CINeMA application and a modified Cochrane Risk of Bias Tool were used to assess the certainty of evidence and methodological quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>93 randomized controlled trials (108 publications) involving 19,016 patients were included. Paclitaxel-based quadruple and quintuple therapies significantly improved ORR (relative risk (RR) = 1.74, 95% confidence interval (CI) [1.39–2.71], low certainty of evidence) and OS duration (weighted mean difference (WMD) = 59.16 weeks, 95% CI [28.81–89.51], low) compared to monotherapy. Paclitaxel-based monotherapy and double therapy had the least potential to cause neutropenia. Regimens incorporating TCM showed superior ORR compared to non-TCM combinations and monotherapy (18 randomized controlled trials, 1570 patients; RR = 1.29. 95% CI [1.17–1.41], moderate; RR = 1.55, 95% CI [1.37–1.75], moderate).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Combination therapies, especially those incorporating targeted agents or platinum-based regimens, may exhibit superior efficacy while maintaining acceptable safety profiles. Additionally, TCM may be associated with a higher ORR and a reduced risk of AEs. Further large-scale, high-quality studies are warranted to investigate the efficacy and safety of combining paclitaxel with targeted agents, platinum-based therapies, or TCM in the treatment of TNBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206599","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":"Current Situation on Application of Evidence-Based Pharmacy in National Drug Policy","authors":"Linan Zeng,&nbsp;Dan Liu,&nbsp;Lingli Zhang,&nbsp;Wei Xiao,&nbsp;Zhe Chen,&nbsp;Hailong Li,&nbsp;Sha Diao,&nbsp;Kun Zou,&nbsp;Qiusha Yi","doi":"10.1111/jebm.70033","DOIUrl":"https://doi.org/10.1111/jebm.70033","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206717","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":"Knowledge and Awareness of Generative Artificial Intelligence Use in Medicine Among International Stakeholders: A Cross-Sectional Study","authors":"Xufei Luo,&nbsp;Bingyi Wang,&nbsp;Yule Li,&nbsp;Shuang Liu,&nbsp;Haodong Li,&nbsp;Yaxuan Ren,&nbsp;Wah Yang,&nbsp;Kyle Lam,&nbsp;Stephen R Ali,&nbsp;Gemma Sharp,&nbsp;Fabio Ynoe Moraes,&nbsp;Ye Wang,&nbsp;Di Zhu,&nbsp;Zhenhua Yang,&nbsp;Daher Mohammad,&nbsp;Robert Fruscio,&nbsp;Maged N. Kamel Boulos,&nbsp;Zhicheng Lin,&nbsp;Kazuki Ide,&nbsp;Xuping Song,&nbsp;Lu Zhang,&nbsp;Yih Chung Tham,&nbsp;Hui Liu,&nbsp;Long Ge,&nbsp;Yaolong Chen,&nbsp;Zhaoxiang Bian,&nbsp;the GAMER working group and ADVANCED working group","doi":"10.1111/jebm.70034","DOIUrl":"https://doi.org/10.1111/jebm.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the knowledge, attitudes, and practices (KAP) of medical stakeholders regarding the use of generative artificial intelligence (GAI) tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted among stakeholders in medicine. Participants included researchers, clinicians, and medical journal editors with varying degrees of familiarity with GAI tools. The survey questionnaire comprised 40 questions covering four main dimensions: basic information, knowledge, attitudes, and practices related to GAI tools. Descriptive analysis, Pearson's correlation, and multivariable regression were used to analyze the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall awareness rate of GAI tools was 93.3%. Participants demonstrated moderate knowledge (mean score 17.71 ± 5.56), positive attitudes (mean score 73.32 ± 15.83), and reasonable practices (mean score 40.70 ± 12.86). Factors influencing knowledge included education level, geographic region, and attitudes (<i>p</i> &lt; 0.05). Attitudes were influenced by work experience and knowledge (<i>p</i> &lt; 0.05), while practices were driven by both knowledge and attitudes (<i>p</i> &lt; 0.001). Participants from outside China scored higher in all dimensions compared to those from China (<i>p</i> &lt; 0.001). Additionally, 74.0% of participants emphasized the importance of reporting GAI usage in research, and 73.9% advocated for naming the specific tool used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings highlight a growing awareness and generally positive attitude toward GAI tools among medical stakeholders, alongside the recognition of their ethical implications and the necessity for standardized reporting practices. Targeted training and the development of clear reporting guidelines are recommended to enhance the effective use of GAI tools in medical research and practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197410","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":"Associations of Combined Socioeconomic Status and Healthy Lifestyle With Incidence of Chronic Respiratory Diseases: A Prospective Cohort Study","authors":"Jin Yang,&nbsp;Jilong Huang,&nbsp;Jian Gao,&nbsp;Wenfang Zhong,&nbsp;Peiliang Chen,&nbsp;Qingmei Huang,&nbsp;Yixin Zhang,&nbsp;Fangfei You,&nbsp;Huan Chen,&nbsp;Chuan Li,&nbsp;Weiqi Song,&nbsp;Dong Shen,&nbsp;Jiaojiao Ren,&nbsp;Dan Liu,&nbsp;Zhihao Li,&nbsp;Chen Mao","doi":"10.1111/jebm.70035","DOIUrl":"https://doi.org/10.1111/jebm.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the relationship between socioeconomic status (SES), lifestyle factors, and their combined impact on chronic respiratory diseases (CRDs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were from the UK Biobank and were categorized into SES groups using latent class analysis based on family income, education, and employment status. Lifestyle factors were assessed via 24-hour dietary recalls and structured questionnaires. Each criterion scored 1 (healthy) or 0 (unhealthy), creating a total score from 0 to 4. Multivariable Cox proportional hazards models, interaction analyses, and mediation analyses were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 296,731 participants, 12,128 (4.1%) participants were diagnosed with CRDs. Among low SES groups, healthy lifestyle groups with scores 2, 1, and 0 showed significantly increased hazard ratios of 1.32 (95% CI: 1.21–1.44), 1.77 (95% CI: 1.63–1.93) and 2.36 (95% CI: 2.15–2.60) compared with the healthy lifestyle scores ≥3. The combined effect of SES and healthy lifestyle increased the risk of CRDs by 15% over the risk expected from simply adding their respective effects. The proportion of SES on CRDs incidence mediated by healthy lifestyle factors was statistically significant (<i>p</i> &lt; 0.001), accounting for about 2%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The risk of incident CRDs in the low SES population with an unhealthy lifestyle increased by 32%–136%. Unhealthy lifestyles significantly affect the incidence of CRDs in different SES subgroups. About 2% of the risk between SES and incident CRDs was mediated by lifestyle factors. These findings highlight the importance of addressing socioeconomic disparities and unhealthy lifestyle behaviors in public health strategies aimed at preventing CRDs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191100","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":"Calculation of the Overlap in Umbrella Reviews Based on the Sample Size of Primary Studies","authors":"Hamidreza Ashayeri,&nbsp;Hanieh Salehi-Pourmehr,&nbsp;Ali Jafarizadeh","doi":"10.1111/jebm.70038","DOIUrl":"https://doi.org/10.1111/jebm.70038","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171721","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 Indirect Impact of COVID-19 Pandemic on Mortality, Complications, and Healthcare Utilization Among Patients With Chronic Respiratory Diseases in Hong Kong: An Interrupted Time Series Analysis","authors":"Qi Kang,&nbsp;Yuk Kam Yau,&nbsp;Zhuoran Hu,&nbsp;Jianchao Quan,&nbsp;David Chi Leung Lam,&nbsp;Ivy Lynn Mak,&nbsp;Ian Chi Kei Wong,&nbsp;David Vai Kiong Chao,&nbsp;Welchie Wai Kit Ko,&nbsp;Chak Sing Lau,&nbsp;Cindy Lo Kuen Lam,&nbsp;Eric Yuk Fai Wan","doi":"10.1111/jebm.70039","DOIUrl":"https://doi.org/10.1111/jebm.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to investigate COVID-19's indirect influence on chronic respiratory disease (CRD) patients for two years since the COVID-19 pandemic began.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using population-based data in Hong Kong, we included CRD patients diagnosed from January 2011 to December 2021. Interrupted Time Series Analysis were applied to assess mortality, complications, and healthcare utilization rates during the “pre-COVID-19 pandemic” (January 2012–January 2020), “initial COVID-19 pandemic” (February 2020–February 2021), and “post-initial COVID-19 pandemic” (March 2021–December 2021) periods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 587,049 patients with CRD, all-cause mortality had an increasing trend during the post-initial COVID-19 pandemic period (incidence rate ratio (95% CI): 1.019 (1.005, 1.034); <i>p</i> = 0.007), compared with pre-COVID-19 pandemic period. Nonrespiratory mortality had an increasing trend in the initial COVID-19 pandemic period (1.020 (1.006, 1.033); <i>p</i> = 0.004) and was higher than the pre-pandemic level in the post-initial COVID-19 pandemic. We observed abrupt declines in the incidence rates of asthma exacerbation, acute exacerbation of chronic obstructive pulmonary disease, pneumonia, and acute respiratory failure in the first month of initial COVID-19 pandemic period, remaining below pre-COVID-19 pandemic levels throughout the initial pandemic period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The disruption of usual healthcare impacts mortality rates among patients with CRD without COVID-19, particularly nonrespiratory mortality. Contingency plans on continuing follow-up and monitoring of CRD patients are needed, for example, teleconsultations, shared primary care, and tele-reminders on red-flag symptoms for patients with CRD, when healthcare services may be disrupted during public health crises.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171722","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":"Meta-Epidemiology: A Combination of Epidemiology and Meta-Analysis in Response to the Challenges of Systematic Reviews and Meta-Analysis","authors":"Masoud Mohammadi","doi":"10.1111/jebm.70036","DOIUrl":"https://doi.org/10.1111/jebm.70036","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140473","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":"Large Language Models in Integrative Medicine: Progress, Challenges, and Opportunities","authors":"Hiu Fung Yip,&nbsp;Zeming Li,&nbsp;Lu Zhang,&nbsp;Aiping Lyu","doi":"10.1111/jebm.70031","DOIUrl":"https://doi.org/10.1111/jebm.70031","url":null,"abstract":"<p>Integrating Traditional Chinese Medicine (TCM) and Modern Medicine faces significant barriers, including the absence of unified frameworks and standardized diagnostic criteria. While Large Language Models (LLMs) in Medicine hold transformative potential to bridge these gaps, their application in integrative medicine remains underexplored and methodologically fragmented. This review systematically examines LLMs' development, deployment, and challenges in harmonizing Modern and TCM practices while identifying actionable strategies to advance this emerging field. This review aimed to provide insight into the following aspects. First, it summarized the existing LLMs in the General Domain, Modern Medicine, and TCM from the perspective of their model structures, number of parameters and domain-specific training data. We highlighted the limitations of existing LLMs in integrative medicine tasks through benchmark experiments and the unique applications of LLMs in Integrative Medicine. We discussed the challenges during the development and proposed possible solutions to mitigate them. This review synthesizes technical insights with practical clinical considerations, providing a roadmap for leveraging LLMs to bridge TCM's empirical wisdom with modern medical systems. These AI-driven synergies could redefine personalized care, optimize therapeutic outcomes, and establish new standards for holistic healthcare innovation.</p>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085160","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":"Limited Evidence to Fully Determine the Implementation of Evidence-Based Practice by Healthcare Providers in Africa: A Systematic Review and Meta-Analysis","authors":"Feleke H. Astawesegn,&nbsp;Kedir Y. Ahmed,&nbsp;Subash Thapa,&nbsp;Shakeel Mahmood,&nbsp;Anayochukwu Anyasodor,&nbsp;M. Mamun Huda,&nbsp;Setognal B. Aychilihum,&nbsp;Utpal K. Modal,&nbsp;Allen G. Ross","doi":"10.1111/jebm.70032","DOIUrl":"https://doi.org/10.1111/jebm.70032","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Implementing evidence-based practice (EBP) is a complex process requiring healthcare providers to integrate evidence-based medicine (EBM) into clinical practice, ultimately improving clinical outcomes. This systematic review examined the sources of information for EBP, analyzed the extent of EBP implementation by healthcare providers, and explored the factors influencing EBP in Africa.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We identified articles published between January 1992 and March 2024 by searching Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMbase, PubMed, and Scopus databases. The pooled effect sizes for the prevalence of EBP and odds ratios (ORs) were estimated using random- and fixed-effects models as appropriate. For the qualitative component of the study, we performed a thematic analysis and subsequently integrated and interpreted findings from both the quantitative and qualitative analyses.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty-three studies were included in this review, involving 9722 healthcare providers: 60.3% nurses, 15.9% physicians, and 15.4% midwives. Our findings revealed a lack of detailed information on how healthcare providers utilized different forms of EBM to inform EBP and clinical outcomes in Africa. Self-reported EBP was 57.3% among nurses and 37.3% among physicians. Nigeria had the highest self-reported EBP (75.2%), whereas Egypt had the lowest (18.9%). Common sources of information reported for EBP were PubMed, UpToDate, the Cochrane Library, clinical guidelines, and training programs. Factors associated with EBP included knowledge of EBP (OR = 2.13, 95% confidence interval [CI]: 1.83–2.47), positive attitude toward EBP (OR = 1.95, 95% CI: 1.76–2.15), and having EBM training (OR = 3.08, 95% CI: 2.08–4.57), and a managerial role (OR = 2.16, 95% CI: 1.37–3.41). The availability of guidelines (OR = 1.88, 95% CI: 1.5–2.37) and internet access (OR = 1.90, 95% CI: 1.54–2.34) were also found to increase EBP. Our qualitative analysis identified common barriers to EBP, including a lack of support, resistance to change, poor communication, and failure to integrate EBP courses into the continuing education curricula.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This systematic review found limited information on the sources of EBM, how it was delivered, and its frequency of use in clinical practice. Thus, the correlation between EBM, EBP, and clinical outcomes was not fully transparent. Further studies are required to examine the medical conditions","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074694","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}