Journal of Evidence‐Based Medicine最新文献

{"title":"The Prophylactic Effect of Acupuncture for Migraine Without Aura: A Randomized, Sham-Controlled, Clinical Trial","authors":"Mingsheng Sun,&nbsp;Chaorong Xie,&nbsp;Yanan Wang,&nbsp;Xuguang Yang,&nbsp;Linlin Dong,&nbsp;Taipin Guo,&nbsp;Xiaoqin Chen,&nbsp;Jing Luo,&nbsp;Yutong Zhang,&nbsp;Xixiu Ni,&nbsp;Lu Liu,&nbsp;Jiao Chen,&nbsp;Siyuan Zhou,&nbsp;Ling Zhao","doi":"10.1111/jebm.70059","DOIUrl":"10.1111/jebm.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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: <i>No</i>. ChiCTR2000032308.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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; <i>p =</i> 0.069). MPA demonstrated superior responder rates (risk difference = 17.2%, 95% CI 5.2 to 29.1; <i>p =</i> 0.007) and pain reduction (MD = –0.6, 95% CI –1.1 to –0.2; <i>p =</i> 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70059","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":"OA","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,&nbsp;Yuan Feng,&nbsp;Xue Peng,&nbsp;Dan Liu,&nbsp;Liang Huang,&nbsp;Linan Zeng,&nbsp;Lingli Zhang","doi":"10.1111/jebm.70061","DOIUrl":"10.1111/jebm.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate zinc supplementation's efficacy in pregnancy, addressing gaps in previous reviews regarding high-risk subgroups and combination therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Zinc monotherapy may benefit healthy pregnancies and high-risk groups, but combination regimens show no additional advantages. Further research should confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70061","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":"OA","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,&nbsp;Guohua Zhang,&nbsp;Weize Kong,&nbsp;Liping Guo,&nbsp;Xiuxia Li,&nbsp;Zhipeng Wei,&nbsp;Yongbin Lu,&nbsp;Howard White,&nbsp;Yaolong Chen,&nbsp;Kehu Yang","doi":"10.1111/jebm.70062","DOIUrl":"10.1111/jebm.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"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,&nbsp;Xiaojian Ji,&nbsp;Lidong Hu,&nbsp;Yiwen Wang,&nbsp;Simin Liao,&nbsp;Jiawen Hu,&nbsp;Yinan Zhang,&nbsp;Lulu Zeng,&nbsp;Shiwei Yang,&nbsp;Jian Zhu,&nbsp;Feng Huang","doi":"10.1111/jebm.70055","DOIUrl":"10.1111/jebm.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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; <i>p</i> = 0.015) and axial-with-peripheral subgroups (1.1 vs. 1.8; <i>p</i> = 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, <i>p</i> = 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, <i>p</i> = 0.020) and SSZ use (HR = 0.47, <i>p</i> = 0.004) emerged as protective factors, whereas smoking significantly increased risk (HR = 1.97, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"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,&nbsp;Peng Liu,&nbsp;Sijun Yu,&nbsp;Xia Liu,&nbsp;Fan Wang,&nbsp;Chunhui Liu,&nbsp;Xiaozhen Hu,&nbsp;Yongquan Jing,&nbsp;Linqiang Liu,&nbsp;Xuxia Zhang,&nbsp;Yuzeng Xue,&nbsp;Guanzhong Zheng,&nbsp;ChangYu Wang,&nbsp;Zhongming Zhao,&nbsp;Yanjie Zheng,&nbsp;Wenzhai Cao,&nbsp;Huanyi Zhang,&nbsp;Feng Gao,&nbsp;Jing Zhou,&nbsp;Zidong Bie,&nbsp;Guoqiang Yuan,&nbsp;Lei Wang,&nbsp;Jun Qian,&nbsp;Xiaochen Tian,&nbsp;Haitao Zhang,&nbsp;Xiangdong Li,&nbsp;Zhenhua Jia,&nbsp;Ningxin Ding,&nbsp;Yuejin Yang","doi":"10.1111/jebm.70060","DOIUrl":"10.1111/jebm.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Tongxinluo (TXL) capsule, a traditional Chinese medicine compound, has proven effective in acute myocardial infarction (AMI), but its cost-effectiveness is unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> &lt; 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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TXL is a cost-effective option compared to placebo in AMI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70060","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Coronary Angiographic-Derived and Intracoronary Imaging-Based Fractional Flow Reserve in Assessing Coronary Artery Stenosis Severity: A Systematic Review and Network Meta-Analysis","authors":"Jianchang Xie,&nbsp;Lu Ye,&nbsp;Jianmin Yang,&nbsp;Yigang Zhong,&nbsp;Peng Xu,&nbsp;Beibei Gao,&nbsp;Ningfu Wang,&nbsp;Xianhua Ye,&nbsp;Guoxin Tong,&nbsp;Jinyu Huang","doi":"10.1111/jebm.70054","DOIUrl":"10.1111/jebm.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review and network meta-analysis aimed to compare the accuracy of coronary angiographic-derived fractional flow reserve (Angio-FFR), optical coherence tomography (OCT)-FFR, and intravascular ultrasound (IVUS)-FFR in evaluating the severity of coronary artery stenosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, and Cochrane Library were searched from January 1, 2010 to April 1, 2024 for studies on the accuracy assessment of Angio-FFR, OCT-FFR, and IVUS-FFR. A network meta-analysis was performed with accuracy and analysis of variance models. The diagnostic performance was evaluated through absolute sensitivity (SEN), specificity (SPE), diagnostic dominance index (DDI), and diagnostic odds ratio (DOR), with the corresponding 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 86 studies (16,552 lesions). Network meta-analysis showed that IVUS-FFR demonstrated the highest absolute SEN of 0.92 (0.91, 0.94), while OCT-FFR demonstrated the highest absolute SPE of 0.92 (0.91, 0.94). In comparison to Angio-FFR, intracoronary imaging (ICI)-FFR demonstrated superior diagnostic performance, with a DDI and DOR of 1.00 (95% CI: 0.99, 1.01) versus 0.96 (95% CI: 0.94, 0.98) and 79.18 (95% CI: 62.20, 92.35) versus 56.15 (95% CI: 52.86, 59.29), respectively. Furthermore, ICI-FFR demonstrated significantly greater overall accuracy than Angio-FFR, with a relative risk of 1.03 (95% CI: 1.01–1.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This comprehensive network meta-analysis establishes that ICI-FFR provides superior diagnostic performance for coronary artery stenosis assessment compared to Angio-FFR. These findings support the clinical value of ICI modalities in functional stenosis evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855513","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":"Intravenous Iron in Heart Failure Patients With Iron Deficiency: A Meta-Analysis of Randomized Controlled Trials","authors":"Yangguang Liu,&nbsp;Jiahuan Li,&nbsp;Yingwen Chen,&nbsp;Lingxiao Li,&nbsp;Ling Zhao,&nbsp;Xiaomei Zhang,&nbsp;Yuli Huang","doi":"10.1111/jebm.70057","DOIUrl":"10.1111/jebm.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of intravenous iron therapy in heart failure (HF) patients with iron deficiency (ID) is still controversial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We performed an extensive search of electronic databases for pertinent studies, encompassing all records up to March 4, 2024. Using random-effects models in a meta-analysis, the collected outcomes data were then synthesized and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Fourteen trials with 7786 participants (iron therapy: <i>n</i> = 3994; control: <i>n</i> = 3792) were included. Intravenous iron therapy can decrease the risk of composite events of total hospitalization for HF and cardiovascular (CV) death (RR = 0.82 [0.72, 0.92]), total hospitalization for HF (RR = 0.78 [0.66, 0.91]), first hospitalization for HF and CV death (OR = 0.78 [0.65, 0.93]), CV death (OR = 0.86 [0.76, 0.98]), first hospitalization for HF(OR = 0.77 [0.61, 0.99]), but not significantly reduce the risk of all-cause mortality (OR = 0.93 [0.83, 1.04]). Furthermore, intravenous iron treatment can improve the distance of 6-min walking test (6MWT) (WMD = 18.99 [7.41, 30.57]). Subgroup analyses found that intravenous iron may be more beneficial in HF patients with transferrin saturation (TSAT) &lt;20%, and those with ischemic heart disease. Meta-regression analysis revealed that baseline hemoglobin levels served as a significant moderator of the therapeutic efficacy of intravenous iron supplementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For HF patients with ID, intravenous iron therapy can decrease the risk of hospitalization for HF, CV death and improve their exercise capacity. Patients with ischemic cardiomyopathy or with TSAT &lt;20% may derive greater benefit from intravenous iron therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855514","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":"Validation of a Self-Assessment Tool for Osteoporosis and Vertebral Fracture Primary Screening in Elderly Men","authors":"Li Shen,&nbsp;Chao Gao,&nbsp;Tianrui He,&nbsp;Liting Chu,&nbsp;Jie Wang,&nbsp;Zhenlin Zhang,&nbsp;Guangjun Yu","doi":"10.1111/jebm.70045","DOIUrl":"10.1111/jebm.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The early identification of osteoporosis and vertebral fractures (VFs) is vital for improving the quality of life in elderly men. This study aimed to validate the effectiveness of a self-assessment tool for osteoporosis and VFs primary screening in the elderly men.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This real-world study analyzed data from two sources: an electronic health record (EHR) database comprising 7187 subjects and a community database including 6313 subjects. Restricted cubic spline curves were utilized to analyze the relationship between the osteoporosis self-assessment tool for Asians (OSTA) index and the prevalence of osteoporosis, overall VFs, and moderate to severe VFs. Diagnostic performance was assessed by calculating sensitivity, specificity, and area under the receiver operating characteristic curve (AUC), and optimal cutoff values were determined for different age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With a cutoff value of −1, the OSTA index demonstrated good diagnostic performance for identifying osteoporosis, achieving an AUC of 0.712 (<i>p</i> &lt; 0.001), with sensitivity and specificity of 81.6% and 78.1%, respectively. The screening performance was notably higher among individuals aged 70–79 and those over 80 years, with AUCs of 0.79 and 0.81, respectively, and sensitivities exceeding 90%. For moderate to severe VFs, the OSTA index demonstrated a sensitivity of 86.6%, a specificity of 53.1%, and an AUC of 0.628.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large-scale real-world study supports the utility of the OSTA index as a valid tool for the primary screening of osteoporosis and VFs in the elderly men.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649668","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":"Retrieve Then Rerank: An End-to-End Learning Paradigm for Biomedical Entity Linking","authors":"Yuling Cao,&nbsp;Lanya Peng,&nbsp;Yipeng Zhang,&nbsp;Cui Yang","doi":"10.1111/jebm.70053","DOIUrl":"10.1111/jebm.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Biomedical entity linking is essential in natural language processing for identifying and linking biomedical concepts to entities in a knowledge base. Current methods, which involve a multistage recognition-retrieve-read process, achieve high performance but are hindered by slow inference times and error propagation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors propose ER2, an End-to-End entity linking paradigm following a Retrieval-Rerank framework. It reversely selects mentions in context and their corresponding entities based on the prior knowledge of candidate entities, enabling jointly performing candidates retrieval, mention detection, and candidates rerank in one pass via a lighten-weight reranker that models deep relevance between the context and its candidates at the embedding level. We further introduce a more powerful cross-encoder as the teacher model, thereby enhancing the rerank performance via knowledge distillation from the teacher to the student reranker.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Experiments on several end-to-end entity linking benchmarks demonstrate the efficiency and effectiveness. Notably, our method achieves competitive performance compared with the previous state-of-the-art methods while being nearly 10 times faster.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The research has a significant reference for connecting mentions within unstructured contexts to their corresponding entities in KBs, thereby facilitating the application effect of downstream tasks such as automatic diagnosis, drug–drug interaction prediction and personalized medicine and other fields.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553702","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":"Validation of the Quality Assessment Tool for Systematic Reviews and Meta-Analyses of Real-World Studies","authors":"Tadesse Gebrye,&nbsp;Chidozie Mbada,&nbsp;Zalmai Hakimi,&nbsp;Francis Fatoye","doi":"10.1111/jebm.70052","DOIUrl":"https://doi.org/10.1111/jebm.70052","url":null,"abstract":"&lt;p&gt;Randomized controlled trials (RCTs) are considered the gold standard for assessing the efficacy of medical interventions [&lt;span&gt;1&lt;/span&gt;]. However, real-world evidence (RWE) is increasingly recognized as essential for comprehensive healthcare decision-making. RCTs provide high internal validity and establish clear causal relationships due to their controlled environments and strict criteria. Nevertheless, the highly selective patient populations and controlled settings of RCTs can limit the external validity of their findings, making it challenging to generalize results to broader, more diverse populations [&lt;span&gt;2&lt;/span&gt;]. RWE is derived from real-world data (RWD), such as electronic health records and insurance claims, and provides clinical insights into the usage, benefits, and risks of medical products. Unlike RCTs, RWE offers perspectives on treatment performance in everyday practice, which can significantly aid healthcare decision-making [&lt;span&gt;3&lt;/span&gt;]. RWD serves to bridge the gap between clinical trials and real-world settings, informing guidelines, policy decisions, and new therapy approvals [&lt;span&gt;4&lt;/span&gt;]. This type of evidence captures a wider range of patient populations and healthcare environments, making it particularly valuable for understanding the effectiveness, safety, and cost-effectiveness of interventions in real-world conditions.&lt;/p&gt;&lt;p&gt;Regulatory bodies and healthcare organizations increasingly rely on RWE to fill gaps left by RCTs [&lt;span&gt;5&lt;/span&gt;]. For instance, the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have incorporated RWE to support regulatory decisions and postmarket surveillance [&lt;span&gt;6&lt;/span&gt;]. When making healthcare recommendations, it is crucial that they are grounded in the best available research evidence [&lt;span&gt;7&lt;/span&gt;]. Incorporating this evidence into healthcare practices can help reduce variations in healthcare delivery. The volume of research studies on healthcare is now enormous for healthcare professionals. RWE is instrumental in understanding the effectiveness and safety of interventions across diverse populations and in identifying rare adverse events and long-term outcomes, thus enhancing healthcare practices and policies [&lt;span&gt;8&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;To summarize and present the findings of individual research studies a structured approach is required. This structured approach, systematic review, provides a comprehensive and unbiased synthesis of many relevant studies in a single document. One of the most critical components of conducting a systematic review is the assessment of the quality of the included studies, as this significantly impacts the overall quality of evidence produced [&lt;span&gt;9&lt;/span&gt;]. Quality appraisal refers to evaluating how well a study was designed and conducted looking at its methodological soundness, such as whether it used an appropriate study design, followed rigorous procedures, and addressed key elements like sample selection and dat","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144492704","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}