Journal of Evidence‐Based Medicine最新文献

{"title":"Pharmacological Interventions for Acute Pancreatitis in Adults: An Overview of Systematic Reviews","authors":"Ling Ding,&nbsp;Linge Jian,&nbsp;Jiayue Xu,&nbsp;Qiao He,&nbsp;Yuning Wang,&nbsp;Che Sun,&nbsp;Wen Wang,&nbsp;Xin Sun","doi":"10.1111/jebm.70007","DOIUrl":"https://doi.org/10.1111/jebm.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To provide a comprehensive assessment of the efficacy and safety of pharmacological interventions for AP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was an overview of systematic reviews based on randomized controlled trials comparing pharmacological interventions with placebo or blank control in adults with AP. We searched PubMed, Embase, and the Cochrane Database of Systematic Reviews from inception to January 13, 2024, with an update on February 4, 2025. The effect value of each medication on each outcome of interest defined as a “combo” was assessed. Findings were categorized as efficacious, not efficacious, or inconclusive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen reviews (167 unique trials, 12,930 participants) reported the efficacy of 14 medications on 5 outcomes, yielding 35 distinct combos. Seven combos showed efficacy with low certainty evidence: low molecular weight heparin (risk ratio 0.31, 95% confidence interval, 0.18–0.51), omega-3 fatty acids (0.30, 0.14–0.65), and antioxidants (0.69, 0.49–0.98) for mortality; low molecular weight heparin (0.38, 0.22–0.65), chengqi-series decoctions (0.48, 0.36–0.63), and ulinastatin (0.43, 0.24–0.78) for multiple organ failure; and neostigmine (mean difference –2.81, 95 % confidence interval –3.75 to –1.87) for length of intensive care unit stay. Half of the remaining combos showed no efficacy, while the other half was inconclusive for very low certainty evidence. Safety data were limited, with one review reporting no significant adverse events for neostigmine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Some pharmacological interventions exhibited potential efficacy for specific AP outcomes, albeit with low certainty evidence. Further verifying those medications is crucial in advancing the treatment landscape for AP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535828","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":"Towards Diagnostic Intelligent Systems in Leukemia Detection and Classification: A Systematic Review and Meta-analysis","authors":"Mehrad Aria,&nbsp;Zohreh Javanmard,&nbsp;Donia Pishdad,&nbsp;Vahid Jannesari,&nbsp;Maryam Keshvari,&nbsp;Mahshid Arastonejad,&nbsp;Reza Safdari,&nbsp;Mohammad Esmaeil Akbari","doi":"10.1111/jebm.70005","DOIUrl":"https://doi.org/10.1111/jebm.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Leukemia is a type of blood cancer that begins in the bone marrow and results in high numbers of abnormal white blood cells. Automated detection and classification of leukemia and its subtypes using artificial intelligence (AI) and machine learning (ML) algorithms plays a significant role in the early diagnosis and treatment of this fatal disease. This study aimed to review and synthesize research findings on AI-based approaches in leukemia detection and classification from peripheral blood smear images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted across four e-databases (Web of Science, PubMed, Scopus, and IEEE Xplore) from January 2015 to March 2023 by searching the keywords “Leukemia,” “Machine Learning,” and “Blood Smear Image,” as well as their synonyms. All original journal articles and conference papers that used ML algorithms in detecting and classifying leukemia were included. The study quality was assessed using the Qiao Quality Assessment tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1325 articles identified through a systematic search, 190 studies were eligible for this review. The mean validation accuracy (ACC) of the ML methods applied in the reviewed studies was 95.38%. Among different ML methods, modern techniques were mostly considered to detect and classify leukemia (60.53% of studies). Supervised learning was the dominant ML paradigm (79% of studies). Studies utilized common ML methodologies for leukemia detection and classification, including preprocessing, feature extraction, feature selection, and classification. Deep learning (DL) techniques, especially convolutional neural networks, were the most widely used modern algorithms in the mentioned methodologies. Most studies relied on internal validation (87%). Moreover, K-fold cross-validation and train/test split were the commonly employed validation strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI-based algorithms are widely used in detecting and classifying leukemia with remarkable performance. Future studies should prioritize rigorous external validation to evaluate generalizability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497058","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":"Inadequate Reporting of Harm From Randomized Clinical Trials in Top Medical Publications","authors":"Rui Zheng,&nbsp;Liyuan Tao,&nbsp;Yang Sun,&nbsp;Hongcai Shang,&nbsp;Mitchell Levine","doi":"10.1111/jebm.70006","DOIUrl":"https://doi.org/10.1111/jebm.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the quality of harm reporting in randomized controlled trials (RCTs) published in high-impact general medical journals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design and Setting</h3>\u0000 \u0000 <p>Publications of RCTs involving drugs compared with placebo controls, that were published in five general medical journals with high Impact Factors were identified from January 2022 to December 2023. Data relating to the presentation and discussion of harm were extracted and analyzed based on the Consort Harm framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 175 eligible RCTs (<i>AIM</i>: <i>n</i> = 5; <i>BMJ</i>: <i>n</i> = 8; <i>JAMA</i>: <i>n</i> = 26, <i>Lancet</i>: <i>n</i> = 64, and <i>NEJM</i>: <i>n</i> = 72). None of the studies referenced the CONSORT Harms 2004 statement. Seventy-one percent of studies (<i>n</i> = 125) did not mention how harm data about patients’ symptoms were collected and 86.3% of the analyses (<i>n</i> = 151) were limited to descriptive statistics. Only 45.1% of studies (<i>n</i> = 79) discussed the balance of benefits and harms. Common limitations included unclear methodological details, selective reporting, and inadequate analysis of results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RCTs published in five highly cited general medical journals contain deficiencies in harm reporting. The recently updated Consort Harm 2022 provides an implementable evaluation and guidance tool and should be actively promoted among researchers, reviewers, and journal editors. More attention to adequate and reasonable reporting requirements for harms in RCTs is necessary to provide a better opportunity for evidence-based decision making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143513774","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":"Dysphagia Rehabilitation Using Digital Technology: A Scoping Review","authors":"Na-Kyoung Hwang,&nbsp;Tae-Hyung Yoon,&nbsp;Moon-Young Chang,&nbsp;Ji-Su Park","doi":"10.1111/jebm.70009","DOIUrl":"https://doi.org/10.1111/jebm.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Digital health technology in swallowing rehabilitation offers personalized exercises, remote monitoring, and real-time feedback, enhancing accessibility and effectiveness of therapy. This scoping review was conducted to summarize what types and features of digital technology-based dysphagia rehabilitation interventions exist, how they are applied in patients with dysphagia, and what the effectiveness and facilitators and barriers to intervention application are.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched Medline Complete, Embase, CINAHL, Scopus, and gray literature for articles published between January 2000 and June 2023. We used subheadings and terms related to digital health, dysphagia, and rehabilitation to search for articles. The included studies were mapped according to the types and features, effectiveness, enablers, barriers, and future improvements of swallowing rehabilitation using digital technologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five studies met the inclusion criteria. Three types of digital swallowing rehabilitation interventions were identified: home-based rehabilitation using the mHealth app, synchronous telepractice and monitoring, as well as game-based biofeedback and tracking. The included studies reported positive results regarding physiological changes in swallowing function, swallowing performance, and quality of life. Digital unfamiliarity, resources for digital access, and technical issues related to the failure of the mobile device operating system were identified as barriers to the use of digital swallowing rehabilitation technology and future improvements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Digital technology has potential value in dysphagia rehabilitation. In the future, developing various interventions utilizing the advantages of digital technology and conducting additional research to validate their effectiveness is necessary. Additionally, improved digital familiarity, better accessibility, better technology, and management practices will be needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497183","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":"Can GPTs Accelerate the Development of Intelligent Diagnosis and Treatment in Traditional Chinese Medicine? A Survey and Empirical Analysis","authors":"Yan Guo,&nbsp;Heyuan Wang,&nbsp;Xue Ren,&nbsp;Tengjiao Wang,&nbsp;Wei Chen,&nbsp;Ziming Xu,&nbsp;Hui Ge","doi":"10.1111/jebm.70004","DOIUrl":"https://doi.org/10.1111/jebm.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Intelligent traditional Chinese medicine (TCM) is a key pathway toward the modernization and globalization of TCM in the era of artificial intelligence. Due to its unique terminology and diagnostic framework, TCM's intelligentization process has long faced a range of challenges, from the digitization and formalization of knowledge bases to the differentiation of syndromes and personalized treatment. Recently, the advent of large language models (LLMs) like GPTs has marked a transformative milestone in semantic understanding tasks, attracting widespread attention from the medical, academic, and industrial communities. Nonetheless, LLMs often suffer from accuracy and logical reasoning limitations within specific fields and may manifest hallucinations in the generative outputs. Through a comprehensive review of existing literature and empirical analyses, this study delves into the potential and challenges of adapting LLMs to TCM. Promising perspectives on future developments at this innovative intersection are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475546","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":"Association Between Recurrent Aphthous Ulcers and Oral Biodiversity: A Systematic Review and Meta-Analysis","authors":"Lin Zhao,&nbsp;Hongyu Xie,&nbsp;Lunwei Kang,&nbsp;Ga Liao","doi":"10.1111/jebm.70001","DOIUrl":"https://doi.org/10.1111/jebm.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the relationship between recurrent aphthous ulcers (RAU) and dysbiosis of the oral microbiota.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted across several databases, including the Cochrane Library, PubMed, Web of Science Core Collection, Embase, Scopus, CBM, CNKI, WanFang, and VIP, to identify relevant studies from the inception of the library until September 20, 2024. All included studies were evaluated for quality using the Newcastle–Ottawa scale. These studies assessed the diversity and abundance of oral microorganisms in patients with RAU in comparison to healthy individuals. Results were synthesized via random-effects meta-analysis (<i>I</i>² statistic for heterogeneity). Mean differences (MD) and 95% confidence intervals (CI) were applied to evaluate the pooled effects of outcomes. The systematic review was registered in PROSPERO (CRD42024615516).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 10 studies involving 343 patients and 348 controls were included in this study, 7 of these were utilized for meta-analysis to conduct a quantitative assessment. The meta-analysis showed that in terms of alpha diversity, saliva samples collected from patients with RAU exhibited a significantly lower Chao 1 index of alpha diversity (MD = –41.22, 95% CI –64.34 to –18.09, <i>p</i> &lt; 0.01), and that patients with ulcerated sites in the oral mucosa demonstrated a higher Chao 1 index when compared to healthy sites within the oral mucosa (MD = 27.48, 95% CI 2.98 to 51.97, <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Significant differences in the Chao 1 index between patients and healthy controls, along with variations in beta diversity and the relative abundance of taxa, indicate that microbial dysbiosis may play a crucial role in the development of RAU.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439210","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":"Clinical Assessment of Common Medications for Nonalcoholic Fatty Liver Disease: A Systematic Review and Bayesian Network Meta-Analysis","authors":"Rui Shi,&nbsp;Keyan Chai,&nbsp;Haojia Wang,&nbsp;Jiying Zhou,&nbsp;Siyun Yang,&nbsp;Jiaqi Li,&nbsp;Chuanqi Qiao,&nbsp;Xiaoguang Sheng,&nbsp;Xiaomeng Zhang,&nbsp;Jiarui Wu","doi":"10.1111/jebm.70002","DOIUrl":"https://doi.org/10.1111/jebm.70002","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;With a steadily rising prevalence, nonalcoholic fatty liver disease (NAFLD) was a leading global cause of liver-related health problems. In the clinical management of NAFLD, various western pharmaceuticals were widely utilized. This network meta-analysis aimed to evaluate the effectiveness of common western medications for NAFLD patients.&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 systematically reviewed and screened articles based on predesigned criterion about western medications for NAFLD, which were from Embase, Cochrane Library, PubMed, CNKI, WanFang, and China Science and Technology Journal Database until August 1, 2024. Eligible studies included randomized controlled trials of patients aged 18 or older with NAFLD, comparing Western medicines to placebos or other Western medicine treatments. The risk of bias assessment tool 2.0 from the Cochrane system was used to assess the quality of the included articles. A Bayesian network meta-analysis was conducted using WinBUGS 1.4.3 with a random-effects model and Markov Chain Monte Carlo methods. Treatment rankings were based on Surface Under the Cumulative Ranking Curve (SUCRA) values, and heterogeneity was assessed with &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; and &lt;i&gt;Q&lt;/i&gt; statistics. The outcomes were analyzed in WinBUGS and visualized using Stata 14.0, generating network plots and cumulative probability rankings to compare treatment effects. The systematic review was registered in PROSPERO (CRD42024509176).&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;Based on 37 included articles involving 7673 patients, pioglitazone demonstrated the most significant effects in resolving nonalcoholic steatohepatitis without worsening fibrosis, increasing high-density lipoprotein cholesterol levels, and achieving a ≥ 2-point reduction in NAFLD activity scores (odds ratio [OR] = 0.09, 95% confidence interval [CI]: 0.01 to 0.81), with a SUCRA probability of 91.4%. Aldafermin showed remarkable effects in improving liver function markers, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transpeptidase, with cumulative probabilities of 90% for ALT and 69.8% for AST. Cluster analysis revealed that Resmetirom and Aldafermin were superior options for enhancing liver function, while pioglitazone emerged as the best treatment for the comprehensive improvement of NAFLD.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pioglitazone outperformed other western medicines in terms of overall efficacy when treating NAFLD, but Aldafermin and Resmetirom showed sup","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431172","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":"Key Insights From a Rapid Review of Nondental Procedural Sedation Clinical Practice Guidelines for Adults With Intellectual and Developmental Disability","authors":"Andrea Simpson,&nbsp;Jessica Smith,&nbsp;Matthew Yates,&nbsp;Hannah Barden,&nbsp;Cassandra Gorton,&nbsp;Michelle Templeton","doi":"10.1111/jebm.70003","DOIUrl":"https://doi.org/10.1111/jebm.70003","url":null,"abstract":"&lt;p&gt;People with intellectual and developmental disabilities (IDD) experience significantly higher rates of physical and mental health conditions compared to the general population [&lt;span&gt;1, 2&lt;/span&gt;]. This group also faces substantial barriers to accessing healthcare, often leading to unmet health needs and poor health outcomes [&lt;span&gt;3&lt;/span&gt;]. For many people with IDD, routine clinical procedures, such as blood tests or immunizations, can be distressing [&lt;span&gt;4&lt;/span&gt;]. This distress may stem from past trauma, complex communication needs, insufficient adjustments for sensory sensitivities, needle phobia, or the lack of accessible information about medical procedures [&lt;span&gt;5&lt;/span&gt;]. As a result, it is not uncommon for clinicians to delay or abandon medical interventions for this population, placing individuals at risk for vaccine-preventable diseases and delays in diagnosing or managing health conditions [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;For this reason, people with IDD can require procedural modifications for routine medical procedures, such as blood tests and immunizations. A range of nonpharmacological interventions, such as graduated exposure [&lt;span&gt;7&lt;/span&gt;] and distractions using auditory or visual stimuli [&lt;span&gt;8&lt;/span&gt;], have been proposed. For individuals who experience heightened anxiety during minor procedures, pharmacological interventions like sedation may be necessary.&lt;/p&gt;&lt;p&gt;Clinical practice guidelines (CPGs) for sedation in this population are limited, especially outside of dental care. We carried out a rapid review aimed to identify and assess existing CPGs for procedural sedation in adults with IDD. The review followed the rapid review guidelines of the Agency for Healthcare Research and Quality [&lt;span&gt;9&lt;/span&gt;]. A PICO framework guided the review question, focusing on CPGs for procedural sedation (excluding dental care) in adults with IDD. Electronic searches were conducted across MEDLINE, Embase, Emcare, PsycINFO, and Scopus. Study selection and data extraction were carried out by two reviewers with disagreements resolved by a third. The AGREE II tool [&lt;span&gt;10&lt;/span&gt;] was employed to assess the quality of the included guidelines. Data were extracted from 9 studies on study characteristics, procedural models of care, and key patient safety outcomes, including procedure completion rates, adverse side effects, and escalation in sedation dosage or type.&lt;/p&gt;&lt;p&gt;The 9 studies originated from several countries, including the United Kingdom (&lt;i&gt;n&lt;/i&gt; = 3), the United States (&lt;i&gt;n&lt;/i&gt; = 5), Australia (&lt;i&gt;n&lt;/i&gt; = 1), and Italy (&lt;i&gt;n&lt;/i&gt; = 1). The clinical procedures across the studies ranged from premedication, behavioral strategies, desensitization programs, to virtual reality exposure therapy. Clinical qualifications varied, with most procedures involving a multidisciplinary team that included anesthetists, nurses, psychologists, behavioral therapists, and other healthcare professionals, depending on the intervention's nature. The reviewed ","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424289","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":"Prognostic Significance of Hypophosphatemia in Kidney Transplant Patients: A Systematic Review and Meta-Analysis","authors":"Nipith Charoenngam,&nbsp;Thanitsara Rittiphairoj,&nbsp;Pitchaporn Yingchoncharoen,&nbsp;Chalothorn Wannaphut,&nbsp;Thanathip Suenghataiphorn,&nbsp;Thitiphan Srikulmontri,&nbsp;Phuuwadith Wattanachayakul,&nbsp;Nutchapon Xanthavanich","doi":"10.1111/jebm.70000","DOIUrl":"https://doi.org/10.1111/jebm.70000","url":null,"abstract":"&lt;p&gt;Hypophosphatemia is a common electrolyte disorder in kidney transplant (KT) patients, occurring in up to 93% of cases. This condition is mediated by persistent hyperparathyroidism and elevated serum fibroblast growth factor-23 (FGF-23) due to long-standing phosphate retention, leading to increased phosphaturia when the kidney's intrinsic ability to handle phosphate normalizes [&lt;span&gt;1&lt;/span&gt;]. In severe cases, hypophosphatemia can lead to muscle weakness, cardiomyopathy, hemolytic anemia and respiratory failure [&lt;span&gt;1&lt;/span&gt;]. However, the clinical significance of hypophosphatemia in milder cases is less well-established. Interestingly, some studies have shown that the presence of hypophosphatemia in KT patients indicated a favorable prognosis, including decreased risks of graft failure, mortality and cardiovascular disease (CVD) [&lt;span&gt;2, 3&lt;/span&gt;]. Other studies, however, demonstrated a U-shaped association between serum phosphate levels and adverse outcomes [&lt;span&gt;4, 5&lt;/span&gt;]. Therefore, using systematic review and meta-analysis techniques, we aimed to summarize all available data to investigate the association between hypophosphatemia and various clinical outcomes, including graft failure, all-cause mortality, cardiovascular mortality and CVD.&lt;/p&gt;&lt;p&gt;Three investigators (T.S., T.S., C.W.) independently searched publications indexed in PubMed and Embase databases from inception to March 27, 2024. Search terms were based on terms associated with “hypophosphatemia” and “kidney transplant.” No language restrictions were applied. The detailed search strategy is provided in Supplemental Material 1.&lt;/p&gt;&lt;p&gt;Eligible studies must include a cohort of KT patients with hypophosphatemia and a comparator cohort of KT patients without hypophosphatemia, excluding those with hyperphosphatemia. These studies should compare the risk of incident clinical outcomes, including all-cause mortality, cardiovascular mortality, CVD, and graft failure. Effect estimates and 95% confidence intervals (CIs) representing the risk ratio of incident outcomes between KT patients with and without hypophosphatemia must be reported. Studies that reported the association between serum phosphate as a continuous variable and clinical outcomes were deemed ineligible, as this association may be influenced by the effect of hyperphosphatemia.&lt;/p&gt;&lt;p&gt;The eligibility of the retrieved articles was evaluated by three investigators (P.Y., N.X., P.W.). Any discrepancies in evaluation were resolved through discussions with the senior investigator (N.C.). The quality of each study was assessed by two investigators (N.C. and P.Y.) using the Newcastle-Ottawa Quality Assessment Scale (NOS) for cohort studies.&lt;/p&gt;&lt;p&gt;Meta-analyses were performed for outcomes reported by at least four studies. Effect estimates with standard errors were extracted from each included study. The extracted data were combined together using the generic inverse variance method as described by DerSimonian and Laird. Since t","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424290","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":"Sodium Characteristic Curve Predicts Mortality Risk in Hospitalized Patients: A Retrospective Cohort Study","authors":"Siyu Liang,&nbsp;Lize Sun,&nbsp;Nan Jiang,&nbsp;Yuelun Zhang,&nbsp;Hanze Du,&nbsp;Shi Chen,&nbsp;Hui Pan","doi":"10.1111/jebm.12676","DOIUrl":"https://doi.org/10.1111/jebm.12676","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389179","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}