Journal of Evidence‐Based Medicine最新文献

{"title":"Comparison of 11 Formulas and Breastfeeding for Atopic Dermatitis and Growth in Pediatric Cow's Milk Protein Allergy: A Systematic Review and Network Meta-Analysis of 23 Randomized Controlled Trials","authors":"Tengfei Li, Qingyong Zheng, Jianguo Xu, Yiyi Li, Mingyue Zhang, Bowa Zhang, Li Zhou, Jinhui Tian","doi":"10.1111/jebm.70026","DOIUrl":"https://doi.org/10.1111/jebm.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the effectiveness of various formulas and the ability of breastfeeding with the exclusion of cow milk protein to reduce the Scoring Atopic Dermatitis (SCORAD) index and promote growth in infants with cow milk protein allergy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic search of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure, WanFang Data, Weipu, and the China Biomedical Literature Database. The search period ranged from the inception of each database to December 2023 (with an update until January 15, 2025). We included randomized controlled trials (RCTs) comparing formulas and breastfeeding for cow's milk protein allergy in infants. Two independent reviewers extracted data via standardized methods and assessed the risk of bias via the revised Cochrane risk-of-bias 2.0 tool. We performed a network meta-analysis (NMA) via a Bayesian fixed-effects model in RStudio and assessed the certainty of the evidence via the Confidence in Network Meta-Analysis (CINeMA) online application. The protocol for this NMA was preregistered in PROSPERO (No. CRD42024504707).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This analysis included 23 RCTs involving 1997 children and assessed 12 interventions. Compared with the regular formula, the pectin-thickened amino acid formula (TAAF) might reduce the SCORAD index (−12.49, 95% confidence interval [CI] −20.38 to −4.48, low certainty). At ≤6 months of follow-up, compared with rice-hydrolyzed formula (RHF), breastfeeding might improve the length-for-age <i>Z</i> score (LAZ) (0.47, 95% CI 0.13–0.81, moderate certainty), and breastfeeding (0.39, 95% CI 0.02–0.77, low certainty) and extensively hydrolyzed formula (EHF) with probiotics (0.38, 95% CI 0.00–0.77, low certainty) might respectively improve the weight-for-age <i>Z</i> score (WAZ) and weight-for-length <i>Z</i> score (WLZ). At the 12-month follow-up, EHF might improve the LAZ (0.41, 95% CI 0.11–0.71, low certainty) and WLZ (0.37, 95% CI 0.18–0.56, low certainty) compared with RHF, whereas the amino acid formula (AAF) may improve the WAZ (0.33, 95% CI 0.02–0.63, low certainty).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Low-certainty evidence suggested that TAAF might reduce the SCORAD index. Moderate or low certainty evidence indicated that, at ≤6 months of follow-up, breastfeeding might improve the LAZ and WAZ, whereas EHF with probiotics might improve the WLZ. At the 12-month follow-up, EHF might improve the LAZ and WLZ, whereas AAF might imp","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770315","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":"Development and Performance of a Large Language Model for the Quality Evaluation of Multi-Language Medical Imaging Guidelines and Consensus","authors":"Zhixiang Wang,&nbsp;Jing Sun,&nbsp;Hui Liu,&nbsp;Xufei Luo,&nbsp;Jia Li,&nbsp;Wenjun He,&nbsp;Zhenhua Yang,&nbsp;Han Lv,&nbsp;Yaolong Chen,&nbsp;Zhenchang Wang","doi":"10.1111/jebm.70020","DOIUrl":"https://doi.org/10.1111/jebm.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to develop and evaluate an automated large language model (LLM)-based system for assessing the quality of medical imaging guidelines and consensus (GACS) in different languages, focusing on enhancing evaluation efficiency, consistency, and reducing manual workload.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We developed the QPC-HASE-GuidelineEval algorithm, which integrates a Four-Quadrant Questions Classification Strategy and Hybrid Search Enhancement. The model was validated on 45 medical imaging guidelines (36 in Chinese and 9 in English) published in 2021 and 2022. Key evaluation metrics included consistency with expert assessments, hybrid search paragraph matching accuracy, information completeness, comparisons of different paragraph matching approaches, and cost-time efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The algorithm demonstrated an average accuracy of 77%, excelling in simpler tasks but showing lower accuracy (29%–40%) in complex evaluations, such as explanations and visual aids. The average accuracy rates of the English and Chinese versions of the GACS were 74% and 76%, respectively (<i>p</i> = 0.37). Hybrid search demonstrated superior performance with paragraph matching accuracy (4.42) and information completeness (4.42), significantly outperforming keyword-based search (1.05/1.05) and sparse-dense retrieval (4.26/3.63). The algorithm significantly reduced evaluation time to 8 min and 30 s per guideline and reduced costs to approximately 0.5 USD per guideline, offering a considerable advantage over traditional manual methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The QPC-HASE-GuidelineEval algorithm, powered by LLMs, showed strong potential for improving the efficiency, scalability, and multi-language capability of guideline evaluations, though further enhancements are needed to handle more complex tasks that require deeper interpretation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770316","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 the Artificial Intelligence Method and System for “Multiple Diseases Holistic Differentiation” in Traditional Chinese Medicine and Its Interpretability to Clinical Decision","authors":"Zhe Chen,&nbsp;Dong Zhang,&nbsp;Pengfei Nie,&nbsp;Guanhao Fan,&nbsp;Zhiyuan He,&nbsp;Hui Wang,&nbsp;Chenyue Zhang,&nbsp;Fengwen Yang,&nbsp;Chunxiang Liu,&nbsp;Junhua Zhang","doi":"10.1111/jebm.70016","DOIUrl":"https://doi.org/10.1111/jebm.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The development of artificial intelligence (AI) for traditional Chinese medicine (TCM) has played an important role in clinical decision-making, mainly reflected in the intersectionality and variability of symptoms, syndromes, and patterns for TCM multiple diseases holistic differentiation (MDHD). This study aimed to develop a TCM AI method and system for clinical decisions more transparent with explainable structural framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study developed the TCM syndrome elements integration with priori rule and deep learning (TCM-SEI-RD) method and TCM-MDHD system by high-quality expert knowledge datasets, to predict various TCM syndromes and patterns in hierarchical modules. TCM-BERT-CNN model fused the BERT with CNN model capture feature-related sequence, as the benchmark model in the TCM-SEI-RD method, to improve the performance of predicting TCM syndrome elements. The framework of the TCM-MDHD system involved the TCM-SEI-RD method and TCM “diseases—syndromes—patterns” benchmark sequences, to provide distributed results with credibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For predicting results to the overall TCM syndrome elements, the TCM-SEI-RD achieves 95.4%, 94.43%, and 94.89% in precision, recall, and <i>F</i>1 score, respectively, and 3.33%, 2.28%, and 2.81% improvement over the benchmark model. TCM-MDHD system demonstrates credibility grading at each stage in various diseases and uses the practical example to illustrate the process of distributed decision-making results and transparency with credibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our method and system, as the general AI technologies for TCM syndromes and patterns diagnosis in multiple diseases, can provide the clinical diagnostic basis with the best performance for the TCM preparations rational use, and distribute interpretability to the clinical decision-making process.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761883","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":"Expert Consensus on Perioperative Physician–Pharmacist Airway Co-Management","authors":"Dongmei Meng,&nbsp;Yuan Qiu,&nbsp;Shiyue Li,&nbsp;Jun Liu,&nbsp;Lunxu Liu,&nbsp;Qiang Pu,&nbsp;Zhen You,&nbsp;Lan Lan,&nbsp;Dehui Chen,&nbsp;Guoying Wang,&nbsp;Ping Wang,&nbsp;Xiaowen Zhang,&nbsp;Hui Xie,&nbsp;Yuwen He,&nbsp;Suzhen He,&nbsp;Zhihua Zheng,&nbsp;Li Wei,&nbsp;Jun Zhao,&nbsp;Jianguo Zhu,&nbsp;Hui Tian,&nbsp;Anchang Liu,&nbsp;Chuangqi Chen,&nbsp;Kejing Tang,&nbsp;Gening Jiang,&nbsp;Yuping Li,&nbsp;Gang Jin,&nbsp;Zheng Jiao,&nbsp;Jian Hu,&nbsp;Sheng Yan,&nbsp;Haibin Dai,&nbsp;Qiang Zhang,&nbsp;Yong Cui,&nbsp;Xingang Li,&nbsp;Zhigang Zhao,&nbsp;Daqiang Sun,&nbsp;Libing Ma,&nbsp;Yingtong Zeng,&nbsp;Dan Guo,&nbsp;Lei Zhang,&nbsp;Li Wei,&nbsp;Jianxing He","doi":"10.1111/jebm.70008","DOIUrl":"https://doi.org/10.1111/jebm.70008","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Airway management during the perioperative period is a vital component of perioperative care. However, there is a lack of consensus on the selection of medications, timing of administration, and the management of airway complications. This consensus aimed to promote a more rational and standardized application of airway management medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical medical and pharmaceutical experts were invited to participate in this study using the modified Delphi method. Participants completed two rounds of online surveys, with the second round based on the responses from the first round.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 42) reached a consensus on 11 clinical issues and formed 11 recommendations for clinical practice, each with a consensus degree of more than 80%. The recommendations covered aspects of preoperative, intraoperative, and postoperative risk factors evaluation, along with crucial points of medication monitoring in preventing and treating perioperative pulmonary complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The modified Delphi method resulted in consensus recommendations for the perioperative physician–pharmacist airway co-management. We hope this consensus will prevent pulmonary complications and improve patient outcomes through collaborative discussions between physicians and pharmacists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741624","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":"New Icebergs in Evidence-Based Medicine","authors":"José Nunes de Alencar","doi":"10.1111/jebm.70028","DOIUrl":"https://doi.org/10.1111/jebm.70028","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726881","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":"Synthesizing Public Health Preparedness Mechanisms for High-Impact Infectious Disease Threats: A Jurisdictional Scan","authors":"KM Saif-Ur-Rahman,&nbsp;Nikita N. Burke,&nbsp;Lena Murphy,&nbsp;Randal Parlour,&nbsp;Máirín Boland,&nbsp;Petek Eylul Taneri,&nbsp;Bearach Reynolds,&nbsp;Mary Horgan,&nbsp;John N. Lavis,&nbsp;Declan Devane","doi":"10.1111/jebm.70019","DOIUrl":"https://doi.org/10.1111/jebm.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>High-impact infectious diseases pose major global health challenges, underscoring the urgent need for robust public health preparedness. Despite efforts to improve global health security, recent pandemics have revealed significant weaknesses in health systems’ preparedness and response capabilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed and synthesized key strategies and lessons from existing public health preparedness plans for high-impact infectious diseases. This included examining national and global plans, focusing on strategic approaches, evidence integration, and real-world implementation lessons. A narrative synthesis, based on the Public Health Emergency Preparedness (PHEP) model, identified effective practices and areas needing improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We screened 1987 documents, selecting 38 for detailed analysis. Findings highlighted strategies for long-term health emergency preparedness, workforce development, enhancing global health frameworks, and investing in infrastructure. Challenges included maintaining laboratory detection, managing sentinel surveillance, and logistical issues. Effective approaches emphasized early threat detection, rapid response, healthcare capacity, medical supply management, and strategic communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Effective public health preparedness for high-impact infectious diseases requires a coordinated approach, including early threat detection, rapid response, robust healthcare systems, and strategic communication. Past outbreaks show the need for continuous investment, evidence-based policies, and adaptable health systems. Future research should assess ongoing preparedness efforts and implementation challenges.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726908","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 Most Recent Research Advancements of AI in the Area of Evidence-Based Science: Analyses Based on the Global Evidence Summit 2024","authors":"Jie Zhang,&nbsp;Xufei Luo,&nbsp;Meihua Wu,&nbsp;Zijing Wang,&nbsp;Luyuan Sun,&nbsp;Shiyue Zhou,&nbsp;Qianling Shi,&nbsp;Yaolong Chen,&nbsp;the ADVANCED Working Group","doi":"10.1111/jebm.70027","DOIUrl":"https://doi.org/10.1111/jebm.70027","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698963","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":"From Manual to Machine: Revolutionizing Day Surgery Guideline and Consensus Quality Assessment With Large Language Models","authors":"Xingyu Wan,&nbsp;Ruiyan Wang,&nbsp;Junxian Zhao,&nbsp;Tianhu Liang,&nbsp;Bingyi Wang,&nbsp;Jie Zhang,&nbsp;Yujia Liu,&nbsp;Yan Ma,&nbsp;Yaolong Chen,&nbsp;Xinghua Lv","doi":"10.1111/jebm.70017","DOIUrl":"https://doi.org/10.1111/jebm.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the methodological and reporting quality of clinical practice guidelines/expert consensus for ambulatory surgery centers published since 2000, combining manual assessment with large language model (LLM) analysis, while exploring LLMs' feasibility in quality evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched Chinese/English databases and guideline repositories. Two researchers independently screened literature and extracted data. Quality assessments were conducted using AGREE II and RIGHT tools through both manual evaluation and GPT-4o modeling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>54 eligible documents were included. AGREE II domains showed mean compliance: Scope and purpose 25.00%, Stakeholder involvement 20.16%, Rigor of development 17.28%, Clarity of presentation 41.56%, Applicability 18.06%, Editorial independence 26.39%. RIGHT items averaged: Basic information 44.44%, Background 36.11%, Evidence 14.07%, Recommendations 34.66%, Review and quality assurance 3.70%, Funding and declaration and management of interests 24.54%, Other information 27.16%. LLMs'-evaluated documents demonstrated significantly higher scores than manual assessments in both tools. Subgroup analyses revealed superior quality in documents with evidence retrieval, conflict disclosure, funding support, and LLM integration (<i>P</i> &lt;0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current guidelines and consensus related to day surgery need to improve their methodological quality and quality of reporting. The study validates LLMs' supplementary value in quality assessment while emphasizing the necessity of maintaining manual evaluation as the foundation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689251","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":"AI-Empowered Evidence-Based Research and Clinical Decision-Making","authors":"Xufei Luo,&nbsp;Long Ge,&nbsp;Lu Zhang,&nbsp;Yaolong Chen,&nbsp;Liang Du,&nbsp;ADVANCED working group","doi":"10.1111/jebm.70014","DOIUrl":"https://doi.org/10.1111/jebm.70014","url":null,"abstract":"","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689317","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":"Medication Management in Patients With Polypharmacy in Primary Care: A Scoping Review of Clinical Practice Guidelines","authors":"Loes Engels,&nbsp;Marjan van den Akker,&nbsp;Petra Denig,&nbsp;Henri Stoffers,&nbsp;Heike Gerger,&nbsp;Jolijn Bohnen,&nbsp;Jesse Jansen","doi":"10.1111/jebm.70015","DOIUrl":"10.1111/jebm.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Inappropriate polypharmacy increases the risk of medication-related issues. Adequate management of polypharmacy is a challenge involving different healthcare professionals, complex decision-making and ideally including patient involvement. The objective of this scoping review was to provide an overview of national recommendations for medication management of patients with polypharmacy in primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review of clinical practice guidelines focusing on medication management in adults with polypharmacy, applicable to primary care was performed. Databases (G-I-N, Turning Research into Practice and PubMed), network, and a global report were screened for guidelines published after 2000 in English, Dutch, German, Spanish, French, or Russian. Raw data were extracted in duplicate using an extraction framework focusing on strategies, involvement of professionals, patient involvement, and implementation. Qualitative content analysis was used. Guideline quality was assessed using AGREE-II. The study was registered with the Open Science Framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight guidelines originating from eight countries were included. The most common recommended strategy was a medication review conducted by a general practitioner and/or a community pharmacist. Tasks and target population differed per guideline. Most guidelines recommended involving the patient in the process, mostly to elicit the patient's experiences and treatment goals. Few guidelines included advice on the implementation of recommendations. Three out of eight guidelines were of good quality (AGREE-II score &gt;70% in 5/6 domains).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most guidelines recommended a medication review, with patient involvement, as a strategy for medication management in polypharmacy in primary care. Guidance on task division and implementation of guidelines in practice was less clear. This review illustrates room for guideline improvements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16090,"journal":{"name":"Journal of Evidence‐Based Medicine","volume":"18 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663651","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}