Systematic Reviews最新文献

{"title":"How can interprofessional collaboration be fostered and sustained in team-based care integration for older people in community settings? A realist evidence synthesis.","authors":"Deirdre O'Donnell, Carmel Davies, Catherine Devaney, Apolonia Radomska, Marie O'Shea, Gráinne O'Donoghue, Aoife De Brún, Sarah Donnelly, Helen Whitty, P J Harnett, Deirdre Lang, Emer Ahern, Sahar Hammoud, Éidín Ní Shé","doi":"10.1186/s13643-025-02862-8","DOIUrl":"https://doi.org/10.1186/s13643-025-02862-8","url":null,"abstract":"<p><strong>Background: </strong>Community-centred care integration for older adults is a cornerstone of the WHO's Integrated Care for Older People (ICOPE) implementation framework. Realising the potential of care integration for older people requires cohesive coordination of services and interprofessional collaboration (IPC) within and across teams. There is a gap in research evidence to understand how IPC can be fostered and sustained within team-based community care integration for older people. We report on a realist evidence synthesis to identify the contextual influences and mechanisms that support IPC in interprofessional community care teams for older people.</p><p><strong>Methods: </strong>The three phases of the realist synthesis included an exploratory scoping of research evidence and consultation with four local stakeholder groups to produce initial programme theories. The second phase involved systematic retrieval and synthesis of evidence, including peer-reviewed published empirical studies and grey literature recommended by an expert panel. The third phase involved the development of refined programme theory with stakeholder validation. The stakeholder cohorts included representatives of older people and caregivers, healthcare professionals and operational managers of community specialist older person teams, national policymakers, and programme managers.</p><p><strong>Results: </strong>The resource and reasoning mechanisms that enable contexts for IPC and their associated outcomes are identified within seven programme theory areas: (1) professional identity and growth, (2) information sharing and care coordination across boundaries, (3) effective operational and clinical governance, (4) developing a team learning culture, (5) meaningful inclusion of older people and caregivers, (6) quality improvement and programme development, (7) workforce planning and retention.</p><p><strong>Conclusions: </strong>The results provide policymakers and clinicians with evidence-based programme theory that will catalyse critical dialogue on IPC implementation. This programme theory informs the prioritisation of resources to enable favourable contexts for successful IPC intervention development and implementation. This research complements and expands the work presented in the WHO ICOPE implementation framework. We encourage local realist application and evaluation of the programme theory within varying health system contexts.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"117"},"PeriodicalIF":6.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full-thickness skin graft versus split-thickness skin graft for fasciocutaneous radial forearm free flap donor site closure: a systematic review and meta-analysis.","authors":"Jasper J E Moors, Zhibin Xu, Kunpeng Xie, Ashkan Rashad, Oliver Vladu, Jan Egger, Rainer Röhrig, Frank Hölzle, Behrus Puladi","doi":"10.1186/s13643-025-02863-7","DOIUrl":"https://doi.org/10.1186/s13643-025-02863-7","url":null,"abstract":"<p><strong>Background: </strong>The radial forearm free flap (RFFF) is widely used in microvascular reconstructions. However, donor site morbidity remains a concern, with complications such as wound healing issues, functional impairments, and aesthetic concerns. While both full-thickness skin grafts (FTSG) and split-thickness skin grafts (STSG) are commonly used for donor site closure, there is insufficient evidence to determine which technique leads to fewer complications. This study aims to systematically compare FTSG and STSG in RFFF donor site closure.</p><p><strong>Methods: </strong>We searched six databases and four clinical trial registries up to 1 March 2025. We focused on studies comparing FTSG and STSG. Primary outcome was the incidence of wound complications. Secondary outcomes included functional and aesthetic impairment. Risk of bias was assessed using the Risk Of Bias In Non-Randomized Studies-of Interventions (ROBINS-I) and quality of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Fifteen studies were analyzed, involving 933 donor site closures. No RCTs met our inclusion criteria. Meta-analysis comparing FTSG versus STSG revealed no significant differences in major wound complications (RR 0.43; 95% CI 0.11 to 1.70; p = 0.23) and minor wound healing complications (RR 0.83; 95% CI 0.60 to 1.13; p = 0.23), with the evidence graded as low to very low certainty.</p><p><strong>Conclusion: </strong>Current evidence does not conclusively favor either FTSG or STSG for radial forearm free flap donor site closure regarding wound, functional, or aesthetic outcomes. Future well-designed RCTs are needed to provide higher-quality evidence to guide clinical decision-making. Until more robust evidence becomes available, the optimal skin graft choice should be guided by patient-specific factors, surgical considerations, and donor site characteristics.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023351903.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"118"},"PeriodicalIF":6.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-intensity interval training and strength conditioning in patients with chronic lymphocytic leukemia: a systematic review.","authors":"Pedro M P Cunha, Ricardo J Ribeiro, Andreia Pizarro, Jorge Mota, Jose C D Ribeiro","doi":"10.1186/s13643-025-02764-9","DOIUrl":"10.1186/s13643-025-02764-9","url":null,"abstract":"<p><strong>Background: </strong>This systematic review explores the impact of physical exercise on chronic lymphocytic leukemia (CLL) patients' physical fitness, immunologic, and quality of life outcomes.</p><p><strong>Methods: </strong>Eligible studies were searched in PubMed and Web of Science up to February 2024 and were included if they involved participants in adult age, with confirmed CLL diagnose, using physical activity protocols with study design helding intervention protocols, clinical trials, or quantitative data reporting. Bias was assessed with ROBINS-I and RoB2 tools from Cochrane. The results are presented in tables and figures. A qualitative synthesis describes the main outcomes of the included studies. Meta-analysis was not performed due to significant heterogeneity.</p><p><strong>Results: </strong>This review identifies 92 studies, with 6 meeting the inclusion criteria, with a sample size of 323 patients. These studies focus on cardiovascular training combined with resistance training (four studies with total sample of 177 patients), continuous cardiovascular training (one study with 122 patients), and endurance resistance training (one study with 24 patients), highlighting the importance of physical exercise in CLL patients before treatment, with significant improvements in physical fitness and immunologic parameters on intervention groups.</p><p><strong>Discussion: </strong>The paucity regarding exercise influence on CLL, with small samples of patients in pilot study experiments, noted that exercise plays a vital role in improving physical fitness and immunologic parameters. However, none addressed strength training, which is known as one of the best options to increase muscular mass in physical activity interventions. The inconsistency of intervention and/or evaluation protocols ravels the advice of exercise and medical professionals on prescribing different modes of exercise, improving compliance with the prescribed exercise program, and determining which intervention in the context of exercise prescription should be used. More studies are needed to evaluate the impact of physical activity on the health-related quality of life and life span of the CLL patient.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023464877.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"116"},"PeriodicalIF":6.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Place-based approaches to improve the mental health and wellbeing of children and young people: a rapid realist review.","authors":"Anna March, Kate Allen, Karuna Davies, Julie Harris, Alison Bethel, Laura Kennedy, Tamanna Malhotra, Rachael Stemp, Bianca Alexandrescu, Tim Hobbs, Peter Fonagy, Steve Pilling, Vashti Berry","doi":"10.1186/s13643-025-02838-8","DOIUrl":"10.1186/s13643-025-02838-8","url":null,"abstract":"<p><strong>Background: </strong>Adolescent mental health continues to be a pressing public health concern across the globe, in spite of renewed efforts in recent years to improve mental health and wellbeing outcomes. With many mental health services and systems ill-equipped to meet young people's needs, there is growing evidence that prevention interventions addressing the social and structural determinants of mental health should be prioritised. Consequently, there is a move away from isolated interventions towards 'place-based approaches' that aim to unlock systemic or structural change. However, there is limited evidence on how these approaches create change and the different contextual factors or underlying mechanisms that influence outcomes. This is the first realist review on place-based approaches to improve young people's mental health.</p><p><strong>Methods: </strong>This rapid realist review synthesises relevant literature on place-based approaches to improve the mental health and wellbeing of children and young people. The review involved consultation with programme developers, an expert panel of content specialists and a Young Person's Advisory Group. Online databases were searched for peer-reviewed and grey literature published between January 2000 and August 2023, resulting in 5685 articles.</p><p><strong>Results: </strong>Fifteen articles from eight countries were included in the review, from which 11 realist context-mechanism-outcome configurations (CMOCs) were developed to explain the underlying mechanisms present in the place-based approaches. These CMOCs were categorised into three themes: (1) Building relationships and trust, (2) bringing a social determinants lens, and (3) educating and empowering community stakeholders.</p><p><strong>Conclusions: </strong>This review provides valuable insights into the mechanisms underpinning place-based approaches. However, the mechanisms identified primarily address the intermediate outcomes of place-based approaches, such as engaging the right stakeholders and creating opportunities for youth voices to be heard. Articles did not address the challenges around long-term sustainability and there remain crucial questions around the pathway to wider systemic change. Recommendations are included for future development and evaluation of place-based approaches to improve young people's mental health.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023450778.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"115"},"PeriodicalIF":6.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal daratumumab-based regimen for patients with newly diagnosed and previously untreated multiple myeloma: systematic review and component network meta-analysis.","authors":"Xiaohua Huang, Jia Zhou, Yuxiao Qian, Jing He, Lu Yang, Zhigang Wang, Diu Wei, Mengjie Li, Wei Ma, Haiyan Lang","doi":"10.1186/s13643-025-02804-4","DOIUrl":"10.1186/s13643-025-02804-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Daratumumab (Dara)-based regimens have been investigated in randomized controlled trials (RCTs) involving patients with newly diagnosed and previously untreated multiple myeloma (NDMM), but the optimal daratumumab-based regimen remains unclear. This study compares the efficacy of daratumumab-containing regimens for NDMM patients and explores optimal combinations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Databases were searched from inception until February 29, 2024. Trials comparing regimens with and without daratumumab, as well as their mutual comparisons, were included. Random effects models for serious adverse events (SAEs) and fixed effects models for other outcomes were utilized in both network meta-analysis (NMA) and component NMA (CNMA), with pooled effects estimated. The efficacy of all possible combinations of daratumumab with other drugs was assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 17 trials were included, enrolling 7261 patients, of whom 2083 were treated with daratumumab. The optimal regimens for different outcomes were identified as follows: Dara-bortezomib (V)-melphalan (M)-corticosteroids (D) (Dara-VMD) showed the best results for both overall response rate (ORR) [RR = 1.97; 95% CI: 1.42 to 2.75; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 16 trials; 7136 participants; P = 0.00] and ≥ very good partial response (≥ VGPR) [RR = 7.46; 95% CI: 4.10 to 13.46; I&lt;sup&gt;2&lt;/sup&gt; = 23.96%; 16 trials; 7118 participants; P = 0.00]; Dara-V-thalidomide (T)-D (Dara-VTD) was optimal for achieving ≥ complete response (≥ CR) [RR = 14.15; 95% CI: 3.74 to 53.52; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 17 trials; 7261 participants; P = 0.00]. The individual effects of daratumumab were calculated as follows: [ORR: RR = 1.14; 95% CI: 1.08 to 1.21; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 16 trials; 7136 participants; P = 0.00; ≥ VGPR: RR = 1.46; 95% CI: 1.36 to 1.58; I&lt;sup&gt;2&lt;/sup&gt; = 23.96%; 16 trials; 7118 participants; P = 0.00; ≥ CR: RR = 1.77; 95% CI: 1.55 to 1.99; I&lt;sup&gt;2&lt;/sup&gt; = 0.00; 17 trials; 7261 participants; P = 0.00; progression-free survival (PFS): hazard ratio (HR) = 0.53; 95% CI: 0.43 to 0.65; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 13 trials; 5977 participants; P = 0.00; overall survival (OS): HR = 0.68; 95% CI: 0.58 to 0.79; I&lt;sup&gt;2&lt;/sup&gt; = 28.97%; 12 trials; 5977 participants; P = 0.00]. Additionally, the optimal regimens for PFS and OS were Dara-lenalidomide (R)-D [HR = 0.37; 95% CI: 0.23 to 0.61; I&lt;sup&gt;2&lt;/sup&gt; = 0.00%; 13 trials; 5977 participants; P = 0.00] and Dara-VRD [HR = 0.40; 95% CI: 0.19 to 0.85; I&lt;sup&gt;2&lt;/sup&gt; = 28.97%; 12 trials; 5977 participants; P = 0.02], respectively. Finally, CNMA indicated that Dara-VRD, Dara-carfilzomib (K)-RD, Dara-RD, and Dara-cyclophosphamide (C)-RD were four regimens, which could improve remission rate, and reduce death or progression during induction and prolong lifetime.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Dara-VRD, Dara-KRD, Dara-RD, and Dara-CRD are optimal daratumumab-based regimens for patients with newly diagnosed and previously ","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"113"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deficiency of B vitamins in women of childbearing age, pregnant, and lactating women in Brazil: a systematic review.","authors":"Tatiane Salgado Galvão de Macedo, Michel Carlos Mocellin, Simone Augusta Ribas, Michelle Teixeira Teixeira, Alessandra da Silva Pereira, Gabriel Montalvão Palermo, Cintia Chaves Curioni","doi":"10.1186/s13643-025-02861-9","DOIUrl":"10.1186/s13643-025-02861-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the prevalence of B-complex vitamin deficiencies in Brazilian women of childbearing age, pregnant women, and lactating women.</p><p><strong>Methods: </strong>This systematic review analyzed cross-sectional and cohort studies published up to August 2023 and indexed in MEDLINE, SciELO, LILACS, Scopus, Embase, Web of Science, and the Brazilian Digital Library of Theses and Dissertations. Additional data were obtained by contacting researchers from Brazilian public universities. Studies assessing deficiency rates using biochemical markers were included. Two reviewers independently selected studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute tool.</p><p><strong>Results: </strong>Of the 3772 records identified, 13 studies were included. Only folate (n = 13), B12 (n = 11), and B6 (n = 1) deficiencies were investigated, and all studies were cross-sectional. B12 deficiency prevalence varied widely, reaching up to 29.4%. Folate deficiencies were generally low, with only one study reporting a rate as high as 37%. Other B-complex vitamins were insufficiently studied. Most studies had methodological limitations, particularly small sample sizes. The significant heterogeneity across studies limited the feasibility of a pooled quantitative meta-analysis.</p><p><strong>Conclusion: </strong>There is a clear need for more robust studies across all Brazilian regions to improve understanding of vitamin deficiency rates and to support effective nutritional interventions.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42020188474.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"111"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social prescribing for people living with long-term health conditions: a scoping review.","authors":"Anna Wilson, Helen Noble, Karen Galway, Julie Doherty","doi":"10.1186/s13643-025-02848-6","DOIUrl":"10.1186/s13643-025-02848-6","url":null,"abstract":"<p><strong>Introduction: </strong>Social prescribing links people to activities and services typically provided by local voluntary and community sectors to address social determinants of health and wellbeing. People living with long-term health conditions are a target population. This relatively new approach is rapidly expanding, and there is varied evidence regarding how social prescribing is being delivered for people living with long-term conditions. This scoping review aims to report on what is known about the approach for these patient populations.</p><p><strong>Methods: </strong>Electronic databases MEDLINE, CINAHL, Scopus, Web of Science, and PsycINFO were searched in December 2023, and relevant sources of gray literature in January 2024, with both updated in February 2025. Studies eligible for inclusion included adults (18 +) with long-term conditions engaging with social prescribing in health and community contexts. Studies published in English in any year were included. A data charting template captured key characteristics including reasons for referral, referral pathways, activities and services being utilized, and outcome measures. A descriptive narrative synthesis was conducted, guided by the review questions to explore the current evidence.</p><p><strong>Results: </strong>Thirty-seven sources of evidence were included. Diabetes was the most common of 65 conditions identified (n = 23). The presence of a long-term condition was the most frequent reason for referral (n = 30), followed by mental health concerns (n = 15), and social isolation or loneliness (n = 11). Most referrals were made within primary care (n = 33), to a link worker or social prescriber (n = 29), who supported participants to access activities and services including exercise (n = 22), information, support, and advice (n = 19), mental health support (n = 15), social and leisure activities (n = 15) and condition-specific support (n = 14). Wellbeing was the most commonly identified measured outcome (n = 23), with studies utilizing the Warwick Edinburgh Mental Wellbeing Scales (n = 7) and Wellbeing Star (n = 7) most frequently.</p><p><strong>Conclusions: </strong>While common factors were identified, there is considerable variation in social prescribing approaches for people living with long-term conditions, reflecting the diversity of needs, availability of community services, and necessity for personalized care. Further research is needed to inform the development of evidence-based practice which addresses the complex needs of diverse patient populations and supports access to a broad range of referral pathways.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"114"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best evidence toolkits: a case study on interventions for preventing violence against women and girls (VAWG).","authors":"Michelle Richardson, Theo Lorenc, Katy Sutcliffe, Amanda Sowden, James Thomas","doi":"10.1186/s13643-025-02798-z","DOIUrl":"10.1186/s13643-025-02798-z","url":null,"abstract":"<p><p>Research teams report challenges in conducting overviews and many of these relate to the synthesis of outcome data from multiple reviews that lead to unclear evidence. This limits research from being used by policymakers and other review users who need accessible robust evidence. In this commentary, we present a case study on creating a toolkit of interventions for preventing violence against women and girls (VAWG). This toolkit is underpinned by systematic methods and a priori criteria that identify a single best up-to-date systematic review of each subtopic. The best evidence toolkit approach does not require the synthesis of multiple reviews and produces clear, standardised evidence across subtopics efficiently. This approach offers a pragmatic alternative to overviews when presenting a broad spectrum of intervention approaches, populations or outcomes. This approach may be particularly beneficial when the primary aim is to communicate with policymakers.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"112"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods and validity indicators for measuring adherence to statins in secondary cardiovascular prevention: a systematic review.","authors":"Adriana López-Pineda, María Martinez-Muñoz, Rauf Nouni-García, Amanda Esquerdo-Arroyo, Álvaro Carbonell-Soliva, Elizabeth Ramirez-Familia, Mª Isabel Tomás-Rodríguez, Jose A Quesada, Concepción Carratalá-Munuera C, Vicente F Gil-Guillén","doi":"10.1186/s13643-025-02853-9","DOIUrl":"10.1186/s13643-025-02853-9","url":null,"abstract":"<p><strong>Background: </strong>Adherence to statin therapy is crucial for reducing the recurrence of cardiovascular events. Numerous methods exist to measure medication adherence, including those based on prescription data, patient self-report, medication counting, and direct methods. It is important to determine which of these methods are appropriate for use in clinical practice. This systematic review aimed to identify the methods used to measure adherence and persistence to statins in patients undergoing cardiovascular secondary prevention and to evaluate the validity indicators of these methods.</p><p><strong>Methods: </strong>This systematic review included studies reporting methods to measure adherence and/or persistence to statins in cardiovascular secondary prevention. Medline, Embase, and Scopus databases were searched from inception to February 2025. Rayyan was used for the study selection and extraction data processes. Validity indicators of the adherence/persistence methods were collected; it was reported. Risk of bias of studies reporting the method validity was evaluated using the COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) tool.</p><p><strong>Results: </strong>A total of 77 studies were included. Regarding adherence measurement, the most frequently used method was prescription refill records (n = 55) and self-report methods (n = 20). Electronic monitoring methods (n = 2), self-perceived adherence by physician (n = 1), and pill counting (n = 1) were less frequently used methods. Direct methods, using HPLC-MS/MS, were used in combination with other indirect methods (n = 5). For measuring persistence, prescription refill records were the predominant method (n = 9), while self-report methods were used in three studies, and one study used a standardized questionnaire. Several of the indirect methods have validity indicators for measuring adherence in different study populations and to different medications. Only one study provides validity indicators for the MAT questionnaire specifically adapted for statins.</p><p><strong>Conclusions: </strong>The methods for measuring adherence to statins in secondary cardiovascular prevention were predominantly indirect, relying on prescription and supply records and self-report methods. Pill counting, electronic monitoring, and direct measurement via LC-MS/MS were less commonly used. Persistence was primarily measured through prescription refill records. None of the indirect methods was validated; thus, their use for measuring adherence to statins is not recommended. There is a need for new validated tools, incorporating a gender perspective, to measure adherence to statins in this population.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023463981.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"110"},"PeriodicalIF":6.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing cancer diagnosis and dose biodistribution: a meta-analysis of [68ga] FAPI- 46 vs. [18f] FDG imaging.","authors":"Samaneh Abbasi, Mohsen Dehghani, Sara Khademi, Rasoul Irajirad, Zahra Pakdin Parizi, Mahdieh Sahebi, Masoumeh Sadeghi, Alireza Montazerabadi, Meysam Tavakoli","doi":"10.1186/s13643-025-02835-x","DOIUrl":"https://doi.org/10.1186/s13643-025-02835-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Advancements in novel peptides significantly affect cancer diagnosis by targeting cancer-specific markers, thereby improving imaging modalities, such as positron emission tomography combined with computed tomography (PET/CT) for more accurate tumor detection. This systematic review and meta-analysis aimed to assess the diagnostic accuracy of [18F] Fluorodeoxyglucose (FDG) and &lt;sup&gt;68&lt;/sup&gt;Ga-fibroblast activation protein inhibitor (FAPI- 46) PET/CT for early cancer detection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search was conducted in Scopus, MEDLINE, Web of Science, and Embase databases up to March 28, 2024, using MeSH keywords. Titles and abstracts were screened to identify studies on hybrid [68Ga] FAPI- 46 and [18F] FDG, followed by a detailed full-text evaluation. Only cohort or cross-sectional studies published in English, focusing on the clinical diagnosis of cancer patients, were included, while reviews, case reports, conference proceedings, and abstracts were excluded. Random-effects meta-analysis was used for the estimation of pooled specificity and sensitivity with 95% confidence intervals (CIs). In addition, the heterogeneity was assessed across studies and subgroup meta-analyses for the detection rate via Stata.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 615 retrieved studies, nine articles were incorporated in the present systematic review, with five (n = 144 patients) eligible for meta-analysis. For [68Ga] FAPI- 46, the pooled sensitivity and specificity compared with immunohistopathology were 0.96 (95% CI 0.84, 0.99) and 0.92 (95% CI 0.53, 0.99), respectively, with a positive likelihood ratio (LR +) of 4.41 (95% CI 1.64, 11.79) and a negative likelihood ratio (LR -) of 3.07 (95% CI 1.01, 9.37). For [18F] FDG, pooled sensitivity and specificity compared with immunohistopathology were 0.73 (95% CI 0.34, 0.93) and 0.83 (95% CI 0.57, 0.95), with an LR + of 12.73 (95% CI 1.43, 113.45) and an LR - of 0.32 (95% CI 0.11, 0.17). The pooled odds ratio for the detection rate on a per-lesion basis was 1.73 (95% CI 0.99, 3.02) for [68Ga] FAPI- 46 compared with [18F] FDG. The pooled weighted mean differences in the standardized uptake value (SUV&lt;sub&gt;max&lt;/sub&gt;) for primary tumor uptake and the tumor-to-background ratio (TBR) in [68Ga] FAPI- 46 vs. 18F-FDG were 4.40 (95% CI - 0.7, 9.5) and 6.18 (95% CI 1.74, 10.61), respectively. Moderate to high heterogeneity was noted because of the variations in patient selection, interpretation criteria, and scanning procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study revealed that [68Ga] FAPI- 46 outperforms [18F] FDG in cancer diagnosis, with higher sensitivity (0.96 vs. 0.73) and specificity (0.92 vs. 0.83). [Ga] FAPI- 46 improved tumor detection with higher SUVmax and TBR. While FDG had a higher LR +, its lower LR - highlighted more false negatives. Accordingly, [68Ga] FAPI- 46 exhibited superior accuracy and reliability than FDG in cancer diagnosis.&lt;/p&gt;&lt;p&gt;","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"109"},"PeriodicalIF":6.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}