Systematic Reviews最新文献

{"title":"Public preferences for allocating health system resources in Canada: a systematic review.","authors":"Shehzad Ali, Roxanne Garaszczuk, Jessica Moodie, Lauren Cipriano, Lina Ghattas, Samya Ali","doi":"10.1186/s13643-025-02864-6","DOIUrl":"10.1186/s13643-025-02864-6","url":null,"abstract":"<p><strong>Background: </strong>Conventional economic evaluations are based on the principle of health maximization. However, this approach does not consider societal preferences to prioritize health care for certain social groups and health conditions, and the public concern over health disparities. In recent years, equity-informative economic evaluation methods have been developed to incorporate societal concerns over for health inequities. These methods use quantitative evidence based on preference elicitation exercises to inform allocation of health system resources.</p><p><strong>Objective: </strong>To systematically review Canadian studies that quantify public preferences for allocating health care resource across social groups and health conditions.</p><p><strong>Methods: </strong>Three electronic databases were searched on January 1st, 2024: Ovid Embase, Ovid MEDLINE, and EBSCO EconLit. In addition, the reference lists of relevant papers were also scanned to detect any other suitable studies. The systematic review included studies that met the following criteria: they were survey-based, sampled Canadian residents and involved preference elicitation, where participants made decisions about resource allocation or responded to hypothetical scenarios about redistributing lifetime health. Qualitative studies and non-preference-based studies were excluded. Risk of Bias was assessed using the CLARITY Group's tool for evaluating cross-sectional surveys of attitudes and practices. Two reviewers conducted screening, full-text review, and data extraction. Studies were narratively synthesized.</p><p><strong>Results: </strong>Eight studies, with 8,969 participants, were identified that investigated public preferences for prioritizing health care in relation to age, income, disease rarity, and baseline health. Age-related preferences tended to favor children and younger patients over older patients. Aversion to socioeconomic-related health inequality was heterogeneous and was associated with respondent characteristics. No clear preference was found for treatments for rare diseases over common conditions, or for baseline quality of life and life expectancy. Two studies exposed participants to moral reasoning exercises that led to slightly lower levels of preference for prioritization of specific conditions or groups.</p><p><strong>Conclusion: </strong>While the identified studies in the review were heterogenous, they provide some evidence supporting the prioritization of healthcare resources for children and younger patients over older patients. There is limited Canadian evidence on societal values related to health inequity associated with socioeconomic status, sex/gender, race/ethnicity, and other social determinants of health. Future research can help bridge this gap.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"128"},"PeriodicalIF":6.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286555","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":"Which school-based interventions work better to combat obesity in children? A network meta-analysis.","authors":"Bahareh Nikooyeh, Zahra Yari, Zahra Hariri, Ghazal Baghdadi, Hootan Yazdani, Mohammad Esmail Motlagh, Tirang R Neyestani","doi":"10.1186/s13643-025-02871-7","DOIUrl":"10.1186/s13643-025-02871-7","url":null,"abstract":"<p><strong>Background: </strong>Adolescent obesity is linked to a higher risk of becoming obese adults and developing chronic diseases. School-based interventions, focusing on nutritional education and physical activity (PA), are crucial for preventing childhood obesity. This study aimed to evaluate the effectiveness of such interventions using network meta-analysis.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Web of Science, and the Cochrane Library for studies on school-based obesity interventions. Interventions included behavioral, nutritional, and physical activity components. Network meta-analysis (NMA) employed random-effects models, generating network plots. Surface under the cumulative ranking curve (SUCRA) ranked intervention efficacy.</p><p><strong>Results: </strong>Sixty-one studies were included. School-based interventions significantly reduced body mass index z-score (z-BMI; mean difference [MD]: - 0.06; 95% CI: - 0.1, - 0.03) and BMI (MD: - 0.351; 95% CI: - 0.566, - 0.135). NMA indicated that combined interventions, PA + health education (HE) + school policy (SP), were more effective in reducing BMI than HE alone (MD: - 0.61; 95% CI: - 1.2, - 0.02). SUCRA rankings highlighted PA + HE + SP and PA alone as the most effective interventions in reducing BMI and z-BMI, respectively.</p><p><strong>Conclusion: </strong>School-based interventions are effective long-term strategies for managing childhood obesity. Combining PA, HE, and SP showed the highest efficacy in reducing BMI. Meanwhile, intervention duration and parental involvement did not show any significant additional effect, necessitating further prospective studies.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"125"},"PeriodicalIF":6.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267259","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":"Post-abortion family planning use and its determinants among women who received abortion care in sub-Saharan Africa: a systematic review and meta-analysis.","authors":"Berihun Agegn Mengistie, Saron Abeje Abiy, Tazeb Alemu Anteneh, Solomon Berhe Wubneh, Fantahun Andualem, Mihret Melese, Elsa Awoke Fentie, Abebaw Setegn, Muluken Demeke, Gebeyehu Nigussie Amare, Gashaw Worku, Gizachew Aynalem Tegegne, Tilahun Nega Godana, Wondimnew Mersha Biset, Nuhamin Tesfa Tsega, Getie Mihret Aragaw","doi":"10.1186/s13643-025-02837-9","DOIUrl":"10.1186/s13643-025-02837-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Post-abortion family planning (PAFP) refers to the use of modern contraceptive methods, preferably immediately following an abortion and within 48 h of the abortion, or before fertility returns. It is highly recommended to delay pregnancy for at least 6 months following an induced or spontaneous abortion to reduce the occurrence of adverse maternal and neonatal outcomes. In sub-Saharan Africa (SSA), there is a high burden of unsafe abortions and an unintended pregnancy rate. Additionally, there are inconsistent study findings that have been done to investigate the prevalence and determinant factors of post-abortion family planning use in the region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review followed standard methods and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol for this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with reference number CRD42024518297. The eligible publications were searched by PubMed, Research4Life, Scopus, EMBASE, and Google Scholar. The data were extracted using Microsoft Excel 2019 and analyzed using Stata software version 17. The methodological quality of the included studies was assessed using the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist. Publication bias was assessed by using the funnel plot and Egger's test. A random-effects model was used to estimate the pooled prevalence of post-abortion family planning. The I&lt;sup&gt;2&lt;/sup&gt; test was performed to assess the statistical heterogeneity among the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This systematic review and meta-analysis included 80 eligible articles from 16 sub-Saharan African countries, with a total of 248,299 study participants. The pooled prevalence of post-abortion family planning use in sub-Saharan Africa was 60.67% (95% CI 55.61-65.73). In addition, the commonly adopted contraception methods after abortion were injectables, 34.98% (95% CI 27.59, 42.37), followed by 20.71% (95% CI 17.20, 24.22) of oral contraception pills, and 20.38% (95% CI 16.82, 23.94) utilized implants. Women aged 15-24 years (AOR = 3.40, 95% CI 2.12, 5.44), being married (AOR = 2.70, 95% CI 1.68, 4.34), attaining secondary school (AOR = 2.75, 95% CI 1.62, 4.66) and college or above (AOR = 2.92, 95% CI 1.85, 4.62), unplanned pregnancy (AOR = 5.03, 95% CI 2.93, 8.61), having prior history of abortion (AOR = 1.88, 95% CI 1.35, 2.62), having good knowledge about family planning (AOR = 2.86, 95% CI 2.37, 3.46), prior family planning use (AOR = 3.82, 95% CI 2.62, 5.58), positive attitude towards family planning methods (AOR = 2.78, 95% CI 1.81, 4.28), partner support (AOR = 2.32, 95% CI 1.64, 3.30), and received post-abortion family planning counseling (AOR = 2.86, 95% CI 2.37, 3.46) were predictors that significantly associated with contraceptive utilization following abortion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclus","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"126"},"PeriodicalIF":6.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267257","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":"Quality improvement needed for rapid review reports: a literature quality assessment based on Cochrane RR evidence-based methodology.","authors":"Donghua Yang, Yongjia Zhou, Xiao Tang, Tianyi Zhang, Yiyi Li, Jun Zhang, Jinhui Tian, Limei Yang","doi":"10.1186/s13643-025-02870-8","DOIUrl":"10.1186/s13643-025-02870-8","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to assess the reporting quality of rapid reviews (RRs) against the Cochrane Rapid Reviews Methodological Guidance to identify areas for improvement.</p><p><strong>Methods: </strong>A literature quality assessment was conducted through systematic searches in PubMed, the Cochrane Library, and Web of Science until February 28, 2023. An expert guided the search strategy, and the reporting quality of RRs was evaluated. Descriptive statistics were used to summarize reporting quality, and subgroup analyses were performed to examine differences between groups. Categorical variables were compared using the chi-square (χ²) test to identify statistically significant differences in reporting adherence across different subgroups.</p><p><strong>Results: </strong>Among the 112 rapid reviews analyzed, fewer than 50% fully reported four key methodological components: topic refinement with stakeholders, eligibility criteria co-definition, risk of bias assessment tools, and protocol/software reporting. Reports published after 2021 demonstrated slightly higher overall quality compared to those published before 2020, with significant improvements in protocol development (Item 2: χ² = 10.434, P < 0.0001), PICOS specification (Item 3: χ² = 5.378, P = 0.02), and protocol registration (Item 23: χ² = 6.638, P = 0.01). Cochrane Rapid Reviews (CRRs) achieved 100% compliance in several key areas, including setting restrictions with justification (Item 4: χ² = 52.923, P < 0.001) and study selection (Item 14: χ² = 14.897, P < 0.001). The impact of journal prestige was also evident: publications in high-impact factor (IF > 5) journals showed significantly better compliance in stakeholder involvement (Item 1: χ² = 8.856, P = 0.003) but comparable adherence to protocol registration (Item 23: ≤ 20.3%).</p><p><strong>Conclusions: </strong>While RR quality is improving post-2021, critical gaps persist in stakeholder engagement and protocol transparency. Mandatory adoption of Cochrane guidelines-particularly protocol registration (Item23) and dual data extraction (Item17)-should be prioritized in journal submission policies.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"127"},"PeriodicalIF":6.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267258","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":"Evidence map of nutrient interventions for major depression: a systematic review protocol.","authors":"Dongbo Zhang, Chenqi Li, Xue Tian, Gen Miao, Wenjing Shi, Hongtao Lu, Yicui Qu, Mengyu Cai, Yuxiao Tang, Hui Shen, Biao Gao","doi":"10.1186/s13643-025-02868-2","DOIUrl":"10.1186/s13643-025-02868-2","url":null,"abstract":"<p><strong>Background: </strong>Depression severely impacts quality of life globally. While traditional treatments show efficacy, many patients respond poorly. Nutritional interventions demonstrate potential as safe, economical adjunctive therapies. However, current evidence is scattered and heterogeneous, lacking systematic evaluation. This study aims to systematically evaluate evidence for various nutritional interventions in depression and create an evidence gap map (EGM).</p><p><strong>Methods: </strong>We will conduct a systematic review using the EGM approach. Major medical databases will be searched for relevant studies published up to present. Two independent researchers will screen literature, extract data, and assess evidence quality. Multiple tools will be used for quality assessment: Cochrane Risk of Bias Tool 2.0 for RCTs, ROBINS-I for non-RCTs, Newcastle-Ottawa Scale for observational studies. The GRADE system will be employed for overall evidence grading. EPPI-Reviewer Web will generate the EGM. We will analyze evidence distribution, time trends, and explore impacts of population characteristics and depression subtypes.</p><p><strong>Discussion: </strong>This study will provide critical methodological references for nutritional psychiatry. Expected results include identifying nutrient categories with robust antidepressant evidence, evaluating evidence distribution for different interventions, and exploring differential effects across populations and depression subtypes. Findings will inform individualized nutritional strategies, improve clinical guidelines, and potentially influence public health policies.</p><p><strong>Systematic review registration: </strong>CRD42024590644. Date of registration: 30/09/2024.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"124"},"PeriodicalIF":6.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258986","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":"Prevalence and molecular epidemiology of carbapenem resistance in Asia: a systematic review and meta-analysis.","authors":"Nishadi Jayathilaka, Sashini Shehana, Dilini Nakkawita, Thamarasi Senaratne","doi":"10.1186/s13643-025-02776-5","DOIUrl":"10.1186/s13643-025-02776-5","url":null,"abstract":"<p><strong>Background: </strong>Carbapenems are a group of last-resort antibiotics used to treat serious life-threatening infections. The emergence of resistance to carbapenems is a major public health threat. However, comprehensive information on the prevalence and molecular epidemiology of carbapenem resistance (CR) among Asian countries is lacking. Therefore, we aimed to determine the prevalence of CR and associated molecular determinants quantitatively among Asian countries.</p><p><strong>Methods: </strong>In this systematic review and meta-analysis, we searched published reports in electronic databases such as PubMed, ScienceDirect, the Cochrane Library, and Web of Science from 1^st of January 2014 to 31^st of January 2024 that fulfilled these criteria; original studies conducted in Asian countries including clinical isolates, and published in English. Data extraction and risk-of-bias assessment were performed by two independent reviewers. The pooled prevalence of CR with 95% confidence interval (CI) was computed with a random effects model. Heterogeneity across studies was determined by I². The geographical location, income level, publication year, and sample size were analyzed as subgroups.</p><p><strong>Results: </strong>We identified 2518 eligible studies, of which 37 assessed the CR prevalence data of 10,433 patients. The pooled prevalence (PPr) of CR was 31.3% (95% CI: 0.22 to 0.40; I² = 99.9%; P = 0.00). A trend of CR incidence was observed from 2004 to 2023, with PPr values ranging from 7.4% to 50.6%. A variation in the distribution of CR genes was observed, with bla_NDM being the most common gene, followed by bla_OXA and bla_KPC. Univariate meta-regression analysis indicated that geographical location, income level, publication year, and sample size did not significantly affect heterogeneity (P < 0.05).</p><p><strong>Conclusion: </strong>The results suggest that surveillance of CR among Asian countries is essential to reduce the burden of antibiotic resistance. Mitigating the impact of CR infections will safeguard the efficacy of carbapenems for future generations and reduce further dissemination of CR genes.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024515806.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"123"},"PeriodicalIF":6.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12139192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235308","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":"Government policy interventions to reduce veterinary antimicrobial consumption in production animals: a protocol for a systematic review and evidence map.","authors":"Kayla Strong, Fiona Emdin, Sam Orubu, Susan Rogers Van Katwyk, Heather Ganshorn, Jeremy Grimshaw, Mathieu J P Poirier","doi":"10.1186/s13643-025-02829-9","DOIUrl":"10.1186/s13643-025-02829-9","url":null,"abstract":"<p><strong>Background: </strong>Globally, agricultural production systems consume two-thirds of all antimicrobials. These systems are used to raise animals that produce products for consumption, such as meat, eggs, milk, and wool. The World Bank estimates that by 2030, AMR will reduce global livestock production by up to 7.5%, resulting in economic losses of up to one trillion USD. Governments worldwide have implemented various policies to promote antimicrobial stewardship in production animals, such as requiring veterinary prescriptions for antimicrobial use, restricting certain antimicrobials, and prohibiting antimicrobial use for growth promotion. However, the efficacy of these measures remains uncertain, necessitating a comprehensive review to guide policymakers. This review will identify and describe implemented government policy interventions to reduce veterinary AMU and AMR in production animals. A secondary analysis will map the policy pathways and the stakeholders involved in their successful implementation.</p><p><strong>Methods: </strong>An electronic search strategy has been developed in consultation with a public health librarian and a veterinary health librarian. CAB Abstracts, MEDLINE, Web of Science, and ProQuest Dissertations will be searched, and additional studies will be identified using gray literature searches. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change antimicrobial use in production animals. For inclusion within the review, studies must (1) describe the government policy, (2) quantitatively measure the impact of the policy in production animals using a rigorous study design, and (3) measure the impact of the intervention through antimicrobial use (AMU) or AMR. Two independent reviewers will screen for eligibility using defined criteria, and data will be extracted using Covidence software and Excel, respectively. Results will be synthesized narratively and visually (using maps and Sankey plots) to identify evidence gaps.</p><p><strong>Discussion: </strong>This systematic review is intended to inform future government policies addressing antimicrobial resistance and antimicrobial use in production animal systems. It will also inform future research priorities by identifying evidence gaps about the effectiveness of various policy interventions.</p><p><strong>Systematic review registration: </strong>Open Science framework.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"122"},"PeriodicalIF":6.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217004","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":"Can ginger improve cardiovascular health indices? A protocol for a GRADE-assessed systematic review and planned dose-response meta-analysis of randomized controlled trials.","authors":"Ali Jafari, Amirhossein Sahebkar","doi":"10.1186/s13643-025-02867-3","DOIUrl":"10.1186/s13643-025-02867-3","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVDs), which encompass a range of disorders impacting the heart and blood vessels, continue to pose a significant global public health challenge. Ginger (Zingiber officinale) has attracted attention among various treatment options for its potential advantages in promoting cardiovascular well-being. Renowned for its anti-inflammatory, antioxidant, and anti-hypertensive properties, ginger is a widely used culinary and medicinal plant. The objective of this research is to provide a comprehensive summary and systematic analysis of the existing scientific literature pertaining to the effects of ginger supplementation on glycemic profile, lipid profile, anthropometric measures, blood pressure, inflammatory markers, liver function tests, oxidative stress parameters, and adipokines. This analysis aims to establish a foundation for clinical interventions.</p><p><strong>Methods: </strong>A methodical electronic exploration will be carried out to discover articles in various databases such as Scopus, PubMed, EMBASE, CENTRAL, and Web of Science. The search will specifically target randomized controlled trials (RCTs) that include both healthy and diseased individuals. Two evaluators will independently review articles, extract information, and evaluate the quality of the studies using the Cochrane risk of bias assessment tool (RoB 2). Any discrepancies will be addressed by involving a third reviewer. The quality of cumulative evidence will be evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Should a sufficient quantity of suitable studies be found, a meta-analysis will be conducted on the chosen outcomes.</p><p><strong>Discussion: </strong>This protocol outlines a comprehensive approach for systematically reviewing and conducting a dose-response meta-analysis on the effects of ginger supplementation on CVD risk factors. The proposed methodological rigor, including independent evaluation and GRADE assessment, will ensure high-quality evidence synthesis from available RCTs. The findings from this planned review will help inform future research directions and potentially guide clinical recommendations regarding ginger supplementation for cardiovascular health.</p><p><strong>Systematic review registration: </strong>PROSPERO: CRD42024571362.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"121"},"PeriodicalIF":6.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209564","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":"Circulating cell-free DNA methylation as biomarker for lung cancer detection: a systematic review and meta-analysis of diagnostic studies.","authors":"Diana Inês Machado, Tiago Brito-Rocha, Sofia Salta, Teresa Monjardino, Rui Henrique, Carmen Jerónimo","doi":"10.1186/s13643-025-02860-w","DOIUrl":"10.1186/s13643-025-02860-w","url":null,"abstract":"<p><p>Lung cancer (LC) is the most incident malignancy and a leading cause of cancer-related fatalities. The lack of dissemination of effective screening tools hinders early detection, resulting in late-stage diagnosis, mostly associated with high mortality. Gene-specific methylation alterations detected in plasma or serum circulation cell-free DNA (ccfDNA) have been investigated as a possible screening tool. Thus, the main aim of this systematic review and meta-analysis was to critically assess published data on the use of ccfDNA methylation-based biomarkers for detection of LC. PubMed, including MEDLINE and Scopus databases, were systematically searched for eligible articles evaluating the diagnostic performance of ccfDNA methylation alterations in that setting. A bivariate random-effect model was employed to calculate pool estimated sensitivity and specificity. Accuracy subgroup analyses, according to histological subtype, stage, and smoker status were carried out. A total of 1961 articles were retrieved, of which 44 met inclusion criteria. The meta-analysis generated a pooled sensitivity of 54% (CI 95% 48-60%) and a pooled specificity of 86% (CI 95% 83-87%) for LC detection. The most frequently tested host-genome methylation markers were RASSF1 A, APC, SHOX2, SOX17, and HOXA9. Overall, methylation analysis of ccfDNA detects LC with high specificity but modest sensitivity. Further research is required to improve diagnostic performance, establish methodological standards and determine whether this might complement existing screening strategies to increase effectiveness. Systematic review registration PROSPERO CRD42023408964.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"120"},"PeriodicalIF":6.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209565","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":"Effectiveness of interventions designed to increase safe medicine disposal: a systematic review and meta-analysis of randomised trials.","authors":"Amy Soo-Bin Ma, Andrew J McLachlan, Christina Abdel Shaheed, Danijela Gnjidic, Jonathan Penm, Toni Riley, Stephanie Mathieson","doi":"10.1186/s13643-025-02820-4","DOIUrl":"10.1186/s13643-025-02820-4","url":null,"abstract":"<p><strong>Background: </strong>Drug-related harm is a major cause of mortality, poisonings, hospitalisations and misuse. Reducing the availability of unused medicines is a component of ensuring medication safety. However, the current literature on how to increase the implementation of medicine disposal strategies needs to be clarified. This systematic review evaluated the effectiveness of strategies designed to promote medicine disposal.</p><p><strong>Methods: </strong>Electronic databases and clinical trial registries were searched from inception to 16th February 2024 without restriction for randomised trials of any interventions aiming to increase medicine disposal compared to any control. Medicine disposal could be done using any method as reported by eligible studies. The primary outcome was the change in the proportion of participants who disposed of unused medicines. Secondary outcomes were changes in patient (e.g. knowledge of disposal strategies), population (e.g. poisonings), environmental (e.g. preventing going to landfill) and economic (e.g. cost-effectiveness) outcomes. The original Cochrane tool was used to assess the risk of bias. Random-effects meta-analysis was conducted on the primary outcome, and a narrative synthesis was performed on secondary outcomes due to heterogeneity. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess the quality of evidence. PROSPERO registration: CRD42023491797.</p><p><strong>Results: </strong>Eighteen randomised trials were included (plus five ongoing, registered trials). All studies were conducted in North America, published from 2016 to 2023, targeted opioid analgesic disposal and included 5347 participants. Interventional strategies of providing disposal kits (risk ratio [RR] 1.42, 95% confidence Interval [CI] 1.13 to 1.79, moderate evidence), education alone (RR 1.47, 95% CI 1.03 to 2.09, low evidence), education plus reminder prompts (RR 2.51, 95% CI 1.30 to 4.83, moderate evidence) and education plus disposal kits (RR 2.00, 95% CI 1.03 to 3.87, moderate evidence) increased disposal compared to routine practice. Secondary outcomes were infrequently reported, including no studies reporting population-level (poisonings, hospitalisations) and environmental outcomes.</p><p><strong>Conclusions: </strong>There is moderate quality of evidence supporting interventions of disposal kits, disposal kit and education and education with text reminders to increase the disposal of unused medicines compared to routine practice. The conclusions of this review should be interpreted following consideration on the quality of evidence and the number of trials conducted.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"119"},"PeriodicalIF":6.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192260","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}