Systematic Reviews最新文献

{"title":"How Delphi studies in the health sciences find consensus: a scoping review.","authors":"Julia Schifano, Marlen Niederberger","doi":"10.1186/s13643-024-02738-3","DOIUrl":"10.1186/s13643-024-02738-3","url":null,"abstract":"<p><strong>Background: </strong>Delphi studies are primarily used in the health sciences to find consensus. They inform clinical practice and influence structures, processes, and framework conditions of healthcare. The practical research-how Delphi studies are conducted-has seldom been discussed methodologically or documented systematically. The aim of this scoping review is to fill this research gap and to identify shortcomings in the methodological presentation in the literature. On the basis of the analysis, we derive recommendations for the quality-assured implementation of Delphi studies.</p><p><strong>Methods: </strong>Forming the basis of this scoping review are publications on consensus Delphi studies in the health sciences between January 1, 2018, and April 21, 2021, in the databases Scopus, MEDLINE via PubMed, CINAHL, and Epistemonikos. Included were publications in German and English containing the words \"Delphi\" in the title and \"health\" and \"consensus\" in the title or abstract. The practical research was analyzed for the qualitative content of the publications according to three deductive main categories, to which an influence on the result of Delphi studies can be imputed (expert panel, questionnaire design, process and feedback design).</p><p><strong>Results: </strong>A total of 287 consensus Delphi studies were included in the review, whereby 43% reported having carried out a modified Delphi. In most cases, heterogeneous expert groups from research, clinical practice, health economics, and health policy were surveyed. In about a quarter of the Delphi studies, affected parties, such as patients, were part of the expert panel. In the Delphi questionnaires it was most common for standardized Likert scales to be combined with open-ended questions. Which method was used to analyze the open-ended responses was not reported in 62% of the Delphi studies. Consensus is largely (81%) defined as percentage agreement.</p><p><strong>Conclusions: </strong>The results show considerable differences in how Delphi studies are carried out, making assessments and comparisons between them difficult. Sometimes an approach points to unintended effects, or biases in the individual judgments of the respondents and, thus, in the overall results of Delphi studies. For this reason, we extrapolate suggestions for how certain comparability and quality assurance can be achieved for Delphi studies.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"14"},"PeriodicalIF":6.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984878","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":"Naso-intestinal versus gastric tube for enteral nutrition in patients undergoing mechanical ventilation: a systematic review and meta-analysis.","authors":"Chuanjin Liu, Junxun Jiang, Zunjia Wen, Tao You","doi":"10.1186/s13643-024-02743-6","DOIUrl":"10.1186/s13643-024-02743-6","url":null,"abstract":"<p><strong>Background: </strong>A systematic appraisal of the comparative efficacy and safety profiles of naso-intestinal tube versus gastric tube feeding in the context of enteral nutrition for mechanically ventilated (MV) patients is imperative. Such an evaluation is essential to inform clinical practice, ensuring that the chosen method of nutritional support is both optimal and safe for this patient population.</p><p><strong>Methods: </strong>We executed an exhaustive search across PubMed et al. databases to identify randomized controlled trials (RCTs) that scrutinize the role of naso-intestinal and gastric tubes for mechanically ventilated (MV) patients up to May 30, 2024. The process of study selection, quality assessment, and data extraction was conducted independently by two researchers. RevMan 5.3 software was used for meta-analysis.</p><p><strong>Results: </strong>Our meta-analysis included 8 RCTs, published between 1992 and 2018, encompassing a total of 676 MV patients. The results indicated that naso-intestinal tube feeding, compared to gastric tube feeding, was associated with a significant reduction in the incidence of ventilator-associated pneumonia (VAP) [Risk Ratio (RR) = 0.69, 95% confidence interval (CI) (0.52, 0.92)] and gastric retention (RR = 0.11, 95% CI (0.04, 0.28)). No statistically significant differences were observed in the incidence of aspiration (RR = 0.93, 95% CI (0.35, 2.50)) vomiting (RR = 0.70, 95% CI (0.23, 2.08)), abdominal distension (RR = 0.87, 95% CI (0.29, 2.63)), or diarrhea (RR = 1.10, 95% CI (0.77, 1.55)).</p><p><strong>Conclusions: </strong>The current evidence indicates that naso-intestinal tube feeding is efficacious in lowering the incidence of VAP and gastric retention among MV patients, without a corresponding escalation in the risk of adverse events, including aspiration, vomiting, abdominal distension, and diarrhea. These insights significantly augment the existing corpus of knowledge pertaining to the optimization of enteral nutrition strategies for patients on mechanical ventilation.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"13"},"PeriodicalIF":6.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984879","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":"Role of preconception nutrition supplements in maternal anemia and intrauterine growth: a systematic review and meta-analysis of randomized controlled trials.","authors":"Sumera Aziz Ali, Jeanine Genkinger, Ka Kahe, Linda Valeri, Nayab Khowaja, Nancy F Krebs, Louise Kuhn","doi":"10.1186/s13643-024-02726-7","DOIUrl":"10.1186/s13643-024-02726-7","url":null,"abstract":"<p><strong>Background: </strong>Impaired intrauterine growth, a significant global health problem, contributes to a higher burden of infant morbidity and mortality, mainly in resource-poor settings. Maternal anemia and undernutrition, two important causes of impaired intrauterine growth, are prioritized by global nutrition targets of 2030. We synthesized the evidence on the role of preconception nutrition supplements in reducing maternal anemia and improving intrauterine growth.</p><p><strong>Methods: </strong>We undertook a review of the randomized controlled trials (RCTs) assessing the effect of preconception nutrition supplements on maternal hemoglobin, an indicator to estimate maternal anemia, and markers of intrauterine growth including birth weight, length, head circumference, and small for gestational age. Additionally, we examined preterm birth as an important perinatal outcome. We searched PubMed, CINAHL, Web of Science, Cochrane Central, and Embase. We computed summary mean differences and risk ratios (RR) with 95% confidence intervals (CIs) using random-effect models. We employed I² and Cochran's Q test statistics to assess heterogeneity. We used a revised Cochrane risk-of-bias (RoB version 2.0) and GRADE (grading of recommendations, assessment, development, and evaluation) tools to assess the risk of bias and quality of evidence of eligible RCTs, respectively.</p><p><strong>Results: </strong>We identified 20 eligible RCTs (n = 27,659 women). Preconception nutrition supplements (iron and folic acid, multiple micronutrients, and a lipid-based nutrient supplement) overall increased maternal hemoglobin by 0.30 g/dL ((0.03, 0.57); I² = 79%; n=9). However, we did not find a significant effect of the supplements on birth weight (12.25 gm ((- 22.66, 47.16); I² = 55%; n=10)), length (0.15 cm (- 0.26, 0.56); I² = 68%; n = 5), head circumference (- 0.23 cm (- 0.88, 0.43); I² = 84%; n=4), small for gestational age (RR 0.91 (0.80, 1.04); I² = 31%; n=8), or preterm birth (RR 0.93 (0.69,1.25); I² = 57%; n=12). In general, the quality of evidence was assessed as very low to moderate.</p><p><strong>Conclusion: </strong>Preconception nutrition supplements studied to date appear to reduce maternal anemia. However, it is uncertain whether there are beneficial effects of the supplements on intrauterine growth. Low quality of evidence warrants future well-designed RCTs to produce solid scientific data, particularly of a more comprehensive package of preconception nutrition supplements that include both macro- and micronutrients.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023464966.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"11"},"PeriodicalIF":6.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979974","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 Communication Rules for Policy (ECR-P) critical appraisal tool.","authors":"Evangelos Danopoulos, John A D Aston, Aarushi Shah, Claudia R Schneider","doi":"10.1186/s13643-025-02757-8","DOIUrl":"10.1186/s13643-025-02757-8","url":null,"abstract":"<p><strong>Background: </strong>Scientific papers increasingly put forward scientific-based policy recommendations (SPRs) as a means of closing the circle of science, policy and practice. Assessing the quality of such SPRs is crucial, especially within the context of a systematic review. Here, we present ECR-P (Evidence Communication Rules for Policy)-a critical appraisal tool that we have developed, which can be used in assessing not only the quality of SPRs but also the quality of their evidence base and how effectively these have both been communicated.</p><p><strong>Methods: </strong>The rationale behind ECR-P centres on three dimensions of quality; two are the well-established concepts of internal and external validity. Here, we introduce a third-evidence communication-encompassing both evidence veracity and quality of communication. Elements of the three dimensions of quality are considered within the context of the five rules of evidence communication. These are as follows: inform, not persuade; offer balance, not false balance; disclose uncertainties; state evidence quality and pre-empt misunderstandings.</p><p><strong>Results: </strong>Development of ECR-P has been carried out by an interdisciplinary team and was piloted with a systematic review reported more fully elsewhere. ECR-P comprises a set of preliminary considerations which capture key aspects for the assessment, leading on to the main tool whose structure is domain-based, each domain mapping to one of the five rules of evidence communication. The domains include 25 signalling questions designed to obtain essential information for the critical appraisal. The questions focus on either the study's evidence or the policy recommendations. Domain-based judgement is derived from responses to the signalling questions and an accompanying algorithm, followed by an overall quality judgement.</p><p><strong>Conclusions: </strong>ECR-P has been designed to provide a standardised and transparent approach to assess the quality and communication of SPRs and their evidence base. The tool, which could be applied across all scientific fields, has been developed to fit primarily with the systematic reviewing process but could also serve as a stand-alone tool. Besides review assessors, it can also be used by policymakers, researchers, peer reviewers, editors and any other stakeholders interested in evidence-based policymaking and high-quality evidence communication. We encourage further independent testing of the tool in real-world evidence-based research.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"10"},"PeriodicalIF":6.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979959","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":"Healthcare professionals' understanding of children's rights: a systematic review of the empirical evidence-base.","authors":"Sahar Mazied Alshammari, Mark A Linden, Helen Kerr, Helen Noble","doi":"10.1186/s13643-025-02756-9","DOIUrl":"10.1186/s13643-025-02756-9","url":null,"abstract":"<p><strong>Background: </strong>The concept of children's rights emerged during the 1980s and emphasised the role of children as active participants in matters which concern them.</p><p><strong>Aim: </strong>This review aims to identify and synthesise the empirical evidence base on healthcare professionals' (HCPs) understanding of children's rights.</p><p><strong>Methods: </strong>Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, and the Web of Science) were systematically searched in May 2023. The Mixed Methods Appraisal Tool (MMAT) was used to quality appraise full-text papers included in the review. A descriptive narrative synthesis of the studies' findings was performed.</p><p><strong>Results: </strong>A total of 15 relevant studies from 10 countries were identified and included in the review. The number of participants included ranged from 6 to 1048 for HCPs with a broad range of sampling methods. Based on the narrative synthesis of the included studies, three main themes were identified: (1) Barriers to implementing children's rights in healthcare, (2) Factors that contribute to children's rights implementation, and (3) Study instruments used to measure outcomes.</p><p><strong>Conclusions: </strong>HCPs require a better understanding of children's rights to implement these rights into practice. Listening to children, building trusting relationships with children, and continuing professional development of HCPs could help to address barriers to understanding children's rights. There is a pressing need for the development of a tool that is capable of tracking changes in the understanding of children's rights in healthcare environments as efforts to increase awareness become more widely recognised.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"9"},"PeriodicalIF":6.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967041","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":"Community-based interventions against HIV-related stigma: a systematic review of evidence in Sub-Saharan Africa.","authors":"Emmanuel Kimera, Linda Grace Alanyo, Irumba Pauline, Maureen Andinda, Enos Masereka Mirembe","doi":"10.1186/s13643-024-02751-6","DOIUrl":"10.1186/s13643-024-02751-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;HIV-related stigma remains a key barrier to the attainment of the UNAIDS global goal of ending AIDS by 2030. Due to the social and contextual nature of HIV-related stigma, community-based interventions may be more effective in addressing it. In this review, we synthesized evidence on the effectiveness and features of community-based interventions against HIV-related stigma in Sub-Saharan Africa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;MEDLINE, EMBASE, CINAHL, Psych INFO, and Web of Science were searched in July 2023. We also searched Google Scholar and reference lists of all selected studies. Included studies were randomized controlled trials, mixed methods studies, as well as pre-test and post-test studies that evaluated the effectiveness of a community-based intervention to reduce HIV-related stigma in the general population or among specific groups. Data extraction was done using a pre-designed and pre-tested form. We performed a synthesis without meta-analysis, utilizing Fisher's method to combine p-values, to demonstrate evidence of an effect in at least one study. Additionally, we applied framework thematic analysis to qualitatively synthesize the intervention characteristics of the included studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of nine journal articles were included, largely with a high risk of bias. Results from the combined p-values provide strong evidence supporting the effectiveness of community-based interventions in reducing HIV-related stigma in at least one of the studies (p &lt; 0.001, X&lt;sup&gt;2&lt;/sup&gt; = 73.1, 18 degrees of freedom). Most studies involved people living with HIV (PLH) alone as intervention recipients and as intervention implementers. Community members with unknown HIV status were involved in only 2 studies. The intervention strategies were largely information sharing through workshops and training as well as individualized counselling. In few studies, additional support in the form of referrals, nutritional supplements, and adherence support was provided to PLH during the interventions. Most studies were judged to be of moderate to high cost except in 3 where the intervention implementers were PLH within the community, volunteering in the home-based support approach. The involvement of community members in the design of intervention strategies was not seen in all the studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Community-based interventions appear to be effective in reducing HIV-related stigma. However, more robust randomized trials are needed to provide stronger evidence for this effect. Although these interventions have been multifariously developed in Sub-Saharan Africa, comprehensive strategies involving the stigmatized and the \"stigmatizers\" in a social change approach are lacking. The application of strategies without the involvement of community members in their design takes away a sense of community responsibility, and this threatens the sustainability of such interventions.&lt;/p&gt;&lt;","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"8"},"PeriodicalIF":6.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11720753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967040","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":"Synthesizing evidence to guide the design and implementation of effective strategies for discontinuing postoperative antibiotic prophylaxis in surgical settings: an umbrella review post-WHO 2018 recommendations.","authors":"George Msema Bwire, Renatus B Magati, Hafidhi H Ntissi, Tusaligwe Mbilinyi, Martine A Manguzu, Goodluck G Nyondo, Belinda J Njiro, Lilian B Nkinda, Castory G Munishi, Obadia Nyongole, Pacifique Ndayishimiye, Mtebe V Majigo","doi":"10.1186/s13643-024-02750-7","DOIUrl":"10.1186/s13643-024-02750-7","url":null,"abstract":"<p><strong>Background: </strong>Postoperative antibiotic prophylaxis (PAP) involves using antibiotics after surgery to prevent surgical site infections (SSIs). However, studies have shown that PAP offers no additional benefits compared to discontinuation after surgical incision closure, prompting its de-implementation to prevent unnecessary antibiotic use that may contribute to antibiotic resistance. We conducted this review to synthesize evidence for guiding the design and implementation of effective strategies for discontinuing PAP practice and optimizing antibiotic use in surgical settings.</p><p><strong>Methods: </strong>This umbrella review searched for articles from PubMed/MEDLINE and Scopus, focusing on reviews conducted on human subjects on PAP to prevent SSIs, published in English language from 2019 to 5th July 2024. This review followed guidelines from PRISMA-P and PRIOR. The risk of bias (methodological quality) was assessed using AMSTAR-2. The pooled risk ratio (RR) was estimated using a fixed-effects model (Mantel-Haenszel method), while I² was used to assess the heterogeneity between reviews. This review was registered with PROSPERO (CRD42024566124).</p><p><strong>Results: </strong>In our umbrella review, we screened 1156 articles, with 28 review articles found eligible for final analysis, involving over 457 primary studies. About 80,483 patients were involved in 9 meta-analysis reviews, which were used to estimate the pooled RR. We found no significant benefits to patients from continuing PAP beyond 24-h post-surgery compared to immediate discontinuation, RR: 1.07 (95% CI: 0.97-1.17, I²: 25%, p-value: 0.22). Strategies such as regularly assessing and refining guidelines to fit specific surgical settings and patients' characteristics, multidisciplinary collaboration, availability of resources needed for best practices, education and training healthcare workers on SSI prevention and antibiotic stewardship, and patient education in SSI prevention and proper antibiotic use were recommended to improve best practices in surgical settings.</p><p><strong>Conclusions: </strong>Prolonging antibiotic prophylaxis beyond 24-h post-surgery did not show significant protective benefits against SSIs. Our findings support the 2018 WHO recommendation for the immediate discontinuation of PAP following surgical incision closure in clean and clean-contaminated procedures. Further de-implementation research studies are needed to guide the effective discontinuation of PAP practice.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"7"},"PeriodicalIF":6.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955391","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":"Sex and gender in perioperative cardiovascular research: protocol for a scoping review.","authors":"Ana Sjaus, Nicole Fakhory","doi":"10.1186/s13643-024-02716-9","DOIUrl":"10.1186/s13643-024-02716-9","url":null,"abstract":"<p><strong>Background: </strong>The inadequate inclusion of sex and gender in medical research has resulted in biased clinical guidance and disparities in knowledge and patient outcomes. Despite efforts by regulatory and funding agencies, opportunities to generate sex-specific knowledge are frequently overlooked. While certain disciplines in cardiovascular medicine have made notable progress, these advances have yet to permeate the literature on perioperative cardiovascular complications in non-cardiac surgery. Prompted by the recent findings on sex-specific perioperative cardiovascular outcomes, this review aims to scope the literature in this field and categorize methodological approaches used to incorporate sex and gender in studies of this patient population.</p><p><strong>Methods: </strong>Joanna Briggs Institute (JBI) methodology for scoping reviews will be followed in stages elaborated by Levac (2010). A comprehensive search strategy will be used to identify relevant primary research published since 2010. Screening will be performed by independent reviewers using predefined inclusion and exclusion criteria. Data will be extracted from full text and supplementary materials of selected articles. Results will be presented as proportions of studies reporting sex and gender, the assigned purpose of these variables in analysis, and where they are reported in the article. In addition, articles will be mapped to the source, country of origin, and year of publication. Narrative summaries will be provided to outline key findings and assess the depth of the literature within each of the major topics (risk assessment/prediction, diagnosis, treatment, prognosis, and outcomes).</p><p><strong>Discussion: </strong>Increasing recognition of the profound and complex implications of sex and gender in medicine has fuelled calls for greater attention to participation equity, sex-specific analysis and reporting. Focusing on perioperative cardiovascular complications, this review has the potential to identify knowledge gaps for future research, as well as areas of strength that could support formal knowledge synthesis or secondary analysis of data from past research.</p><p><strong>Scoping review registration: </strong>Submitted on August 15th, 2023 (Web of Science osf.io/u25sf).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"6"},"PeriodicalIF":6.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11708003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955389","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":"Epicutaneous immunotherapy for food allergy: a systematic review and meta-analysis.","authors":"Xiaohong Xiang, Jingwei Hu, Rangui Sachu, Chonghua Gao, Hongyan Niu, Yi Gao, Shiju Chen, Xiaotian Cui, Xiang Li","doi":"10.1186/s13643-024-02727-6","DOIUrl":"10.1186/s13643-024-02727-6","url":null,"abstract":"<p><strong>Background: </strong>There is ongoing debate about the safety and efficacy of epicutaneous immunotherapy (EPIT) in treating food allergies. The systematic review and meta-analysis aimed to evaluate the safety and efficacy of EPIT.</p><p><strong>Methods: </strong>We systematically searched international trial registers (ClinicalTrials.gov), PubMed, Embase, the Cochrane Central of Controlled Trials (CENTRAL), and Web of Science from the inception of the database until June 25, 2023. Two authors independently screened potential studies based on the following criteria: food allergy, epidermal immunotherapy, and randomized controlled trials(RCTs). The risk-of-bias assessment was performed using the Cochrane risk-of-bias 2 (ROB 2) tool. The primary outcomes included desensitization, local adverse events, systemic adverse events, and quality of life. Secondary outcomes included epinephrine utilization, topical medication utilization, and severe adverse events. We assessed certainty of evidence by the GRADE approach.</p><p><strong>Results: </strong>Ten studies involving 1970 participants were included. Ten high-quality RCTs focusing on peanut allergy and cow's milk allergy were included in the analysis. The meta-analysis revealed that EPIT promoted desensitization in patients with food allergy (RR 2.11, 95% CI 1.72-2.58; I ² = 0%, high certainty), particularly in aged ≤ 11 years (RR 3.84, 95% CI 2.39-6.26; I ² = 34%). Additionally, treatment duration ≥ 52 weeks was found to increase immune tolerance (RR 3.37, 95% CI 2.39-4.75; I ² = 13%). Patients who undergo EPIT treatment not only raised the local adverse reactions (RR 1.63, 95% CI 1.10-2.41; I ² = 82%, low certainty) but also raised systemic adverse reactions (RR 1.52, 95% CI 1.01-2.28; I ² = 0%, high certainty).</p><p><strong>Conclusion: </strong>After EPIT treatment, patients with food allergy can effectively increase their immune tolerance to food. However, it also significantly increases mild-to-moderate anaphylaxis. There is limited data on the impact of EPIT on quality of life and other food allergic diseases, indicating a need for further research.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"4"},"PeriodicalIF":6.3,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923278","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":"Associations between HEXACO personality traits, substance use disorders, and behavioral addictions: a protocol for a comprehensive systematic review and meta-analysis.","authors":"Farangis Sharifibastan, Eilin Kristine Erevik, Katharina Teresa Enehaug Morken, Ståle Pallesen","doi":"10.1186/s13643-024-02741-8","DOIUrl":"10.1186/s13643-024-02741-8","url":null,"abstract":"<p><strong>Background: </strong>While research has explored the connection between addiction and personality, no systematic study has examined how substance use disorders (SUD) and behavioral addictions specifically relate to the HEXACO model of personality. This systematic review and meta-analysis aim to fill this gap by investigating the association between HEXACO personality traits and various addictions, including illegal substances (e.g., narcotics and cannabis) and behavioral addictions (e.g., gambling, gaming, social media addiction, and compulsive sexual behavior disorder) across different populations.</p><p><strong>Methods: </strong>The protocol is in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. Searches will be conducted in databases including APA PsycINFO (Ovid), MEDLINE (Ovid), ProQuest, Web of Science, CINAHL, Wiley Online Library, and Google Scholar. Empirical studies published as full papers in peer-reviewed journals or as full dissertations, in English, other European languages, or Persian, investigating the association between HEXACO personality traits and addictive disorders are eligible. Two reviewers will independently screen all citations and full-text articles, and extract data using the Covidence software. They will further assess the risk of bias and quality of the studies using the Newcastle-Ottawa Scale (NOS) for longitudinal and cohort studies, an adapted version of the NOS for cross-sectional studies. Publication bias will be evaluated using funnel plots, Egger's test, and trim and fill analysis. In addition to a narrative summary, meta-analyses will be conducted if data are sufficient. Random effects models will be used to pool effect sizes. Subgroup analyses and meta-regression will be performed to investigate potential sources of heterogeneity. Sensitivity analyses will examine the robustness of the results. Data analysis will be conducted using Comprehensive Meta-Analysis (CMA), version 4.</p><p><strong>Discussion: </strong>This review and meta-analysis will be the first to systematically explore and integrate the evidence available on the association between the HEXACO personality traits and SUD and behavioral addictions. By consolidating information, the study will enhance our understanding of the role of personality traits in the development, maintenance, and treatment of SUD and behavioral addictions.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023468153.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"14 1","pages":"1"},"PeriodicalIF":6.3,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923270","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}