Systematic Reviews最新文献

{"title":"Understanding context in the implementation of school health promotion: a scoping review and conceptual framework.","authors":"Madhura Joshi, Anu Linnansaari, Jackline Ngowi, Elizabeth Mwaniki, Kevin Kahshamba, Salla Atkins","doi":"10.1186/s13643-026-03232-8","DOIUrl":"10.1186/s13643-026-03232-8","url":null,"abstract":"<p><strong>Background: </strong>Schools offer an influential setting for delivering health promotion interventions. However, the success of these efforts largely depends on how well the implementation context is understood and addressed. While \"context\" is recognized as a key concept in implementation science, it remains inconsistently defined and applied. Therefore, the aim of this scoping review was to critically examine theoretical approaches used in implementation of school health intervention programs, and to explore how these approaches conceptualize and address context. Ultimately, the goal is to develop a conceptual framework that can support researchers, practitioners, and decision-makers in better understanding and addressing context in school health promotion.</p><p><strong>Method: </strong>This scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines. A search was conducted in Medline and ASSIA on June 18th, 2024. Articles were screened independently by two authors. After data extraction, a reflexive thematic analysis approach was used to analyze data.</p><p><strong>Results: </strong>Our findings reveal that various theoretical approaches including implementation, adaptation, and system frameworks, as well as organizational and actor-network theory, have been utilized to conceptualize and address context in school health promotion. These approaches were applied across different stages of implementation: planning, delivery, and evaluation. However, our results confirm considerable variation in how these theoretical approaches address and define context. These different ways of defining context not only highlight a lack of consensus around its definition but also have significant implications leading to the prioritization of certain aspects of context over others, resulting in a fragmented, incomplete understanding of the social, cultural, economic, and political setting within which interventions are implemented. Using reflexive thematic analysis, we identified two overarching themes. The first theme, dimensions of context, comprises four contextual dimensions: organizational, socio-cultural, economic, and political. The second theme, features of context, captures the dynamic, interconnected, non-linear nature of context, and its spatial and temporal aspects. Together, these dimensions and features are integrated into a visual framework, the Contextual Framework for School Implementation (CFSI). The framework is further supported by practical guiding questions spanning all implementation phases: planning, delivery, and evaluation, emphasizing the importance of considering implementation context from the outset of program development.</p><p><strong>Conclusions: </strong>This review examined how theoretical approaches have been used to understand and address context in school health promotion. It shows that while context is often recognized as important, current ways of describing and applying it are fragmented","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206348","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":"How is shared decision making used in the treatment of patients with liver disease? a scoping review.","authors":"Haeun Kang, Da Young Ryu, Yeonsoo Jang","doi":"10.1186/s13643-026-03227-5","DOIUrl":"10.1186/s13643-026-03227-5","url":null,"abstract":"<p><strong>Background: </strong>Shared decision making (SDM) is an approach in which healthcare providers and patients collaboratively consider the best available evidence when making treatment decisions; patients are also supported in evaluating available options and forming informed preferences. However, evidence regarding treatment decision making contexts involving SDM for patients with liver disease remains limited. Therefore, this scoping review analyzes the contextual environments in which SDM is implemented during the treatment of patients with liver disease and examines the characteristics of patient participation in the SDM process.</p><p><strong>Methods: </strong>This study focused on treatment decision making contexts (context) involving SDM (concept) among patients with liver disease (population). Following the Arksey and O'Malley scoping review method, structured searches of articles published until March 2025 were conducted in four electronic databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science. The search terms used were \"shared decision making\" and \"liver disease.\" Eight studies were ultimately included in the review.</p><p><strong>Results: </strong>SDM was applied in treatment contexts, including medication initiation, surgical decision making, and the selection of therapeutic approaches such as hepatic resection and radiofrequency ablation. Five (62.5%) out of the eight studies included surgery as an option, and four (50.0%) focused on patients with liver cancer. When the patients with liver disease participated in the SDM process, they were presented with treatment options, provided information about these options, and asked to express their preferences. However, only one study evaluated decision making outcomes.</p><p><strong>Conclusions: </strong>Cancer-related and surgical decision making contexts were the most frequent targets for SDM in this review. However, patient decision aids (PDAs) are currently unavailable for any liver disease. Additionally, only one study included a process for re-evaluating prior decisions. Future research and clinical practice should incorporate mechanisms for re-evaluating prior decisions and support the development of PDAs for liver disease.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176686","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":"The differential effects of psychotherapeutic and pharmacologic intervention on symptom severity and functioning in children and adolescents with internalizing problems: a systematic review protocol.","authors":"Dylan Johnson, Peter Szatmari, Brendan F Andrade, Karolin Krause, Emma Nolan, Carly Albaum","doi":"10.1186/s13643-026-03231-9","DOIUrl":"10.1186/s13643-026-03231-9","url":null,"abstract":"<p><strong>Background: </strong>Internalizing problems, such as depression and anxiety, are common among children and adolescents, contributing significantly to impairment in various domains of functioning, including academic, social, and family life. While pharmacologic and psychotherapeutic interventions are effective in reducing symptoms, it remains unclear whether these treatments have similar effects to improve functioning. Functional impairment in youth can have long-term consequences, including increased risks for mental health issues, physical health problems, and social difficulties. Despite its importance, functional improvement is often overlooked in mental health intervention research. This study aims to systematically review and meta-analyze interventions that target internalizing symptoms, and assess both symptom reduction and improvements in functioning as treatment outcomes.</p><p><strong>Methods: </strong>This systematic review and meta-analysis will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. A comprehensive search of electronic databases, including CINAHL, EMBASE, MEDLINE, and PsycINFO, will identify randomized controlled trials published between 2014 and 2024 that evaluate psychotherapeutic or pharmacologic treatments for depressive or anxiety symptoms in children and adolescents. Eligible studies will measure both symptom severity and functioning outcomes. Data will be extracted independently by two reviewers, and effect sizes will be calculated using standardized mean differences. Multilevel meta-analytic procedures will be employed to assess both mean differences and variability within studies. Moderator analyses will explore factors such as treatment type, internalizing disorder subtype, and sociodemographic factors. Risk of bias will be assessed using the Cochrane Risk of Bias 2 tool, and the Grading of Recommendations, Assessment, Development, and Evaluations framework will guide the synthesis of the evidence.</p><p><strong>Discussion: </strong>This review aims to provide a comprehensive understanding of the effectiveness of mental health interventions for youth with internalizing disorders, focusing on both reductions in symptom severity and improvements in functioning. The findings will contribute to the development of clinical guidelines and treatment recommendations, emphasizing the importance of addressing functional outcomes in addition to symptom reduction. The results will have implications for the design and evaluation of future interventions aimed at improving the well-being of children and adolescents.</p><p><strong>Systematic review registration: </strong>This systematic review is registered in the PROSPERO database (CRD42024610658).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158191","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":"Efficacy and safety of loncastuximab tesirine in relapsed or refractory diffuse large B-cell lymphoma: a systematic review and meta-analysis.","authors":"Abat Khan, Hira Habib, Ayesha Imran Butt, Iftikhar Khan, Khushbakhat Aziz, Ehsanullah Alokozay, Haneen Kamran, Soban Ali Qasim, Ammara Saleem, Shaiq Ijaz, Bilal Khan, Muhammad Siddique Karimi, Saad Javed Malik, Asim Elahi, Jose Sandoval-Sus","doi":"10.1186/s13643-026-03216-8","DOIUrl":"10.1186/s13643-026-03216-8","url":null,"abstract":"<p><strong>Background: </strong>Relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) remains a therapeutic challenge, particularly for patients ineligible for stem-cell transplantation or CAR T-cell therapy. Loncastuximab tesirine, a CD19-directed antibody-drug conjugate, has demonstrated promising single-agent activity in recent studies and is approved in this setting. In this meta-analysis, we aim to assess the efficacy and safety of loncastuximab tesirine monotherapy in patients with R/R DLBCL.</p><p><strong>Methods: </strong>A systematic review was conducted per PRISMA 2020 guidelines, searching PubMed, Embase, and Cochrane CENTRAL from inception until March 2025. Studies reporting clinical outcomes of loncastuximab tesirine monotherapy with defined efficacy and safety endpoints were included. Seven studies met the inclusion criteria, including three clinical trials and four observational cohort studies. Two reviewers independently extracted data. Pooled analyses were conducted in R (version 4.5.1) using absolute risk and random-effects modeling. Heterogeneity was assessed using the I² statistic; publication bias was evaluated via Egger's test and funnel plots.</p><p><strong>Results: </strong>The pooled overall response rate (ORR) was 47.3% (95% CI 33.5-61.3%), and the complete response (CR) rate was 22.0% (95% CI 16.7-27.7%). One-year overall survival (OS) and progression-free survival (PFS) were 48.2% (95% CI 17.8-79.3%) and 31.2% (95% CI 9.2-58.9%), respectively, with substantial heterogeneity across studies. In the clinical trial subgroup, ORR and CR were 47.3% (95% CI 33.3-61.5%) and 23.9% (95% CI 21.9-26.1%), while 1-year OS and PFS were 43.8% (95% CI 25.2-63.3%) and 28.0% (95% CI 14.6-43.8%), respectively. No publication bias was detected. Treatment-emergent adverse events (AEs) occurred in 98.7% of patients, with grade ≥ 3 events in 82.6%. Common hematologic AEs included anemia (47.7%; grade ≥ 3: 13.6%), leukopenia (16%, grade ≥ 3: 9.7%), neutropenia (32.9%; grade ≥ 3: 22.4%), and thrombocytopenia (24.3%; grade ≥ 3: 16.1%). Frequent non-hematologic AEs included fatigue (20%), fever (15.6%), vomiting (12.4%), and abdominal pain (11.4%). Other reported events included hypokalemia (25.5%), rash (20%), and peripheral edema (23.7%).</p><p><strong>Conclusion: </strong>This meta-analysis supports the efficacy of loncastuximab tesirine monotherapy in heavily pretreated R/R DLBCL, with an ORR of ~ 47% and manageable toxicity. These findings reinforce its role as a valuable treatment option in patients with limited alternatives and highlight the need for randomized studies to optimize patient selection and sequencing strategies.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164501","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":"Preferences and user experience of wearable devices in cardiac rehabilitation: a systematic review and mixed-methods synthesis protocol.","authors":"Rongxiang Zhang, Linjing Wu, Pingping Huang, Shiqi Chen, Feng Tian, Yuan Chen","doi":"10.1186/s13643-026-03233-7","DOIUrl":"10.1186/s13643-026-03233-7","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation (CR) is an essential intervention for improving prognosis in patients with cardiovascular diseases. Despite its proven benefits, participation remains suboptimal due to time, geographic, and resource constraints. Wearable devices have emerged as promising tools to support home- and community-based CR by enabling continuous monitoring and personalized feedback. However, evidence on their effectiveness, user preferences, and experiences is inconsistent, and existing research often overlooks patients' subjective perceptions. Understanding these experiences is crucial for optimizing device design and promoting sustained use.</p><p><strong>Methods: </strong>This systematic review and mixed-methods synthesis has been prospectively registered in PROSPERO (registration number: CRD420251170358) and will be reported in accordance with the PRISMA-P and PRISMA 2020 reporting guidelines. Eligible studies will include quantitative, qualitative, and mixed-methods research focusing on the use of non-invasive wearable devices among CR patients, healthcare providers, or caregivers. Databases including PubMed, Embase, CINAHL, Cochrane Library, CNKI, Wanfang, VIP, and SinoMed will be searched from inception to October 2025, complemented by gray literature and trial registries. Two reviewers will independently conduct study selection, data extraction, and risk of bias assessment using Cochrane RoB 2.0, ROBINS-I, and JBI tools. Quantitative data will be summarized descriptively and, where appropriate, meta-analyzed using random-effects models. Qualitative findings will be synthesized through thematic analysis guided by the Technology Acceptance Model and integrated with quantitative results using a convergent mixed-methods approach.</p><p><strong>Discussion: </strong>This review will synthesize current evidence on user preferences, experiences, and determinants related to wearable devices in cardiac rehabilitation. The anticipated findings are expected to clarify how factors such as comfort, usability, privacy, and trust influence acceptance and adherence. By integrating quantitative and qualitative evidence, the review will provide a more comprehensive understanding of technology use in CR. These insights may inform patient-centered device design, guide clinical implementation strategies, and highlight priorities for future research and digital health innovation.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420251170358.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164567","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":"Comparative efficacy and safety of multiple acupoint electrical stimulation therapies for postoperative cognitive dysfunction in cancer patients: a network meta-analysis.","authors":"Ziyi Chen, Rongze Ma, Hejia Wan, Bingning Zhang, Huiyao Wang, Feifan Wang, Xin Wang, Yuling Zheng","doi":"10.1186/s13643-026-03217-7","DOIUrl":"10.1186/s13643-026-03217-7","url":null,"abstract":"<p><strong>Background: </strong>Surgery is a primary treatment modality for cancer, yet it is associated with postoperative complications, including postoperative cognitive dysfunction (POCD), which can adversely affect recovery and quality of life. Multiple non-pharmacological approaches, including electroacupuncture (EA), transcutaneous electrical acupoint stimulation (TEAS), and transcutaneous auricular vagus nerve stimulation (taVNS), are employed to mitigate POCD. However, direct comparisons of their relative efficacy are lacking.</p><p><strong>Objective: </strong>This network meta-analysis aimed to comparatively assess the efficacy of distinct acupoint electrical stimulation modalities-EA, TEAS, and taVNS-in alleviating POCD among surgical oncology patients.</p><p><strong>Methods: </strong>In accordance with Cochrane guidelines, a systematic review coupled with network meta-analysis was undertaken. Randomized controlled trials (RCTs) investigating acupoint electrical stimulation therapies for POCD in cancer patients were searched in databases including CNKI, Wanfang, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library from inception to November 1, 2024. Study quality was assessed using the Cochrane Risk of Bias tool. Network meta-analysis was performed using the BUGSnet package in R 4.3.2. Outcome measures included Mini-Mental State Examination (MMSE) scores and the incidence of POCD on postoperative 1-day, 3-day, and 7-day.</p><p><strong>Results: </strong>Twenty-three RCTs involving 2055 patients and 6 interventions were included, namely EA, TEAS, taVNS, sham EA, sham TEAS, and blank control. Network meta-analysis revealed that for MMSE scores on postoperative 1-day and 3-day, EA and TEAS showed statistically significant differences compared to blank controls, whereas taVNS did not. By postoperative 7-day, no significant differences were observed among EA, TEAS, taVNS, and blank controls in MMSE scores. For POCD incidence on 1-day and 3-day, EA and TEAS demonstrated significant differences compared to sham EA, sham TEAS, and blank controls. By postoperative 7-day, EA and TEAS remained significantly superior to sham TEAS and blank controls in reducing POCD incidence. Cumulative probability ranking indicated that TEAS had the highest probability of being the best for MMSE scores on 1-day and 3-day, while EA ranked highest for MMSE at 7 days, and for reducing POCD incidence at all time points.</p><p><strong>Conclusion: </strong>Based on probability rankings, TEAS may be more effective in improving postoperative MMSE scores, whereas EA appears superior in reducing POCD incidence. However, due to modest differences in ranking values and methodological limitations, these findings indicate trends rather than establishing definitive superiority.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024617801.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158133","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":"Health risk assessment of wildfire smoke exposure: a protocol for a systematic review and meta-analysis.","authors":"Chala Daba Yadate, Daniel Odo, Md Rezanur Rahaman, Hilary Bambrick, Michael Tong","doi":"10.1186/s13643-026-03226-6","DOIUrl":"10.1186/s13643-026-03226-6","url":null,"abstract":"<p><strong>Background: </strong>Wildfire, driven by climate change, continues to pose significant health, social, economic and environmental challenges in the twenty-first century. Although the association between wildfire smoke exposure and health outcomes has been studied, comprehensive systematic reviews and meta-analyses on the global health risks of wildfire smoke exposure are lacking, and the quality and strength of evidence remain uncertain. Therefore, we aim to undertake a comprehensive systematic review and meta-analysis to assess the health risks associated with wildfire smoke exposure at global, regional and national levels in the context of climate change, evaluate the quality and strength of available evidence and identify evidence gaps for future research.</p><p><strong>Methods: </strong>This review will adhere to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) guidelines. PubMed, Scopus and Web of Science will be searched to identify relevant articles. A group of researchers will independently screen the retrieved articles using Covidence, based on the inclusion and exclusion criteria. A narrative synthesis will be performed for the included studies. A random-effects meta-analysis will be performed using R software (version 4.3) to determine the pooled association between wildfire smoke air pollutants and health outcomes. Higgins' I² and Egger's test will be employed to assess heterogeneity and publication bias, respectively. Sensitivity and sub-group analysis will also be performed. Risk of bias will be assessed using the Office of Health Assessment and Translation Risk of Bias Rating Tool for Human Studies. The Grading of Recommendations Assessment, Development and Evaluation guidelines will be used to evaluate the quality of evidence. The strength of evidence will be rated as either sufficient, limited, inadequate, or lacking according to the Navigation Guide Framework.</p><p><strong>Discussions: </strong>This systematic review and meta-analysis will explore the health risk associated with wildfire smoke exposure across global, regional and national levels encompassing a range of climate zones. The findings from this meta-analysis will provide updated evidence to guide policy makers and communities in efforts to reduce mortality and morbidity associated with wildfire-related air pollutants. The results will also help healthcare providers and emergency responders in managing the growing health risk of wildfire-related air pollutant smoke exposure.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD420250654944.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164582","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":"Benralizumab in severe eosinophilic asthma: a comprehensive systematic review and meta-analysis of randomized controlled trials evaluating lung function, asthma control, and safety outcomes.","authors":"Abbas Al Mutair, Yasmine Alabbasi, Hanan F Alharbi, Hanan Alyami, Haifa Mohmmed Al-Shammari, Abdullah Awad Al-Omari, Eman A Bomozah, Faiza Aljarameez, Muhammad Daniyal","doi":"10.1186/s13643-026-03215-9","DOIUrl":"10.1186/s13643-026-03215-9","url":null,"abstract":"<p><strong>Background: </strong>Benralizumab, a monoclonal antibody, targets eosinophils by blocking an interleukin-5 receptor, improving severe allergic asthma. Severe eosinophilic asthma affects about 10% of asthma patients and often requires high-dose corticosteroids, which are linked to adrenal insufficiency and poor outcomes. This study will perform a detailed review and meta-analysis to evaluate the effectiveness and safety of benralizumab in eosinophilic asthma.</p><p><strong>Method: </strong>The analysis included relevant RCTs identified through systematic searches of PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from April 2013 to January 2024. The study included variables such as exacerbation, Asthma Control Questionnaire (ACQ), forced expiratory volume (FEV₁), and adverse events.</p><p><strong>Results: </strong>A total of 5502 patients with eosinophilic asthma were enrolled across 15 randomized-controlled trials; 3061 received benralizumab and 2441 received placebo. A meta-analysis showed that benralizumab significantly improved FEV₁ compared with control, with a pooled mean difference of 0.107 L (95% CI 0.059, 0.155; p < 0.001). Using a random-effects model with Hartung-Knapp adjustment, the pooled mean difference was - 0.174 (95% CI - 0.326, - 0.022; p = 0.030), indicating a statistically significant improvement in ACQ while the pooled odds ratio (OR) for adverse effects was 0.93 (95% CI 0.71, 1.23; p = 0.583) showing no statistically significant difference between benralizumab and control in the risk of adverse effects.</p><p><strong>Conclusion: </strong>The meta-analysis indicated that benralizumab provides significant improvement in lung function (FEV₁) and asthma control (ACQ) compared to placebo in severe eosinophilic asthma. Clinically, the average FEV₁ improvement of approximately 0.11 L represents a small but valuable gain for patients with significant baseline obstruction, though it falls below the threshold for a minimal clinically important difference (MCID) in ACQ scores. However, substantial heterogeneity was observed across studies, demonstrating that these pooled estimates represent average effects and that individual patient responses may vary considerably.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42024548225.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150983","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":"Acupuncture for vascular mild cognitive impairment: an updated systematic review and meta-analysis of randomized controlled trials.","authors":"An-Qi Cai, Le-Yan Hu, Yi-Ying Wang, Shuai Dong, Bo Li, Guo-Yan Yang, Jian-Ping Liu, Hui-Juan Cao","doi":"10.1186/s13643-026-03207-9","DOIUrl":"10.1186/s13643-026-03207-9","url":null,"abstract":"<p><strong>Background: </strong>Vascular mild cognitive impairment (VMCI) is a potentially transitional state between normal aging and vascular dementia. The presence of macroscopic white matter lesions (WML) of moderate or severe extension on brain MRI is the hallmark of the vascular mild cognitive impairment.</p><p><strong>Objective: </strong>To assess the effectiveness and safety of acupuncture for vascular mild cognitive impairment.</p><p><strong>Methods: </strong>Six electronic databases and two clinical trial websites were searched for randomized controlled trials which investigated the effects of acupuncture compared with sham acupuncture, drugs or usual care (such as cognitive rehabilitation). Studies comparing acupuncture combined with other therapies with this therapy alone for VMCI were also included. The quality of the trials selected was evaluated according to the Cochrane 'risk of bias' tool. RevMan V.5.4 software was employed for data analysis. Risk ratio (RR) or mean difference (MD) and their 95% confidence interval (CI) were used for a dichotomous or continuous variable, respectively.</p><p><strong>Results: </strong>Forty-nine trials with 3555 participants were included, with the exception of one trial judged to have a low risk of bias, 43 trials were all judged to have some concerns or a high risk of bias. Meta-analysis showed superior effect of acupuncture as add-on treatment to usual care on increasing the MMSE scores (MD 2.15, 95% CI 1.61 to 2.69, 7 trials, 536 participants, I² = 22%, P < 0.00001). Five trials also found superior effect of body acupuncture as add-on treatment to usual care on increasing the MoCA scores (MD 2.50, 95% CI 1.80 to 3.20, 5 trials, 340 participants, I² = 0%, P < 0.00001). Among the included studies, two studies reported adverse reactions.</p><p><strong>Conclusions: </strong>Acupuncture seems to be a promising treatment for vascular cognitive impairment to slow the progression of the disease and improve cognitive function. However, evidence is limited due to heterogeneity and the small number of included trials.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022382245.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150970","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":"Correction: Impact of alcohol consumption, substance use, and smoking on treatment outcomes in tuberculosis: a systematic review and meta-analysis.","authors":"Bahram Heshmati, Sanaz Omidi, Younes Mohammadi","doi":"10.1186/s13643-026-03210-0","DOIUrl":"10.1186/s13643-026-03210-0","url":null,"abstract":"","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":"15 1","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138948","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}