BMJ Evidence-Based Medicine最新文献

{"title":"Educating health professionals in evidence-based practice in 2026.","authors":"Tiziano Innocenti, Gordon Guyatt, Nino Cartabellotta, Paul Glasziou, Dragan Ilic, David Nunan","doi":"10.1136/bmjebm-2025-114184","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114184","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating data extraction error by a large language model from randomised controlled trials: a large-scale empirical study.","authors":"Shiqi Fan, Ming Chen, Suhail A Doi, Zhangnan Ye, Zhen Peng, Yuan Tian, Chengzhi Zhang, Luis Furuya-Kanamori, Lifeng Lin, Evan Mayo-Wilson, Mohammad Hassan Murad, Xiuhong Meng, Chang Xu","doi":"10.1136/bmjebm-2025-114044","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114044","url":null,"abstract":"<p><strong>Objective: </strong>To examine the potential errors of a general large language model (LLM) (ie, Claude 3.5 Sonnet) on data extraction from randomised controlled trials (RCTs).</p><p><strong>Design and setting: </strong>An empirical study comparing Claude 3.5 Sonnet extractions against a human-performed verification dataset. The extraction tasks for Claude 3.5 Sonnet were based solely on original RCT portable document format (PDF) files. For PDFs that could not be directly extracted by Claude 3.5 Sonnet, optical character recognition was employed to convert them into text format before extraction.</p><p><strong>Participants: </strong>A random sample of 664 trials was selected from a well-established trial bank and a final data pool was established based on rigorous manual cross-checking as a reference standard.</p><p><strong>Data sources: </strong>PubMed, EMBASE, Scopus, Web of Science (all databases) and the Cochrane Central Register of Controlled Trials (CENTRAL) up to February 2023.</p><p><strong>Eligibility criteria for selecting studies: </strong>RCTs on children involving medication and adverse events.</p><p><strong>Main outcome measures: </strong>Claude 3.5 Sonnet was applied to extract the basic information (eg, trial design, population information and source of funding) and adverse outcomes (ie, name of adverse events, number of events). Claude 3.5 Sonnet outputs were compared against the final data pool and all errors were recorded. Results are presented as error rates and with 95% CI, estimated using a generalised linear mixed model.</p><p><strong>Results: </strong>For the 664 trials, a total of 23 069 data cells were extracted via Claude 3.5 Sonnet, with 10 624 for basic information and 12 445 for adverse outcomes. The overall error rate for data extraction was 6.6% (95% CI 5.4% to 8.2%), with 5.7% (95% CI 5.2% to 6.1%) in basic information and 7.6% (95% CI 4.9% to 11.8%) in adverse outcomes. When stratified the 1542 total errors by error types, misallocation (assigning data to incorrect fields; 57.1%, 881/1542) and missed or omitted data (incomplete extraction of available data; 23.2%, 357/1542) accounted for the two most frequent errors, with misallocation occurring more in basic information (53.3%, 470/881), while missed or omitted data occurred more in adverse outcomes (96.1%, 343/357). Post hoc analysis examining the association between trial reporting quality (assessed using Consolidated Standards of Reporting Trials (CONSORT) 2025 and LLM data extraction error rates indicated that higher CONSORT adherence was associated with lower extraction error rates.</p><p><strong>Conclusions: </strong>The data extraction error of Claude was relatively low, but it alerts LLM applications in evidence synthesis. Detailed checking for LLM outputs should be the primary consideration for evidence synthesisers.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing shared decision-making in clinical practice: a systematic review and meta-analysis of studies using OPTION-12 and OPTION-5.","authors":"Cato Caroline Bresser, Andrea Duarte-Díaz, Himar González-Pacheco, Amado Rivero-Santana, Yolanda Ramallo-Fariña, Jet Westerink, Lea Dijksman, Harm van Melick, Paul van der Nat, France Légaré, Glyn Elwyn, Mirjam Garvelink, Lilisbeth Perestelo-Perez","doi":"10.1136/bmjebm-2025-113830","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-113830","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Observing Patient Involvement in Decision Making (OPTION)-12 and OPTION-5 assess the extent to which observers score healthcare professionals' (HCPs) involvement of patients in shared decision-making (SDM). We systematically reviewed studies measuring the extent to which HCPs involve patients in the decision-making process using the OPTION instrument.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we updated a previous systematic review and included new studies reporting OPTION-12 or OPTION-5 scores from recordings of real-world clinical encounters, involving patients and HCPs making healthcare-related decisions. Searches were conducted across PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases (2012-2025), supplemented by citation screening and outreach to professional networks. We extracted study characteristics, OPTION version, psychometric data and item-level score details. We also assessed the study quality using the reports of rating procedures and conducted meta-analyses, subgroup analyses using a priori hypotheses and completed meta-regressions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 174 studies were included, comprising almost 20 000 clinical consultations: 102 studies used only OPTION-12 and 64 used only OPTION-5, while four studies reported using both scales. Mean OPTION-12 and OPTION-5 score for studies unaffected by interventions were 25.1 (95% CI 22.1 to 28.2, k=76, I&lt;sup&gt;2&lt;/sup&gt;=99.71%) and 31.8 (95% CI 26.6 to 37.1, k=42, I&lt;sup&gt;2&lt;/sup&gt;=99.55%), respectively. Subgroup analyses revealed significantly higher scores in studies with postintervention OPTION-scores for both OPTION-12 (38.4 vs 25.1, p&lt;0.001, k=91, I&lt;sup&gt;2&lt;/sup&gt;=99.55%) and OPTION-5 (47.7 vs 31.8, p&lt;0.001, k=65, I&lt;sup&gt;2&lt;/sup&gt;=99.39%). In univariable meta-regression, longer consultation duration and female patient percentage (only for OPTION-12) were associated with higher scores. However, multivariable meta-regression revealed that clinical setting was the sole independent predictor for OPTION-12 (p=0.007), whereas consultation duration remained the primary independent predictor for OPTION-5 (p=0.003).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Since the 2015 previous review, little overall improvement has been observed. This limited progress raises important questions about how we interpret changes in observed SDM. Specifically, it remains unclear what degree of change in OPTION-12 scores reflects a meaningful improvement. Our multivariable findings provide a more nuanced perspective: while consultation duration remains the primary independent predictor for patient involvement when measured with OPTION-5, clinical setting emerges as a more critical independent driver for OPTION-12. These results suggest that the influence of time is not uniform across assessment tools and that structural barriers in different clinical environments ","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity and representativeness in pragmatic drug trials: methodological and ethical considerations.","authors":"Rafael Dal-Re, Ana Abreu, Tor Biering-Sørensen, Christopher P Gale, Sigrun Halvorsen, Søren Holm, Borja Ibanez, Stefan James, Roberto Latini, David Shaw","doi":"10.1136/bmjebm-2025-114106","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114106","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on 'Effectiveness and clinical relevance of kinesio taping in musculoskeletal disorders: an overview of systematic reviews and evidence mapping' by Mo <i>et al</i>.","authors":"Jean-Pascal Grenier","doi":"10.1136/bmjebm-2026-114689","DOIUrl":"https://doi.org/10.1136/bmjebm-2026-114689","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing shared decision-making towards social justice: insights into an intersectional and decolonial approach from a Brazil-Canada partnership.","authors":"Roberta de Carvalho Corôa, Eliane Chaves Vianna, Monica Vieira, Amédé Gogovor","doi":"10.1136/bmjebm-2024-113590","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113590","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering seeding trials: examining non-scientific purposes in clinical trials.","authors":"Sukhun Kang, Ivan Lin, Sungyong Chang","doi":"10.1136/bmjebm-2025-114242","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114242","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and clinical relevance of kinesio taping in musculoskeletal disorders: an overview of systematic reviews and evidence mapping.","authors":"Qingcong Mo, Zhenmeng Deng, Jialing Zheng, Tong Wu, Fangfei Hu, Siqi Xu, Jihua Zou, Xiaoyan Zheng","doi":"10.1136/bmjebm-2025-114067","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114067","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effectiveness and clinical relevance of kinesio taping (KT) in musculoskeletal disorders (MSDs) at different follow-ups.</p><p><strong>Design: </strong>Overview of systematic reviews (SRs) and evidence mapping.</p><p><strong>Information sources: </strong>Ten electronic databases were searched for SRs published from inception to 31 December 2024, and updated on 15 October 2025.</p><p><strong>Eligibility criteria: </strong>SRs with and without meta-analysis of randomised controlled trials (RCTs) were eligible for inclusion if they compared KT with interventions other than KT (eg, active interventions, no tape, placebo/sham KT) in participants with MSDs.</p><p><strong>Main outcome measures: </strong>The primary outcomes were pain intensity, function/disability, range of motion, muscle strength, quality of life and disease-specific symptoms. The secondary outcome was adverse events (AEs).</p><p><strong>Results: </strong>A total of 128 SRs (73 published SRs and 55 registered yet unpublished SRs) involving 15 812 participants from 310 unique RCTs were included. Substantial SRs were focused on lower extremity conditions (45%) and reported pain intensity (89%). Most SRs were evaluated as critically low (78%) in methodological quality and low (58%) in risk of bias, with a median total compliance rate of 75.6% in reporting quality. Findings from new meta-analyses indicated that KT may reduce pain intensity in the immediate (Hedges' g -0.69, 95% CI -0.81 to -0.57) and short (Hedges' g -0.57, 95% CI -0.77 to -0.37) term and improve function/disability (Hedges' g -0.54, 95% CI -0.69 to -0.40) in the immediate term. These effect estimates may achieve the predefined minimal clinically important difference of 0.5 SD (medium effect size). KT may show little to no effect on pain intensity in the medium term, function/disability in the short and medium term, muscle strength, range of motion, disease-specific symptoms at all follow-ups. The effects of KT may vary across subgroups or conditions, and its impact on quality of life is unclear. AEs related to KT mainly included skin irritation (number needed to harm (NNH) 173) and pruritus (NNH 356). All evidence was highly inconclusive due to very low certainty (Grading of Recommendations Assessment, Development and Evaluation), non-significant level (evidence level) and unstable clinical relevance across most outcomes.</p><p><strong>Conclusions: </strong>Current evidence is very uncertain regarding the clinical effects of KT on MSDs. Considerable heterogeneity, unclear clinical relevance and potential AEs may limit its application in clinical practice. Further high-quality, well-reported RCTs and SRs are warranted to address the uncertainty regarding overall effects along with comprehensive consideration of heterogeneity in KT usage.</p><p><strong>Prospero registration number: </strong>CRD42024517528.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence contamination: what it is and why it matters.","authors":"Chang Xu, Luis Furuya-Kanamori, Zhichun Gu, Yoon Loke, Lifeng Lin, Jennifer Stone, Zhaohu Fan, Su Golder, Zongshi Qin, Xiaodong Guan, Justin Clark, Liang Du, Sheyu Li, Yang Song, Linan Zeng, Haitao Chu, Mohammad Hassan Murad, Ben W Mol, Sunita Vohra, Suhail A Doi","doi":"10.1136/bmjebm-2025-114305","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114305","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147526549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of various exercise interventions in insomnia patients: a systematic review and network meta-analysis.","authors":"Zhi-Jun Bu, Feng-Shuang Liu, Md Shahjalal, Yi-Ke Song, Meng-Chi Li, Rong-Er Zhuo, Qing-Hong Zhong, Ya-Wen Du, Chen-Ge Lu, Zi-Han Yang, Han-Yu Yang, Pu Zhong, Jian-Ping Liu, Zhao-Lan Liu","doi":"10.1136/bmjebm-2024-113512","DOIUrl":"10.1136/bmjebm-2024-113512","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare the effectiveness of different exercise interventions in improving sleep quality and alleviating insomnia severity among patients with insomnia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Our study design was a systematic review and network meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Our study eligibility criteria was restricted to include randomised controlled trials (RCTs) involving adults with insomnia that evaluated exercise-based interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;PubMed, Cochrane Library, Embase, Web of Science, SPORTDiscus, and PsycINFO databases were systematically searched from inception to 1 April 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Risk of bias and certainty assessment: &lt;/strong&gt;Risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. The certainty of the evidence was evaluated using the Confidence in Network Meta-Analysis (CINeMA) platform.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis of results: &lt;/strong&gt;A frequentist network meta-analysis was performed to assess the effectiveness of interventions, with outcomes presented as mean differences (MDs) and 95% confidence intervals (95% CIs). Sleep outcomes were measured using validated tools, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), sleep diaries, and combined objective sleep measures such as polysomnography or actigraphy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The review included 1348 participants from 22 RCTs, examining 13 distinct interventions, of which seven were exercise-based: yoga, Tai Chi, walking or jogging, aerobic plus strength exercise, strength training alone, aerobic exercise combined with therapy, and mixed aerobic exercises. Among the included trials, four (18%) were rated as low risk of bias, 15 (68%) had some concerns, and three (14%) were considered to have a high risk. Compared with active controls (eg, usual care, lifestyle modifications), yoga likely results in a large increase in total sleep time (MD 110.88 minutes (min), 95% CI 58.66 to 163.09; moderate-certainty evidence) and may improve sleep efficiency (MD 15.59%, 95% CI 5.76 to 25.42; low-certainty evidence), reduce wake after sleep onset (MD -55.91 min, 95% CI -98.14 to -13.68; low-certainty evidence), and shorten sleep onset latency (MD -29.27 min, 95% CI -50.09 to -8.45; low-certainty evidence), all based on sleep diary data. Walking or jogging may result in a large reduction in ISI scores (MD -9.57 points, 95% CI -12.12 to -7.02; low-certainty evidence). Tai Chi may reduce PSQI scores (MD -4.57 points, 95% CI -7.50 to -1.63; low-certainty evidence), increase total sleep time (MD 52.07 min, 95% CI 25.53 to 78.61; low-certainty evidence), reduce wake after sleep onset (MD -36.11 min, 95% CI -62.81 to -9.42; low-certainty evidence), and shorten sleep onset latency (MD -24.76 min, 95% CI -41.07 to -8.46; low-certainty evidence), also based on sleep diary data. Additionally, Tai Chi may increase total sleep time as measured by combined obje","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"102-113"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}