BMJ Evidence-Based Medicine最新文献

{"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":"https://doi.org/10.1136/bmjebm-2024-113512","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effectiveness of different exercise interventions in improving sleep quality and alleviating insomnia severity among patients with insomnia.</p><p><strong>Design: </strong>Our study design was a systematic review and network meta-analysis.</p><p><strong>Eligibility criteria: </strong>Our study eligibility criteria was restricted to include randomised controlled trials (RCTs) involving adults with insomnia that evaluated exercise-based interventions.</p><p><strong>Data sources: </strong>PubMed, Cochrane Library, Embase, Web of Science, SPORTDiscus, and PsycINFO databases were systematically searched from inception to 1 April 2025.</p><p><strong>Risk of bias and certainty assessment: </strong>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.</p><p><strong>Synthesis of results: </strong>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.</p><p><strong>Results: </strong>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":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-15","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}

{"title":"Examining the layered health literacy demands in low-value care contexts.","authors":"Danielle Marie Muscat, Tessa Copp, Brooke Nickel, Kirsten McCaffery","doi":"10.1136/bmjebm-2024-113443","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113443","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616164","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":"Open science for qualitative research.","authors":"Crystal N Steltenpohl, Brinna Mawhinney, Veli-Matti Karhulahti, Annayah M B Prosser","doi":"10.1136/bmjebm-2024-113532","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113532","url":null,"abstract":"<p><p>Open scholarship practices-often also referred to as open research or open science-are increasingly seen as relevant to the research lifecycle. What open scholarship looks like in practice will inevitably vary by field, methodology, epistemology, access to resources, and other considerations. In this article, we outline a few important considerations for researchers who use qualitative research methods in deciding which open scholarship practices are most applicable for their own work and suggest a few practices that may be of interest, namely data sharing, preregistration, negative case analysis, audit trails and member checking. Engagement or disengagement of any given practice should be guided by demands of research epistemology, context, community, topicn and methodology. Finally, we suggest a few places for researchers to start if they wish to learn more about open scholarship more broadly and engage with critical conversations around these practices.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616165","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":"Understanding synthetic data: artificial datasets for real-world evidence.","authors":"Randi Foraker, Jon D Morrow, Julie A Johnson, Adam B Wilcox, Alan J Forster, Philip R O Payne","doi":"10.1136/bmjebm-2024-113617","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113617","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552073","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":"CARE extension guideline for acupuncture case reports.","authors":"Yuting Duan, Zhirui Xu, Yongqi Zhang, Shujuan Liu, Juexuan Chen, Yaolong Chen, Nenggui Xu, Chunzhi Tang, Peijing Rong, Liming Lu, Yu Wang, Ye-Seul Lee, Tae-Hun Kim, David S Riley, Lin Shi, Myeong Soo Lee, Lin Yu","doi":"10.1136/bmjebm-2025-113641","DOIUrl":"10.1136/bmjebm-2025-113641","url":null,"abstract":"<p><p>Existing reporting checklists lack the specificity and comprehensiveness required to effectively guide the documentation of acupuncture case reports. Therefore, we developed a reporting guideline tailored specifically for acupuncture case reports, building upon the CAse REport (CARE) statement. A multidisciplinary group of international experts including clinicians, researchers and methodologists was convened to draft the initial checklist in accordance with the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network. Through an extensive literature review and a series of expert interviews, the final CARE for acupuncture checklist comprised of 30 items. 38 experts from diverse disciplines participated in three rounds of modified Delphi surveys to refine and clarify these items. CARE for acupuncture is a comprehensive reporting guideline focused on acupuncture case reports developed with rigorous methodology. We hope that CARE for acupuncture will further guide authors, editors, peer reviewers and readers to enhance the transparency, completeness and accuracy of reporting of case reports in acupuncture.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494545","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":"Outcomes of the first national oral cancer screening programme in Taiwan, 2004-2022: a population-based study.","authors":"Wayne Gao, Min-Kuang Tsai, Thu Win Kyaw, Yea-Hung Chen","doi":"10.1136/bmjebm-2024-113340","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113340","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates whether Taiwan's national oral cancer screening programme, implemented in 1999, has led to a reduction in late-stage oral cancer and mortality.</p><p><strong>Design: </strong>An observational population-based ecological cohort study (2004-2022) using data from the Taiwan Cancer Registry, a nationwide cancer registry.</p><p><strong>Setting: </strong>Taiwan, an island nation with a population of 23.5 million.</p><p><strong>Participants: </strong>The entire male population in the nation diagnosed with oral cancer between 2004 and 2022.</p><p><strong>Main outcome measures: </strong>Change in stage-specific, age-standardised incidence and mortality of oral cancer and their annual percentage change (APC). We hypothesised that an effective screening programme would lead to an increase in early-stage cancer diagnoses while reducing late-stage cancer incidence and mortality.</p><p><strong>Results: </strong>A total of 92 342 males were diagnosed with oral cancer in Taiwan between 2004 and 2022. Following the introduction of the national oral cancer screening programme, the incidence of early-stage (stages 0-1) oral cancer increased 2.4-fold from 6.6 to 14.5 per 100 000 males between 2004 and 2013 (APC: 11.3% (95% CI 9.4% to 13.5%), p<0.001). However, early-stage incidence subsequently declined to 11.8 per 100 000 males by 2022 (APC: -3.2% (95% CI -5.2% to -1.6%), p<0.001), corresponding to a period of decreased screening uptake between 2015 and 2022. The late-stage (stages 2-4) oral cancer increased from 24.5 to 28.3 per 100 000 males between 2004 and 2009 (APC: 3.3% (95% CI 1.8% to 6.6%), p<0.001) and then remained relatively stable between 2009 and 2022 (APC: 0.1% (95% CI -0.5% to 0.5%), p=0.65). Oral cancer mortality increased from 14.4 to 16.6 per 100 000 males over the entire examined period between 2004 and 2022 (APC: 0.76% (95% CI 0.5% to 1.1%), p<0.001), showing no observed decline despite two decades of screening efforts and a continued decrease in prevalence of betel quid use.</p><p><strong>Conclusions: </strong>Although oral cancer screening detected more early-stage cancer, no reduction in population late-stage incidence or mortality was observed. Therefore, reducing betel quid and cigarette consumption should be the primary focus for oral cancer control. The public health response to oral cancer should borrow from lessons learnt in tobacco control.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538412","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":"Accurate is not enough: select formats for communicating probabilities to achieve specific outcomes.","authors":"Brian J Zikmund-Fisher, Jessica S Ancker","doi":"10.1136/bmjebm-2025-113738","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-113738","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538411","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":"Encouraging the use of the best available evidence in journal clubs for practising clinicians.","authors":"Ignacio Neumann, Federico Bottaro, Ariel Izcovich, Agustín Bengolea, Camila Agnoletti, Martin Alberto Ragusa, Fernando Tortosa, Lorena Karzulovic, Luz María Letelier, Hugo Catalano, Holger Schünemann","doi":"10.1136/bmjebm-2024-113448","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113448","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494546","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":"Children's and caregivers' participation in the development of paediatric core outcome sets: a cross-sectional analysis.","authors":"Ruobing Lei, Janne Estill, Haiyun Wang, Jin Xiong, Qiu Li, Yaolong Chen, Paula Williamson","doi":"10.1136/bmjebm-2024-113521","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113521","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to address the status of children's and caregivers' participation in the development of paediatric core outcome sets (COS).</p><p><strong>Methods: </strong>We included all paediatric COS from a previous systematic review and searched the Core Outcome Measures in Effectiveness Trials database to 26 February 2024 for recent paediatric COS. We used descriptive and thematic analysis methods to present the characteristics of the included COS and to describe children's and caregivers' participation in the development, including any facilitators and barriers. We assessed the degree of participation of children and caregivers in two steps: by rating whether their views were considered in forming the outcome list (yes/no) and then whether their views were integrated in determining the most important outcomes (fully integrated/partially integrated/not integrated).</p><p><strong>Results: </strong>A total of 114 paediatric COS were included. 60 (53%) COS involved children and caregivers in the development process. 29 (48%) of the 60 COS considered children's and caregivers' views in forming the initial outcome list, which was most often conducted by interview (n=12 of 29, 41%). Regarding determining the most important outcomes, 35 (58%) of the 60 COS fully integrated children's and caregivers' views, and the most common method was the Delphi survey with consensus meeting (n=29 of 35, 83%); the youngest child participants were aged 7 years. The most frequently mentioned facilitator of children's and caregivers' participation was the engagement of patient groups or organisations.</p><p><strong>Conclusion and relevance: </strong>We evaluated the degree of children's and caregivers' participation in the development of COS and found that strategies to promote children's and caregivers' participation should be constructed.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483121","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":"MetaImpact: a novel tool to enable evidence-based sample sizes for future trials.","authors":"Clareece Nevill, Terence J Quinn, Nicola Cooper, Alex Sutton","doi":"10.1136/bmjebm-2025-113694","DOIUrl":"10.1136/bmjebm-2025-113694","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336310","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}