BMJ Evidence-Based Medicine最新文献

{"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":"135-138"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","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}

{"title":"It is time to improve the quality of service standards using evidence-based practice.","authors":"Zhenggang Bai, Nannan Shi, Haibo Cheng, Xiaoliang Cheng","doi":"10.1136/bmjebm-2025-114228","DOIUrl":"10.1136/bmjebm-2025-114228","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"73-74"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218444","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":"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":"125-131"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","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":"Evaluation of reported claims of sex-based differences in treatment effects across meta-analyses: a meta-research study.","authors":"Lum Kastrati, Sara Farina, Angelica Valz Gris, Hamidreza Raeisi-Dehkordi, Erand Llanaj, Hugo G Quezada-Pinedo, Lia Bally, Taulant Muka, John P A Ioannidis","doi":"10.1136/bmjebm-2024-113359","DOIUrl":"10.1136/bmjebm-2024-113359","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Differences in treatment effects between men and women may have important implications across diverse interventions and diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to evaluate claims of sex-based differences in treatment effects across published meta-analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Eligibility criteria: &lt;/strong&gt;Published meta-analyses of randomised controlled trials (RCTs) that had any mention of sex (male/female) subgroup or related analysis in their abstract INFORMATION SOURCES: PubMed (searched up to 17 January 2024).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Synthesis: &lt;/strong&gt;We determined how many meta-analyses had made claims of sex-based differences in treatment effects. These meta-analyses were examined in depth to determine whether the claims reflected sex-treatment interactions with statistical support or fallacious claims, and we categorised the frequency of different fallacies or genuine interactions. We also investigated how many of the genuine and fallacious claims were considered and discussed in Up-To-Date. Whenever possible, we reanalysed the p value for sex-treatment interaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Number of claims with statistical support and fallacious claims; clinical implications of subgroup differences as well as the credibility of subgroup analyses assessed by the Instrument to assess the Credibility of Effect Modification Analyses criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;216 meta-analysis articles fulfilled the eligibility criteria. Of them, 99 stated in the abstract that there was no sex-based difference, and 20 mentioned a sex-based subgroup analysis but without reporting results in the abstract. The other 97 meta-analyses made 115 claims of sex-based differences. 27 of the 115 positive claims for subgroup differences made across 21 articles had statistical support at p&lt;0.05, of which 4 were mentioned in Up-To-Date, with none leading to different recommendations for men and women. 39 of the 115 positive claims made across 35 articles were fallacious, where the sex-treatment interaction was not statistically significant. The most common form of fallacy (29/115) was made in instances where there was a significant effect in one sex, but not in the other, with no true difference between the two groups. In 7/115 other claims, there were larger effects in one sex, again, with no true difference between the two groups, and 3/115 other claims had various forms of fallacies.Another 44 articles made 49 claims based on potentially fallacious methods (44 based on meta-regression, and 5 provided the results of only one group), but proper data were unavailable to assess statistical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Few meta-analyses of RCTs make claims of sex-based differences in treatment effects, and most of these claims lack formal statistical support. In the present sample, statistically significant and clinically actionable sex-treatment interactions were ra","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"114-124"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332350","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":"10.1136/bmjebm-2024-113443","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"79-82"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","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":"Developing a core outcome set for dysphagia interventions in Parkinson's disease: an international Delphi consensus study.","authors":"Julia Hirschwald, Paul Conroy, Gary Boyle, Tobias Warnecke, Margaret Walshe","doi":"10.1136/bmjebm-2024-113543","DOIUrl":"10.1136/bmjebm-2024-113543","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a core outcome set (COS) for oropharyngeal dysphagia (swallowing disorder) interventions in Parkinson's disease by agreeing core outcomes and definitions, outcome measurement instruments (OMIs) and time points of measurement for these core outcomes.</p><p><strong>Design: </strong>International online Delphi survey and consensus meetings.</p><p><strong>Participants: </strong>Individuals living with oropharyngeal dysphagia and Parkinson's disease, family members and caregivers, healthcare professionals and researchers in the field of oropharyngeal dysphagia and Parkinson's disease.</p><p><strong>Methods: </strong>A long list of outcomes was generated previously through scoping reviews, online surveys and focus groups with key stakeholders. Building on this, an international three-round online Delphi survey was conducted where participants rated the importance of outcomes. In subsequent online consensus meetings, core outcomes, their definitions, OMIs and time points of measurement were agreed on.</p><p><strong>Results: </strong>90 participants from 21 countries completed all three rounds of the Delphi survey. Of these, 35 participated in a consensus meeting. Six outcomes were agreed as the core outcomes: 'penetration/aspiration', 'aspiration pneumonia', 'choking', 'oropharyngeal dysphagia severity', 'swallowing related quality of life' and 'post swallow pharyngeal residue'.</p><p><strong>Conclusions: </strong>The use of a COS in future oropharyngeal dysphagia intervention studies in Parkinson's disease will facilitate comparative effectiveness research and ensure that outcomes are relevant to all key stakeholders. This should help improve the evidence base for oropharyngeal dysphagia interventions in Parkinson's disease.</p><p><strong>Registration: </strong>The study was registered prospectively with the Core Outcome Measures in Effectiveness Trials Database on 24 September 2021 (www.comet-initiative.org, registration number: 1942).</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"93-101"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975690","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":"Are we ready for AI-augmented generalists?","authors":"Jiajie Zhang","doi":"10.1136/bmjebm-2024-113597","DOIUrl":"10.1136/bmjebm-2024-113597","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"139-140"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in the selection and measurement of outcomes in psychiatric trials.","authors":"Sophie Juul, Pascal Faltermeier, Faiza Siddiqui, Johanne Juul Petersen, Caroline Barkholt Kamp, Rikke Hermann Jakobsen, Lehana Thabane, Joanna Moncrieff, Mark Horowitz, Zainab Samaan, Michael Pascal Hengartner, Lawrence Mbuagbaw, Markus Harboe Olsen, Christian Gluud, Janus Christian Jakobsen","doi":"10.1136/bmjebm-2024-113171","DOIUrl":"10.1136/bmjebm-2024-113171","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"75-78"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967720","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":"Standardised mean difference.","authors":"Daniel Gallardo-Gómez, Kerry Dwan","doi":"10.1136/bmjebm-2024-113579","DOIUrl":"10.1136/bmjebm-2024-113579","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"132-134"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180471","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":"Patient-reported outcomes and acupuncture-related adverse events are overlooked in acupuncture randomised controlled trials: a cross-sectional meta-epidemiological study.","authors":"Yuting Duan, Pinge Zhao, Shujuan Liu, Siqi Wu, Yuening Deng, Zhirui Xu, Xinyu Li, Lin Shi, Yao Wu, Yuejuan Cai, Feng Jiang, Lin Yu","doi":"10.1136/bmjebm-2024-113497","DOIUrl":"10.1136/bmjebm-2024-113497","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the patient-reported outcomes (PROs) and acupuncture-related adverse events (A-AEs) in acupuncture randomised controlled trials (RCTs).</p><p><strong>Design: </strong>Cross-sectional meta-epidemiological study.</p><p><strong>Data sources: </strong>We comprehensively searched for eligible studies between 1 January 2014 and 1 May 2024, in MEDLINE, EMBASE, CENTRAL, CBM, CNKI, Wanfang Data and VIP Database.</p><p><strong>Eligibility criteria: </strong>RCTs that used acupuncture as the intervention group to obtain the efficacy and/or safety of acupuncture therapy. Acupuncture therapy should be based on Traditional Medicine theory.</p><p><strong>Main outcome measures: </strong>We assessed (1) the general characteristics of acupuncture RCTs; (2) the general characteristics of PROs; (3) the reporting scores of PROs by the Extension of Consolidated Standards of Reporting Trials of Patient-Reported Outcomes (CONSORT PRO Extension); (4) the general characteristic of A-AEs; (5) the incidence of A-AEs.</p><p><strong>Results: </strong>We included 476 studies in this study. 296 (62.2%) used PROs as study outcomes, 272 (57.1%) reported safety outcomes. The Visual Analogue Scale (149, 23.7%) and the Pittsburgh Sleep Quality Index (42, 6.7%) were the most common PROs reported. The reporting of PROs was incomplete, with sufficiently reporting scores ranging from 2.7% to 97.6% across the CONSORT PRO Extension. 164 studies reported A-AEs, of which 141 reported specific details, and we found that the OR for the incidence of AEs in the acupuncture group compared to the control group was 1.434 (95% CI 1.148 to 1.793). We identified 1277 reports of A-AEs in eligible studies, predominantly tissue injury (eg, haematoma, bleeding), irritation (eg, pain, post-acupuncture discomfort), with no reports of serious A-AEs. The reporting of A-AEs lacked details on the acquisition methods (15.5%), occurrence time (5.5%), A-AEs' treatment (18.1%) and A-AEs' recovery (19.7%). Studies that reported funding, registry information, acupuncturist qualifications and non-significant primary outcomes were associated with the A-AEs' reporting, and the difference was statistically significant (p≤0.05).</p><p><strong>Conclusion: </strong>This study found that the reporting of PROs and A-AEs was insufficient in acupuncture RCTs. Future studies should clarify the clinical significance of using PROs as outcomes and report AEs comprehensively to provide patients with sufficient information on the benefits and harms of acupuncture treatments.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"83-92"},"PeriodicalIF":7.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973990","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}