BMJ Evidence-Based Medicine最新文献

{"title":"AI in healthcare: an introduction for clinicians.","authors":"Ahmed Maiter, Samer Alabed, Genevera Allen, Fares Alahdab","doi":"10.1136/bmjebm-2024-112966","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-112966","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036402","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":"Proposed framework for unifying disease definitions in guideline development.","authors":"Hassan Kawtharany, Muayad Azzam, M Hassan Murad, Rebecca L Morgan, Yngve Falck-Ytter, Shahnaz Sultan, Philipp Dahm, Reem A Mustafa","doi":"10.1136/bmjebm-2024-113134","DOIUrl":"https://doi.org/10.1136/bmjebm-2024-113134","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036403","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":"Efforts towards the institutionalisation of evidence-informed decision-making.","authors":"Laura Boeira, Emily Hayter, Sandy Oliver, Laurenz Mahlanza-Langer, Donald Simeon, Mukdarut Bangpan, Veronica Osorio Calderon, Ludovic Reveiz, Shelly-Ann Hunte, Firmaye Bogale Wolde, Tanja Kuchenmuller","doi":"10.1136/bmjebm-2024-112962","DOIUrl":"10.1136/bmjebm-2024-112962","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7617397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027719","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":"Risk ratios, odds ratios and the risk difference.","authors":"Rachel Richardson, Afroditi Kanellopoulou, Kerry Dwan","doi":"10.1136/bmjebm-2024-113088","DOIUrl":"10.1136/bmjebm-2024-113088","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"66-67"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859009","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":"What is the vibration of effects?","authors":"Constant Vinatier, Sabine Hoffmann, Chirag Patel, Nicholas J DeVito, Ioana Alina Cristea, Braden Tierney, John P A Ioannidis, Florian Naudet","doi":"10.1136/bmjebm-2023-112747","DOIUrl":"10.1136/bmjebm-2023-112747","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"61-65"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598379","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":"Pilot study on large language models for risk-of-bias assessments in systematic reviews: A(I) new type of bias?","authors":"Joseph Barsby, Samuel Hume, Hamish Al Lemmey, Joseph Cutteridge, Regent Lee, Katarzyna D Bera","doi":"10.1136/bmjebm-2024-112990","DOIUrl":"10.1136/bmjebm-2024-112990","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"71-74"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086781","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":"Successes, shortcomings and learning opportunities for evidence-based medicine from the COVID-19 pandemic.","authors":"Arnav Agarwal, Gordon Guyatt","doi":"10.1136/bmjebm-2023-112815","DOIUrl":"10.1136/bmjebm-2023-112815","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"1-4"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854737","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":"Pharmacological interventions for preventing upper gastrointestinal bleeding in people admitted to intensive care units: a network meta-analysis.","authors":"Ingrid Toews, Salman Hussain, John L Z Nyirenda, Maria A Willis, Lucia Kantorová, Simona Slezáková, Minyahil Tadesse Boltena, John Victor Peter, Luis Eduardo Santos Fontes, Miloslav Klugar, Behnam Sadeghirad, Joerg J Meerpohl","doi":"10.1136/bmjebm-2024-112886","DOIUrl":"10.1136/bmjebm-2024-112886","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the efficacy and safety of pharmacological interventions for preventing upper gastrointestinal (GI) bleeding in people admitted to intensive care units (ICUs).</p><p><strong>Design and setting: </strong>Systematic review and frequentist network meta-analysis using standard methodological procedures as recommended by Cochrane for screening of records, data extraction and analysis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence.</p><p><strong>Participants: </strong>Randomised controlled trials involving patients admitted to ICUs for longer than 24 hours were included.</p><p><strong>Search methods: </strong>The Cochrane Gut Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Latin American and Caribbean Health Science Information database (LILACS) databases were searched from August 2017 to March 2022. The search in MEDLINE was updated in April 2023. We also searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP).</p><p><strong>Main outcome measures: </strong>The primary outcome was the prevention of clinically important upper GI bleeding.</p><p><strong>Results: </strong>We included 123 studies with 46 996 participants. Cimetidine (relative risk (RR) 0.56, 95% CI 0.40 to 0.77, moderate certainty), ranitidine (RR 0.54, 95% CI 0.38 to 0.76, moderate certainty), antacids (RR 0.48, 95% CI 0.33 to 0.68, moderate certainty), sucralfate (RR 0.54, 95% CI 0.39 to 0.75, moderate certainty) and a combination of ranitidine and antacids (RR 0.13, 95% CI 0.03 to 0.62, moderate certainty) are likely effective in preventing upper GI bleeding.The effect of any intervention on the prevention of nosocomial pneumonia, all-cause mortality in the ICU or the hospital, duration of the stay in the ICU, duration of intubation and (serious) adverse events remains unclear.</p><p><strong>Conclusions: </strong>Several interventions seem effective in preventing clinically important upper GI bleeding while there is limited evidence for other outcomes. Patient-relevant benefits and harms need to be assessed under consideration of the patients' underlying conditions.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"22-35"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598378","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":"Rapid reviews methods series: assessing the appropriateness of conducting a rapid review.","authors":"Chantelle Garritty, Barbara Nussbaumer-Streit, Candyce Hamel, Declan Devane","doi":"10.1136/bmjebm-2023-112722","DOIUrl":"10.1136/bmjebm-2023-112722","url":null,"abstract":"<p><p>This paper, part of the Cochrane Rapid Review Methods Group series, offers guidance on determining when to conduct a rapid review (RR) instead of a full systematic review (SR). While both review types aim to comprehensively synthesise evidence, RRs, conducted within a shorter time frame of typically 6 months or less, involve streamlined methods to expedite the process. The decision to opt for an RR depends on the urgency of the research question, resource availability and the impact on decision outcomes. The paper categorises scenarios where RRs are appropriate, including urgent decision-making, informing guidelines, assessing new technologies and identifying evidence gaps. It also outlines instances when RRs may be inappropriate, cautioning against conducting them solely for ease, quick publication or only cost-saving motives.When deciding on an RR, it is crucial to consider both conceptual and practical factors. These factors encompass the urgency of needing timely evidence, the consequences of waiting for a full SR, the potential risks associated with incomplete evidence, and the risk of not using synthesised evidence in decision-making, among other considerations. Key factors to weigh also include having a clearly defined need, a manageable scope and access to the necessary expertise. Overall, this paper aims to guide informed judgements about whether to choose an RR over an SR based on the specific research question and context. Researchers and decision-makers are encouraged to carefully weigh potential trade-offs when opting for RRs.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"55-60"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130641","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":"Associations between device-measured and self-reported physical activity and common mental disorders: Findings from a large-scale prospective cohort study.","authors":"Zhe Wang, Zhi Cao, Jiahao Min, Tingshan Duan, Chenjie Xu","doi":"10.1136/bmjebm-2024-112933","DOIUrl":"10.1136/bmjebm-2024-112933","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the associations between device-measured and self-reported physical activity (PA) and incident common mental disorders in the general population.</p><p><strong>Design and setting: </strong>Large-scale prospective cohort study.</p><p><strong>Participants: </strong>Using the UK Biobank data, a validated PA questionnaire was used to estimate self-reported weekly PA in 365 656 participants between 2006 and 2010 while 91 800 participants wore wrist-worn accelerometers for 7 days in 2013-2015 to derive objectively measured PA. All the participants were followed up until 2021.</p><p><strong>Main outcome measures: </strong>Incidences of depression and anxiety were ascertained from hospital inpatient records. Cox proportional hazards models and restricted cubic splines were used to assess the associations between subjectively and objectively measured PA and common mental disorders.</p><p><strong>Results: </strong>During a median follow-up of 12.6 years, 16 589 cases of depression, 13 905 cases of anxiety and 5408 cases of comorbid depression and anxiety were documented in the questionnaire-based cohort. We found J-shaped associations of self-reported PA with incident risk of depression and anxiety, irrespective of PA intensities. The lowest risk for depression occurred at 550, 390, 180 and 560 min/week of light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA) and moderate-to-vigorous PA (MVPA), respectively. During a median follow-up of 6.9 years, a total of 2258 cases of depression, 2166 cases of anxiety and 729 cases of comorbid depression and anxiety were documented in the accelerometer-based cohort. We found L-shaped associations of device-measured MPA and VPA with incident depression and anxiety. MPA was adversely associated with incident depression and anxiety until 660 min/week, after which the associations plateaued. The point of inflection for VPA occurred at 50 min/week, beyond which there was a diminished but continued reduction in the risks of depression and anxiety.</p><p><strong>Conclusion: </strong>Different patterns of associations between self-reported and device-measured PA and mental health were observed. Future PA guidelines should fully recognise this inconsistency and increasingly employ objectively measured PA standards.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"45-54"},"PeriodicalIF":9.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598376","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}