BMJ Evidence-Based Medicine最新文献

{"title":"Advancing the 'Choosing Wisely' campaign to reduce low-value care in China.","authors":"Jay Pan, Wendy Levinson, Xiaolin Wei, Liyong Lu","doi":"10.1136/bmjebm-2025-114176","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114176","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197378","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":"Trump's statements about acetaminophen and the problem of epistemic corrections.","authors":"Federico Germani, Giovanni Spitale, Arthur L Caplan","doi":"10.1136/bmjebm-2025-114372","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114372","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164059","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":"Cluster-randomised controlled trials.","authors":"Marty Chaplin","doi":"10.1136/bmjebm-2025-114304","DOIUrl":"https://doi.org/10.1136/bmjebm-2025-114304","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146163923","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":"Rapid reviews methods series: practical guidance for conducting timely evidence syntheses.","authors":"Ursula Griebler, Juan Va Franco","doi":"10.1136/bmjebm-2025-114270","DOIUrl":"10.1136/bmjebm-2025-114270","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"1-2"},"PeriodicalIF":7.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145586011","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":"Time deficiency: an affliction of healthcare systems and how to ameliorate it.","authors":"Stephen H Bradley, Victor M Montori","doi":"10.1136/bmjebm-2024-113455","DOIUrl":"10.1136/bmjebm-2024-113455","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"71-72"},"PeriodicalIF":7.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959396","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":"How to promote the application of reporting guidelines in acupuncture research.","authors":"Xiaoyu Liu, Shiyan Yan","doi":"10.1136/bmjebm-2024-113386","DOIUrl":"10.1136/bmjebm-2024-113386","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"66-70"},"PeriodicalIF":7.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085741","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":"Alcohol use and risk of dementia in diverse populations: evidence from cohort, case-control and Mendelian randomisation approaches.","authors":"Anya Topiwala, Daniel F Levey, Hang Zhou, Joseph D Deak, Keyrun Adhikari, Klaus P Ebmeier, Steven Bell, Stephen Burgess, Thomas E Nichols, Michael Gaziano, Murray Stein, Joel Gelernter","doi":"10.1136/bmjebm-2025-113913","DOIUrl":"10.1136/bmjebm-2025-113913","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between alcohol consumption and dementia.</p><p><strong>Design: </strong>Prospective cohort and case-control analyses combined with linear and non-linear Mendelian randomisation.</p><p><strong>Setting: </strong>Two large-scale population-based cohorts: the US Million Veteran Programme and the UK Biobank. Genetic analyses used summary statistics from genome-wide association studies (GWAS).</p><p><strong>Participants: </strong>559 559 adults aged 56-72 years at baseline were included in observational analyses (mean follow-up: 4 years in the US cohort; 12 years in the UK cohort). Genetic analyses used summary data from multiple large GWAS consortia (2.4 million participants).</p><p><strong>Main outcome measures: </strong>Incident all-cause dementia, determined through health record linkage, and genetic proxies.</p><p><strong>Results: </strong>During follow-up, 14 540 participants developed dementia and 48 034 died. Observational phenotype-only analyses revealed U-shaped associations between alcohol and dementia risk: higher risk was observed among non-drinkers, heavy drinkers (>40 drinks per week; HR 1.41, 95% CI 1.15 to 1.74), and those with alcohol use disorder (AUD) (HR 1.51, 95% CI 1.42 to 1.60) compared with light drinkers. In contrast, Mendelian randomisation genetic analysis identified a monotonic increase in dementia risk with greater alcohol consumption. A 1 SD increase in log-transformed drinks per week was associated with a 15% dementia increase (inverse-variance weighted (IVW) OR 1.15, 95% CI 1.03 to 1.27). A twofold increase in AUD prevalence was associated with a 16% increase in dementia risk (IVW OR 1.16, 95% CI 1.03 to 1.30). Alcohol intake increased dementia, but individuals who developed dementia also experienced a decline in alcohol intake over time, suggesting reverse causation-where early cognitive decline leads to reduced alcohol consumption-underlies the supposed protective alcohol effects in observational studies.</p><p><strong>Conclusions: </strong>These findings provide evidence for a relationship between all types of alcohol use and increased dementia risk. While correlational observational data suggested a protective effect of light drinking, this could be in part attributable to reduced drinking seen in early dementia; genetic analyses did not support any protective effect, suggesting that any level of alcohol consumption may contribute to dementia risk. Public health strategies that reduce the prevalence of alcohol use disorder could potentially lower the incidence of dementia by up to 16%.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"13-22"},"PeriodicalIF":10.8,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7618643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129871","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":"Encounter versus patient decision aids to enhance shared decision-making.","authors":"Joshua Christensen, Angie Fagerlin, Kirstin Beck, Elissa M Ozanne","doi":"10.1136/bmjebm-2024-113208","DOIUrl":"10.1136/bmjebm-2024-113208","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"3-6"},"PeriodicalIF":7.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963736","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":"Unknowns of drug company payment disclosure: why the UK needs payment transparency legislation.","authors":"Piotr Ozieranski, Emily Rickard, Shai Mulinari","doi":"10.1136/bmjebm-2024-113101","DOIUrl":"10.1136/bmjebm-2024-113101","url":null,"abstract":"","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"7-12"},"PeriodicalIF":7.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944316","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":"AI-driven speech biomarkers for disease diagnosis and monitoring: a systematic review and meta-analysis.","authors":"Yi Yang, Xiaoyan Zhao, Peng Zhao, Dire Ying, Junyu Wang, Yihe Jiang, Qiaoqin Wan","doi":"10.1136/bmjebm-2025-113759","DOIUrl":"10.1136/bmjebm-2025-113759","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to comprehensively review the literature on the use of speech biomarkers in disease diagnosis and monitoring, focusing on recording protocols, speech tasks, speech features and processing algorithms.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Data sources: </strong>We conducted a search of six databases: PubMed, Embase, Scopus, Web of Science, PsycINFO and IEEE Xplore, covering studies published from database inception to May 2024.</p><p><strong>Main outcome measures: </strong>The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) and the Quality Assessment of Prognostic Accuracy Studies (QUAPAS). Pooled sensitivity and specificity were calculated using a random-effects model. Subgroup analyses examined potential sources of heterogeneity, such as disease type, language, speech tasks, features and algorithms.</p><p><strong>Results: </strong>A total of 96 studies were included, with 83 adopting a cross-sectional design and 50 having sample sizes of fewer than 100 participants. Assessment with QUADAS-2 and QUAPAS revealed that most included studies exhibited a high risk of bias in patient selection and index test domains, while concerns regarding applicability were generally low across studies. These studies covered 20 different diseases, with cognitive disorders, depression and Parkinson's disease being the most frequently studied. The pooled sensitivity and specificity for diagnostic models were 0.80 (95% CI 0.74 to 0.86) and 0.77 (95% CI 0.69 to 0.84) for psychiatric disorders (11 studies, n=2577); 0.85 (95% CI 0.83 to 0.88) and 0.83 (95% CI 0.79 to 0.86) for cognitive disorders (27 studies, n=2068); and 0.81 (95% CI 0.76 to 0.85) and 0.83 (95% CI 0.78 to 0.88) for movement disorders (20 studies, n=852). Further subgroup analyses identified recording device, language, speech task, speech features and algorithm selection as significant contributors to heterogeneity.</p><p><strong>Conclusions: </strong>This review and meta-analysis of 96 studies highlights the influence of devices, environments, languages, tasks, features and algorithms on speech model performance across diseases. While speech biomarkers show promise for screening and monitoring-particularly via smartphones-the high risk of bias in many studies, especially in patient selection and index test interpretation, limits the strength of current evidence. Future large-scale, prospective studies are needed to validate generalisability and support clinical implementation.</p><p><strong>Prospero registration number: </strong>CRD42024551962.</p>","PeriodicalId":9059,"journal":{"name":"BMJ Evidence-Based Medicine","volume":" ","pages":"46-56"},"PeriodicalIF":10.8,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249679","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}