目的对针刺治疗膝骨关节炎系统评价的方法学质量和证据质量进行再评价。方法通过计算机检索PubMed、Web of Science、Cochrane Library、Ovid、中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)自建...目的对针刺治疗膝骨关节炎系统评价的方法学质量和证据质量进行再评价。方法通过计算机检索PubMed、Web of Science、Cochrane Library、Ovid、中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(维普网)自建库至2020年4月16日针刺治疗膝骨关节炎的系统评价/Meta分析,筛选后提取相关信息,分别采用AMSTAR 2和GRADE系统评价纳入文献的方法学质量,并对结局指标进行证据质量分级。结果共纳入10篇系统评价/Meta分析文献,涉及23个结局指标。AMSTAR 2质量评价表明,10篇文献方法学质量均为极低,所有文献均未提前注册和报告研究计划(条目2)、未说明纳入研究类型的原因(条目3)、未提供排除文献的清单和理由(条目7);此外,研究者未重视资金来源和利益冲突对研究结果的影响(条目10、条目16)。23个指标中20个为低级或极低级证据,大多数指标因不精确性和存在发表偏倚而降级。结论目前,针刺治疗膝骨关节炎系统评价方法学和证据质量较低,难以科学指导临床应用和决策,尚需更高质量的循证证据。展开更多
Objective:To evaluate the methodological quality of the systematic reviews(SRs)of acupuncture and moxibustion for chronic constipation and rate the evidence bodies of their Meta-analysis.Methods:We searched MEDLINE,EM...Objective:To evaluate the methodological quality of the systematic reviews(SRs)of acupuncture and moxibustion for chronic constipation and rate the evidence bodies of their Meta-analysis.Methods:We searched MEDLINE,EMBASE,Chinese Biomedical Literature Database(CBM),the China National Knowledge Infrastructure(CNKI),the VIP Database and the WanFang Database.Systematic Aseviews and Meta-analysis of all Randomized Controlled Trials(RCTs)of acupuncture and moxibustion for chronic constipation were included.Data from the included studies were extracted by two independent reviewers and were re-evaluated with AMSTAR 2 and Grades of Recommendation,Assessment,Development,and Evaluation(GRADE).Results:We included 12 SRs/Meta-analysis with only one conducted outside China.Evaluated with AMSTAR 2,methodology of one SR was of medium quality,methodologies of 7 SRs were of low quality,and methodologies of 4 SRs were of critical low quality.Among 54 outcome measures screened from included SRs,7 outcome measures introduced evidence bodies of moderate quality,22 outcome measures were of low quality and 25 outcome measures were of very low quality.No high level of quality was awarded to any evidence body.Conclusion:Overall,the quality level of SR/Meta-analysis of acupuncture/moxibustion for chronic constipation is low.The SRs/Meta-analysis of acupuncture/moxibustion for chronic constipation can be used for guideline formulation and clinical decision making by taking into account the experience of clinical experts,patients'preference,medical policies and other factors.展开更多
目的对瑜伽干预2型糖尿病有效性的系统评价/Meta分析进行再评价,以指导临床相关科学研究,为医务人员提供决策依据。方法计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、Cochrane Library、Embase、Web of Science、JBI和CINAHL数据库...目的对瑜伽干预2型糖尿病有效性的系统评价/Meta分析进行再评价,以指导临床相关科学研究,为医务人员提供决策依据。方法计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、Cochrane Library、Embase、Web of Science、JBI和CINAHL数据库,搜集瑜伽干预2型糖尿病的系统评价/Meta分析,检索时限均从建库至2023年11月6日。由2名研究者独立进行文献筛选、资料提取,采用AMSTAR对纳入研究评价方法学质量,采用GRADE分级标准评估证据确信度,并对结局指标进行统计分析。结果最终纳入14项系统评价/Meta分析。AMSTAR评价结果显示7项研究为高质量和7项研究为中质量。GRADE评价结果显示证据2项为高确信度,26项为中确信度,其余31项为低或极低确信度。研究结果显示:瑜伽能较好地降低空腹血糖(中等确信度)、糖化血红蛋白(中等确信度)和餐后血糖水平(中等确信度),且在高密度胆固醇(中等确信度)、低密度胆固醇(中等确信度)、甘油三脂(中等确信度)、总胆固醇(中等确信度)、收缩压和舒张压(中等确信度)、肌肉力量(高等确信度)、心肺健康(中等确信度)和体重水平(中等确信度)等方面也优于其他干预。结论现有证据表明瑜伽具有较好的血糖控制效果,且在血脂参数和人体测量指标方面也存在一定的疗效,但当前研究证据质量和确信度较低,今后的研究者应规范研究设计,为2型糖尿病的预后治疗提供更多高质量证据。展开更多
基金Ministry of Science and Technology of the People's Republic of China,"Development of International Clinical Practice Guideline,Technical Operation Standard and Service Standard of Acupuncture and Moxibustion".Granting number:2019YFC1712200。
文摘Objective:To evaluate the methodological quality of the systematic reviews(SRs)of acupuncture and moxibustion for chronic constipation and rate the evidence bodies of their Meta-analysis.Methods:We searched MEDLINE,EMBASE,Chinese Biomedical Literature Database(CBM),the China National Knowledge Infrastructure(CNKI),the VIP Database and the WanFang Database.Systematic Aseviews and Meta-analysis of all Randomized Controlled Trials(RCTs)of acupuncture and moxibustion for chronic constipation were included.Data from the included studies were extracted by two independent reviewers and were re-evaluated with AMSTAR 2 and Grades of Recommendation,Assessment,Development,and Evaluation(GRADE).Results:We included 12 SRs/Meta-analysis with only one conducted outside China.Evaluated with AMSTAR 2,methodology of one SR was of medium quality,methodologies of 7 SRs were of low quality,and methodologies of 4 SRs were of critical low quality.Among 54 outcome measures screened from included SRs,7 outcome measures introduced evidence bodies of moderate quality,22 outcome measures were of low quality and 25 outcome measures were of very low quality.No high level of quality was awarded to any evidence body.Conclusion:Overall,the quality level of SR/Meta-analysis of acupuncture/moxibustion for chronic constipation is low.The SRs/Meta-analysis of acupuncture/moxibustion for chronic constipation can be used for guideline formulation and clinical decision making by taking into account the experience of clinical experts,patients'preference,medical policies and other factors.
文摘目的对瑜伽干预2型糖尿病有效性的系统评价/Meta分析进行再评价,以指导临床相关科学研究,为医务人员提供决策依据。方法计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、Cochrane Library、Embase、Web of Science、JBI和CINAHL数据库,搜集瑜伽干预2型糖尿病的系统评价/Meta分析,检索时限均从建库至2023年11月6日。由2名研究者独立进行文献筛选、资料提取,采用AMSTAR对纳入研究评价方法学质量,采用GRADE分级标准评估证据确信度,并对结局指标进行统计分析。结果最终纳入14项系统评价/Meta分析。AMSTAR评价结果显示7项研究为高质量和7项研究为中质量。GRADE评价结果显示证据2项为高确信度,26项为中确信度,其余31项为低或极低确信度。研究结果显示:瑜伽能较好地降低空腹血糖(中等确信度)、糖化血红蛋白(中等确信度)和餐后血糖水平(中等确信度),且在高密度胆固醇(中等确信度)、低密度胆固醇(中等确信度)、甘油三脂(中等确信度)、总胆固醇(中等确信度)、收缩压和舒张压(中等确信度)、肌肉力量(高等确信度)、心肺健康(中等确信度)和体重水平(中等确信度)等方面也优于其他干预。结论现有证据表明瑜伽具有较好的血糖控制效果,且在血脂参数和人体测量指标方面也存在一定的疗效,但当前研究证据质量和确信度较低,今后的研究者应规范研究设计,为2型糖尿病的预后治疗提供更多高质量证据。