Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising ...Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising strategy to mitigate the adverse effects of prolonged sitting and promote physical activity,ultimately promoting overall health.However,previous ambiguity in defining this concept has resulted in a fragmented and inconsistent evidence base,impeding practical applications,the development of guidelines,and policymaking.The purpose of this study is to establish an operational definition of SBAE by synthesizing systematic reviews and research trials alongside an expert consensus.Additionally,it seeks to evaluate acute and long-term efficacy and feasibility,providing evidence-based recommendations for practice and future research directions.Methods:A literature search was performed across PubMed and Web of Science,followed by systematic screening and summarization of eligible studies based on predefined inclusion criteria.Inclusion criteria encompassed various modes/types of SBAE(bouts lasting≤10 min,performed multiple times daily with≥30 min intervals);both aerobic and resistance exercise were considered.Relevant systematic reviews and research trials were included.Methodological quality,risk of bias,and evidence certainty were assessed.Expert consensus was obtained through a survey to evaluate recommendations and agreement levels on findings.Results:After analyzing 27 systematic reviews,135 research studies,and an expert consensus involving 48 researchers from 11 countries,SBAE is defined as any exercise mode of activity,regardless of intensity,that is accumulated in either continuous or intermittent bouts lasting≤10 min per session(including multiple intermittent sets)that are performed multiple times(≥2 sessions/day)per day,with intervals of≥30 min between bouts or otherwise sufficient time for recovery.When used to interrupt prolonged periods of sedentary time,SBAE mitigates the acute adverse effects of sedentary behavior on more than 10 clinical biomarkers of endocrine,cardiovascular,and brain health/function among adults of diverse ages and conditions.Moreover,SBAE was superior for improving acute glycemic control compared to a single continuous exercise session.As a long-term intervention(average of 11 weeks),SBAE can improve over 20 health outcomes,including peak oxygen uptake,resting blood pressure,and metabolic health.Additionally,SBAE might be more effective than continuous exercise for improving longer-term glycemic control and body composition.Long-term completion rates for SBAE interventions are generally high(95%),with low dropout rates(12%)and high adherence rates even without supervision(85%),and its safety has been preliminarily validated.Conclusion:An operational definition of SBAE is provided along with its classification and acute and long-term efficacy.Practical exercise prescription recommendations and evidence-based strategies for various populations and contexts are provided.Future research should focus on generating high-quality evidence for SBAE in 5 key areas:quantification and monitoring,population-specific responses,optimization of exercise prescriptions,intervention efficacy,and practical implementation.Additionally,addressing policy,environmental,and promotional barriers is crucial for transitioning from expert consensus to public consensus,and for facilitating the application of this strategy in real-world environments.展开更多
OBJECTIVE:In recent years,the number of clinical research reports on acupuncture and manipulation for the treatment of greater occipital neuralgia has gradually increased,but the quality is uneven.There is currently n...OBJECTIVE:In recent years,the number of clinical research reports on acupuncture and manipulation for the treatment of greater occipital neuralgia has gradually increased,but the quality is uneven.There is currently no literature evaluating the quality of published reports,which is not conducive to the promotion of clinical use of these therapies.Therefore,this article assessed the reporting quality of randomized controlled trials on acupuncture and manipulation for greater occipital neuralgia.METHODS:Cochrane Library,PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),VIP,WanFang Data,and Chinese BioMedical Literature Database(CBM)from inception to May 20,2024 were searched.The reporting quality of included randomized controlled trials was independently evaluated by two investigators using the CONSORT statement,STRICTA checklist,and Cochrane bias of risk assessment tool.A third investigator resolved any disagreement.RESULTS:A total of 62 articles were included.Based on the CONSORT statement,59.46%(22/37)of all entries had a reporting rate of less than 50%,mainly including“Identification as a randomized trial in the title(1/62,1.61%),”“How sample size was determined(7/62,11.29%),”“Implementation(1/62,1.61%),”“Blinding(1/62,1.61%),”and“Reports of Funding(4/62,6.45%).”According to the STRICTA checklist,29.41%(5/17)of all entries had a reporting rate of less than 50%,mainly including“Details of other interventions(7/58,12.07%),”“Setting and context of treatment(0/58,0%),”and“Description of participating acupuncturists(0/58,0%).”CONCLUSION:The reporting quality of randomized controlled trials on acupuncture and manipulation therapy for greater occipital neuralgia remains low.Future researchers need to make greater efforts to strictly adhere to the CONSORT statement and STRICTA checklist during trial design,implementation,and reporting.This will facilitate the standardization of research in this field and enhance the reliability and reproducibility of the research results.展开更多
Declaration of Competing Interest statements is updated in the published version of the following articles that appeared in issues of Resources Chemicals and Materials.The appropriate updated Declaration of Competing ...Declaration of Competing Interest statements is updated in the published version of the following articles that appeared in issues of Resources Chemicals and Materials.The appropriate updated Declaration of Competing Interest state-ments,provided by the Authors,are included below.展开更多
Internal audit plays a strategic role in ensuring the reliability of government financial statements,which are essential tools for achieving public financial accountability and transparency.This study aims to analyze ...Internal audit plays a strategic role in ensuring the reliability of government financial statements,which are essential tools for achieving public financial accountability and transparency.This study aims to analyze the role of internal audit in improving the quality of government financial reporting using a literature review approach based on agency theory.The method employed is a systematic literature review of 12 scholarly articles(7 national and 5 international),as well as relevant books and official reports published within the last five years(2019-2024).The findings indicate that an effective and independent internal audit can reduce information asymmetry between the government(agent)and the public(principal),enhance compliance with Government Accounting Standards(SAP),and strengthen internal controls and financial governance.This study concludes that a competent internal audit function is a critical prerequisite for producing reliable,relevant,and accountable financial statements.The findings support agency theory and offer key recommendations for strengthening internal audit practices in the public sector.展开更多
Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Journal of Dermatologic Science and Cosmetic Technology.The appropr...Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Journal of Dermatologic Science and Cosmetic Technology.The appropriate Declaration/Competing Interest statements,provided by the Authors,are included below.展开更多
Ethical Statements and Participant’s Consents were not included in the published version of the following articles that appeared in previous issues of Allergy Medicine.The appropriate Ethical Statements and Particip...Ethical Statements and Participant’s Consents were not included in the published version of the following articles that appeared in previous issues of Allergy Medicine.The appropriate Ethical Statements and Participant’s Consents provided by the Authors,are included below:“Exploring drug-induced toxic epidermal necrolysis:A case series and comprehensive review”[Allergy Medicine,Volume 3,March 2025,100011]https://doi.org/10.1016/j.allmed.2024.100011 Ethical Statement:This research involves retrospective case analyses using de-identified patient data.There were no prospective interventions,and informed consent has been obtained.展开更多
The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration of Co...The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration of Competing Interest statements,provided by authors,are included below.展开更多
The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Compe...The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Competing Interest statements,provided by authors,are included below.展开更多
Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosi...Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.^([1-3]) A metaanalysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.^([4])This underscores the critical importance of prompt and eff ective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.展开更多
The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Compe...The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Competing Interest statements,provided by authors,are included below.展开更多
The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration of Co...The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration of Competing Interest statements,provided by authors,are included below.展开更多
The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Compe...The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Competing Interest statements,provided by authors,are included below.展开更多
诊断准确性试验(diagnostic test accuracy,DTA)的系统评价/Meta分析报告规范(PRISMA-DTA)用于规范和提高DTA的系统评价/Meta分析的报告质量,其于2018年1月发表在JAMA杂志。本文对其条目进行解读,以促进国内学者对PRISMA-DTA的理解和应...诊断准确性试验(diagnostic test accuracy,DTA)的系统评价/Meta分析报告规范(PRISMA-DTA)用于规范和提高DTA的系统评价/Meta分析的报告质量,其于2018年1月发表在JAMA杂志。本文对其条目进行解读,以促进国内学者对PRISMA-DTA的理解和应用,以期提高DTA的系统评价/Meta分析报告质量。展开更多
目的系统评价心血管疾病相关指南、共识和声明的质量。方法系统检索多个中英文数据库及权威指南发布平台,包括中国知网、万方、Scopus、PubMed、英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE...目的系统评价心血管疾病相关指南、共识和声明的质量。方法系统检索多个中英文数据库及权威指南发布平台,包括中国知网、万方、Scopus、PubMed、英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)和美国心脏协会(American Heart Association,AHA)官方网站,检索时间范围为2008年1月至2025年7月。由两位研究人员独立进行方法学与报告质量评价,其中,指南、共识及声明的方法学严谨性采用国际通用的AGREE Ⅱ量表进行评价,声明的报告规范性则依据RIGHT清单进行评价。为确保评价结果的可信度,研究者间评分的一致性通过计算组内相关系数(intraclass correlation coefficient,ICC)进行检验。结果共纳入21部指南、11部共识和3部声明。根据AGREEⅡ的评价结果,纳入的指南、共识与声明在“范围和目的”(96.89%)及“表达的清晰性”(95.91%)两个领域得分最高,平均标准化得分均高于95%;在“参与人员”(75.23%)、“制定的严谨性”(77.06%)和“编辑独立性”(71.29%)领域得分处于中等水平,“应用性”领域得分相对较低(58.26%)。最终遴选出15部A级和20部B级指南/共识/声明。RIGHT评价结果的平均报告率为58.95%。其中,“资金资助与利益冲突声明和管理”(90.00%)领域得分最高;“证据”(56.66%)、“推荐意见”(34.00%)、“评审与质量保证”(58.33%)三个领域得分相对较低;其他领域包括“基本信息”(67.50%)、“背景”(74.00%)、“其他方面”(66.67%)三个领域得分处于中等水平。结论心血管疾病相关指南、共识和声明的方法学和报告质量有待进一步提升。未来仍需严格遵循国际标准制定更高质量的心血管疾病指南、共识和声明,并强化推荐意见的临床可操作性。展开更多
A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the ...A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the pediatric and adolescent population. An electronic search was performed with the MEDLINE, EMBASE, Science Direct, and Scielo databases, as well as guidelines＇ Web sites until September 2015. Four guidelines were included in the qualitative synthesis. In general, the recommendations provided by the CPG/BPS were consistent despite the existence of some gaps across the studies. The guidelines issued by the American Urological Association （AUA） and American Society for Reproductive Medicine （ASRM） did not provide evidence-based levels for the recommendations given. Most of the recommendations given by the European Association of Urology （EAU） and European Society of Pediatric Urology （ESPU） were derived from nonrandomized clinical trials, retrospective studies, and expert opinion. Among all CPG/BPS, only one was specifically designed for the pediatric population. The studied guidelines did not undertake independent cost-effectiveness and risk-benefit analysis. The main objectives of these guidelines were to translate the best evidence into practice and provide a framework of standardized care while maintaining clinical autonomy and physician judgment. However, the limitations identified in the CPG/BPS for the diagnosis and management of varicocele in children and adolescents indicate ample opportunities for research and future incorporation of higher quality standards in patient care.展开更多
The robotic surgical system has been applied in liver surgery.However,controversies concerns exist regarding a variety of factors including the safety,feasibility,efficacy,and cost-effectiveness of robotic surgery.To ...The robotic surgical system has been applied in liver surgery.However,controversies concerns exist regarding a variety of factors including the safety,feasibility,efficacy,and cost-effectiveness of robotic surgery.To promote the development of robotic hepatectomy,this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts'consensus and recommendations to promote its development.Based on the World Health Organization Handbook for Guideline Development,a Consensus Steering Group and a Consensus Development Group were established to determine the topics,prepare evidence-based documents,and generate recommendations.The GRADE Grid method and Delphi vote were used to formulate the recommendations.A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings.Based on the published articles and expert panel opinion,7 recommendations were generated by the GRADE method using an evidence-based method,which focused on the safety,feasibility,indication,techniques and cost-effectiveness of hepatectomy.Given that the current evidences were low to very low as evaluated by the GRADE method,further randomized-controlled trials are needed in the future to validate these recommendations.展开更多
文摘Background:Insufficient physical activity and prolonged sedentary behavior have emerged as major global public health challenges.Short bouts(≤10 min)of accumulated exercise(SBAE)throughout the day may be a promising strategy to mitigate the adverse effects of prolonged sitting and promote physical activity,ultimately promoting overall health.However,previous ambiguity in defining this concept has resulted in a fragmented and inconsistent evidence base,impeding practical applications,the development of guidelines,and policymaking.The purpose of this study is to establish an operational definition of SBAE by synthesizing systematic reviews and research trials alongside an expert consensus.Additionally,it seeks to evaluate acute and long-term efficacy and feasibility,providing evidence-based recommendations for practice and future research directions.Methods:A literature search was performed across PubMed and Web of Science,followed by systematic screening and summarization of eligible studies based on predefined inclusion criteria.Inclusion criteria encompassed various modes/types of SBAE(bouts lasting≤10 min,performed multiple times daily with≥30 min intervals);both aerobic and resistance exercise were considered.Relevant systematic reviews and research trials were included.Methodological quality,risk of bias,and evidence certainty were assessed.Expert consensus was obtained through a survey to evaluate recommendations and agreement levels on findings.Results:After analyzing 27 systematic reviews,135 research studies,and an expert consensus involving 48 researchers from 11 countries,SBAE is defined as any exercise mode of activity,regardless of intensity,that is accumulated in either continuous or intermittent bouts lasting≤10 min per session(including multiple intermittent sets)that are performed multiple times(≥2 sessions/day)per day,with intervals of≥30 min between bouts or otherwise sufficient time for recovery.When used to interrupt prolonged periods of sedentary time,SBAE mitigates the acute adverse effects of sedentary behavior on more than 10 clinical biomarkers of endocrine,cardiovascular,and brain health/function among adults of diverse ages and conditions.Moreover,SBAE was superior for improving acute glycemic control compared to a single continuous exercise session.As a long-term intervention(average of 11 weeks),SBAE can improve over 20 health outcomes,including peak oxygen uptake,resting blood pressure,and metabolic health.Additionally,SBAE might be more effective than continuous exercise for improving longer-term glycemic control and body composition.Long-term completion rates for SBAE interventions are generally high(95%),with low dropout rates(12%)and high adherence rates even without supervision(85%),and its safety has been preliminarily validated.Conclusion:An operational definition of SBAE is provided along with its classification and acute and long-term efficacy.Practical exercise prescription recommendations and evidence-based strategies for various populations and contexts are provided.Future research should focus on generating high-quality evidence for SBAE in 5 key areas:quantification and monitoring,population-specific responses,optimization of exercise prescriptions,intervention efficacy,and practical implementation.Additionally,addressing policy,environmental,and promotional barriers is crucial for transitioning from expert consensus to public consensus,and for facilitating the application of this strategy in real-world environments.
文摘OBJECTIVE:In recent years,the number of clinical research reports on acupuncture and manipulation for the treatment of greater occipital neuralgia has gradually increased,but the quality is uneven.There is currently no literature evaluating the quality of published reports,which is not conducive to the promotion of clinical use of these therapies.Therefore,this article assessed the reporting quality of randomized controlled trials on acupuncture and manipulation for greater occipital neuralgia.METHODS:Cochrane Library,PubMed,Web of Science,Embase,China National Knowledge Infrastructure(CNKI),VIP,WanFang Data,and Chinese BioMedical Literature Database(CBM)from inception to May 20,2024 were searched.The reporting quality of included randomized controlled trials was independently evaluated by two investigators using the CONSORT statement,STRICTA checklist,and Cochrane bias of risk assessment tool.A third investigator resolved any disagreement.RESULTS:A total of 62 articles were included.Based on the CONSORT statement,59.46%(22/37)of all entries had a reporting rate of less than 50%,mainly including“Identification as a randomized trial in the title(1/62,1.61%),”“How sample size was determined(7/62,11.29%),”“Implementation(1/62,1.61%),”“Blinding(1/62,1.61%),”and“Reports of Funding(4/62,6.45%).”According to the STRICTA checklist,29.41%(5/17)of all entries had a reporting rate of less than 50%,mainly including“Details of other interventions(7/58,12.07%),”“Setting and context of treatment(0/58,0%),”and“Description of participating acupuncturists(0/58,0%).”CONCLUSION:The reporting quality of randomized controlled trials on acupuncture and manipulation therapy for greater occipital neuralgia remains low.Future researchers need to make greater efforts to strictly adhere to the CONSORT statement and STRICTA checklist during trial design,implementation,and reporting.This will facilitate the standardization of research in this field and enhance the reliability and reproducibility of the research results.
文摘Declaration of Competing Interest statements is updated in the published version of the following articles that appeared in issues of Resources Chemicals and Materials.The appropriate updated Declaration of Competing Interest state-ments,provided by the Authors,are included below.
文摘Internal audit plays a strategic role in ensuring the reliability of government financial statements,which are essential tools for achieving public financial accountability and transparency.This study aims to analyze the role of internal audit in improving the quality of government financial reporting using a literature review approach based on agency theory.The method employed is a systematic literature review of 12 scholarly articles(7 national and 5 international),as well as relevant books and official reports published within the last five years(2019-2024).The findings indicate that an effective and independent internal audit can reduce information asymmetry between the government(agent)and the public(principal),enhance compliance with Government Accounting Standards(SAP),and strengthen internal controls and financial governance.This study concludes that a competent internal audit function is a critical prerequisite for producing reliable,relevant,and accountable financial statements.The findings support agency theory and offer key recommendations for strengthening internal audit practices in the public sector.
文摘Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Journal of Dermatologic Science and Cosmetic Technology.The appropriate Declaration/Competing Interest statements,provided by the Authors,are included below.
文摘Ethical Statements and Participant’s Consents were not included in the published version of the following articles that appeared in previous issues of Allergy Medicine.The appropriate Ethical Statements and Participant’s Consents provided by the Authors,are included below:“Exploring drug-induced toxic epidermal necrolysis:A case series and comprehensive review”[Allergy Medicine,Volume 3,March 2025,100011]https://doi.org/10.1016/j.allmed.2024.100011 Ethical Statement:This research involves retrospective case analyses using de-identified patient data.There were no prospective interventions,and informed consent has been obtained.
文摘The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration of Competing Interest statements,provided by authors,are included below.
文摘The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Competing Interest statements,provided by authors,are included below.
文摘Hemoptysis is defined as bleeding originating from the respiratory tract distal to the larynx and is associated with a wide spectrum of underlying conditions,including bronchiectasis,pulmonary malignancies,tuberculosis,aspergillosis,and vascular malformations.^([1-3]) A metaanalysis involving patients with massive hemoptysis reported a mortality rate of 3.5%.^([4])This underscores the critical importance of prompt and eff ective embolization of the responsible artery to improve outcomes,particularly in patients presenting with life-threatening hemoptysis.
文摘The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Competing Interest statements,provided by authors,are included below.
文摘The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration of Competing Interest statements,provided by authors,are included below.
文摘The Declaration of Competing Interest statements were not included in the published version of the following articles that appeared in previous issues of Water Science and Engineering.The appropriate Declaration Competing Interest statements,provided by authors,are included below.
文摘诊断准确性试验(diagnostic test accuracy,DTA)的系统评价/Meta分析报告规范(PRISMA-DTA)用于规范和提高DTA的系统评价/Meta分析的报告质量,其于2018年1月发表在JAMA杂志。本文对其条目进行解读,以促进国内学者对PRISMA-DTA的理解和应用,以期提高DTA的系统评价/Meta分析报告质量。
文摘目的系统评价心血管疾病相关指南、共识和声明的质量。方法系统检索多个中英文数据库及权威指南发布平台,包括中国知网、万方、Scopus、PubMed、英国国家卫生与临床优化研究所(National Institute for Health and Care Excellence,NICE)和美国心脏协会(American Heart Association,AHA)官方网站,检索时间范围为2008年1月至2025年7月。由两位研究人员独立进行方法学与报告质量评价,其中,指南、共识及声明的方法学严谨性采用国际通用的AGREE Ⅱ量表进行评价,声明的报告规范性则依据RIGHT清单进行评价。为确保评价结果的可信度,研究者间评分的一致性通过计算组内相关系数(intraclass correlation coefficient,ICC)进行检验。结果共纳入21部指南、11部共识和3部声明。根据AGREEⅡ的评价结果,纳入的指南、共识与声明在“范围和目的”(96.89%)及“表达的清晰性”(95.91%)两个领域得分最高,平均标准化得分均高于95%;在“参与人员”(75.23%)、“制定的严谨性”(77.06%)和“编辑独立性”(71.29%)领域得分处于中等水平,“应用性”领域得分相对较低(58.26%)。最终遴选出15部A级和20部B级指南/共识/声明。RIGHT评价结果的平均报告率为58.95%。其中,“资金资助与利益冲突声明和管理”(90.00%)领域得分最高;“证据”(56.66%)、“推荐意见”(34.00%)、“评审与质量保证”(58.33%)三个领域得分相对较低;其他领域包括“基本信息”(67.50%)、“背景”(74.00%)、“其他方面”(66.67%)三个领域得分处于中等水平。结论心血管疾病相关指南、共识和声明的方法学和报告质量有待进一步提升。未来仍需严格遵循国际标准制定更高质量的心血管疾病指南、共识和声明,并强化推荐意见的临床可操作性。
文摘A systematic review was conducted to identify and qualitatively analyze the methods as well as recommendations of Clinical Practice Guidelines （CPG） and Best Practice Statements （BPS） concerning varicocele in the pediatric and adolescent population. An electronic search was performed with the MEDLINE, EMBASE, Science Direct, and Scielo databases, as well as guidelines＇ Web sites until September 2015. Four guidelines were included in the qualitative synthesis. In general, the recommendations provided by the CPG/BPS were consistent despite the existence of some gaps across the studies. The guidelines issued by the American Urological Association （AUA） and American Society for Reproductive Medicine （ASRM） did not provide evidence-based levels for the recommendations given. Most of the recommendations given by the European Association of Urology （EAU） and European Society of Pediatric Urology （ESPU） were derived from nonrandomized clinical trials, retrospective studies, and expert opinion. Among all CPG/BPS, only one was specifically designed for the pediatric population. The studied guidelines did not undertake independent cost-effectiveness and risk-benefit analysis. The main objectives of these guidelines were to translate the best evidence into practice and provide a framework of standardized care while maintaining clinical autonomy and physician judgment. However, the limitations identified in the CPG/BPS for the diagnosis and management of varicocele in children and adolescents indicate ample opportunities for research and future incorporation of higher quality standards in patient care.
基金Supported by National Key Research and Development Program of China,No.2017YFC0110405National Natural Science Foundation of China,No.81500499
文摘The robotic surgical system has been applied in liver surgery.However,controversies concerns exist regarding a variety of factors including the safety,feasibility,efficacy,and cost-effectiveness of robotic surgery.To promote the development of robotic hepatectomy,this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts'consensus and recommendations to promote its development.Based on the World Health Organization Handbook for Guideline Development,a Consensus Steering Group and a Consensus Development Group were established to determine the topics,prepare evidence-based documents,and generate recommendations.The GRADE Grid method and Delphi vote were used to formulate the recommendations.A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings.Based on the published articles and expert panel opinion,7 recommendations were generated by the GRADE method using an evidence-based method,which focused on the safety,feasibility,indication,techniques and cost-effectiveness of hepatectomy.Given that the current evidences were low to very low as evaluated by the GRADE method,further randomized-controlled trials are needed in the future to validate these recommendations.
