Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic ...Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
Background:The bibliometrics of acupuncture are growing rapidly.However,the absence of reporting guidelines may lead to significant duplication and waste,thereby undermining the research’s value.To address this,a kno...Background:The bibliometrics of acupuncture are growing rapidly.However,the absence of reporting guidelines may lead to significant duplication and waste,thereby undermining the research’s value.To address this,a knowledge mapping was generated based on published studies to investigate the characteristics of bibliometric studies on acupuncture and the extent of duplicate publications,with the overarching goal of providing a comprehensive overview of the knowledge structure in this field.Methods:This cross-sectional study used three databases(PubMed,Web of Science,and Scopus)to identify relevant studies up to May 1,2024.In addition,the reference lists were retrieved as a supplement.To track research trends,we employed Microsoft Excel and R software to extract,code,and analyze information.Study selection,data extraction,and validation were performed independently by at least two reviewers.The reporting quality of included studies was assessed using the Preliminary guideline for reporting bibliometric reviews of the biomedical literature(BIBLIO).Results:Among the 6,221 bibliometric reviews examined,113 relevant publications were identified,80 focusing on various diseases/conditions.The annual number of publications has gradually increased,with the output in the past four years being 3.52 times higher than that before 2020.China(106)and Chengdu University of Traditional Chinese Medicine(16)have the highest number of publications.The most prolific author is Fan-Rong Liang,with six articles.The first bibliometric study,by Hai-Yan Li,was published in 2010.Journal of Pain Research,with 36 articles,holds the most publications.The top three diseases:diseases of the nervous system;symptoms,signs,or clinical findings not elsewhere classified;and mental,behavioral,or neurodevelopmental disorders.There may be potential duplication in research on 13 diseases/conditions,notably stroke,migraine,pain/analgesia,cancer pain,shoulder pain,facial paralysis/bell’s palsy,chronic pain,and cognitive impairment.In BIBLIO,the most frequently missing items are issues/topics(item 2),quality assessment(item 11),and descriptive findings(item 13).Conclusion:This study demonstrates that acupuncture bibliometrics is actively utilized to identify dominant diseases/conditions,aiding scholars in understand the knowledge structure and main topics.Although the number of related studies is increasing,with an average of 25 studies annually,overlap in some areas highlights the need for adherence to reporting guidelines and careful topic selection to ensure truly valuable insights and knowledge contributions.The adherence to BIBLIO’s 20 proposed items across analyzed articles,highlighting important in reporting practices.展开更多
Colorectal cancers comprise a large percentage of tumors worldwide,and transverse colon cancer(TCC)is defined as tumors located between hepatic and splenic flexures.Due to the anatomy and embryology complexity,and lac...Colorectal cancers comprise a large percentage of tumors worldwide,and transverse colon cancer(TCC)is defined as tumors located between hepatic and splenic flexures.Due to the anatomy and embryology complexity,and lack of large randomized controlled trials,it is a challenge to standardize TCC surgery.In this study,the current situation of transverse/extended colectomy,robotic/laparoscopic/open surgery and complete mesocolic excision(CME)concept in TCC operations is discussed and a heatmap is conducted to show the evidence level and gap.In summary,transverse colectomy challenges the dogma of traditional extended colectomy,with similar oncological and prognostic outcomes.Compared with conventional open resection,laparoscopic and robotic surgery plays a more important role in both transverse colectomy and extended colectomy.The CME concept may contribute to the radical resection of TCC and adequate harvested lymph nodes.According to published studies,laparoscopic or robotic transverse colectomy based on the CME concept was the appropriate surgical procedure for TCC patients.展开更多
BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological ...BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological features of MGISTs and to offer evidence for the diagnosis and treatment.METHODS Data of consecutive patients with MGISTs who were diagnosed at Peking University People’s Hospital(PKUPH)from 2008 to 2019 were retrospectively evaluated.Further,a literature search was conducted by retrieving data from PubMed,EMBASE,and the Cochrane library databases from inception up to November 30,2019.RESULTS In all,12 patients were diagnosed with MGISTs at PKUPH,and 43 published records were ultimately included following the literature review.Combined analysis of the whole individual patient data showed that female(59.30%),young(14.45%),and syndromic GIST(63.95%)patients comprised a large proportion of the total patient population.Tumors were mainly located in the small intestine(58.92%),and both CD117 and CD34 were generally positive.After a mean 78.32-mo follow-up,the estimated median overall survival duration(11.5 years)was similar to single GISTs,but recurrence-free survival was relatively poorer.CONCLUSION The clinical and oncological features are potentially different between MGISTs and single GIST.Further studies are needed to explore appropriate surgical approach and adjuvant therapy.展开更多
Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate t...Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate the efficacy of acupuncture for FM,identify research gaps,and provide information that could guide the design of future studies.Methods:Seven electronic databases–Cochrane Library,PubMed,Embase,China Biomedical Literature Database,VIP,Wanfang Database,and Chinese National Knowledge Infrastructure–were searched for relevant articles on acupuncture for FM.The search period was from the dates of inception of the databases to December 19,2022.Original clinical studies and systematic reviews on the use of acupuncture-related modalities for the treatment of FM were included.The basic information,quality assessments,and evidence maps of the included studies are presented as charts and bubble plots.The quality assessment tools used for evaluating the different types of studies included in the present study were Cochrane Collaboration’s tool,Canadian Institute of Health Economics quality appraisal tool,and A MeaSurement Tool to Assess systematic Reviews 2.Results:Fifty studies were included in this study.Of these,39(78.00%)were randomized controlled trials(RCTs),6(12.0%)were case series,and 5(10.0%)were systematic reviews.The included studies focused on manual acupuncture and conventional treatment in the treatment and control groups,respectively.The outcomes analyzed in the RCTs included pain(94.9%),sleep quality(46.2%),depression(46.2%),physical function(46.2%),stiffness(35.9%),well-being(35.9%),work status(35.9%),anxiety(33.3%),fatigue(33.3%),quality of life(17.9%),and overall effective rate(10.3%).The methodological quality of most of the studies was low or critically low regardless of the study design.In most studies,the therapeutic effect of acupuncture was significantly superior to that of the comparator.展开更多
Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based supp...Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.展开更多
Background:Influenza places a heavy public health burden in numerous countries every year.In addition to vaccines,there are some interventions that are effective in preventing influenza.Objective:This overview of syst...Background:Influenza places a heavy public health burden in numerous countries every year.In addition to vaccines,there are some interventions that are effective in preventing influenza.Objective:This overview of systematic reviews(SRs)aimed to evaluate the efficacy and safety of interventions for influenza prevention.Search strategy:We searched the Cochrane Database of Systematic Reviews,2020,Issue 1 for relevant Cochrane SRs using the keywords‘‘common cold,"‘‘influenza,"and‘‘flu."Inclusion criteria:Cochrane SRs that investigated the prevention of influenza were included.Participants included the general population without influenza or influenza-like symptoms,who were treated with preventative interventions and compared to individuals receiving no treatment or placebo.Data extraction and analysis:Two reviewers independently screened citations against pre-defined inclusion criteria and extracted data.The methodological quality of these SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-II(AMSTAR-II)guidelines.The primary outcome of our analysis was the incidence of influenza,and the secondary outcomes were the incidence of influenza-like illness and hospitalization.In addition to the narrative summary of SR findings,we also pooled data from homogeneous trials among these SRs and produced evidence mapping.We conducted a network meta-analysis to compare the effect across interventions and used the Cochrane approach to grading of recommendations,assessment,development,and evaluation(GRADE)to assess the quality of evidence.Results:Eleven Cochrane SRs were included,covering five medications,eleven vaccinations and four complementary therapies.Among these SRs,73%scored"high"quality on AMSTAR-II rating.We found that eight interventions,including amantadine,garlic,and six different vaccines,were beneficial for reducing the incidence of influenza compared to placebo,while oseltamivir,zanamivir,Ganmao capsule,Echinacea,and another three types of vaccine were probably beneficial.Ganmao capsule ranked highest for influenza prevention in the network meta-analysis,followed by amantadine,garlic,and vaccines of all types.Monovalent inactivated parenteral vaccine was found to be beneficial in reducing the incidence of influenza-like illness.None of the interventions reduced the hospitalization rate.Conclusion:High-quality evidence showed that garlic or vaccine had advantages in preventing influenza,and that vitamin C is not effective.The effect of other interventions needs to be further verified with highquality evidence.展开更多
Recent studies have pointed out that the widespread iron deposits in southwestern Fujian metallogenic belt(SFMB)(China) are skarn-type deposits associated with the Yanshanian granites. There is still excellent potenti...Recent studies have pointed out that the widespread iron deposits in southwestern Fujian metallogenic belt(SFMB)(China) are skarn-type deposits associated with the Yanshanian granites. There is still excellent potential for mineral exploration because large areas in this belt are covered by forest. A new predictive model for mapping skarn-type Fe deposit prospectivity in this belt was developed and focused on in this study, using five criteria as evidence:(1) the contact zones of Yanshanian granites(GRANITE);(2) the contact zones within the late Paleozoic marine sedimentary rocks and the carbonate formations(FORMATION);(3) the NE-NNE-trending faults(FAULT);(4) the zones of skarn alterations(SKARN); and(5) the aeromagnetic anomaly(AEROMAGNETIC). The fuzzy weights of evidence(FWof E) method, developed from the classical weights of evidence(Wof E) and based on fuzzy sets and fuzzy probabilities, could provide smaller variances and more accurate posterior probabilities and could effectively minimize the uncertainty caused by omitted or wrongly assigned data and be more flexible than the Wof E. It is an efficient and widely used method for mineral potential mapping. Random forests(RF) is a new and useful method for data-driven predictive mapping of mineral prospectivity method, and needs further scrutiny. Both prospectivity results respectively using the FWof E and RF methods reveal that the prediction model for the skarn-type Fe deposits in the SFMB is successful and efficient. Both methods suggested that the GRANITE and FORMATION are the most valuable evidence maps, followed by SKARN, AEROMAGNETIC, and FAULT. This is coincident with the skarn-type Fe deposit mineral model in the SFMB. The unstable performance experienced when FORMATION was omitted might indicate that the highest uncertainty and risk in follow-up exploration is related to the sequences. In addition, the performance of the RF method for the skarn-type Fe deposits prospectivity in the SFMB is better than the FWof E; therefore, it could be used to guide further exploration of skarn-type Fe prospects in the SFMB.展开更多
Objectives Primary care attachment represents an inclusive,equitable and cost-effective way of enhancing health outcomes globally.However,the growing shortage of family physicians threatens to disrupt patient-provider...Objectives Primary care attachment represents an inclusive,equitable and cost-effective way of enhancing health outcomes globally.However,the growing shortage of family physicians threatens to disrupt patient-provider relationships.Understanding the consequences of these disruptions is essential for guiding future research and policy.The objectives of this study were to map the existing evidence on the impacts of changes in primary care attachment,identify research gaps and recommend areas for further investigation.Design Scoping review following Joanna Briggs Institute(JBI)guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.Two researchers conducted all stages of screening,and study quality was assessed using JBI critical appraisal tools.Key themes included causes of attachment change,direction of change and outcomes aligned with the quintuple aim framework.Both qualitative and quantitative findings were synthesised narratively.Eligibility criteria Peer-reviewed,English-language articles published between 1999 and 2024 on primary care attachment changes.Information sources PubMed,Scopus and Web of Science.Results Of 2045 studies screened,31 met inclusion criteria,with 60%published after 2020.Most studies originated from high-income countries,particularly the USA(35%)and Canada(29%).Attachment losses and transfers were the most frequently studied,while attachment and unattachment durations were less explored.These changes in attachment were consistently shown to impact patients,providers,clinics and the healthcare system,influencing all aims of the quintuple aim framework,including clinical outcomes,healthcare utilisation,costs,equity and patient experience.Commonly assessed outcomes included clinical impact(68%),health equity(48%),patient experience(32%)and costs(23%),with no study assessing provider experience.Conclusions This scoping review maps the published literature on changes in primary care attachment and introduces clarifying terminology.Key research gaps include geographical diversity(lack of studies from lowand middle-income countries),attachment gain(limited research on strategies to reconnect unattached patients),attachment duration(insufficient evidence on long-term health outcomes),economic implications(underexplored costs of physician turnover and disruption),provider experiences(lack of studies on how changes in primary care attachment impact provider burnout,job satisfaction and workload)and patient health outcomes(focus on healthcare utilisation rather than direct health outcomes).These findings underscore the need for further research and offer valuable insights for future studies and policy development.展开更多
Objective: Through showing the full picture of double-arm controlled clinical research and systematic review evidence in the field of orally administrated Chinese herbal medicine(CHM) for treatment of lung cancer, to ...Objective: Through showing the full picture of double-arm controlled clinical research and systematic review evidence in the field of orally administrated Chinese herbal medicine(CHM) for treatment of lung cancer, to provide a reference for future clinical research and to indicate a direction for future systematic reviews. Methods: A comprehensive search of clinical controlled studies was performed regarding orally administered CHM treatment for lung cancer published from January 1970 to September 2020. The language was restricted to Chinese and English. Relevant data were extracted, the quality of systematic reviews was evaluated, and the research evidence was visually displayed. Results: Randomized controlled trials were the most common type of research design. The research sample sizes were typically small. Oral CHM showed certain curative advantages in treating lung cancer. The key stages in oral CHM intervention for lung cancer are chemotherapy, radiotherapy, and late palliative treatment. The advantageous outcomes of oral CHM treatment of lung cancer are the short-term efficacy, quality of life, and adverse reactions. The perioperative stage, overall survival, pharmacoeconomic evaluation, and Chinese medicine decoctions are weak research areas. Conclusions: CHM has staged and therapeutic advantages in treating lung cancer. The overall methodological quality is poor, and the level of evidence requires improvement. It is necessary to carry out large-scale, standardized, and higherquality research in the superior and weak areas of CHM treatment of lung cancer.展开更多
Background:We systematically searched and summarized clinical studies on traditional Chinese medicine(TCM)for age-relatedmacular degeneration(AMD)with the method of evidence map.We aimed to provide evidence and resear...Background:We systematically searched and summarized clinical studies on traditional Chinese medicine(TCM)for age-relatedmacular degeneration(AMD)with the method of evidence map.We aimed to provide evidence and research direction for the prevention or treatment of AMD with TCM in the future.Materials and methods:We searched PubMed,Web of Science,EMBASE,and Chinese databases including CNKI(Chinese National Knowledge Infrastructure),WanFang and VIP,ClinicalTrials.gov,and ChineseClinical Trial Registry Center studies on the prevention or treatment of TCMfor AMD from January 2000 to November 2022.We showed distribution features of these studies in the form of text description,graphs,and tables.Results:The final 258 articles included 245 clinical studies,9 systematic reviews ormeta-analyses,and 4 guidelines,expert consensus,or clinical pathway.After analyzing the articles with a focus on the stage of AMD,study type,sample size,intervention measures,outcome indicators,and the quality of evidence,we found that the studies were increasing,most of which were wet AMD,the main study type was randomized controlled trials,and the sample size was mostly fewer than 100 cases.Different interventions of TCM,such as Chinese medicine,Chinese patentmedicine,or acupuncture,showed the potential benefits of improving vision,reducing fundus lesions,and alleviating some uncomfortable symptoms.However,the sample size of these studies was small.The outcome indicators were not unified,and the stage of AMD was unclear.The quality of articles was lower,and there were few studies on early AMD.The advantages of TCM for the prevention or treatment of AMD remained unclear.Conclusions:Early intervention will be the focus and direction of AMD in the prevention or treatment of TCM,and more standardized clinical studies of TCM for early AMD need to be designed and carried out in the future.展开更多
基金Supported by China Academy of Chinese Medical Sciences Innovation FundC12021A03503National Natural Science Fund of China81973968+1 种基金Fundamental Research Funds for Central Public Welfare Scientific Research InstitutesZZ13-024-9"The Belt and Road"TCM Cooperation Project of China Academy of Chinese Medical Sciences in 2019GH201901。
文摘Background:Acupuncture is used to relieve symptoms,reducing recurrence,and improve the lives of patients with skin diseases.Objective:To identify,describe,and organize the available evidence on acupuncture for atopic eczema(AE)using evidence mapping of randomized controlled trials(RCTs),systematic reviews(SRs),and metaanalyses.Methods:We searched eight databases from inception to October 30,2021,for RCTs,SRs,and metaanalyses of acupuncture for patients with AE.Two reviewers screened the papers,before extracting the data and assessing the quality of the included studies.The basic and clinical characteristics,and quality of assessment of the studies were assessed using descriptive statistics and qualitative analyses.A bubble plot was used to visualize the evidence map to indicate the relationship between the type and frequency of outcomes,the quality and overall effects of acupuncture,and the outcomes of the studies.Results:Forty-five studies(Forty RCTs,five SRs,and meta-analyses)were included.The number of publications increased rapidly after 2013 and peaked in 2019.The most frequently applied intervention was one type of acupuncture therapy.The most frequent comparison was between acupuncture and active medicine.The symptomatic outcome was the most commonly used,and the quality of the included studies was relatively low.All included studies showed a significantly better outcome in the acupuncture group compared to the control group(P<0.05).Most outcomes in the included studies were of low or critically low quality.Several symptomatic outcomes and health-related quality of life outcomes in the included RCTs indicated moderate quality,while some symptomatic outcomes and global symptom improvement in the included SRs and meta-analyses indicated low quality.Conclusion:The majority of studies related to acupuncture for AE indicated promising results,but with relatively low quality;thus,further studies with more robust designs should be conducted to validate the results.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-C-202006)the High-level traditional Chinese medicine key subject construction project of National Administration of Traditional Chinese Medicine-Evidence-based Traditional Chinese Medicine(ZYYZDXK-2023249).
文摘Background:The bibliometrics of acupuncture are growing rapidly.However,the absence of reporting guidelines may lead to significant duplication and waste,thereby undermining the research’s value.To address this,a knowledge mapping was generated based on published studies to investigate the characteristics of bibliometric studies on acupuncture and the extent of duplicate publications,with the overarching goal of providing a comprehensive overview of the knowledge structure in this field.Methods:This cross-sectional study used three databases(PubMed,Web of Science,and Scopus)to identify relevant studies up to May 1,2024.In addition,the reference lists were retrieved as a supplement.To track research trends,we employed Microsoft Excel and R software to extract,code,and analyze information.Study selection,data extraction,and validation were performed independently by at least two reviewers.The reporting quality of included studies was assessed using the Preliminary guideline for reporting bibliometric reviews of the biomedical literature(BIBLIO).Results:Among the 6,221 bibliometric reviews examined,113 relevant publications were identified,80 focusing on various diseases/conditions.The annual number of publications has gradually increased,with the output in the past four years being 3.52 times higher than that before 2020.China(106)and Chengdu University of Traditional Chinese Medicine(16)have the highest number of publications.The most prolific author is Fan-Rong Liang,with six articles.The first bibliometric study,by Hai-Yan Li,was published in 2010.Journal of Pain Research,with 36 articles,holds the most publications.The top three diseases:diseases of the nervous system;symptoms,signs,or clinical findings not elsewhere classified;and mental,behavioral,or neurodevelopmental disorders.There may be potential duplication in research on 13 diseases/conditions,notably stroke,migraine,pain/analgesia,cancer pain,shoulder pain,facial paralysis/bell’s palsy,chronic pain,and cognitive impairment.In BIBLIO,the most frequently missing items are issues/topics(item 2),quality assessment(item 11),and descriptive findings(item 13).Conclusion:This study demonstrates that acupuncture bibliometrics is actively utilized to identify dominant diseases/conditions,aiding scholars in understand the knowledge structure and main topics.Although the number of related studies is increasing,with an average of 25 studies annually,overlap in some areas highlights the need for adherence to reporting guidelines and careful topic selection to ensure truly valuable insights and knowledge contributions.The adherence to BIBLIO’s 20 proposed items across analyzed articles,highlighting important in reporting practices.
文摘Colorectal cancers comprise a large percentage of tumors worldwide,and transverse colon cancer(TCC)is defined as tumors located between hepatic and splenic flexures.Due to the anatomy and embryology complexity,and lack of large randomized controlled trials,it is a challenge to standardize TCC surgery.In this study,the current situation of transverse/extended colectomy,robotic/laparoscopic/open surgery and complete mesocolic excision(CME)concept in TCC operations is discussed and a heatmap is conducted to show the evidence level and gap.In summary,transverse colectomy challenges the dogma of traditional extended colectomy,with similar oncological and prognostic outcomes.Compared with conventional open resection,laparoscopic and robotic surgery plays a more important role in both transverse colectomy and extended colectomy.The CME concept may contribute to the radical resection of TCC and adequate harvested lymph nodes.According to published studies,laparoscopic or robotic transverse colectomy based on the CME concept was the appropriate surgical procedure for TCC patients.
文摘BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological features of MGISTs and to offer evidence for the diagnosis and treatment.METHODS Data of consecutive patients with MGISTs who were diagnosed at Peking University People’s Hospital(PKUPH)from 2008 to 2019 were retrospectively evaluated.Further,a literature search was conducted by retrieving data from PubMed,EMBASE,and the Cochrane library databases from inception up to November 30,2019.RESULTS In all,12 patients were diagnosed with MGISTs at PKUPH,and 43 published records were ultimately included following the literature review.Combined analysis of the whole individual patient data showed that female(59.30%),young(14.45%),and syndromic GIST(63.95%)patients comprised a large proportion of the total patient population.Tumors were mainly located in the small intestine(58.92%),and both CD117 and CD34 were generally positive.After a mean 78.32-mo follow-up,the estimated median overall survival duration(11.5 years)was similar to single GISTs,but recurrence-free survival was relatively poorer.CONCLUSION The clinical and oncological features are potentially different between MGISTs and single GIST.Further studies are needed to explore appropriate surgical approach and adjuvant therapy.
基金Supported by the (CACMS) Innovation Fund:C12021A03503National Natural Science Foundation of China:81973968+2 种基金China Center for Evidence Based Traditional Chinese Medicine,CCEBTCM:2020YJSZX-1"The Belt and Road" TCM Cooperation Project of China Academy of Chinese Medical Sciences:GH201901the Fundamental Research Funds for the Central Public Welfare Research Institutes:ZZ13-024-9。
文摘Objective:The body of research on acupuncture as a treatment strategy for fibromyalgia(FM)is steadily growing.This evidence map identifies,describes,and summarizes the current status of studies conducted to evaluate the efficacy of acupuncture for FM,identify research gaps,and provide information that could guide the design of future studies.Methods:Seven electronic databases–Cochrane Library,PubMed,Embase,China Biomedical Literature Database,VIP,Wanfang Database,and Chinese National Knowledge Infrastructure–were searched for relevant articles on acupuncture for FM.The search period was from the dates of inception of the databases to December 19,2022.Original clinical studies and systematic reviews on the use of acupuncture-related modalities for the treatment of FM were included.The basic information,quality assessments,and evidence maps of the included studies are presented as charts and bubble plots.The quality assessment tools used for evaluating the different types of studies included in the present study were Cochrane Collaboration’s tool,Canadian Institute of Health Economics quality appraisal tool,and A MeaSurement Tool to Assess systematic Reviews 2.Results:Fifty studies were included in this study.Of these,39(78.00%)were randomized controlled trials(RCTs),6(12.0%)were case series,and 5(10.0%)were systematic reviews.The included studies focused on manual acupuncture and conventional treatment in the treatment and control groups,respectively.The outcomes analyzed in the RCTs included pain(94.9%),sleep quality(46.2%),depression(46.2%),physical function(46.2%),stiffness(35.9%),well-being(35.9%),work status(35.9%),anxiety(33.3%),fatigue(33.3%),quality of life(17.9%),and overall effective rate(10.3%).The methodological quality of most of the studies was low or critically low regardless of the study design.In most studies,the therapeutic effect of acupuncture was significantly superior to that of the comparator.
基金Supported by WFAS 2023 International Standard Project of Acupuncture-Moxibustion:WFASRP2023-SC05Tianjin Nankai District Pilot Demonstration Project for Integrated Inheritance and Innovation of Traditional Chinese Medicine:20250102001Beijing Natural Science:7252224。
文摘Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.
基金supported by the National Natural Science Foundation of China(to HJC,Grant Number 81804000)the National Chinese Medicine Inheritance and Innovation Team Project from Beijing University of Chinese Medicine–Chinese Medicine Epidemic Disease Inheritance and Innovation Team。
文摘Background:Influenza places a heavy public health burden in numerous countries every year.In addition to vaccines,there are some interventions that are effective in preventing influenza.Objective:This overview of systematic reviews(SRs)aimed to evaluate the efficacy and safety of interventions for influenza prevention.Search strategy:We searched the Cochrane Database of Systematic Reviews,2020,Issue 1 for relevant Cochrane SRs using the keywords‘‘common cold,"‘‘influenza,"and‘‘flu."Inclusion criteria:Cochrane SRs that investigated the prevention of influenza were included.Participants included the general population without influenza or influenza-like symptoms,who were treated with preventative interventions and compared to individuals receiving no treatment or placebo.Data extraction and analysis:Two reviewers independently screened citations against pre-defined inclusion criteria and extracted data.The methodological quality of these SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-II(AMSTAR-II)guidelines.The primary outcome of our analysis was the incidence of influenza,and the secondary outcomes were the incidence of influenza-like illness and hospitalization.In addition to the narrative summary of SR findings,we also pooled data from homogeneous trials among these SRs and produced evidence mapping.We conducted a network meta-analysis to compare the effect across interventions and used the Cochrane approach to grading of recommendations,assessment,development,and evaluation(GRADE)to assess the quality of evidence.Results:Eleven Cochrane SRs were included,covering five medications,eleven vaccinations and four complementary therapies.Among these SRs,73%scored"high"quality on AMSTAR-II rating.We found that eight interventions,including amantadine,garlic,and six different vaccines,were beneficial for reducing the incidence of influenza compared to placebo,while oseltamivir,zanamivir,Ganmao capsule,Echinacea,and another three types of vaccine were probably beneficial.Ganmao capsule ranked highest for influenza prevention in the network meta-analysis,followed by amantadine,garlic,and vaccines of all types.Monovalent inactivated parenteral vaccine was found to be beneficial in reducing the incidence of influenza-like illness.None of the interventions reduced the hospitalization rate.Conclusion:High-quality evidence showed that garlic or vaccine had advantages in preventing influenza,and that vitamin C is not effective.The effect of other interventions needs to be further verified with highquality evidence.
基金the joint financial support from a research project on "Quantitative models for prediction of strategic mineral resources in China" (Grant No. 201211022) by China Geological Surveythe National Natural Science Foundation of China (Grant Nos. 41372007, 41430320 & 41522206)the Program for New Century Excellent Talents in University (Grant No. NCET-13-1016)
文摘Recent studies have pointed out that the widespread iron deposits in southwestern Fujian metallogenic belt(SFMB)(China) are skarn-type deposits associated with the Yanshanian granites. There is still excellent potential for mineral exploration because large areas in this belt are covered by forest. A new predictive model for mapping skarn-type Fe deposit prospectivity in this belt was developed and focused on in this study, using five criteria as evidence:(1) the contact zones of Yanshanian granites(GRANITE);(2) the contact zones within the late Paleozoic marine sedimentary rocks and the carbonate formations(FORMATION);(3) the NE-NNE-trending faults(FAULT);(4) the zones of skarn alterations(SKARN); and(5) the aeromagnetic anomaly(AEROMAGNETIC). The fuzzy weights of evidence(FWof E) method, developed from the classical weights of evidence(Wof E) and based on fuzzy sets and fuzzy probabilities, could provide smaller variances and more accurate posterior probabilities and could effectively minimize the uncertainty caused by omitted or wrongly assigned data and be more flexible than the Wof E. It is an efficient and widely used method for mineral potential mapping. Random forests(RF) is a new and useful method for data-driven predictive mapping of mineral prospectivity method, and needs further scrutiny. Both prospectivity results respectively using the FWof E and RF methods reveal that the prediction model for the skarn-type Fe deposits in the SFMB is successful and efficient. Both methods suggested that the GRANITE and FORMATION are the most valuable evidence maps, followed by SKARN, AEROMAGNETIC, and FAULT. This is coincident with the skarn-type Fe deposit mineral model in the SFMB. The unstable performance experienced when FORMATION was omitted might indicate that the highest uncertainty and risk in follow-up exploration is related to the sequences. In addition, the performance of the RF method for the skarn-type Fe deposits prospectivity in the SFMB is better than the FWof E; therefore, it could be used to guide further exploration of skarn-type Fe prospects in the SFMB.
文摘Objectives Primary care attachment represents an inclusive,equitable and cost-effective way of enhancing health outcomes globally.However,the growing shortage of family physicians threatens to disrupt patient-provider relationships.Understanding the consequences of these disruptions is essential for guiding future research and policy.The objectives of this study were to map the existing evidence on the impacts of changes in primary care attachment,identify research gaps and recommend areas for further investigation.Design Scoping review following Joanna Briggs Institute(JBI)guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.Two researchers conducted all stages of screening,and study quality was assessed using JBI critical appraisal tools.Key themes included causes of attachment change,direction of change and outcomes aligned with the quintuple aim framework.Both qualitative and quantitative findings were synthesised narratively.Eligibility criteria Peer-reviewed,English-language articles published between 1999 and 2024 on primary care attachment changes.Information sources PubMed,Scopus and Web of Science.Results Of 2045 studies screened,31 met inclusion criteria,with 60%published after 2020.Most studies originated from high-income countries,particularly the USA(35%)and Canada(29%).Attachment losses and transfers were the most frequently studied,while attachment and unattachment durations were less explored.These changes in attachment were consistently shown to impact patients,providers,clinics and the healthcare system,influencing all aims of the quintuple aim framework,including clinical outcomes,healthcare utilisation,costs,equity and patient experience.Commonly assessed outcomes included clinical impact(68%),health equity(48%),patient experience(32%)and costs(23%),with no study assessing provider experience.Conclusions This scoping review maps the published literature on changes in primary care attachment and introduces clarifying terminology.Key research gaps include geographical diversity(lack of studies from lowand middle-income countries),attachment gain(limited research on strategies to reconnect unattached patients),attachment duration(insufficient evidence on long-term health outcomes),economic implications(underexplored costs of physician turnover and disruption),provider experiences(lack of studies on how changes in primary care attachment impact provider burnout,job satisfaction and workload)and patient health outcomes(focus on healthcare utilisation rather than direct health outcomes).These findings underscore the need for further research and offer valuable insights for future studies and policy development.
基金Supported by the Evidence-Based Medicine Program of Chinese Academy of Chinese Medical Sciences (No.ZZ13-024-6)Evidence-Based Capacity Building Project of Traditional Chinese Medicine Oncology (No.60101)。
文摘Objective: Through showing the full picture of double-arm controlled clinical research and systematic review evidence in the field of orally administrated Chinese herbal medicine(CHM) for treatment of lung cancer, to provide a reference for future clinical research and to indicate a direction for future systematic reviews. Methods: A comprehensive search of clinical controlled studies was performed regarding orally administered CHM treatment for lung cancer published from January 1970 to September 2020. The language was restricted to Chinese and English. Relevant data were extracted, the quality of systematic reviews was evaluated, and the research evidence was visually displayed. Results: Randomized controlled trials were the most common type of research design. The research sample sizes were typically small. Oral CHM showed certain curative advantages in treating lung cancer. The key stages in oral CHM intervention for lung cancer are chemotherapy, radiotherapy, and late palliative treatment. The advantageous outcomes of oral CHM treatment of lung cancer are the short-term efficacy, quality of life, and adverse reactions. The perioperative stage, overall survival, pharmacoeconomic evaluation, and Chinese medicine decoctions are weak research areas. Conclusions: CHM has staged and therapeutic advantages in treating lung cancer. The overall methodological quality is poor, and the level of evidence requires improvement. It is necessary to carry out large-scale, standardized, and higherquality research in the superior and weak areas of CHM treatment of lung cancer.
基金This studywas supported by China Center for Evidence Based Traditional ChineseMedicine(2020YJSZX-2)Capital Health Research and Development of Special Fund(2020-2-4183)+2 种基金National Natural Science Foundation of China(no.81973912,no.82274589)China Academy of Chinese Medical Sciences Innovation Fund(CI2021A02602)the Fundamental Research Funds for the Central Public Welfare Research Institutes(no.ZZ16-XRZ-063).
文摘Background:We systematically searched and summarized clinical studies on traditional Chinese medicine(TCM)for age-relatedmacular degeneration(AMD)with the method of evidence map.We aimed to provide evidence and research direction for the prevention or treatment of AMD with TCM in the future.Materials and methods:We searched PubMed,Web of Science,EMBASE,and Chinese databases including CNKI(Chinese National Knowledge Infrastructure),WanFang and VIP,ClinicalTrials.gov,and ChineseClinical Trial Registry Center studies on the prevention or treatment of TCMfor AMD from January 2000 to November 2022.We showed distribution features of these studies in the form of text description,graphs,and tables.Results:The final 258 articles included 245 clinical studies,9 systematic reviews ormeta-analyses,and 4 guidelines,expert consensus,or clinical pathway.After analyzing the articles with a focus on the stage of AMD,study type,sample size,intervention measures,outcome indicators,and the quality of evidence,we found that the studies were increasing,most of which were wet AMD,the main study type was randomized controlled trials,and the sample size was mostly fewer than 100 cases.Different interventions of TCM,such as Chinese medicine,Chinese patentmedicine,or acupuncture,showed the potential benefits of improving vision,reducing fundus lesions,and alleviating some uncomfortable symptoms.However,the sample size of these studies was small.The outcome indicators were not unified,and the stage of AMD was unclear.The quality of articles was lower,and there were few studies on early AMD.The advantages of TCM for the prevention or treatment of AMD remained unclear.Conclusions:Early intervention will be the focus and direction of AMD in the prevention or treatment of TCM,and more standardized clinical studies of TCM for early AMD need to be designed and carried out in the future.
