Objective To systematically review the efficacy and safety of polyethylene glycol and sodium phosphate in bowel preparation of capsule endoscopy. Methods We searched CNKI, CBM, WanFang Data, PubMed, EMbase, and The Cochrane Library (Issue 6, 2016) up to June 2016, to collect randomized controlled trials (RCTs) about polyethylene glycol and sodium phosphate in bowel preparation of capsule endoscopy. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies, and then meta-analysis was performed by using RevMan 5.0 software. Results A total of six RCTs involving 531 patients were included. The results of meta-analysis showed that: compared with the sodium phosphate solution group, the polyethylene glycol solution group had poor intestinal cleansing effect (OR=0.43, 95%CI 0.21 to 0.88,P=0.02), higher incidence of adverse reaction (OR=3.20, 95%CI 1.13 to 9.06,P=0.03); but shorter gastric retention time (OR=–11.61, 95%CI –13.71 to –9.51,P<0.000 01) and residence time in the small intestine (OR=–4.17, 95%CI –7.74 to –0.60,P=0.02). Conclusion The efficacy of oral polyethylene glycol is poor in cleaning effect and adverse reaction than sodium phosphate solution, but better in the digestive tract residence time for capsule endoscopy. Due to the limited quality and quantity of included studies, the above conclusion is still needed to be proved by more high-quality studies.
Interpretation of results of clinical research should not only focus on statistical significance (P value less than 0.05) but also clinical significance. The minimal clinically significance difference (MCID) assists to answer the question with the results being clinically significant. In addition, MCID plays an important role in evidence assessment during clinical guideline development, sample size estimation for clinical trials, and clinical decision-making. This paper primarily introduces the terminology and definition of MCID and four common methods used to estimate MCID.
The method of network meta-analysis of diagnostic test accuracy is in the exploratory stage. We had explored and introduced several methods of network meta-analysis of diagnostic test accuracy before. Based on example, we introduce ANOVA model for performing network meta-analysis of diagnostic test accuracy step-by-step.
ObjectiveTo systematically review the efficacy and safety of pediatric tuina in the treatment of children with acute diarrhea.MethodsCNKI, VIP, WanFang Data, CBM, PubMed and The Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on the treatment of children acute diarrhea with tuina from inception to November 20th, 2020. Two researchers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 15 RCTs involving 1 464 children were included. The results of meta-analysis showed that compared with Western medicine, tuina for children with acute diarrhea could increase the cure rate (RR=1.43, 95%CI 1.26 to 1.63, P<0.001), shorten the time for the frequency of diarrhea to return to normal (MD=−0.86, 95%CI −1.05 to −0.66, P<0.001) and the time for stool traits to return to normal (MD=−1.07, 95%CI −1.15 to −0.99, P<0.001). There was no statistically significant difference in the incidence of adverse reactions between tuina and Western medicine (RR=0.25, 95%CI 0.03 to 2.23, P=0.22).ConclusionsCurrent evidence shows that tuina has a superior effect on treating children with acute diarrhea, the incidence of adverse reactions is not increased. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusions.
Umbrella review is a research method that comprehensively analyzes the systematic reviews and meta-analysis of a research question. In recent years, the research methods of umbrella review have been widely used, but the quality of umbrella review is uneven. Therefore, this paper focuses on the production methods and existing challenges of umbrella review, in order to provide references for domestic researchers to make umbrella review.
AutoMeta is a semi-automated, interactive, user-friendly online platform developed by Chinese scholars with independent intellectual property rights. This platform is designed to assist users in completing pairwise meta-analysis, inverse variance meta-analysis, network meta-analysis, and diagnostic test accuracy meta-analysis and use the GRADE method to achieve automatic grading of certainty of evidence. Nowadays, the AutoMeta platform can conduct the pairwise meta-analysis and inverse variance meta-analysis, as well as the automatic grading of certainty of evidence for pairwise meta-analysis. This article introduces the platform to users in terms of its development techniques, operation methods and verification of the accuracy of results, aiming to assist researchers to conduct systematic reviews quickly.
Objective To evaluate the diagnostic accuracy of enzyme immunoassay (EIA) for chlamydia trachomatis (CT). Methods The diagnosis trials on EIA for CT were searched in the databases such as PubMed (1966 to Dec. 2011), The Cochrane Library (Issue 12, 2011), EMbase (1974 to Dec. 2011), CNKI (1994 to Dec. 2011), VIP (1989 to Dec. 2011) and CBM (1978 to Dec. 2011), meanwhile the manual and other retrieves were also conducted. Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accuracy studies (QUADAS), and then meta-analysis was performed using Meta Analyst and RevMan 5.0 software. Results A total of 17 trials involving 9 461 participants were included. The results of meta-analysis showed that the weighted sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under SROC curve were 0.847 (95%CI 0.571 to 0.995), 0.964 (95%CI 0.890 to 0.994), 25.972 (95%CI 18.587 to 36.293), 0.156 (95%CI 0.114 to 0.212), 228.875 (95%CI 127.136 to 412.028), and 0.953, respectively. Conclusion EIA for CT has higher sensitivity and specificity, so EIA is recommended for preliminary screening CT and diagnosing the highly suspected cases or the patients without obvious signs and symptoms.
Objective To assess the methodological quality of systematic reviews or meta-analyses of intervention published in the Chinese Journal of Evidence-Based Medicine, so as to provide evidence for improving the domestic methodological quality. Methods The systematic reviews or meta-analyses of intervention published from 2001 to 2011 were identified by searching the Chinese Journal of Evidence-Based Medicine. The methodological quality of included studies was assessed by AMSTAR scale. The Excel software was used to input data, and Mata-Analyst software was used to conduct statistical analysis. Results A total of 379 studies were included. The average score of AMSTAR was 6.15±1.35 (1.5-9.5 point). Just some items of AMSTAR scale were influenced by the following features of included studies: publication date, funded or not, number of author, author’s unit, and number of author’s unit. The total AMSTAR score of studies published after 2008 was higher than those published before 2008 (P=0.02), but the improvement of methodological quality was limited. While the total AMSTAR score of studies published by 3 or more than 3 authors were higher than those published by 2 or less than 2 authors (P=0.04). Conclusion The methodological quality of the included studies published in the Chinese Journal of Evidence-Based Pediatrics is uneven. Although the methodological quality improves somewhat after the publication of AMSTAR scale, there is no big progress, so it still needs to be further improved.
Objective To survey the current situation of the systematic review (SR)/ meta-analysis (MA) related to interventions published in the Chinese medical journals entitled with evidence-based. Methods According to the inclusion and exclusion criteria, the Journal of Evidence-Based Medicine (2001.1 to 2011.12), the Chinese Journal of Evidence-based Medicine (2001.1 to 2011.12), the Chinese Journal of Evidence Based Pediatrics (2006.1 to 2011.12) and the Chinese Journal of Evidence-Based Cardiovascular Medicine (2008.1 to 2011.12) were searched for SRs/MAs related to interventions. Two reviewers extracted data independently using predesigned a data extraction form, crosschecked data, and discussed to solve discrepancy. Excel software was used to for statistical analysis. Results A total of 487 SRs/MAs were included. 379 (77.82%) SRs/MAs were published in the Chinese Journal of Evidence-Based Medicine, 70 (14.38%) in the Journal of Evidence-Based Medicine, 30 (6.17%) in Chinese Journal of Evidence-Based Pediatrics, and 8 (1.63%) in the Chinese Journal of Evidence-Based Cardiovascular Medicine. The number of SRs/MAs published generally increased during 2001 to 2011. The number of author of SRs/MAs was 5±2, the number of studies that included randomized controlled trials (RCTs) of SRs/MAs varied from 1 to 129 (median: 8), involving 20 diseases. 83 (17.04%) SRs/MAs focused on neoplasms, 64 (17.04%) on diseases of the circulatory system, and 54 (11.09%) on diseases of the genitourinary system. 82.75% of the included 487 SRs/MAs assessed the methodological quality of included RCTs. 44 (9.03%) SRs/MAs mentioned the methods of quality assessment, without reporting the results. The Cochrane Collaboration’s tool for assessing risk of bias was the most frequently used for evaluation (314 SRs/MAs, 64.48%). Conclusion The number of SRs/MAs related to interventions published in the journals entitled with evidence-based is increasing generally and their topics are extensive. However, further studies should be improved in the aspects of selecting and applying the quality assessment criteria of randomized controlled trials.
Objective To assess the effectiveness of acupunctures in treatment of primary dysmenorrhea by using network meta-analysis. Methods Databases including the PubMed, EMbase, The Cochrane Library (Issue 6, 2016), CBM, CNKI and WanFang Data were searched for relevant clinical randomized controlled trials (RCTs) comparing acupunctures with ibuprofen or other kinds of acupuncture from inception to July 6th 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by using Stata 13.0 and WinBugs 1.43 software. Results A total of 56 RCTs involving 4 600 PD patients were included. The results of network meta-analysis showed that: for the clinical effects: simple acupuncture, acupuncture plus moxa-moxibustion, acupuncture plus indirect-moxibustion, electroacupuncture, warm-acupuncture and electroacupuncture plus warm-acupuncture were superior to ibuprofen, acupuncture plus moxa-moxibustion, acupuncture plus indirect-moxibustion and warm-acupuncture were superior to simple acupuncture. For VAS score, there was no significant difference among all treatments. Simple acupuncture and ibuprofen were superior to acupuncture plus indirect-moxibustion in dysmenorrhea symptom scores. Conclusion The included 6 kinds of acupunctures are superior to ibuprofen and different acupunctures have different advantages in the treatment of PD. When selecting treatment regimen, it is better to consider the clinical situation and TCM syndrome differentiation.