ObjectiveTo systematically review the methodological quality of guidelines concerning attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, and to compare differences and similarities of the drugs recommended, in order to provide guidance for clinical practice. MethodsGuidelines concerning ADHD were electronically retrieved in PubMed, EMbase, VIP, WanFang Data, CNKI, NGC (National Guideline Clearinghouse), GIN (Guidelines International Network), NICE (National Institute for Health and Clinical Excellence) from inception to December 2013. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations were compared. ResultsA total of 9 guidelines concerning ADHD in children and adolescents were included, with development time ranging from 2004 to 2012. Among 9 guidelines, 4 were made by the USA, 3 in Europe and 2 by UK. The levels of recommendations were Level A for 2 guidelines, and Level B for 7 guidelines. The scores of guidelines according to the domains of AGREE Ⅱ decreased from "clarity of presentations", "scope and purpose", "participants", "applicability", "rigour of development" and "editorial independence". Three evidence-based guidelines scored the top three in the domain of "rigour of development". There were slightly differences in the recommendations of different guidelines. ConclusionThe overall methodological quality of ADHD guidelines is suboptimal in different countries or regions. The 6 domains involving 23 items in AGREE Ⅱ vary with scores, while the scores of evidence-base guidelines are higher than those of non-evidence-based guidelines. The guidelines on ADHD in children and adolescents should be improved in "rigour of development" and "applicability" in future. Conflicts of interest should be addressed. And the guidelines are recommended to be developed on the basis of methods of evidence-based medicine, and best evidence is recommended.
ObjectiveTo evaluate the relationship between OPRM1 gene rs1799971 polymorphism and opioid analgesics requirement after surgery in Asians. MethodsWe electronically searched databases including CNKI, CBM, VIP, WanFang Data, EMbase and MEDLINE to collect studies about the correlation between OPRM1 gene rs1799971 polymorphism and opioid analgesics requirement after surgery in Asia. The retrieval time was from the establishment to March 1st, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of including studies, and then meta-analysis was performed by using RevMan 5.2 software. ResultsA total of 10 case-control studies involving 1 612 patients were included. The results of meta-analysis showed that the requirement of opioid analgesics after surgery for GG genotype carriers was more than AG carriers (SMD=-0.44, 95%CI -0.61 to -0.28, P<0.000 01), AA genotype carriers (SMD=-0.55, 95%CI -0.71 to -0.38, P<0.000 01), and AA+AG genotype carriers (SMD=-0.50, 95%CI -0.66 to -0.35, P<0.000 01). ConclusionThe current evidence showed that the requirement of opioid analgesics after surgery for GG genotype of rs1799971 polymorphism in OPRM1 gene is higher in Asians. Due to the limited quality and quantity of included studies, the above results are needed to be further validated by more studies.