ObjectiveTo systematically evaluate the potential effectiveness of JinHuang powder in the treatment of diabetic foot ulcers (DFUs). MethodsDatabases including PubMed, The Cochrane Library, Web of Science, CBM, WanFang data, VIP and CNKI were electronically searched from their inception to December 2013, to identify randomized controlled trials (RCTs) about JinHuang powder for DFUs. Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies, and then meta-analysis was performed by using RevMan 5.1 software. ResultsA total of 3 RCTs involving 198 patients were included. The results of meta-analysis showed that:the JinHuang powder group were superior to the control group in total effective rate (RR=1.25, 95%CI 1.10 to 1.41, P=0.00) and the wound healing time (SMD=-3.32, 95%CI -5.69 to -0.96, P=0.00). ConclusionCurrent evidence suggests that the JinHuang powder is an effective therapeutic method for DFUs. Because of the limitations of quantity and quality of the eligible studies, large sample size studies are needed to validate the conclusion.
Meta-analyses include meta-analysis of the published literature (MPL) and meta-analysis of individual patient data (MIPD). Recursive cumulative meta-analysis is a method used to reorganize the secondary analysis data based on original studies thus to ensure a timely update, in addition, it can also be used to analyze the data from longer followup of existing trials. By using this method, with the each newly included or updated study, the change of pooled effect size in each pooled step can be detected, therefore, the bias/heterogeneity and stability of pooled results can be evaluated. In this article, we briefly introduced the concept of recursive cumulative meta-analysis and an example was used to illustrate this method.
Network meta-analysis (NMA) is a new statistical approach which comes from head to head meta-analysis. Hence, NMA inherits all methodology challenges of head to head meta-analysis and with increased complexity results due to more intervention treatments involved. The issue of sample size and statistical power in individual trial and head to head meta-analysis is widely emphasized currently; however, they are not been paid due attention in NMA. This article aims to introduce the theory, computational principles and software implementation using examples with step by step approach.