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Use of AMSTAR-2 in the methodological assessment of systematic reviews: protocol for a methodological study
Background: Systematic reviews (SRs) with or without meta-analyses (MAs) are widely used in resolving questions in various healthcare areas (such as, traditional Chinese medicine, public health and surgery), and they are the cornerstone of evidence-based healthcare. However, the reliability of SRs is typically influenced by their methodological quality. AMSTAR (A Measurement Tool to Assess Systematic Reviews) and AMSTAR-2 tools can assess the methodological quality of SRs, and the use of AMSTAR has been investigated. However, AMSTAR-2 is now widely used to evaluate the methodological quality of SRs, but the use of AMSTAR-2 for determining the methodological quality of SRs has not yet been investigated and assessed thoroughly. Thus, we designed the present study to investigate the use of AMSTAR-2 in studies that assessed the methodological quality of a sample of SRs with the AMSTAR-2 and provide references to potential users of AMSTAR-2 tool. Methods: Four commonly used electronic databases including PubMed, EmBase, the Cochrane Library, and Web of Science will be searched following a comprehensive search strategy to identify and retrieve studies that have used AMSTAR-2 tool for evaluating the methodological quality of SRs. Two independent authors will retrieve bibliometric information and methodological data, including all author names, time of publication, and journal names, whether a specific score value was given for each item, and whether overall quality assessment was performed. Descriptive statistical analyses will be used to present the study results, e.g., frequencies and percentages, mean and standard deviation (SD) or median and interquartile range (IQR). In addition, subgroup analyses will be performed to identify the methodological differences (e.g., the reporting of study designs included in SRs) between overviews and methodological studies. The risk ratio (RR) with 95% confidence interval (95% CI) will be calculated to measure the methodological differences. Cytoscape 3.7.1 software tool will be used to construct collaboration network maps. Further, Microsoft Office Excel 2016 and Stata 12.0 will be used to manage and analyze data. Discussion: The results of this study will identify any gaps in the use of AMSTAR-2 and important bibliometric features, such as active researchers and journals, provide guidance to researchers in various healthcare areas (such as, traditional Chinese medicine and public health) for using AMSTAR-2 tool and help them in developing cooperation and submitting their manuscripts.
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Facilitators, barriers and strategies for health-system guidance implementation: a critical interpretive synthesis protocol
Background As systematically developed statements regarding possible courses of action, health system guidance (HSG) can assist with making decisions about addressing problems or achieving goals in health systems. However, there are conceptual and methodological challenges in HSG implementation due to the complexity of health-system policy-making, the diversity of available evidence and vast differences in contexts. To address these gaps, we aim to develop a theoretical framework for supporting HSG implementation as part of a broader effort to promote evidence-informed policy-making in health systems. Methods To develop a theoretical framework about facilitators, barriers and strategies for HSG implementation, we will apply a critical interpretive synthesis (CIS) approach to synthesize the findings from a range of relevant literature. We will search 11 electronic databases and seven organizational websites to identify relevant published and grey literature. We will check the references of included studies and contact experts to identify additional eligible papers. Finally, we will conduct purposively sampling of the literature to fill any identified conceptual gaps. We will use relevance and five quality criteria to assess included papers. A standardized form will be developed for extracting information. We will use an interpretive analytic approach to synthesize the findings, including a constant comparative method throughout the analysis. Two independent reviewers will conduct the literature screening and relevance assessment, and disagreements will be resolved through discussion. The principal investigator will conduct data extraction and synthesis, and a second reviewer will check the sample of extracted data for consistency and accuracy. Discussion A new theoretical framework about facilitators, barriers and strategies for HSG implementation will be developed using a CIS approach. The HSG implementation framework could be widely used for supporting the implementation of HSG covering varied topics and in different contexts (including low-, middle- and high-income countries). In later work, we will develop a tool for supporting HSG implementation based on the theoretical framework. Registration PROSPERO CRD42020214072. Date of Registration: 14 December 2020.
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The reporting quality of N-of-1 trials and protocols still needs improvement
Objective To evaluate the reporting quality of single-patient (N-of-1) trials and protocols based on the CONSORT Extension for N-of-1 trials (CENT) statement and the standard protocol items: recommendations for interventional trials (SPIRIT) extension and elaboration for N-of-1 trials (SPENT) checklist to examine the factors that influenced reporting quality. Methods Four electronic databases were searched to identify N-of-1 trials and protocols from 2015 to 2020. Quality was assessed by two reviewers. We calculated the overall scores based on binary responses in which "Yes" was scored as 1 (if the item was fully reported), and "No" was scored as 0 (if the item was not clearly reported or not definitely stated). Results A total of 78 publications (55 N-of-1 trials and 23 protocols) were identified. The mean reporting score (SD) of the N-of-1 trials and protocols were 29.24 (0.89) and 29.61 (1.83), respectively. For the items related to outcomes, sample size, allocation concealment protocol, and informed consent materials, the reporting quality was low. Our results showed that the year of publication (t = -0.793, p = 0.872 for the trials and t = 1.352, p = 0.623 for the protocols) and the impact factor of the journal (t = 1.416, p = 0.619 for the trials and t = 0.359, p = 0.667 for the protocols) were not factors associated with better reporting quality. Conclusion With the publication of the CENT 2015 statement and the SPENT 2019 checklist, authors should adhere to the relevant reporting guidelines and improve the reporting quality of N-of-1 trials and protocols.
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Global trends and prospects in microplastics research: A bibliometric analysis
Microplastic pollution is a global enviromental issues. This is the first time in recent decades that quantitative and qualitative evidence from bibliometrics and Altmetric has been used to conduct an in-depth statistical analysis of global microplastics research knowledge and demonstrate research progress, trends and hotspots. We comprehensively searched the Web of Science Core Collection scientific database from its inception (1986) to September 21, 2019. The study shown that the number of papers on microplastics has increased significantly since 2011. Worldwide, researchers in the field come mostly from Western Europe, mainly spread in the UK, Netherlands and Belgium. With the exception of China, the contribution of developing countries was very limited. Moreover, this study systematically elaborated the hotspots in this field (especially in ecological toxicity and human health risks). The results shown that research on marine systems and marine plankton is still dominant. Since human beings are the ultimate consumers of the food chain, microplastics may have potential effects on the human respiratory system and gastrointestinal tract. Towards that end, some topics and perspectives are noted that could indicate the current scientific hotspots and guide future research directions.
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Benefits and harms of drug treatment for type 2 diabetes: systematic review and network meta-analysis of randomised controlled trials
Objective:To compare the benefits and harms of drug treatments for adults with type 2 diabetes, adding non-steroidal mineralocorticoid receptor antagonists (including finerenone) and tirzepatide (a dual glucose dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist) to previously existing treatment options. Design:Systematic review and network meta-analysis. Data sources:Ovid Medline, Embase, and Cochrane Central up to 14 October 2022. Eligibility criteria for selecting studies:Eligible randomised controlled trials compared drugs of interest in adults with type 2 diabetes. Eligible trials had a follow-up of 24 weeks or longer. Trials systematically comparing combinations of more than one drug treatment class with no drug, subgroup analyses of randomised controlled trials, and non-English language studies were deemed ineligible. Certainty of evidence was assessed following the GRADE (grading of recommendations, assessment, development and evaluation) approach. Results:The analysis identified 816 trials with 471 038 patients, together evaluating 13 different drug classes; all subsequent estimates refer to the comparison with standard treatments. Sodium glucose cotransporter-2 (SGLT-2) inhibitors (odds ratio 0.88, 95% confidence interval 0.83 to 0.94; high certainty) and GLP-1 receptor agonists (0.88, 0.82 to 0.93; high certainty) reduce all cause death; non-steroidal mineralocorticoid receptor antagonists, so far tested only with finerenone in patients with chronic kidney disease, probably reduce mortality (0.89, 0.79 to 1.00; moderate certainty); other drugs may not. The study confirmed the benefits of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing cardiovascular death, non-fatal myocardial infarction, admission to hospital for heart failure, and end stage kidney disease. Finerenone probably reduces admissions to hospital for heart failure and end stage kidney disease, and possibly cardiovascular death. Only GLP-1 receptor agonists reduce non-fatal stroke; SGLT-2 inhibitors are superior to other drugs in reducing end stage kidney disease. GLP-1 receptor agonists and probably SGLT-2 inhibitors and tirzepatide improve quality of life. Reported harms were largely specific to drug class (eg, genital infections with SGLT-2 inhibitors, severe gastrointestinal adverse events with tirzepatide and GLP-1 receptor agonists, hyperkalaemia leading to admission to hospital with finerenone). Tirzepatide probably results in the largest reduction in body weight (mean difference -8.57 kg; moderate certainty). Basal insulin (mean difference 2.15 kg; moderate certainty) and thiazolidinediones (mean difference 2.81 kg; moderate certainty) probably result in the largest increases in body weight. Absolute benefits of SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone vary in people with type 2 diabetes, depending on baseline risks for cardiovascular and kidney outcomes (https://matchit.magicevidence.org/230125dist-diabetes). Conclusions:This network meta-analysis extends knowledge beyond confirming the substantial benefits with the use of SGLT-2 inhibitors and GLP-1 receptor agonists in reducing adverse cardiovascular and kidney outcomes and death by adding information on finerenone and tirzepatide. These findings highlight the need for continuous assessment of scientific progress to introduce cutting edge updates in clinical practice guidelines for people with type 2 diabetes.
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甘肃非物质文化遗产数字化保护:现状、问题与对策
随着信息技术的飞速发展,非物质文化遗产数字化已经成为非遗保护的有效措施。本文分析了甘肃省非遗数字化保护的现状、出现的问题,针对问题提出加强甘肃省非遗数字化保护的对策建议。甘肃省在非遗数字化保护方面还有待加强,对非遗的数字化保护应成为甘肃经济和文化的发展契机。
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循证视角下文献证据检索的内容效度研究
应用一个自建的“饱和”文献数据集,从覆盖度和相关性两个方面,对单项检索、交集式组合检索和并集式组合检索的内容效度进行检验,研究发现:单项检索中“全文”检索的内容效度最高,“题名”检索内容效度最低。交集式组合检索普遍存在内容效度风险,且项数越多,内容效度越低。并集式组合检索内容效度普遍较高但内部差异巨大。这对于夯实循证研究的基础,提高元分析和系统评价的质量具有重要意义。
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循证社会科学研究现状的可视化分析
目的 分析循证社会科学的研究现状和发展趋势,探索各领域分支学科之间的协同关系。方法 计算机检索Web of Science、中国科学引文数据库和中文社会科学引文索引数据库,搜集与循证社会科学相关的研究报告,检索时限均从建库至2022年9月。采用VOSviewer软件分析纳入研究的作者和关键词并进行可视化呈现。结果 共纳入相关文献6 969篇,其中中文195篇。最早一篇文献发表于1995年,是关于循证管理的研究。循证社会科学研究发文呈持续增长趋势,发文量最多的国家是美国,发文最多的国外机构是麦克马斯特大学,国内机构为四川大学。关键词分析结果显示,循证政策、循证实践、循证管理、循证决策的出现频次较高;研究问题集中在循证卫生政策制定、新冠肺炎疫情下大数据的应用、气候变化引起疾病的相关证据和真实世界研究等。结论 循证社会科学各领域间在研究内容和方法上联系紧密,并且与循证医学存在多层次,多领域的交叉。但国内循证社会科学尚处于萌芽阶段,还需要完善循证社会科学方法体系,丰富社会科学研究内容,加快填补各领域的证据空白,推动循证社会科学的完善和可持续发展。
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营养学随机对照试验证据质量分级系统:NutriGrade解读
NutriGrade 证 据 质 量 分 级 系 统 针 对 营 养 学 研 究 证 据 所 基 于 的 随 机 对 照 试 验 ( r a n d o m i z e d c o n t r o l l e d t r i a l , R C T ) 和 队 列 研 究 分 别 建 立 了 不 同 的 证 据 质 量 分 级 方 法 。 应 用 于 随 机 对 照 试 验 的 N u t r i G r a d e 证 据 质 量 分 级 部 分 包 括 7 个 评 价 条 目 : ① 偏 倚 风 险 、 研 究 质 量 和 研 究 局 限 性 ( 3 分 ) ; ② 精 确 性 ( 1 分 ) ; ③ 异 质 性 ( 1 分 ) ; ④ 直 接 性 ( 1 分 ) ; ⑤ 发 表 偏 倚 ( 1 分 ) ; ⑥ 资 助 偏 倚 ( 1 分 ) ; ⑦ 研 究 设 计 ( 2 分 ) 。 依 据 评 分 标 准 分 别 对 评 价 条 目 计 分 , 最 终 将 各 条 目 的 评 分 结 果 汇 总 转 化 为 : 高 质 量 证 据 ( 8  1 0 分 ) 、 中 等 质 量 证 据 ( < 8 分 ) 、 低 质 量 证 据 ( < 6 分 ) 和 极 低 质 量 证 据 ( < 4 分 ) 四 个 证 据 质 量 等 级 。 本 文 系 统 解 读 该 部 分 N u t r i G r a d e 的 评 价 条 目 及 评 分 标 准 , 应 用 实 例 加 以 分 析 , 以 期 为 国 内 研 究 者 理 解 和 应 用 此 工 具 提 供 参 考
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偏头痛干预网状Meta分析的报告质量与方法学质量调查
目的 评价偏头痛干预网状Meta分析的报告质量和方法学质量。方法 计算机检索PubMed、Embase、Web of Science和CNKI数据库,搜集相关的网状Meta分析,检索时限均为建库至2022年3月4日。由两位作者独立筛选文献、提取资料,并采用Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network meta-analysis(PRISMA-NMA)和A Measurement Tool to Assess Systematic Reviews 2(AMSTAR-2),分别评价纳入研究的报告质量和方法学质量。结果 共纳入发表于2016~2022年的18篇网状Meta分析。报告质量尚需提高的方面主要涉及PRISMA-NMA的条目5、11、S1、15、16、20、S5、22、23和24;方法学质量评价结果表明3篇(17%)整体方法学质量为低,其余15篇(83%)均为极低,需要改进方面主要包括AMSTAR-2的条目2、7、10、12、13和15。结论 偏头痛干预网状Meta分析的报告质量和方法学质量尚有待提高,建议在制作和报告网状Meta分析时应遵循和参考PRISMANMA清单和AMSTAR-2工具。
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