Ethnopharmacological relevance: Tanreqing injection (TRQI) is an intravenous herbal preparation derived from 5 types of traditional Chinese medicines including Scutellariae Radix, Lonicerae Japonicae Flos, Forsythiae Fructus, bear bile powder and goral horn, incorporating baicalin, chlorogenic acid, ursodeoxycholic acid, and goose deoxycholic acid and other compounds known for anti-inflammatory properties, is widely used in China to treat cough caused by acute trachea-bronchitis disease (ATB). Aim of the study: To investigate the clinical efficacy and safety of Tanreqing injection (TRQI) with and without Western medicine (WM) for cough caused by acute trachea-bronchitis (ATB). Materials and methods: We systematically searched eight databases, including CENTRAL, Embase, PubMed, Science Direct, Wiley, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang, from inception to August 2023 for randomized clinical trials (RCTs) on TRQI for cough caused by ATB. The critical outcomes of interest were time to symptom disappearance, including time for cough symptom to disappear and time to improve cough and sputum production. Important outcomes included symptom disappearance rate, adverse events (AEs) and lung function. We carried out random-effects meta-analysis using Review Manager 5.4 and assessed the certainty of evidence utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: A total of 2872 citations were identified by our search, of which 26 eligible RCTs enrolled 2731 participants. Low to moderate certainty evidence showed that when compared with WM, TRQI plus WM treatment was associated with a favorable effect on the time for cough symptom to disappear (MD-2.21 d, 95% CI-2.64 to-1.78), time to improve cough and sputum production (MD-0.68 d, 95% CI-0.83 to-0.53), symptom disappearance rate (RR 1.37, 95% CI 1.20 to 1.55), forced vital capacity, and forced expiratory volume in 1 s (MD 0.38 L, 95% CI 0.26 to 0.50; MD 2.92%, 95% CI 1.29 to 4.56, respectively). In terms of AEs, there was no association between TRQI plus WM and WM (RR 0.55, 95% CI 0.14 to 2.21; low-certainty evidence). Very low certainty evidence showed that TRQI alone was associated with reduced time to improve cough and sputum (MD-0.14 d, 95% CI-0.26 to-0.02) and increased symptom disappearance rate (RR 1.89, 95% CI 1.24 to 2.88; low certainty evidence) compared to WM.

Diagnosis related groups (DRGs)-based payment is increasingly used worldwide to control hospital costs instead of pre-existing cost-based payment, but the results of evaluations vary. A systematic analysis of the effects of DRGs-based payment is needed. This study aims to conduct a systematic review and meta-analysis to compare the effects of DRGs-based payment and cost-based payment on inpatient health utilization in terms of length of stay (LOS), total inpatient spending per admission and readmission rates. We included studies undertaken with designs approved by the Cochrane Effective Practice and Organisation of Care that reported associations between DRGs-based payment and one or more inpatient healthcare utilization outcomes. After a systematic search of eight electronic databases through October 2018, 18 studies were identified and included in the review. We extracted data and conducted quality assessment, systematic synthesis and meta-analyses on the included studies. Random-effects models were used to handle substantial heterogeneity between studies. Meta-analysis showed that DRGs-based payment was associated with lower LOS (pooled effect: -8.07 % [95 %CI -13.05 to -3.10], p = 0.001), and higher readmission rates (pooled effect: 1.36 % [95 %CI 0.45–2.27], p = 0.003). This meta-analysis revealed that DRGs-based payment may have cost-saving implications by lowering LOS, whereas hardly reduce the readmission rates. Policy-makers considering adopting DRGs-based payment should pay more attention to the hospital readmission rates compared with cost-based payment.

Backgrounds: Pulmonary tuberculosis (PTB) is a major health and economic burden. Accurate PTB detection is an important step to eliminating TB globally. Interferon gamma-induced protein 10 (IP-10) has been reported as a potential diagnostic marker for PTB since 2007. In this study, a meta-analysis approach was used to assess diagnostic value of IP-10 for PTB. Methods: Web of Science, PubMed, the Cochrane Library, and Embase databases were searched for studies published in English up to February 2019. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), the area under the curve (AUC) and hierarchical summary receiver operating characteristic (HSROC) curve were estimated by the HSROC model and random effect model. Results: Eighteen studies including 2836 total participants met our inclusion criteria. The pooled sensitivity, specificity, PLR, and NLR of IP-10 for PTB detection were 86, 88%, 7.00, and 0.16, respectively. The pooled DOR was 43.01, indicating a very powerful discriminatory ability of IP-10. The AUC was 0.93 (95% CI: 0.91-0.95), showed the accuracy of IP-10 was good. Meta-regression showed that there was no heterogeneity with respect to TB burden, study design type, age, IP-10 assay method, IP-10 condition and HIV-infection status. Conclusions: Our results showed that IP-10 is a promising marker for differentiating PTB from non-TB.

Objective: The aim of this study was to determine the diagnostic accuracy of different computer-aided diagnostic (CAD) systems for thyroid nodules classification. Methods: A systematic search of the literature was conducted from inception until March, 2019 using the PubMed, EMBASE, Web of science, and Cochrane library. Literature selection and data extraction were conducted by 2 independent reviewers. Numerical values for sensitivity and specificity were obtained from false negative (FN), false positive (FP), true negative (TN), and true positive (TP) rates, presented alongside graphical representations with boxes marking the values and horizontal lines showing the confidence intervals (CIs). Summary receiver operating characteristic (SROC) curves were applied to assess the performance of diagnostic tests. Data were processed using Review Manager 5.3 and Stata 15. The methodological quality of included studies was assessed using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Trial registration number: PROSPERO CRD42019132540

Background In undertaking a major revision to the Australian Refined Diagnosis Related Group (ARDRG) classification, we set out to contrast Australia's approach to using data on additional (not principal) diagnoses with major international approaches in splitting base or Adjacent Diagnosis Related Groups (ADRGs). Methods Comparative policy analysis/narrative review of peer-reviewed and grey literature on international approaches to use of additional (secondary) diagnoses in the development of Australian and international DRG systems. Analysis European and US approaches to characterise complexity of inpatient care are well-documented, providing useful points of comparison with Australia's. Australia, with good data sources, has continued to refine its national DRG classification using increasingly sophisticated approaches. Hospital funders in Australia and in other systems are often under pressure from provider groups to expand classifications to reflect clinical complexity. DRG development in most healthcare systems reviewed here reflects four critical factors: these socio-political factors, the quality and depth of the coded data available to characterise the mix of cases in a healthcare system, the size of the underlying population, and the intended scope and use of the classification. Australia's relatively small national population has constrained the size of its DRG classifications, and development has been concentrated on inpatient care in public hospitals. Discussion and conclusions Development of casemix classifications in health care is driven by both technical and socio-political factors. Use of additional diagnoses to adjust for patient complexity and cost needs to respond to these in each casemix application.

Authors' objectives: This report aims to identify and summarise evidence that addresses the following research question: What is the clinical and cost effectiveness of artificial intelligence (AI)-assisted review of prostate biopsy in identifying prostate cancer?

Authors' objectives: Acute kidney injury is a serious complication that occurs in the context of an acute critical illness or during a postoperative period. Earlier detection of acute kidney injury may facilitate strategies to preserve renal function, prevent further disease progression and reduce mortality. Acute kidney injury diagnosis relies on a rise in serum creatinine levels and/or fall in urine output; however, creatinine is an imperfect marker of kidney function. There is interest in the performance of novel biomarkers used in conjunction with existing clinical assessment, such as NephroCheck® (Astute Medical, Inc., San Diego, CA, USA), ARCHITECT® urine neutrophil gelatinase-associated lipocalin (NGAL) (Abbott Laboratories, Abbott Park, IL, USA), and urine and plasma BioPorto NGAL (BioPorto Diagnostics A/S, Hellerup, Denmark) immunoassays. If reliable, these biomarkers may enable earlier identification of acute kidney injury and enhance management of those with a modifiable disease course. The objective was to evaluate the role of biomarkers for assessing acute kidney injury in critically ill patients who are considered for admission to critical care.

Authors' objectives: HTW undertook an evidence review to address the following question: in people who present with an acute sore throat, what is the clinical and cost effectiveness of rapid antigen detection tests for diagnosing and managing suspected group A streptococcal infection in the community pharmacy setting? This review is in part adapted from diagnostics guidance produced by the National Institute for Health and Care Excellence (NICE), “Rapid tests for group A streptococcal infections in people with a sore throat”, published in 2019 (DG38).

Authors' objectives: Colorectal cancer covers cancers in both the colon (colon cancer or bowel cancer) and rectum (rectal cancer). It’s one of the most common cancers in Wales, with about 2,300 new cases in Wales each year. Faecal immunochemical tests can detect small amounts of blood in stool samples. They can help GPs decide if people with unexplained CRC-associated symptoms, but no rectal bleeding, should be referred for more urgent tests. Other characteristics, such as age or gender, can also help GPs identify people who are at risk. HTW has assessed tools that included faecal immunochemical tests and other characteristics, to help NHS Wales decide whether to use these tools.