针灸治疗坐骨神经痛系统评价/Meta-分析的方法学质量及报告质量评价

目的:评价目前国内外针灸治疗坐骨神经痛的系统评价/Meta-分析的方法学质量和报告质量。方法:检索国内外大型医学数据库,依照纳入/排除标准进行严格筛选,分别采用AMSTAR量表和PRISMA清单对最终纳入的文献进行方法学质量评价和报告质量评价。结果:(1)纳入的8篇系统评价/Meta-分析,均存在不同程度的方法学质量问题,主要包括:所有研究均未提供纳入文献和排除文献清单报告;87.5%的研究缺少相关利益冲突报告;75%的研究未进行发表偏倚分析等。(2)报告质量方面,存在的主要问题包括:所有研究均未对结构式摘要、目的、方案和注册进行完整报告;75%的研究未对研究特征、其他分析进行完整报告;62.5%的研究未对研究理论基础、研究间偏倚、证据强度总结、资金支持进行完整报告等。结论:目前国内外针灸治疗坐骨神经痛的系统评价/Meta-分析质量参差不齐,需进一步提高方法学水平并规范报告,以期为循证决策提供高质量的证据。     

Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women

Objectives

The aims of the present systematic review and meta-analysis were to determine the relationship between muscular strength and all-cause mortality risk and to examine the sex-specific impact of muscular strength on all-cause mortality in an apparently healthy population.

Periodontal disease in patients with Down syndrome: A systematic review

Background

The authors systematically reviewed the scientific evidence of an association between periodontal disease and Down syndrome (DS).

The association between periodontitis and coronary heart disease: A quality assessment of systematic reviews

BackgroundThe existence of an association between periodontitis and cardiovascular disease has been proposed by investigators in several clinical studies and further confirmed by the results of several systematic reviews. The aim of the Authors' study was to assess the quality of published systematic reviews focused on the association between periodontitis and coronary heart disease (CHD) by using established systematic review assessment checklists.MethodsTwo reviewers conducted a search for systematic reviews focusing on the association between periodontitis and CHD. Three independent reviewers appraised the quality of the selected 13 reviews by using an established and validated assessment tool for systematic reviews and another checklist. They gave each article a total score according to the number of criteria on each checklist that the article fulfilled.ResultsNine reviews satisfied six or more items on the assessment tool, whereas two reviews each satisfied only one item. This assessment shows that published systematic reviews of the periodontitis-CHD association exhibit significant structural and methodological variation, which the authors further confirmed by using the second checklist.ConclusionSystematic reviews of the association between periodontitis and CHD exhibited significant differences in their methodological quality.Practical ImplicationsClinicians should be aware that not all systematic reviews of the periodontitis-CHD association are conducted in a rigorous manner and should be capable of differentiating well-conducted reviews from poorly conducted ones.     

PRISMA声明在评价《循证医学》刊载的干预类系统评价/荟萃分析报告质量中的应用

目的：评价PRISMA声明对发表于《循证医学》杂志的干预类系统评价/Meta分析报告质量的影响。方法：根据 纳入排除标准,纳入2001-2011年发表于《循证医学》的干预性试验系统评价/Meta分析,采用PRISMA量表对纳入系统评价/Meta分析进行评价 ,用Meta Analyst软件进行统计分析。结果：共纳入70个系统评价/Meta分析,涉及14个疾病谱。PRISMA的发布和高校作者发表的系统评 价/Meta分析,可以提高其报告质量（P<0.05）,基金资助和作者数量对文献报告质量影响不大。结论：发表于《循证医学》杂志的系统评 价/Meta分析在文献检索、筛选、偏倚评估和其他分析方法等方面亟待改善,报告质量有待提高。PRISMA的发布可在整体上改善系统评价/Meta 分析的报告质量。     

Total glucosides of paeony for the treatment of rheumatoid arthritis: A methodological and reporting quality evaluation of systematic reviews and meta-analyses

ObjectiveTo assess the methodological, reporting and evidence quality of systematic reviews and meta-analyses of total glucosides of paeony (TGP) for rheumatoid arthritis (RA).MethodsWe comprehensively searched the literature in numerous databases from inception to July 29th, 2020. Two appraisers collected data and assessed the methodological and reporting quality of the included reviews by revised A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) tool and the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA), respectively. The level of evidence quality was evaluated by employing the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) scale.ResultsEleven relevant articles were collected. The results from AMSTAR-2 showed that the methodological quality of all included reviews was critically low; no authors met the standard of those critical domains (0%), particularly in item 2, item 4 and item 7. The PRISMA scores ranged from 16.5 to 25, and one meta-analysis almost conformed to the PRISMA structure. According to GRADE, the 11 studies included 59 outcomes: 27 had very low quality, 22 had low quality, 10 had moderate quality, and none had high quality evidence. The most prominent downgrading factors were risk of bias, followed by publication bias, inconsistency, imprecision, and indirectness.ConclusionsAlthough included studies summarized that TGP was effective and safe in the treatment of RA, the methodological and reporting quality and the quality of evidence was poor overall; decision-makers should be prudent when using TGP in treating RA patients. High-quality and multicenter studies investigating TGP for RA are urgently needed.     

Immunogenicity,safety and tolerability of anti-pneumococcal vaccination in systemic lupus erythematosus patients: An evidence-informed and PRISMA compliant systematic review and meta-analysis

The immunological perturbations associated with systemic lupus erythematosus (SLE) put many patients at a higher risk of infections, including pneumococcal pneumonia. However, the uptake and utility of anti-pneumococcal vaccines in SLE patient is both controversial and not completely agreed upon. Indeed, several epidemiological studies of anti-pneumococcal vaccine safety and efficacy in SLE have reported short-term immunogenicity with elevated anti-pneumococcal antibody titres but inconsistent long-term findings, with some studies finding poor responses, mainly for long-term immune protection. Moreover, the safety and efficacy of the pneumococcal vaccine in SLE patients remains controversial due to the different types of anti-pneumococcal vaccines, and the heterogeneity of SLE patients. Several reviews addressing anti-pneumococcal vaccination in SLE patients exist, however, to the best of our knowledge, the present is the first systematic review and meta-analysis. To better understand the efficacy and safety of pneumococcal vaccination in SLE, a comprehensive literature search was performed identifying 18 studies, which have been included in the present systematic review and meta-analysis. All studies were designed as longitudinal investigations, 2, in particular, were of high quality, being randomized, double-blind trials (RCTs). Four studies had control groups. Total sample size included 601 participants. Vaccine immunogenicity in terms of subjects with protective antibody titers ranged from 36% to 97.6%. According to our systematic review and metanalysis, high erythrocyte sedimentation rate (ESR), older age, earlier SLE onset, high disease activity, and immunosuppressive therapy were predictors of poor immunogenicity, although belimumab was found to have no significant impact. With regard to safety, no serious adverse events were found, with up to one third of cases reporting mild/low-grade complaints.In conclusion, due to the high risk of pneumococcal infection in SLE patients and given the safety and, at least partial, effectiveness, according to our systematic review and meta-analysis, in such patients, preventive strategies mainly by immunization, are required in all age groups and, in those needing immunosuppressive therapy, immunization should be given prior the initiation of the treatment.PROSPERO registration code CRD42018103605.