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The method of scoping review was used to systematically search and sort out the clinical research of oral Chinese patent medicines for ischemic stroke，to understand the scope of relevant research and the distribution of evidence. Three medical catalogs were manually searched to obtain the oral Chinese patent medicines used for ischemic stroke，and 7 databases were retrieved to obtain the clinical research including these oral Chinese patent medicines. Then the clinical evidence results were visualized by description combined with chart analysis. A total of 68 oral Chinese patent medicines were retrieved，and 1 392 articles were included，with 367 published in core journals， involving 35 oral Chinese patent medicines. The research types included randomized controlled trials，cohort studies，case series，case reports，secondary studies，adverse drug reaction reports，pharmacoeconomic evaluations，drug interactions，consensus or guidelines，non-randomized intervention studies and cross-sectional studies，of which randomized controlled trials had the largest number （283， 77.1%），followed by secondary studies and case series （25， 6.7% for each）. Among the 283 randomized controlled trials，there were 159 clinical studies in the acute phase of ischemic stroke，65 in the non-acute phase，and 59 in the unclear phase. Ten intervention control types and 20 outcome index types were summarized. Among them， the composite outcome index and surrogate outcome index were used 217 times （76.7%） and 245 times （86.6%）， respectively，followed by the degree of neurological impairment （three scales）. Future clinical research of oral Chinese patent medicines for ischemic stroke should clarify the stage of the disease，and the research design should specify the advantages of oral Chinese patent medicines intervening in ischemic stroke. Furthermore， publicly-recognized positive controls should be employed，and important clinical outcome indexes should be selected.
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Objective To systematically identify, describe, and evaluate research evidence related to exercise intervention in patients with depression through the evidence mapping method. Methods Related studies on exercise intervention for patients with depression were searched in CNKI, Wanfang Data, CBM, VIP, Web of Science, EMBASE, Cochrane library, and PubMed from inception to July, 2021. The quality of the studies was assessed using the risk of bias (RoB) tool recommended by the Cochrane Handbook Version 5.1.0 and A Measurement Tool to Assess Systematic Review-2 (AMSTAR-2). Based on World Health Organization Family International Classifications (WHO-FICs) framework, an evidence mapping framework was established, using EPPI software and Microsoft Excel 2019 tools for data extraction and coding, and using bubble charts to comprehensively present the research population, intervention categories, original research sample size, and the number of studies included in the systematic review/meta-analysis, conclusion classification and other information. Results A total of 101 randomized controlled trials and 52 systematic reviews/meta-analyses were included. The randomized controlled trials involved three types of intervention strategies with 15 different interventions, mainly including unspecified exercise intervention (28, 27.72%) and yoga intervention (19, 18.81%). The main research outcomes included b1. Global mental functions (92, 91.09%) and d9. Community, social and civic life (19, 18.81%). Among the three types of intervention strategies, rehabilitation accounted for the highest proportion, with 47 studies in total, accounting for 46.53%. The main research population was patients with other specified depression (19, 40.42%), such as patients with major depression and elderly depression. Forty-six research conclusions (97.87%) were classified as "beneficial" or "probably beneficial". In 52 systematic reviews/meta-analyses, nine interventions were involved, mainly including unspecified exercise intervention (17, 32.69%) and yoga intervention (12, 23.08%). The main study outcomes included b1. Global mental functions (41, 78.85%) and adverse reactions (12, 23.08%). Among the three types of intervention strategies, the treatment type accounted for the highest proportion, with a total of 34 studies, accounting for 65.38%. The study population was mainly patients with other specific depression (27, 79.41%), such as adult depression and pregnant women with depression, 28 (82.35%) of the research conclusions were classified as "beneficial" or " probably beneficial". At the same time, the intervention environment/background was mainly outpatient and inpatient environment. Conclusion Exercise intervention may be beneficial for patients with depression. However, the effectiveness of walking, cycling, Qigong, resistance training, and sports game interventions, the optimal intervention duration or intensity, and the adverse effects of the intervention, still need to be further explored by high-quality study in the future.
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Objective To systematically identify, describe, and evaluate research evidence related to exercise intervention in patients with depression through the evidence mapping method. Methods Related studies on exercise intervention for patients with depression were searched in CNKI, Wanfang Data, CBM, VIP, Web of Science, EMBASE, Cochrane library, and PubMed from inception to July, 2021. The quality of the studies was assessed using the risk of bias (RoB) tool recommended by the Cochrane Handbook Version 5.1.0 and A Measurement Tool to Assess Systematic Review-2 (AMSTAR-2). Based on World Health Organization Family International Classifications (WHO-FICs) framework, an evidence mapping framework was established, using EPPI software and Microsoft Excel 2019 tools for data extraction and coding, and using bubble charts to comprehensively present the research population, intervention categories, original research sample size, and the number of studies included in the systematic review/meta-analysis, conclusion classification and other information. Results A total of 101 randomized controlled trials and 52 systematic reviews/meta-analyses were included. The randomized controlled trials involved three types of intervention strategies with 15 different interventions, mainly including unspecified exercise intervention (28, 27.72%) and yoga intervention (19, 18.81%). The main research outcomes included b1. Global mental functions (92, 91.09%) and d9. Community, social and civic life (19, 18.81%). Among the three types of intervention strategies, rehabilitation accounted for the highest proportion, with 47 studies in total, accounting for 46.53%. The main research population was patients with other specified depression (19, 40.42%), such as patients with major depression and elderly depression. Forty-six research conclusions (97.87%) were classified as "beneficial" or "probably beneficial". In 52 systematic reviews/meta-analyses, nine interventions were involved, mainly including unspecified exercise intervention (17, 32.69%) and yoga intervention (12, 23.08%). The main study outcomes included b1. Global mental functions (41, 78.85%) and adverse reactions (12, 23.08%). Among the three types of intervention strategies, the treatment type accounted for the highest proportion, with a total of 34 studies, accounting for 65.38%. The study population was mainly patients with other specific depression (27, 79.41%), such as adult depression and pregnant women with depression, 28 (82.35%) of the research conclusions were classified as "beneficial" or " probably beneficial". At the same time, the intervention environment/background was mainly outpatient and inpatient environment. Conclusion Exercise intervention may be beneficial for patients with depression. However, the effectiveness of walking, cycling, Qigong, resistance training, and sports game interventions, the optimal intervention duration or intensity, and the adverse effects of the intervention, still need to be further explored by high-quality study in the future.
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BACKGROUND@#Influenza places a heavy public health burden in numerous countries every year. In addition to vaccines, there are some interventions that are effective in preventing influenza.@*OBJECTIVE@#This overview of systematic reviews (SRs) aimed to evaluate the efficacy and safety of interventions for influenza prevention.@*SEARCH STRATEGY@#We searched the Cochrane Database of Systematic Reviews, 2020, Issue 1 for relevant Cochrane SRs using the keywords "common cold," "influenza," and "flu."@*INCLUSION CRITERIA@#Cochrane SRs that investigated the prevention of influenza were included. Participants included the general population without influenza or influenza-like symptoms, who were treated with preventative interventions and compared to individuals receiving no treatment or placebo.@*DATA EXTRACTION AND ANALYSIS@#Two reviewers independently screened citations against pre-defined inclusion criteria and extracted data. The methodological quality of these SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-II (AMSTAR-II) guidelines. The primary outcome of our analysis was the incidence of influenza, and the secondary outcomes were the incidence of influenza-like illness and hospitalization. In addition to the narrative summary of SR findings, we also pooled data from homogeneous trials among these SRs and produced evidence mapping. We conducted a network meta-analysis to compare the effect across interventions and used the Cochrane approach to grading of recommendations, assessment, development, and evaluation (GRADE) to assess the quality of evidence.@*RESULTS@#Eleven Cochrane SRs were included, covering five medications, eleven vaccinations and four complementary therapies. Among these SRs, 73% scored "high" quality on AMSTAR-II rating. We found that eight interventions, including amantadine, garlic, and six different vaccines, were beneficial for reducing the incidence of influenza compared to placebo, while oseltamivir, zanamivir, Ganmao capsule, Echinacea, and another three types of vaccine were probably beneficial. Ganmao capsule ranked highest for influenza prevention in the network meta-analysis, followed by amantadine, garlic, and vaccines of all types. Monovalent inactivated parenteral vaccine was found to be beneficial in reducing the incidence of influenza-like illness. None of the interventions reduced the hospitalization rate.@*CONCLUSION@#High-quality evidence showed that garlic or vaccine had advantages in preventing influenza, and that vitamin C is not effective. The effect of other interventions needs to be further verified with high-quality evidence.
Subject(s)
Humans , Bayes Theorem , Influenza, Human/prevention & control , Network Meta-Analysis , Systematic Reviews as Topic , VitaminsABSTRACT
In this study, the evidence mapping methodology was used to systematically retrieve and sort out the clinical research evidence of Chinese patent medicines in the treatment of tension-type headache(TTH), and to understand the distribution of evidence in this field and the basis and quality of evidence. Chinese and English articles on the 28 Chinese patent medicines for TTH, which were recorded in National Essential Medicines List(2018), Medicine Catalogue for National Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance(2020), and Chinese Pharmacopoeia(2020), were retrieved from China National Knowledge Infrastructure(CNKI), Wanfang, VIP, China Biology Medicine disc(CBMdisc), PubMed, EMbase, and Cochrane Library from the establishment to June 2021, followed by descriptive analysis. Then, tables and bubble charts were plotted to analyze the distribution characteristics of evidence. A total of 129 eligible articles were yielded: 126 randomized/non-randomized controlled trials, and 3 systematic reviews. The functions, indications, and composition of the 28 medicines, as well as the proportion of related articles, publication trends, intervention measures, and outcome indicators were compared and analyzed. The results showed that the 28 Chinese patent medicines, composed of 128 Chinese medicinals, can be classified into six categories in terms of function: reinforcing healthy Qi, tranquilizing mind, dispelling stasis, regulating Qi, treating wind, and resuscitating. There are ongoing efforts to study the treatment of TTH with Chinese patent medicine in China, despite of little evidence. The clinical positioning of Chinese patent medicine for TTH is not clear, and clinical research fails to highlight the advantages of Chinese medicine. In addition, the outcome indicators have not been standardized and unified, and there is a lack of evidence on the long-term efficacy of Chinese patent medicine for TTH. This study is the first exploratory application of evidence maps to compare the characteristics and clinical research progress of 28 Chinese patent medicines for TTH, which can provide a reference for research on the optimization of Chinese medicine strategies for TTH.
Subject(s)
Female , Humans , Pregnancy , Asian People , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Medicine, East Asian Traditional , Nonprescription Drugs , Tension-Type HeadacheABSTRACT
OBJETIVO: Identificar las prácticas preventivas para riesgos psicosociales en centros sanitarios iberoamericanos, incluyendo los vacíos de la evidencia, y sintetizar la efectividad según dimensión y nivel de intervención. Métodos: Diseño: revisión sistemática de tipo global evidence mapping. FUENTES DE DATOS: Cochrane Central Register of Controlled Trials, Health Systems Evidence, The Campbell Collaboration, PubMed, BioMed Central, CINAHL, EMBASE, Lilacs y Health Evidence Portal. MÉTODOS DE LA REVISIÓN: se emplearon descriptores ad hoc para identificar ensayos controlados aleatorios y otros tipos de estudio. El período de búsqueda comprendió entre enero de 2003 y marzo de 2020, limitado a los idiomas inglés, portugués y español. Para el registro de síntesis de estudios incluidos se aplicó el protocolo PRISMA-P. La calidad de la evidencia fue evaluada según protocolo GRADE por tres evaluadores externos. RESULTADOS: Se identificaron 8959 estudios y, tras el tamizaje y análisis de elegibilidad, se admitieron 18 estudios para revisión sistemática que involucran a 1777 trabajadores de 176 centros sanitarios de España, Portugal, México, Nicaragua, Colombia, Brasil, Perú y Argentina. La mitad de los estudios incluidos son ensayos controlados aleatorios. Las frecuencias de desenlaces predominantes son de calidad moderada (37,2%), y las de alta calidad son 18,7%. CONCLUSIONES: Las prácticas preventivas con alta calidad de evidencias corresponden a las políticas para mejorar condiciones laborales del trabajo hospitalario nocturno. Prácticas basadas en intervenciones multicomponentes presentan evidencias de baja calidad en cinco dimensiones preventivas. Los vacíos de la evidencia están en seis dominios de la intervención preventiva para los riesgos psicosociales.
OBJECTIVE: To identify preventive practices for psychosocial risks in Ibero-American health centers, including gaps in evidence, and to synthesize effectiveness according to dimensions and level of intervention. METHODS: Design: a global evidence mapping type systematic review. DATA SOURCES: Cochrane Central Register of Controlled Trials, Health Systems Evidence, The Campbell Collaboration, PubMed, BioMed Central, CINAHL, EMBASE, Lilacs, and Health Evidence Portal. REVIEW METHODS: Ad hoc descriptors were used to identify randomized controlled trials and other types of studies. The search was done between January 2003 and March 2020, limited to the English, Portuguese, and Spanish. The PRISMA-P protocol was applied to register the synthesis of the included studies. The quality of the evidence was evaluated according to the GRADE protocol and by three external evaluators. RESULTS: A total of 8959 studies were identified, and, after screening and eligibility assessment, 18 studies were included in the systematic review, involving 1777 workers from 176 health centers in Spain, Portugal, Mexico, Nicaragua, Colombia, Brazil, Peru, and Argentina. Half of the included studies are randomized controlled trials; 37.2% of the included studies were deemed of moderate quality, while 18.7% were of high quality. CONCLUSIONS: Preventive practices with strong evidence correspond to policies that improve the working conditions of night hospital work. We found low-quality evidence in six preventive dimensions for the practices based on multi-component interventions. We found evidence gaps in five domains of preventive interventions for psychosocial risks.