非药物戒烟干预对肺癌筛查高危人群戒烟效果的网状Meta分析

The efficacy of different non-drug smoking cessation interventions on smoking cessation among high-risk populations of lung cancer screening by network meta-analysis

目的采用网状Meta分析评价不同非药物戒烟干预措施对肺癌筛查高危人群戒烟的疗效。方法对Pubmed、Medline(Ovid)、PsycINFO、中文期刊网全文数据库(CNKI)、万方数据库、维普数据库进行检索,检索期限均从2010年01月至2020年09月公开发表的随机对照临床试验。按照纳排标准对检索文献进行筛选,并进行质量评价和提取数据,采用Stata 14.0软件进行统计分析。结果共纳入文献28篇,共纳入34640例高危人群,涉及的干预措施包括5R简短戒烟干预、认知行为疗法、AWARD模式戒烟干预、动机性访谈、网络干预、电话干预、激励机制+电话干预、网络+电话干预、常规治疗和空白对照。网状Meta分析结果显示:在随访6个月的7 d点戒烟率指标上,根据累积曲线下面积(the surface under the cumulative ranking curve,SUCRA)得分排名依次为5R简短戒烟干预(0.88)、认知行为疗法(0.85)、AWARD模式戒烟干预(0.80)、激励机制+电话干预(0.73)、动机性访谈(0.53)、网络+电话干预(0.40)、网络干预(0.37)、电话干预(0.31)、常规治疗(0.13)和空白组(0.03)。在随访12个月的7 d点戒烟率指标上,排名依次为5R简短戒烟干预(0.94)、AWARD模式戒烟干预(0.81)、动机性访谈(0.51)、网络干预(0.40)、电话干预(0.19)和常规治疗(0.14)。结论现有证据表明,无论随访时间长短,5R简短戒烟干预方法对肺癌筛查高危人群戒烟的疗效最好。

Objective To assess the efficacy of different non-drug smoking cessation interventions on smoking cessation among the high-risk populations of lung cancer screening by network meta-analysis.Methods PubMed,MEDLINE(Ovid),PsychINFO,CNKI,WanFang and VIP databases were searched for randomized controlled clinical trials published from January 2010 to September 2020.According to the eligibility criteria,the retrieval literature was screened,the quality evaluation and data extraction were conducted,then,the statistical analysis was performed by using the Stata 14.0 software.Results A total of 28 trials were included,including 34640 cases of high-risk population,involving intervention measures,including 5R short quit smoking intervention,cognitive behavior therapy,award model quit smoking intervention,motivational interview,network intervention,telephone intervention,incentive mechanism plus telephone intervention,network plus telephone intervention,conventional treatment and blank group.The results of network meta-analysis showed that on the 7-day follow-up of 6 months,according to the score of SUCRA,the ranking of smoking cessation rate was 5R short smoking cessation intervention(0.88),cognitive behavior therapy(0.85),AWARD model smoking cessation intervention(0.80),incentive mechanism plus telephone intervention(0.73),motivational interview(0.53),Internet plus telephone intervention(0.40),Internet intervention(0.37),telephone intervention(0.31),conventional treatment(0.13)and blank group(0.03).However,on the 7-day smoking cessation rate of 12-month follow-up,the ranking of smoking cessation rate was 5R short smoking cessation intervention(0.94),AWARD model smoking cessation intervention(0.81),motivational interview(0.51),network intervention(0.40),telephone intervention(0.19)and conventional treatment(0.14).Conclusions The existing evidence shows that no matter the length of follow-up,5R short smoking cessation intervention has the best effect on smoking cessation in high-risk population of lung cancer screening.