Reporting Characteristics of Case Reports of Acupuncture Therapy with CARE Guidelines

Objective： To investigate the reporting characteristics of case reports of acupuncture therapy with CAse Report （CARE） guidelines, and to explore the applicability of the guidelines for these case reports. Methods： Case reports published from January 1, 2011 to December 31, 2013, were identified by searching PubMed and the China Biomedicine Database by using MeSH terms. Screening and data extraction of case reports were conducted by two independent researchers. Assessments based on CARE guidelines and data analysis were conducted by using Excel 2003 and RevMan 5.0. Results： A total of 61 case reports published in 19 journals were identified, which involved 16 major types of diseases. Fifteen （24.6%） case reports declared no conflict of interests, and 5 （8.2%） reported funding sources. None of these case reports met all items of CARE guidelines, and only 6 subordinate items were fully reported among 50% of the case reports. Subgroup analysis indicated that case reports published in English or those that did not have competing interests had higher reporting quality. Conclusions： The reporting quality of case reports of acupuncture therapy is rather low. The reason might be a lack of awareness among authors and the poor dissemination of information regarding CARE guidelines in China. More evaluation studies are needed to promote and improve adherence to CARE guidelines. Moreover, an extended version of CARE guidelines should be developed for cases reports of special interventions such as acupuncture or adverse events caused by interventions.

基于CARE指南评价针刺不良事件报告的质量

Objective:As a popular complementary therapy,the safety of acupuncture must be considered.Acupuncture case reports of adverse events(ACR-AEs)significantly contribute to the assessment of acupuncture safety.However,the reporting quality of ACR-AEs remains unclear.We aimed to promote the application of the CARE(case report)guidelines and improve the reporting quality of ACR-AEs.Methods:We systematically searched for ACR-AE from six databases:Medline,Embase,Chinese Biomedical Literature Service System,China National Knowledge Infrastructure,Wanfang Data,and VIP,and collected published ACR-AEs from January 1,2016,to December 31,2020.We included only case reports of adverse events related to acupuncture therapy.The retrieved case reports were screened and filtered by two reviewers independently.Then,basic information extraction and CARE evaluation of the included ACR-AEs wereperformed.Results:A total of 56 ACR-AE were included,15 of which were from China.The top two major diseases were nervous system diseases(28.6%)and infections(21.4%).For all ACR-AEs,seven of 30 CARE subordinate items were reported in 30%or less,seven items were reported in 30-60%,and only five items got reporting proportion over 90%.In Chinese ACR-AE,only three items,"the main concerns and symptoms of the patient(5b)","types of intervention(9a)"and"adverse and unanticipated events(1od)"were sufficiently reported.In English ACR-AE,item"the main concerns and symptoms of the patient(5b)"and item"the primary takeaway lessons(11d)"were also generally reported.Conclusion:Overall,the reporting quality of ACR-AE was unsatisfactory,and we believe that a special reporting guideline for clinical cases targeted at acupuncture should be extended in future studies.

A protocol for the reporting and methodological quality of robotic surgery case reports

Background:Robotic surgery is a complex innovation intervention.Recently,the number of robotic surgery case reports is increasing,but there is unclear on its reporting and methodological quality.Methods:The PubMed database will be searched with high-specificity search strategy from Jan 1,2012 to Aug 1,2018 to identify relevant records.Microsoft Excel 2016 will be used to generate random number and to select 100 robotic surgery case reports according our eligibility criteria.A data extraction form will be used to extract relevant information including first author,year of publication,journal,etc.The CARE guideline and JBI checklist will be used to separately assess the reporting and methodological quality of included studies.The data extraction and assessment of quality will be completed by independent two authors and any disagreement will be resolved through discussion or consulting the third author.Stratified analyses will be conducted based on extracted information.Review Manager 5.3 software will be used to present the results of stratified analyses with Inverse-Variance random-effect model.Results:The study is ongoing and will be submitted to a peerreviewed journal.Conclusion:The present study will summarize evidence on the reporting and methodological quality of robotic surgery case reports,and provide reference for future case reports but not limited to robotic surgery.Ethics and dissemination:Ethical approval is not required because this study will not include any confidential personal data and interventions on the patients.The results of this study will be published in a peerreviewed publication.

Implementing surviving sepsis campaign bundles in China： a prospective cohort study

Background Surviving sepsis campaign （SSC） bundles have been demonstrated to significantly improve survival in sepsis and septic shock patients worldwide. Compliance with these protocols and resultant mortality in sepsis patients was investigated in intensive care units （ICUs） in China. Methods Adult patients with severe sepsis or septic shock treated from September 2007 to October 2008 in 11 ICUs of Chinese teaching hospitals were included. The primary outcome was compliance with resuscitation and management bundles. Secondary outcomes included individual bundle protocol impact and the effects of the completed bundle protocol number on 28-day mortality. Results Overall compliance during 6-hr resuscitation and 24-hour management bundles were 5.5% and 17.4%, respectively, and 28-day mortality was 33.0%. Compliance with protocols for blood cultures before antibiotics （42.2%）, central venous pressure 〉8 mmHg （65.9%）, central venous oxygen saturation 〉70% （25.0%）, and optimized glucose control （82.1%）, were significantly associated with decreased 28-day mortality （P 〈0.05）. When adjusted for age, acute organ dysfunction, and APACHE II score, compliance with the blood culture before antibiotics protocol produced the most significant decrease in 28-day mortality （OR, 0.33; 95% CI, 0.16-0.70; P=0.004）. Compliance with z5 protocols in the 6-hour resuscitation bundle was also associated with lower 28-day mortality in septic shock patients （OR, 0.17; 95% CI, 0.06-0.54; P = 0.001）. Conclusions Compliance with resuscitation and management bundles is generally poor in China; however, when applied, 6-hour resuscitation bundle are associated with significant reductions in 28-day mortality for sepsis patients.