It is an undeniable fact that systematic reviews play a crucial role in informing clinical practice;however,conventional head-to-head meta-analyses do have limitations.In particular,studies can only be compared in a p...It is an undeniable fact that systematic reviews play a crucial role in informing clinical practice;however,conventional head-to-head meta-analyses do have limitations.In particular,studies can only be compared in a pair-wise fashion,and conclusions can only be drawn in the light of direct evidence.In contrast,network meta-analyses can not only compare multiple interventions but also utilize indirect evidence which increases their precision.On top of that,they can also rank competing interventions.In this mini-review,we have aimed to elaborate on the principles and techniques governing network meta-analyses to achieve a methodologically sound synthesis,thus enabling safe conclusions to be drawn in clinical practice.We have emphasized the prerequisites of a well-conducted Network Meta-Analysis(NMA),the value of selecting appropriate outcomes according to guidelines for transparent reporting,and the clarity achieved via sophisticated graphical tools.What is more,we have addressed the importance of incorporating the level of evidence into the results and interpreting the findings according to validated appraisal systems(i.e.,the Grade of Recommendations,Assessment,Development,and Evaluation system-GRADE).Lastly,we have addressed the possibility of planning future research via NMAs.Thus,we can conclude that NMAs could be of great value to clinical practice.展开更多
Acute fatty liver of pregnancy(AFLP)is a rare but critical obstetric-specific disease with a high fatality rate,posing a serious threat to the safety of mothers and infants.These guidelines were specially formulated t...Acute fatty liver of pregnancy(AFLP)is a rare but critical obstetric-specific disease with a high fatality rate,posing a serious threat to the safety of mothers and infants.These guidelines were specially formulated to standardize AFLP clinical pathways and to improve maternal and infant outcomes.Based on a two-round questionnaire survey,the guideline development team identified the following nine clinical issues that clinicians were most concerned about,and developed recommendations for each of them:prenatal outpatient screening for AFLP,diagnosis,preoperative risk assessment,delivery modes and timing,anesthesia methods,perinatal complications,selecting AFLP patients for artificial liver treatment,prognostic assessment,and monitoring during treatment.The guidelines cover the key issues related to AFLP diagnosis and treatment that concern clinicians.展开更多
文摘It is an undeniable fact that systematic reviews play a crucial role in informing clinical practice;however,conventional head-to-head meta-analyses do have limitations.In particular,studies can only be compared in a pair-wise fashion,and conclusions can only be drawn in the light of direct evidence.In contrast,network meta-analyses can not only compare multiple interventions but also utilize indirect evidence which increases their precision.On top of that,they can also rank competing interventions.In this mini-review,we have aimed to elaborate on the principles and techniques governing network meta-analyses to achieve a methodologically sound synthesis,thus enabling safe conclusions to be drawn in clinical practice.We have emphasized the prerequisites of a well-conducted Network Meta-Analysis(NMA),the value of selecting appropriate outcomes according to guidelines for transparent reporting,and the clarity achieved via sophisticated graphical tools.What is more,we have addressed the importance of incorporating the level of evidence into the results and interpreting the findings according to validated appraisal systems(i.e.,the Grade of Recommendations,Assessment,Development,and Evaluation system-GRADE).Lastly,we have addressed the possibility of planning future research via NMAs.Thus,we can conclude that NMAs could be of great value to clinical practice.
基金This work was supported by the Discipline Construction Funds of Xiangya Hospital Central South University.
文摘Acute fatty liver of pregnancy(AFLP)is a rare but critical obstetric-specific disease with a high fatality rate,posing a serious threat to the safety of mothers and infants.These guidelines were specially formulated to standardize AFLP clinical pathways and to improve maternal and infant outcomes.Based on a two-round questionnaire survey,the guideline development team identified the following nine clinical issues that clinicians were most concerned about,and developed recommendations for each of them:prenatal outpatient screening for AFLP,diagnosis,preoperative risk assessment,delivery modes and timing,anesthesia methods,perinatal complications,selecting AFLP patients for artificial liver treatment,prognostic assessment,and monitoring during treatment.The guidelines cover the key issues related to AFLP diagnosis and treatment that concern clinicians.
