目的 通过Meta分析探讨活性维生素D及普通维生素D降低骨质疏松患者骨折风险的差异。方法 计算机系统检索PubMed、Web of Science、The Cochrane Library、Embase、中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期...目的 通过Meta分析探讨活性维生素D及普通维生素D降低骨质疏松患者骨折风险的差异。方法 计算机系统检索PubMed、Web of Science、The Cochrane Library、Embase、中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期刊全文数据库(WanFang Data),并通过谷歌进行补充检索。检索时间为建库至2018年4月。由2位研究者独立进行文献筛选、基本信息提取及偏倚风险评估,然后进行面对面核对,如遇分歧则通过讨论或咨询第三方解决。使用Cochrane系统评价手册推荐的质量评价工具ROB(Risk of Bias)对纳入文献进行质量评价,采用GRADE工具对结局指标的证据质量进行评价。采用RevMan 5.3 对纳入研究偏倚风险进行呈现,采用Stata12.0软件进行Meta分析、敏感性分析及发表偏倚分析。结果最终纳入10篇研究文献,共837例患者。Meta分析结果显示活性维生素D组椎骨新发骨折人数比率低于普通维生素D组,但差异无统计学意义[风险比(relative risk, RR )=0.674,95% CI (0.452,1.005), P =0.053, I^2=39.3%];活性维生素D组非椎骨骨折发生率低于普通维生素D组,但差异无统计学意义[ RR =0.744,95% CI (0.512,1.081), P =0.121, I^2=24.8%]。活性维生素D组腰椎骨密度改变百分率高于普通维生素D组,差异有统计学意义[均数差(standardized mean difference,SMD)=0.349,95% CI (0.007,0.691), P =0.046, I^2=73.8%];活性维生素D组股骨颈骨密度改变百分率高于普通维生素D组,但差异无统计学意义[ SMD =0.217,95% CI (-0.112,0.545), P =0.196, I^2=52.9%];活性维生素D组全髋骨密度改变百分率高于普通维生素D组,但差异无统计学意义[ SMD =0.302,95% CI (-0.215,0.819), P =0.252, I^2=71.7%]。两组各项不良反应发生率对比差异无统计学意义(均 P >0.05)。结论 现有证据表明,活性维生素D与普通维生素D相比,预防骨质疏松患者骨折发生风险没有明显优势。展开更多
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...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.展开更多
目的了解我国指南制订相关领域的专家及研究人员对患者指南(patient version of guidelines,PVG)的认知度。方法在"2017中国医师协会循证医学专业年会暨甘肃省医师协会/甘肃省医学会循证医学专业年会"会议期间,对指南制订专...目的了解我国指南制订相关领域的专家及研究人员对患者指南(patient version of guidelines,PVG)的认知度。方法在"2017中国医师协会循证医学专业年会暨甘肃省医师协会/甘肃省医学会循证医学专业年会"会议期间,对指南制订专场的参会人员发放纸质版问卷调查;同时跟随国家卫生计生委医管中心标准处的指南调研团队进一步调查深圳、广州、西安、北京等地的指南制订者对PVG的认知度。问卷设计了10个问题以了解被调查者对PVG的知晓度及对PVG制订过程的看法与意见。排除无效问卷后采用Excel 2013软件进行数据录入,采用SPSS 19.0软件进行数据分析。结果共发放调查问卷150份,回收问卷107份(71.3%),其中有效问卷90份(60.0%)。关于PVG的知晓度:30.0%的被调查者停留在"仅听说过"的层面,34.4%的被调查者表示"未听说过";且知晓度与学历、部门、专业、地区间均无显著相关性(P>0.05)。关于对PVG本身及其制订过程的看法与意见:86.7%的被调查者认为需要制订PVG;90%的被调查者认为需要参照一定的规范来呈现和报告PVG;45.6%的被调查者认为制订PVG最大的障碍在于认知不足。结论 PVG制订目前在中国正处于起步阶段,国内指南相关专家对其认知度较低,PVG的制订方法也有待进一步探索。未来应积极开展相关研究促进并推广PVG在国内的发展与应用,从而促进临床实践的优化。展开更多
文摘目的 通过Meta分析探讨活性维生素D及普通维生素D降低骨质疏松患者骨折风险的差异。方法 计算机系统检索PubMed、Web of Science、The Cochrane Library、Embase、中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期刊全文数据库(WanFang Data),并通过谷歌进行补充检索。检索时间为建库至2018年4月。由2位研究者独立进行文献筛选、基本信息提取及偏倚风险评估,然后进行面对面核对,如遇分歧则通过讨论或咨询第三方解决。使用Cochrane系统评价手册推荐的质量评价工具ROB(Risk of Bias)对纳入文献进行质量评价,采用GRADE工具对结局指标的证据质量进行评价。采用RevMan 5.3 对纳入研究偏倚风险进行呈现,采用Stata12.0软件进行Meta分析、敏感性分析及发表偏倚分析。结果最终纳入10篇研究文献,共837例患者。Meta分析结果显示活性维生素D组椎骨新发骨折人数比率低于普通维生素D组,但差异无统计学意义[风险比(relative risk, RR )=0.674,95% CI (0.452,1.005), P =0.053, I^2=39.3%];活性维生素D组非椎骨骨折发生率低于普通维生素D组,但差异无统计学意义[ RR =0.744,95% CI (0.512,1.081), P =0.121, I^2=24.8%]。活性维生素D组腰椎骨密度改变百分率高于普通维生素D组,差异有统计学意义[均数差(standardized mean difference,SMD)=0.349,95% CI (0.007,0.691), P =0.046, I^2=73.8%];活性维生素D组股骨颈骨密度改变百分率高于普通维生素D组,但差异无统计学意义[ SMD =0.217,95% CI (-0.112,0.545), P =0.196, I^2=52.9%];活性维生素D组全髋骨密度改变百分率高于普通维生素D组,但差异无统计学意义[ SMD =0.302,95% CI (-0.215,0.819), P =0.252, I^2=71.7%]。两组各项不良反应发生率对比差异无统计学意义(均 P >0.05)。结论 现有证据表明,活性维生素D与普通维生素D相比,预防骨质疏松患者骨折发生风险没有明显优势。
基金Supported by Special Project of "Lingnan Modernization of Traditional Chinese Medicine" in 2019,Guangdong Provincial R&D Program:2020B1111100008Young Science and Technology Talents Fund of The Affiliated TCM Hospital of Guangzhou Medical University:2022RC07
文摘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.
文摘目的了解我国指南制订相关领域的专家及研究人员对患者指南(patient version of guidelines,PVG)的认知度。方法在"2017中国医师协会循证医学专业年会暨甘肃省医师协会/甘肃省医学会循证医学专业年会"会议期间,对指南制订专场的参会人员发放纸质版问卷调查;同时跟随国家卫生计生委医管中心标准处的指南调研团队进一步调查深圳、广州、西安、北京等地的指南制订者对PVG的认知度。问卷设计了10个问题以了解被调查者对PVG的知晓度及对PVG制订过程的看法与意见。排除无效问卷后采用Excel 2013软件进行数据录入,采用SPSS 19.0软件进行数据分析。结果共发放调查问卷150份,回收问卷107份(71.3%),其中有效问卷90份(60.0%)。关于PVG的知晓度:30.0%的被调查者停留在"仅听说过"的层面,34.4%的被调查者表示"未听说过";且知晓度与学历、部门、专业、地区间均无显著相关性(P>0.05)。关于对PVG本身及其制订过程的看法与意见:86.7%的被调查者认为需要制订PVG;90%的被调查者认为需要参照一定的规范来呈现和报告PVG;45.6%的被调查者认为制订PVG最大的障碍在于认知不足。结论 PVG制订目前在中国正处于起步阶段,国内指南相关专家对其认知度较低,PVG的制订方法也有待进一步探索。未来应积极开展相关研究促进并推广PVG在国内的发展与应用,从而促进临床实践的优化。
