Comparative effects of different types of exercise on health-related quality of life during and after active cancer treatment:A systematic review and network meta-analysis

Background The positive influence of most types of exercise has been reported repeatedly,but what the most effective exercise approaches are for improving health-related quality of life(HRQoL)in people with cancer remains unknown.The aim of this systematic review and network meta-analysis was to synthesize the evidence from intervention studies to assess the effects of different types of exercise on HRQoL during and after cancer treatment.Methods MEDLINE,SPORTDiscus,the Cochrane Library,Web of Science,and Scopus were searched for randomized controlled trials aimed at testing the effects of exercise interventions meant to improve HRQoL in people with cancer.Separate analyses were conducted for HRQoL as measured by general and cancer-specific questionnaires.We also evaluated whether the effects of exercise were different during and after cancer treatment in both the physical and mental HRQoL domains.Results In total,93 studies involving 7435 people with cancer were included.Network effect size estimates comparing exercise intervention vs.usual care were significant for combined exercise(0.35,95%confidence interval(95%CI):0.14–0.56)for HRQoL as measured by general questionnaires,and for combined(0.31,95%CI:0.13–0.48),mind–body exercise(0.54,95%CI:0.18–0.89),and walking(0.39,95%CI:0.04–0.74)for HRQoL as measured by cancer-specific questionnaires.Conclusion Exercise programs combining aerobic and resistance training can be recommended to improve HRQoL during and after cancer treatment.The scarcity and heterogeneity of these studies prevents us from making recommendations about other exercise modalities due to insufficient evidence.

Establishing research priorities in prevention and control of vector-borne diseases in urban areas:a collaborative process

Background:In 2015,following a call for proposals from the Special Programme for Research and Training in Tropical Diseases(TDR),six scoping reviews on the prevention and control of vector-borne diseases in urban areas were conducted.Those reviews provided a clear picture of the available knowledge and highlighted knowledge gaps,as well as needs and opportunities for future research.Based on the research findings of the scoping reviews,a concept mapping exercise was undertaken to produce a list of priority research needs to be addressed.Methods:Members of the six research teams responsible for the“VEctor boRne DiseAses Scoping reviews”(VERDAS)consortium’s scoping reviews met for 2 days with decision-makers from Colombia,Brazil,Peru,Pan-American Health Organization,and World Health Organization.A total of 11 researchers and seven decision-makers(from ministries of health,city and regional vector control departments,and vector control programs)completed the concept mapping,answering the question:“In view of the knowledge synthesis and your own expertise,what do we still need to know about vector-borne diseases and other infectious diseases of poverty in urban areas?”Participants rated each statement on two scales from 1 to 5,one relative to‘priority’and the other to‘policy relevance’,and grouped statements into clusters based on their own individual criteria and expertise.Results:The final map consisted of 12 clusters.Participants considered those entitled“Equity”,“Technology”,and“Surveillance”to have the highest priority.The cluster considered the most important concerns equity issues,confirming that these issues are rarely addressed in research on vector-borne diseases.On the other hand,the“Population mobility”and“Collaboration”clusters were considered to be the lowest priority but remained identified by participants as research priorities.The average policy relevance scores for each of the 12 clusters were roughly the same as the priority scores for all clusters.Some issues were not addressed during the brain-storming.This is the case for governance and for access and quality of care.Conclusions:Based on this work,and adopting a participatory approach,the concept mapping exercise conducted collaboratively with researchers from these teams and high-level decision-makers identified research themes for which studies should be carried out as a priority.

更新临床实践指南需要报告的条目：更新版指南的报告清单

目的临床指南需要根据相关研究结果定期审查以确保其可靠性,但在更新临床指南的过程中仍然缺乏对于更新过程表述的优先报告条目。本文旨在介绍更新版指南报告清单(Checklist for the Reporting of Updated Guidelines,Check Up)及其制定过程。方法基于临床指南更新的研究证据的概述,指南研究与评价工具(Appraisal of Guidelines for Research and EvaluationⅡ,AGREEⅡ)和报告清单专家组(33位)的建议开发了初始清单的各条目。然后,使用多个步骤对本清单进行了完善,包括评估10个现有的更新版临床指南,对关键信息提供者进行访谈[应答率为54.2%(13/24)],清单制定专家组内部进行的一个三轮的德尔菲(Delphi)共识调查,以及来自于临床指南方法学专家[应答率为90%(53/59)]和指南使用者[应答率为55.6%(10/18)]的外部评审意见。结果清单最终包括16个条目,主要涉及:(1)更新版指南的呈现;(2)编辑独立性;(3)更新过程采用的方法。结论更新版指南的报告清单作为一个工具可用于评估更新版指南报告的完整性,并为指南制定者提供撰写报告的要求。