ObjectiveTo compare the effects of different family-based interventions on reducing screen-based exposure among children and adolescents using a network meta-analysis method. MethodsThe CNKI, WanFang Data, CBM, VIP, PubMed, Web of Science, Embase, Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) related to the objects from inception to September 11, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Network meta-analysis was then performed by using Stata and R software. ResultsA total of 17 RCTs involving 2 490 participants were included. The results of the network meta-analysis showed that compared with waiting lists, health education, alternative behavior combined with environmental optimization and rule-setting, behavior monitoring combined with health education, and physical activity combined with alternative behavior could reduce total screen time. The intervention effect of alternative behavior combined with behavior monitoring in reducing total screen time was superior to other intervention measures. Increasing exercise could reduce TV/DVD viewing time. Compared with health education, behavior monitoring combined with health education could reduce weekend screen time. ConclusionThe current evidence indicates that health education, alternative activities combined with environmental optimization and rule-setting, behavior monitoring combined with health education, physical activity combined with alternative activities, physical activity alone, alternative activities combined with behavior monitoring have certain advantages in reducing screen-based exposure among children and adolescents.
With the rapid development of medicine and the emergence of new evidence, the formulation of living guidelines is significant in guiding clinical practice and providing timely and effective references for clinical workers. This article summarizes the status of living guidelines, and puts forward thoughts and suggestions on the challenges and opportunities of the development of living guidelines, in order to promote the development of living guidelines and provide a reference for guideline developers and users.
Network meta-analysis (NMA) is a method that can compare and rank the effects of different interventions, which plays an important role in evidence translation and evidence-based decision-making. In 2014, the GRADE working group first introduced the GRADE method for NMA evidence certainty grading. Since then, its method system has been gradually supplemented and improved. In recent years, the GRADE working group has further improved the methods for evaluating intransitivity and imprecision in NMA, and has made recommendations for the presentation and interpretation of NMA results, forming a complete methodological chain of NMA evidence certainty grading and result interpretation consisting of 6 steps. Our team updated the method system of GRADE applied in NMA with specific cases to provide references for relevant researchers.