AutoMeta is a semi-automated, interactive, user-friendly online platform developed by Chinese scholars with independent intellectual property rights. This platform is designed to assist users in completing pairwise meta-analysis, inverse variance meta-analysis, network meta-analysis, and diagnostic test accuracy meta-analysis and use the GRADE method to achieve automatic grading of certainty of evidence. Nowadays, the AutoMeta platform can conduct the pairwise meta-analysis and inverse variance meta-analysis, as well as the automatic grading of certainty of evidence for pairwise meta-analysis. This article introduces the platform to users in terms of its development techniques, operation methods and verification of the accuracy of results, aiming to assist researchers to conduct systematic reviews quickly.
Network meta-analysis aims to integrate direct and indirect evidence, make a comprehensive comparison and in-depth analysis of three or more interventions and treatments, compare and rank the advantages and disadvantages of different treatment measures, so as to provide strong evidence for decision-making. However, there may be some bias in the process of making network meta-analysis, analyzing data and interpreting results. Therefore, accurate assessment and proper handling of the risks of bias in network meta-analysis is conductive to improve the quality of decision-making and promote the achievement of good clinical outcomes. At present, the number of published network meta-analysis has increased significantly globally, but the quality remains to be improved, and there is a lack of assessment tools for risks of bias in network meta-analysis. In 2025, Canadian scholar Carole Lunny and colleagues developed The Risk of Bias in Network Meta-Analysis tool for evaluating the risk of bias in network meta-analysis and published it in the BMJ, which is important to reduce the bias in network meta-analysis and promote optimal clinical decision-making. This study will interpret it with examples, aiming to help researchers better understand and apply this evaluation tool.
ObjectiveTo systematically review the diagnostic value of optical coherence tomography angiography (OCTA) for primary open-angle glaucoma (POAG). MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library databases were electronically searched to collect diagnostic test on OCTA for POAG from inception to February 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. ResultsA total of 12 diagnostic tests involving 993 subjects were included. Meta-analysis results showed that the sensitivity/specificity of OCTA for diagnosing peripapillary vessel density, retinal vessel density, and optic nerve fiber changes in patients with POAG were 0.77/0.92, 0.56/0.92, and 0.85/0.91, respectively, and the AUC of the SROC curve was 0.94, 0.92 and 0.95, respectively. ConclusionOCTA has high diagnostic accuracy for POAG. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the efficacy of subclavian-carotid transposition (SCT) in treating patients with proximal subclavian artery occlusive diseases who were unable to be intervened, such as failure of intervention, congenital malformation and unwillingness to intervention.MethodsA retrospective review of 19 patients with proximal subclavian artery occlusion who underwent SCT from May 2016 to December 2018 was done. There were 14 males and 5 females with an average age of 54.05±17.34 years. The advantages and disadvantages of SCT in the treatment of proximal subclavian artery occlusion were analyzed.ResultsAll patients achieved immediate remission of symptoms after surgery. The stenosis degree of the proximal subclavian artery decreased from 100.0%±0.0% to 12.7%±10.1% after surgery. The average blood pressure difference between the unaffected side and the affected side decreased from 11.95±10.60 mm Hg to 0.89±5.75 mm Hg (P<0.01). Peripheral nerve injury occurred in 7 (36.8%) patients. The in-patient cost of subclavian artery occlusion patients who received subclavian artery interventional therapy in our hospital during the corresponding period was 3 392.12 yuan higher than that of the SCT group in average (if eliminating the patients whose cost was far from the average value, the cost of interventional therapy was 4 812.01 yuan higher than that of the SCT group in average). During 1-3 years' follow-up, 6 patients with neurological complication relieved. One- and three-year patency rates were 100.0%. No perioperative stroke, death or re-operation happened.ConclusionSCT is an ideal process for the patients with subclavian artery occlusion who cannot accept subclavian artery interventional therapy.
Umbrella review is a research method that comprehensively analyzes the systematic reviews and meta-analysis of a research question. In recent years, the research methods of umbrella review have been widely used, but the quality of umbrella review is uneven. Therefore, this paper focuses on the production methods and existing challenges of umbrella review, in order to provide references for domestic researchers to make umbrella review.
Objective To analyze the current research status, hotspots and development trends in the field of evidence-based health policy briefs at home and abroad. Methods Computer searches of Web of Science Core Collection and CNKI databases for studies related to evidence-based health policy briefs were conducted, and the timeframe of the searches was from the establishment of the databases to August 6, 2024. Charticular, VOSviewer and CiteSpace software were used to visualize and analyze the countries, institutions, journals, authors and keywords of the included literature. Results A total of 145 relevant studies were included, of which 141 were in English and 4 were in Chinese. The number of articles in English showed an overall increasing trend; the country with the largest number of articles was the United States; the organization with the largest number of articles was the World Health Organization; the journal with the largest number of articles was Frontiers in Public Health; and the hot keywords in recent years focused on the food and nutritional safety system, cardiovascular disease, obesity, impact, and public health policy. The research related to "healthcare" and "knowledge translation" is expected to become a frontier hotspot. The number of Chinese studies was relatively small, and the research content involved policy briefs and policy brief methodology in the field of public health. Conclusion Future research may focus on policy briefs on health care, food and nutrition, cardiovascular disease, obesity and other health issues, their impact and the use of policy briefs in the formulation of public health policies. Currently, there is a significant difference between domestic and foreign research in the field of evidence-based health policy briefs, foreign research has tended to mature, while the domestic is still in the embryonic stage, there is an urgent need to enrich the methodological system, enrich the content of the study, and in the future, we can learn from the advanced experience of foreign countries and integrate multidisciplinary research methods, in order to promote the improvement and sustainable development of the field of evidence-based health policy briefs in China.
Living systematic reviews (LSR) represent an evolving methodology for systematic review that is continuously updated to incorporate new evidence in a timely manner, ensuring that healthcare professionals and policymaker shave access to the most last information to make optimal decisions. The global publication of LSR has been a rapid increase. But the quality of reporting remains to be enhanced. In 2024, the PRISMA-LSR working group, in conjunction with the characteristics of LSR to form the reporting standards for living systematic reviews, which plays a significant role in promoting the transparent, complete, and accurate reporting of LSR. It has been published in the BMJ journal. This article interpreted PRISMA-LSR with representative examples, aiming to provide a reference for the standardization of LSR by domestic scholars.
Scientific and rigorous study design could improve the reliability of results of the comparative diagnostic test accuracy studies. The design procedures of a comparative diagnostic test accuracy study included: constructing the clinical questions, identifying the appropriate gold standard, selecting the representative patient sample, calculating the sample size, blindly interpreting and comparing the results of diagnostic tests, and setting up the cut-off value. This paper introduced 5 categories of the designs of comparative diagnostic test accuracy studies: fully paired, partially paired with a random subset, partially paired with a nonrandom subset, unpaired randomized, and unpaired nonrandomized design.
Objective To overview the systematic reviews/meta-analysis (SR/MA) for the effectiveness of yoga on patients with type 2 diabetes mellitus. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Cochrane Library, Embase, Web of Science, JBI and CINAHL databases were electronically searched to collect SR/MA on the intervention of yoga in diabetes mellitus from inception to November 6th, 2023. Two researchers independently screened the literature and extracted data. AMSTAR was used to evaluate the quality of methodology, and GRADE was used to evaluate the certainty of evidence, and the outcome indicators were statistically analyzed. Results A total of 14 SR/MA were included. The evaluation results of AMSTAR showed that 7 articles were of high quality and 7 articles were of moderate quality. The result of GRADE showed that there were 2 items of high-level evidence, 26 items of intermediate evidence, and the remaining 31 items were low-level or very low-level evidence. The results showed that yoga could significantly reduce fasting blood glucose (FBG) (moderate confidence), glycosylated hemoglobin (HA1C) (moderate confidence) and postprandial blood glucose (PPBG) levels (moderate confidence), and was also superior to other interventions in high-density cholesterol (HDL) (moderate confidence), low-density cholesterol (LDL) (moderate confidence), triglyceride (TG) (moderate confidence), total cholesterol (TC) (moderate confidence), systolic blood pressure (SBP) and diastolic blood pressure (DBP) (moderate confidence), muscle strength (high confidence), cardiorespiratory fitness (moderate confidence) and weight (moderate confidence). Conclusion The existing evidence shows that yoga has a good effect on blood glucose control (moderate confidence) and also has a certain effect on lipid parameters (moderate confidence) and anthropometric indicators (moderate confidence), but the quality and confidence of the current research evidence are low. Future researchers should standardize the research design to provide more high-quality evidence for the prognosis and treatment of type 2 diabetes mellitus.
Previous methods of grading evidence for systematic reviews of diagnostic test accuracy have generally focused on assessing the certainty (quality) of evidence at the level of diagnostic indicators. When the question is not limited to follow the diagnostic test accuracy results themselves, the grading results may be inaccurate due to the lack of consideration of the downstream effects of the test accuracy in specific settings. To address these challenges, the GRADE working group conducted a series of studies focused on updating methods to explore or simulate important downstream effects of diagnostic test accuracy outcomes within a contextual framework. This paper aimed to introduce advances in the contextual framework of the GRADE approach to rate the certainty of evidence from systematic reviews of single diagnostic test accuracy.