ObjectiveTo systematically review the efficacy of convalescent plasma (CP) in the treatment of coronavirus disease 2019 (COVID-19). MethodsPubMed, EMbase, The Cochrane Library, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of CP in the treatment of COVID-19 from inception to September 15th, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed using RevMan 5.4.1 software. ResultsA total of 16 RCTs involving 15 301 patients were included. The results of meta-analysis showed that CP treatment did not reduce mortality compared with no-placebo (RR=0.99, 95%CI 0.93 to 1.05, P=0.63) or normal saline (RR=1.06, 95%CI 0.60 to 1.86, P=0.84). However, compared with standard plasma, the mortality of CP group was lower (RR=0.59, 95%CI 0.37 to 0.95, P=0.03). In addition, compared with no-placebo or normal saline, CP treatment could not improve the clinical condition at 28-30 days, reduce mortality at early treatment and in patients without invasive mechanical ventilation when randomized. ConclusionCurrent evidence shows that compared with no-placebo or normal saline, CP does not reduce mortality in patients with COVID-19. However, when the disease progresses to the point where standard plasma is required, CP may reduce mortality. In addition, use of CP in patients with early or non-critical COVID-19 failed to reduce mortality. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To systematically evaluate the effectiveness of dasatinib in doses of 140 mg once daily and 70 mg twice daily for chronic myeloid leukemia (CML). Methods The randomized controlled trials (RCTs) were retrieved from Embase (1974 to November 2011), Pubmed (1966 to November 2011), The Cochrane Library (Issue 11, 2011), CBM (1979 to November 2011), VIP (1989 to November 2011), CNKI (1994 to November 2011), Wanfang Data (1997 to November 2011) and references listed in all articles. RCTs meeting inclusive criteria were included, the data were extracted, the quality was evaluated and cross-checked by two reviewers independently according to Cochrane Handbook for Systematic Reviews of Interventions, and then meta-analyses were conducted using RevMan 5.1 software. Results A total of four studies involving two RCTs and 862 patients were included. Results of meta-analyses showed that when dasatinib was used in the long-term treatment of CML, no significant difference was found between 140 mg once daily and 70 mg twice daily in the complete hematologic response (RR=0.97, 95%CI 0.88 to 1.07, P=0.58), complete cytogenetic response (RR=0.94, 95%CI 0.80 to 1.11, P=0.47) and major cytogenetic response (RR=0.99, 95%CI 0.86 to 1.13, P=0.86). In the short-term treatment of CML, there were no significant differences in the complete hematologic response (RR=0.99, 95%CI 0.90 to 1.07, P=0.73), complete cytogenetic response (RR=0.99, 95%CI 0.78 to 1.26, P=0.95) and major cytogenetic response (RR=1.01, 95%CI 0.83 to 1.22, P=0.95). The subgroup analyses on the long-term treatment of CML in both chronic phase and advanced phase showed that there were no significant differences in the complete hematologic response, major cytogenetic response and complete cytogenetic response. Conclusion In the effectiveness of dasatinib for CML, the dose of 140 mg once daily is similar to the dose of 70 mg twice daily. Considering possible moderate selection bias existing in the methodological quality of the included studies which may affect the authenticity of outcomes, this conclusion should be further proved by conducting more high-quality, large-scale and double- blinded RCTs.
ObjectiveTo systematically evaluate the influencing factors of disaster resilience for medical rescue workers. MethodsPubMed, Cochrane Library, Web of Science, CINAHL, APA PsycInfo, EMbase, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the influencing factors of disaster resilience for medical rescue workers from inception to November 1, 2022. 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 16.0 software. ResultsA total of 36 studies involving 7 974 medical rescue workers were included. The meta-analysis results showed that personal influencing factors, including active coping, rescue confidence, disaster preparedness, knowledge attainment, physical health, and exercise were positively correlated with the disaster resilience of healthcare workers. However, depression, anxiety, stress, and a history of mental illness were negatively related to the disaster resilience of medical rescue workers. Environmental and background factors, including social support, relief supplies, disaster training, economic condition, rescue experience, length of service, and technical title, were positively correlated with the disaster resilience of medical rescue workers. ConclusionCurrent evidence shows that the disaster resilience of medical rescue workers is affected by a variety of personal factors and environmental/background factors. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
The Campbell Collaboration is an international nonprofit academic organization which concerns about production, storage and transmission high quality systematic reviews of the effects of social interventions, and it is called the sister organization of Cochrane Collaboration. Now the thinking and methods of Evidence-based medicine has been widely used in the field of clinical medicine, but its application in non-clinical medicine fields such as education and social area is rarely understood and used. This paper introduced the writing procedures and techniques of Campbell Systematic Review (C2SR), and to make the researchers preliminary understand how to resolve the problems in non-clinical field using the systematic review, and to encourage researchers try to use and write C2SR.
ObjectiveTo systematically review the efficacy of treatments for β-coronaviruses.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, SinoMed, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) of treatments for β-coronaviruses from inception to June 17th, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software.ResultsA total of 109 studies invoving 23 210 patients were included. The results of the systematic review showed that compared with standard of care, corticosteroids could reduce mortality and increase cure rate for COVID-19. However, chloroquine could decrease cure rate. In severe acute respiratory syndrome (SARS) patients, corticosteroids could decrease the cure rate. In Middle East respiratory syndrome (MERS) patients, ribavirin/interferon/both drugs showed higher mortality.ConclusionsThe currently limited evidence shows that corticosteroids may be effective to COVID-19 patients while having limited effects on SARS patients. Hydroxychloroquine or chloroquine may have negative effects on COVID-19 patients. Ribavirin/interferon may be harmful to MERS patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
ObjectiveZero-events studies frequently occur in systematic reviews of adverse events, which consist of an important source of evidence. We aimed to examine how evidence of zero-events studies was utilized in the meta-analyses of systematic reviews of adverse events.MethodsWe conducted a survey of systematic reviews published in two periods: January 1, 2015 to January 1, 2020 and January 1, 2008, to April 25, 2011. Databases were searched for systematic reviews that conducted at least one meta-analysis of any healthcare intervention and used adverse events as the exclusive outcome. An adverse event was defined as any untoward medical occurrence in a patient or subject in healthcare practice. We summarized the frequency of occurrence of zero-events studies in eligible systematic reviews and how these studies were dealt with in the meta-analyses of these systematic reviews.ResultsWe included 640 eligible systematic reviews. There were 406 (63.45%) systematic reviews involving zero-events studies in their meta-analyses, among which 389 (95.11%) involved single-arm-zero-events studies and 223 (54.93%) involved double-arm-zero-events studies. The majority (98.71%) of these systematic reviews incorporated single-arm-zero-events studies into the meta-analyses. On the other hand, the majority (76.23%) of them excluded double-arm-zero-events studies from the meta-analyses, of which the majority (87.06%) did not discuss the potential impact of excluding such studies. Systematic reviews published at present (2015-2020) tended to incorporate zero-events studies in meta-analyses than those published in the past (2008-2011), but the difference was not significant [proportion difference=–0.09, 95%CI (–0.21, 0.03), P=0.12].ConclusionSystematic review authors routinely treated studies with zero-events in both arms as "non-informative" carriers and excluded them from their reviews. Whether studies with no events are "informative" or not, largely depends on the methods and assumptions applied, thus sensitivity analyses using different methods should be considered in future meta-analyses.
Objective To explore the change of particles of Shuanghuanglian Injection (SHLI) admixed with different infusion solutions, and provide a reference for selecting rational menstruum. Methods A comprehensive literature search was executed to collect all the studies on the compatibility of SHLI with different infusion solutions. The reporting quality of the included studies was assessed; particles-related data were extracted and analyzed systematically. Results A total of 338 studies were identified, and 24 studies were included after screening. The quality of the included studies were poor and had heterogeneous outcomes. Generally, the particles of mixture increased dramatically, and there were significant differences among different pharmaceuticals, drug batches and infusion solutions. The pH of solvent had a greater impact on the particles, and the concentration and storage time of prepared liquor were other important factors. The particles of SHLI admixed with Normal Saline were less than 5%, 10% glucose injection and other solvents. Conclusion The particles of SHLI admixed with Normal Saline are the fewest, and commonly can be the preferred solvent. Factors on rational drug use are worthy of further studies; and more attention is needed for the scientificalness of study design.
ObjectivesTo systematically review the detection rate of depression in Chinese individuals with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect observational studies on the detection rate of depression in Chinese with T2DM from inception to January, 2019. Two reviewers independently screened literature, extracted data and evaluated the quality of included studies. Meta-analysis was performed by R 3.6.1 software.ResultsA total of 29 studies involving 96 557 cases were included. Meta-analysis results showed that the total detection rate of depression in Chinese with T2DM was 27% (95%CI 24% to 30%). Subgroup analysis showed that the detection rate of depression in female was 32% (95%CI 20% to 45%), and in male was 26% (95%CI 18% to 37%). The detection rate of depression in rural areas was 36% (95%CI 18% to 54%), and in urban areas was 30% (95%CI 16% to 43%). The detection rate of depression in individuals aged 60 and above was 31% (95%CI 24% to 39%), and in individuals aged less than 60 was 23% (95%CI 10% to 36%). Individuals with a primary school education and below, a middle or high school education and college degree and above education had detection rate of 31%, 23% and 22%, respectively. Individuals with diabetes duration less than 5 years, 5 to 10 years and more than 10 years had detection rates of 23%, 25% and 30%, respectively. Individuals with and without complications had detection rates of 43% and 26%, respectively. The detection rates of mild and moderate to major depression were 20% and 10%, respectively.ConclusionsThe detection rate of depression in Chinese with T2DM is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
ObjectiveTo systematically review the efficacy and safety of crizotinib in the treatment of non-small cell lung cancer (NSCLC).MethodWe electronically searched databases including the Cochrane Library (Issue 5, 2017), PubMed, Embase, China Biology Medicine Database, China National Knowledge Internet Database, VIP Database and Wangfang Data from the establishment to May 2017. The randomized controlled trials (RCTs), non-RCTs, case series and case reports on crizotinib for NSCLC were included. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, assessed the methodological quality of included studies, then make Meta-analysis and descriptive analysis.ResultA total of 15 studies were included, including 4 RCTs, 1 non-RCT, 4 case series and 6 case reports. The results indicated that the progression-free survival time of crizotinib group was 8 months, which was better than chemotherapy group (4.6 months). The results of Meta-analysis showed that the response rate in the crizotinib group was higher than that in the chemotherapy group [RR=2.35, 95%CI (1.59, 3.46), P<0.000 1]. The one year survival rate in the crizotinib group was 74.5%-78.6%. The incidences of adverse reactions including dysopsia, dysgeusia, diarrhea, vomiting, constipation, transaminase lifts, upper respiratory tract infection, edema and dizziness in the crizotinib group were higher than those in the chemotherapy group (P<0.05), while the incidences of adverse reactions including leukopenia, thrombocytopenia, alopecia and fatigue in crizotinib group were lower than those in the chemotherapy group (P<0.05). Subgroup analysis under precision treatment showed the progression-free survival time of anaplastic lymphoma kinase (ALK)-positive group was 8 months, and it was longer than ALK-negative group of 4 months.ConclusionsBased on current evidence, crizotinib is better than chemotherapy for NSCLC. Due to limited quality of the included studies, the above conclusion needs to be verifed by more high quality studies.