ObjectiveTo systematically review the antidepressant efficacy of selective serotonin re-uptake inhibitors (SSRIs) and their effect on inflammatory factors in adults with major depressive disorder (MDD). MethodsElectronic searches were conducted in PubMed, Embase, Web of Science Core Collection, ProQuest, JSTOR, PsycINFO, Cochrane Library, Epistemonikos, CNKI, and CBM databases from inception to December 31, 2024. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was performed using R 4.4.2 software. ResultsA total of 62 controlled studies (including 63 reports) was included, consisting of 36 randomized controlled trials, 4 non-randomized controlled trials, and 23 case-control studies. Meta-analysis showed that the overall antidepressant effect size of SSRIs was SMD=?3.18 (95%CI ?3.56 to ?2.80), with no statistically significant difference in efficacy between different SSRIs (P=0.24). However, their antidepressant efficacy was influenced by the country of origin of the study participants and the duration of intervention. SSRIs exerted significant inhibitory effects on 17 pro-inflammatory factors, but with high heterogeneity. SSRIs had no significant overall effect on anti-inflammatory factors (SMD=0.81, 95%CI ?0.20 to 1.82). However, subgroup analysis revealed that escitalopram exerted significant promoting effects on IL-10 (SMD=1.11, 95%CI 0.61 to1.60) and IL-13 (SMD=2.40, 95%CI 1.84 to 2.95). ConclusionSSRIs are effective antidepressants but vary in their effects on inflammatory factors. Among them, escitalopram has a potential bidirectional regulatory effect on inflammatory factors, and more high-quality multicenter studies are needed in the future for verification.
ObjectiveTo systematically investigate the current status of reporting health economics evidence in clinical practice guidelines and expert consensuses published in China from 2021 to 2023, providing references for the formulation and revision of guidelines and consensuses in our country. MethodsComputer searches were conducted in the CNKI, CBM, WanFang Data, China Academic Journals Full-text Database, PubMed, and Web of Science to collect clinical practice guidelines and expert consensuses published in China from 2021 to 2023. Two researchers independently screened the literature, extracted information on the inclusion of economic evidence in guidelines and consensuses, and then used quantitative analysis methods for description. ResultsA total of 4 236 relevant articles were included, of which 1 066 (25.17%) reported health economics evidence; 120 (11.26%) reported health economics evidence in the formation of recommendation opinions; 109 (10.23%) reported health economics evidence in the grading of evidence quality; 832 (78.05%) reported health economics evidence in the interpretation and explanation of recommendation opinions. ConclusionThe reporting rate of health economics evidence in clinical practice guidelines and expert consensuses published in China is not high. The reporting rate of health economics evidence in consensuses is lower than that in guidelines. It is recommended that during the formulation process of guidelines and consensuses, the application of health economics evidence should be further strengthened in aspects such as the formation of recommendation opinions, the grading of evidence quality, and the interpretation and explanation of recommendation opinions, in order to improve the scientific, rigorous, and applicability of clinical practice guidelines and expert consensuses, and to play the role of guidelines and consensuses in optimizing the allocation of health resources, improving clinical diagnosis and treatment effects, and enhancing the quality of medical care.
The outline of the "Healthy China 2030" states that medical institutions should serve as the primary purchasing agents for medicines and medical consumables, and joints purchasing should be encouraged. Since its establishment, the National Healthcare Security Administration has conducted five batches of national centralized procurement of high-value medical consumables, forming a nationwide collaborative framework involving national, provincial (including inter-provincial alliances), and local municipalities (including local municipal alliances). This study explains the current development status of the centralized procurement of medical consumables in representative countries, and explores the role of research evidence, such as health technology assessment (HTA), in the centralized procurement of medical consumables in China. Looking ahead, various forms of research evidence, such as HTA, will contribute to the dynamic adjustment of the catalogue for the collection and procurement of medical consumables, and the construction of a comprehensive evaluation index system for the clinical use of medical consumables, as well as the integration of evidence-based and artificial intelligence technology for the whole life-cycle management of medical consumables, will inject new impetus into the management of collection and procurement and innovation.
As the highest level of evidence in evidence-based medicine, systematic reviews have a profound impact on clinical practice and policy-making. However, challenges remain regarding the methodological rigor and reproducibility of their results. In recent years, replication research on systematic reviews has emerged as a critical approach to ensuring evidence quality, rational allocation of research resources and advancing evidence-based medicine. This article systematically reviews the theoretical foundations and research value of replication studies in systematic reviews, with a focus on their core design principles and implementation process. Key methodological steps are discussed, including assessing the necessity of replication, determining the type of replication, pre-registration, obtaining data and code, conducting independent re-analyses, and evaluating result consistency. Meanwhile, using the childhood deworming program as an illustrative case, we further outline the practical workflow of conducting replication research and demonstrate its importance in confirming the robustness of evidence and strengthening confidence in decision-making. In addition, this study synthesizes the methodological challenges encountered throughout the entire replication process, from literature searching to data analysis, and discusses future directions involving the integration of artificial intelligence, the development of reporting standards such as PRITERS, and the establishment of supportive research infrastructures. Overall, this work aims to provide methodological guidance for the standardized conduct of replication studies and to support the high-quality development of evidence-informed practice.