This study aims to introduce how to use the PROBAST (prediction model risk of bias assessment tool) to evaluate risk of bias and applicability of the study of diagnostic or prognostic predictive models, including the introduction of the background, the scope of application and use of the tool. This tool mainly involves the four areas of participants, predictors, outcomes and analyses. The risk of bias in the research is evaluated through the four areas, while the applicability is evaluated in the first three. PROBAST provides a standardized approach to evaluate the critical appraisal of the study of diagnostic or prognostic predictive models, which screens qualified literature for data analysis and helps to establish a scientific basis for clinical decision-making.
ObjectiveTo conduct an umbrella review and meta-analysis of the effectiveness of melatonin in preventing delirium in hospitalized patients. MethodsSystematic reviews evaluating the effectiveness of melatonin for delirium prevention in hospitalized patients were retrieved from CNKI, VIP, WanFang Data, CBM, PubMed, Embase, CINAHL, Cochrane Library, and Web of Science. The search time frame spanned from database inception to March 20, 2025. Methodological quality was assessed using AMSTAR 2, and evidence quality was evaluated via the GRADE system. Data analysis was performed using RevMan 5.4. ResultsA total of 30 systematic reviews were included, and 98 evidence items were extracted. Methodological quality assessment identified 13 high-quality, 2 moderate-quality, 8 low-quality, and 7 very low-quality studies. Evidence quality evaluation revealed 19 high-quality, 34 moderate-quality, 31 low-quality, and 14 very low-quality evidence items. A meta-analysis of re-extracted raw data demonstrated that melatonin significantly reduces the incidence of delirium in hospitalized patients (OR=0.51, 95%CI 0.41 to 0.63, P<0.001). ConclusionMelatonin demonstrates beneficial effects in preventing delirium in hospitalized patients. However, due to limitations in the number and quality of included literature, some findings warrant further validation and clarification through high-quality research.