From Clinical Trials to Real-World Data Sciences: Evidence-Based Medicine for Value in Health

Editorial

13 February 2023

Editorial: From randomized clinical trials to real-world data and big data sciences: Generating evidence-based medicine for value in western and herbal medicines

Xiaomo Xiong

Gang Lv

Bin Jiang

and

Kevin Lu

2,010 views

4 citations

Editors

Kevin Lu

University of South Carolina

Bin Jiang

Peking University

Impact

Lower part: staked bar chart with participants rank order of recommendation of each BP method to other patients. HBPM, Home blood pressure monitoring. 1 h-AOBP, 1 h- automated office blood pressure measurement; OBPM, Office Blood Pressure measurement; Awake-ABPM, Awake ambulatory blood pressure monitoring.

Original Research

10 November 2022

Cost-accuracy and patient experience assessment of blood pressure monitoring methods to diagnose hypertension: A comparative effectiveness study

Luis González-de Paz

, 10 more and

Antoni Sisó-Almirall

1,829 views

0 citations

(A)The adverse events for UDCA. (B) The adverse events for OCA. (C) The adverse events for Bezafibrate. (D) The adverse events for NGM282.

Systematic Review

20 October 2022

Efficacy and safety of pharmacological interventions for pruritus in primary biliary cholangitis: A systematic review and meta-analysis

Chenyi Xu

, 3 more and

Mengmeng Du

3,319 views

5 citations

The performance index J4 during the one-leg stance tests. The dancers’ linear acceleration index J4 were about 79.39, 65.20, 80.18, and 77.61%, respectively, of the healthy controls during the four actions. (A) Standing on the dominant foot with eyes open. (B) Standing on the dominant foot with eyes closed. (C) Standing on the non-dominant foot with eyes open. (D) Standing on the non-dominant foot with eyes closed.

Original Research

24 August 2022

Superior gait performance and balance ability in Latin dancers

Yen-Ting Liu

, 6 more and

Adeline Peiling Lee

3,550 views

9 citations

Systematic Review

20 June 2022

Chronic Noise Exposure and Risk of Dementia: A Systematic Review and Dose-Response Meta-Analysis

Linghao Meng

, 5 more and

Lei Huang

Objective: Evidence is scarce about the effect of noise exposure on the risk of dementia. We conducted a systematic review and dose-response meta-analysis, aiming to explore the association between noise exposure and the risk of dementia.

Methods: We searched PubMed, EMBASE and the Cochrane Library to collect studies on chronic noise exposure and the risk of dementia from database inception to September 18, 2021 without language limitations. Two authors independently screened the literature, extracted data and assessed the risk of bias of the included studies. A dose-response meta-analysis and subgroup analysis were then conducted to detect the association between noise exposure and the risk of dementia by using Stata 14.0 software. This study is registered on PROSPERO (CRD42021249243).

Results: A total of 11 studies were eligible for qualitative synthesis, and nine were eligible for quantitative data synthesis. All of them showed moderate to high quality scores in the assessment of risk of bias. We found a positive linear association between the noise increment and dementia risk (R² = 0.58). When noise exposure increased 57 dB, the RR of dementia was 1.47 (95% CI: 1.21–1.78). From the outcome subgroup of AD, AD and dementia, VaD and NAD, we also found a positive association (R² = 0.68, 0.68, 0.58, respectively). When noise exposure increased by 25 dB, the RRs were 1.18 (95% CI: 1.14–1.23), 1.19 (95% CI: 1.14–1.23) and 1.17 (95% CI: 1.06–1.30), respectively. We found a nonlinear association between the noise increment and dementia risk when only cohort studies were included (R² = 0.58). When noise exposure increased by 25 dB, the RR of dementia was 1.16 (95% CI: 1.12–1.20). From the subgroup of AD, AD and dementia, VaD and NAD of cohort studies, the regression curve showed a nonlinear positive association (R² = 0.74, 0.71, 0.43, respectively). When noise exposure increased by 25 dB, the RRs were 1.17 (95% CI: 1.12–1.21), 1.17 (95% CI: 1.12–1.22) and 1.13 (95% CI: 0.99–1.28), respectively.

Conclusion: Based on the current evidence, exposure to noise may be a specific risk factor for dementia. To better prevent dementia, more rigorously designed studies are needed to explore the etiological mechanism of noise and dementia.

4,651 views

20 citations

Decision curve analysis for the ABC-stroke score. Net benefit (y-axis) reflects whether basing ischemic stroke risk prediction on the ABC-stroke score provides greater benefit than harm. The unit of net benefit is true positives (ischemic strokes) per patients. A net benefit of 0.01 means that using the ABC-stroke score increases the number of correctly predicted ischemic strokes by 1 out of 100 target patients, without changing the number of false-positive stroke predictions. Threshold probability (x-axis) refers to the cut-offs of predicted ischemic stroke risk used to decide treatment (19, 20).

Original Research

27 June 2022

The ABC-Stroke Score Refines Stroke Risk Stratification in Patients With Atrial Fibrillation at the Emergency Department

Jan Niederdöckl

, 17 more and

Ziad Hijazi

2,759 views

4 citations

Correspondence analysis biplot (recommended scenarios and economic model).

Policy and Practice Reviews

17 June 2022

Influencing Factors of Health Technology Assessment to Orphan Drugs: Empirical Evidence in England, Scotland, Canada, and Australia

Na Zhou

, 5 more and

Ni Yuan

4,628 views

5 citations

Forest plot of population-based cohort studies of family SEP and lung cancer, stratified by sex (adjusted group).

Systematic Review

06 June 2022

Family Socioeconomic Position and Lung Cancer Risk: A Meta-Analysis and a Mendelian Randomization Study

Xusen Zou

, 11 more and

Wenhua Liang

7,676 views

8 citations

Inverted funnel chart on VAS, ODI, and JOA.

Systematic Review

06 June 2022

Clinical Effectiveness of Conservative Treatments on Lumbar Spinal Stenosis: A Network Meta-Analysis

Xuanwei Chen

, 1 more and

Jianhua Lin

3,581 views

4 citations

The iAM implementation and intervention processes. (A) Implementation process of active iAM intervention; (B) Implementation process of sham iAM intervention; (C) Intervention frequency of the iAM.

Study Protocol

30 May 2022

Efficacy of the Integrative Acupuncture and Moxibustion Treatment in Patients With Major Depressive Disorder: The Study Protocol for a Multicenter, Single-Blinded, Randomized Trial in China

Yuan Zhang

, 16 more and

Wenbin Fu

3,461 views

4 citations

Forest plots for the outcomes. (A) All-cause mortality; (B) Persistent bacteremia; (C) Duration of bacteremia days; (D) Relapsed bacteremia ; (E) Microbiological treatment failure; (F) Embolic or metastatic infection; (G) Adverse events. VAN/DAP, Vancomycin or daptomycin; ASBL, antistaphylococcal β-lactam; TMP-SMX, trimethoprim-sulfamethoxazole.

Systematic Review

17 May 2022

Vancomycin, Daptomycin, Antistaphylococcal β-Lactam, and Trimethoprim-Sulfamethoxazole Monotherapy and Combination Therapy in the Management of Methicillin-Resistant Staphylococcus aureus: A Network Meta-Analysis

Xiaonan Xu

, 5 more and

Xin Gao

2,825 views

2 citations

Heterogeneity analysis of four endometrial receptivity characteristics by seven variables. (A) endometrial pattern; (B) pulse index; (C) endometrial thickness; (D) resistance index. Seven variables including four clinical characteristics. Acupuncture duration, intervention of different routine treatment (IVF-ET, FET or clomiphene for ovulation induction), acupuncture used alone or with other interventions and mean age of participants (≥35y or not) and three methodological characteristics blinding of participants (sham/placebo or no adjuvant treatment); random sequence generation (adequate or not); allocation concealment (adequate or not) (*:0.000 of Pheterogeneity means <0.00001).

Systematic Review

28 April 2022

Xiaoyan Zheng

, 6 more and

Jie Yang

5,057 views

11 citations

Systematic Review

21 April 2022

Economic Burden and Quality of Life of Hepatocellular Carcinoma in Greater China: A Systematic Review

Huimin Zou

, 7 more and

Hao Hu

Background: Hepatocellular carcinoma (HCC) accounts for more than 85%-90% of primary liver cancer globally, and approximately 45% of deaths from HCC occur in greater China. This disease poses a significant economic burden for patients, payers and society and significantly affects patients' quality of life (QoL). However, such impact of HCC in greater China has not been well characterized. This review was conducted to analyze the current evidence about the economic and humanistic impact of HCC in greater China for informing national disease management and identifying clinical gaps yet to be resolved.

Methods: A systematic search literature using seven databases (Web of Science, PubMed, Medline, Cochrane Central, China National Knowledge Infrastructure, Wanfang, and Weipu) was performed to identify interventional and observational studies that reported the impact of HCC on cost or QoL and published before April 6, 2021. The focus population included adult patients with HCC in greater China. This review excluded any studies that focused on any specific treatment. Study quality was assessed using the Effective Public Health Practice Project tool.

Results: Of 39,930 studies retrieved, 27 were deemed eligible for inclusion. The methodologies, perspectives and data sources used in studies were heterogeneous. In greater China, while few studies reported the health expenditures of HCC patients and investigations about economic burden at national level was lacking, the significant economic impact of HCC on patients and their families had been reported. Health-related costs increased as the disease deteriorated. Additionally, HCC also has a negative impact on the QoL of patients, mostly in terms of physical, cognitive, social functioning and severe symptoms.

Conclusions: HCC has brought significant economic and QoL burden to patients in greater China. Both physical and psychological factors predicted QoL in patients with HCC in greater China. Future studies should explore the disease-related economic effects on Chinese patients and their families, the effects of physical and psychological factors on QoL and the relationships of physical and psychological factors in the region.

Systematic Review Registration: www.crd.york.ac.uk/prospero/display_record.php?RecordID=278421, PROSPERO: CRD42021278421

6,060 views

39 citations