英语晨读 ·
山东省立医院疼痛科英语晨读已经坚持10余年的时间了,每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯,二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享,助力疼痛学习。
本次文献选自Suzanne, Amato, Nesbit, et al. Non-pharmacologic treatments for symptoms of diabetic peripheral neuropathy: a systematic review.[J]. Current Medical Research & Opinion, 2018.35(1):15-25
Materials and methods
Study selection
We report here results on non-pharmacologic treatments from a broader systematic review assessing therapies for diabetic peripheral neuropathy. This broader review addresses intensive glucose control as well as pharmacologic interventions. Full details on methods and results are available in the evidence report 7 . We included supplements, which are treatments not approved as pharmacologic agents by the Food and Drug Administration, in the category of non-pharmacologic treatments for this review. We selected non-pharmacologic treatments to include based on inclusion criteria of prior systematic reviews 6,8 and input from experts on diabetic neuropathy. We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to May 24, 2016.
材料和方法
研究对象
该综述全面系统的总结了糖尿病周围神经病变的非药物治疗方案和效果。这些文献也强调血糖控制和药物干预。有关方法和结果的更多细节见参考文献。食品和药物管理局不推荐使用保健品作为药物治疗方案,在该综述中,我们将保健品纳入了非药物治疗方案。非药物治疗方案纳入标准时参考先前系统综述的纳入标准和糖尿病神经病变专家共识。我们检索了时间区间时从最开始到2016年5月24日,检索数据库是PubMed、Embase和Cochrane数据库。
Two trained reviewers independently screened citations toassess eligibility using pre-defined criteria (Supplementary Appendix Table) to identify eligible parallel or crossover randomized controlled trials (RCTs); except for invasive procedures, we only included blinded trials.
两名经过培训的审查人员使用预先设定的筛选标准(补充附录表)独立筛选试验,评估其可信度,以确定合格的平行或交叉随机对照试验(RCTs除了侵入性手术,我们只包括单盲试验)。
Data extraction and quality assessment
Paired investigators abstracted data sequentially and independently assessed risk of bias for individual studies. We used the Cochrane Collaboration’s tool for assessing the risk of bias of RCTs 9 . Reviewers resolved differences through consensus.
数据提取和质量评估
两个研究者轮流提取数据,并独立评估个体研究的偏倚风险。我们使用Cochrane协作工具来评估随机对照试验的偏倚风险。评审者通过共识解决分歧。
Data synthesis and analysis
We did not conduct meta-analyses for any interventions owing to heterogeneity in intervention type or intensity and outcome reporting. We calculated standardized mean differences (SMD) for the difference between symptoms at baseline and follow-up, where possible, given reported data. If not, we reported the direct results from the study. To interpret the SMD, a negative result is in the direction of the intervention group, and a positive result is in the direction of the placebo or sham group. An SMD (Cohen’s d)<0.5 is generally considered a small effect size, 0.5–0.8 is considered moderate, and >0.8 is considered large.
数据合成与分析
由于治疗方案或强度、以及评估结果的差异,我们没有对任何治疗方案进行Meta分析。我们计算了基线症状和随访症状之间的标准化平均差异(SMD),并尽可能地给予量化。不能量化的研究,我们直接报告了研究的结果。为了解读标准化平均差异,阴性结果是干预组的方向,阳性结果是安慰剂或假手术组的方向。SMD<0.5通常被认为是差异较小,0.5–0.8被认为是中等差异,而> 0.8被认为差异较大。
We graded the strength of evidence for the pre-specified critical outcomes of pain and quality-of-life using the scheme recommended by the Methods Guide for Conducting Comparative Effectiveness Reviews 11 . For each comparison of interest, we evaluated study limitations, directness, consistency, precision, and reporting bias.
我们使用《进行比较有效性审查的方法指南》推荐的方案,对预先指定的关键结果(疼痛和生活质量)证据强度进行了分级。对于每一项有意义的比较,我们都评估了研究的局限性、直接性、一致性、精确性和报告偏差。
Role of the funding source
The Agency for Healthcare Research and Quality provided funding. The funding source had no role in study selection, quality assessment or data synthesis, or in the decision to submit the manuscript for publication.
资金来源
美国医疗研究和质量局提供资金。在研究对象的选择、质量评估或数据分析,以及投稿过程中都没有使用资金。
联系客服