The netmeta package is specialized for implementing network meta-analysis. This package was developed based on the theories of classical frequentist under R language framework. The netmeta package overcomes some difficulties of the software and/or packages based on the theories of Bayesian, for these software and/or packages need to set prior value when conducting network meta-analysis. The netmeta package also has the advantages of simple operation process and ease to operate. Moreover, this package can calculate and present the individual matched and pooled results based on the random and fixed effect model at the same time. It also can draw forest plots. This article gives a briefly introduction to show the process to conduct network meta-analysis using netmeta package.
ObjectiveTo systematically review clinical efficacy and safety of bone marrow stem cells transplantation in treating primary dilated cardiomyopathy (DCM). MethodsSuch databases as PubMed, CENTRAL, EMbase, Web of Knowledge, VIP, CNKI, CBM and WanFang Data were searched from inception to March 2014 for the randomized controlled trials (RCTs) about bone marrow stem cells transplantation for DCM. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2.0 software. ResultsA total of ten RCTs involving 374 patients were included. The results of meta-analysis showed that, a) for safety, after 3 months there was no significant difference in the incidence of malignant arrhythmia events between bone marrow stem cell transplantation group and routine treatment group (RR=0.81, 95%CI 0.38 to 1.72, P=0.58); and b) for efficacy, compared with the control group, left ventricular ejection fraction (LVEF) increased in the bone marrow stem cell transplantation group after 3 months (WMD=3.86, 95% CI 2.53 to 5.20, P<0.000 01) and after 6 months (WMD=5.54, 95%CI 3.02 to 8.06, P<0.000 1). The bone marrow stem cell transplantation group were better in increased 6-minute walking distance after 3 months (WMD=22.12, 95%CI 7.78 to 36.46, P=0.003), increased 6-minute walking distance after 6 months (WMD=102.79, 95%CI 50.16 to 155.41, P=0.000 1), decreased perfusion defect of myocardium percentage after 3 months (WMD=-4.00, 95%CI -5.87 to -2.13, P<0.000 1). However, there was no significant difference in left ventricular end-diastolic diameter (LVEDD) between two groups after 3 months (WMD=-0.37, 95%CI -1.67 to 0.93, P=0.57) and after 6 months (WMD=-0.70, 95%CI -2.76 to 1.36, P=0.51). ConclusionBone marrow stem cells transplantation for dilated cardiomyopathy is effective in improve patients' heart function with good safety, with significant difference. Due to limited quantity and quality of the included studies, more high quality and large-scale RCTs are needed to verify the above conclusion.
The key for performing meta-analysis using WinBUGS software is to construct a model of Bayesian statistics. The hand-written code model and Doodle model are two major methods for constructing it. The approach of hand-written code is flexible and convenient, but the language programming is fallibility. The Doodle is complicated, but it is benefit to understand the structure of hand-written code model and prevent error. This article briefly describes how to construct the Doodle model for binary and continuous data of head to head meta-analysis, indirect comparison and network meta-analysis, and ordinal variables meta-analysis.
ObjectiveTo systematically review the major risk factors of road traffic injuries, so as to provide scientific basis for road traffic injuries prevention strategies. MethodsSuch databases as PubMed, EMbase, The Cochrane Library, Springer, EBSCO, CBM, CNKI, VIP, and WanFang Data were searched from inception to March 31st, 2014, to collect case-control studies on the risk factors of motoring vehicle road traffic injuries. According to the inclusion and exclusion criteria, literature screening, data extraction, and methodological quality assessment were independently completed by two reviewers. Meta-analyses were performed using RevMan 5.2 software. ResultsEighteen studies involving 368 845 motor vehicle drivers who had traffic accidents and 411 147 motor vehicle drivers who had no traffic accident were included. The results of meta-analysis showed that, the risk factors mainly included carelessness (OR=19.95, 95%CI 6.42 to 62.03), drunk driving (OR=9.36, 95%CI 4.62 to 18.95), driving without licence (OR=5.07, 95%CI 1.93 to 13.31), illegal operation (OR=4.87, 95%CI 1.98 to 11.93), fatigue driving (OR=4.08, 95%CI 3.21 to 5.18), and lack of driving experience (OR=3.81, 95%CI 2.08 to 6.97). ConclusionCarelessness, drunk driving, driving without licence, illegal operation, fatigue driving, and lack of driving experience are major risk factors of motor vehicle road traffic injuries in China. Controlling these risk factors can effectively reduce the incidence of motor vehicle road traffic injuries.
Compared with traditional head to head meta-analysis, network meta-analysis has more confounding factors and difficulties to handle. Due to the mutual transitivity of evidence in network meta-analysis, heterogeneity may be brought into indirect meta-analysis. Hence, effective differentiation and correct handling of heterogeneity are being current focus. In order to ensure the reliability of the results of network meta-analysis, the concept of homogeneity is proposed and a series of methods are developed for differentiation and handling of homogeneity. Based on the extension of Bucher methods, current methods for differentiation and handling of homogeneity has extended to ten quantitative measures (eg., node analysis method, hypothesis tests, and two-step method). However, because of the differences and the focus of fundamental methodological theories as well as the limitation of statistics power, no highly-effective method has been worked out. Therefore, the exploration of highly-effective, simple and high-resolved methods are still needed.
The Campbell Library is a database of preserving and promoting systematic reviews on social sciences for the purpose of providing evidence-informed decision making. This article introduces the foundation, development, major contents and search methods of the Campbell Library, so as to provide resources and technologies in the field of social sciences as well as new ideas for the development of evidence-based practice in China.
To explore clinical design methods that suit the characteristics of acupuncture science, this article mainly analyzes the design features of pragmatic randomized controlled trials and the advantages and current problems in clinical research on acupuncture. We discuss the differences between pragmatic randomized controlled trials and explanatory randomized controlled trials and the application status of clinical research about acupuncture. We consider that pragmatic randomized controlled trials suit the characteristics of in clinical research on acupuncture with complicated interventions. Exploring the application of pragmatic randomized controlled trials clinical research on acupuncture is beneficial to exploring appropriate clinical research methods that suit the specific characteristics of acupuncture subject, and to objectively and comprehensively assessing clinical efficacy and safety of acupuncture.
ObjectiveTo evaluate the two means of field molluscicidal effect by two different snail control drugs--new plant snail control agent luo-wei (Tea-seed distilled saponins, TDS) and 50% wettable powder of niclosamide (WPN). MethodsSuch databases as CNKI, WanFang Data, VIP and CBM databases were searched for controlled trials about TDS vs. WPN for the molluscicidal effect from their establishment to April 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies, and then meta-analysis was performed by using RevMan 5.2 software. ResultsA total of 9 studies were included. The results of meta-analysis showed that:Snails mortality rate of TDS on 7 d was lower (RR=0.96, 95%CI 0.93 to 1.00, P=0.04) than WPN and no significant difference of the snails mortality rate on 1 d or 3 d between the two groups was found by means of immersion. Meanwhile, by means of spraying, there were no significant differences on the snails mortality rate on 1 d, 3 d, 7 d, 15 d between the two groups; densities of living snails on 15 d wasn't, either. Based on GRADE system, the evidence was at level B or C. ConclusionCompared with WPN, TDS has reached the requirements of the natural source twin-screw agent field evaluation. The molluscicidal effect of TDS is better, with its large stock and low price, it is worthy to do further popularization.
ObjectiveTo systematically review the efficacy of early physical rehabilitation for patients with stroke-induced hemiplegia. MethodsDatabases including PubMed, Web of Knowledge, The Cochrane Library (Issue 7, 2014), EMbase, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about early physical rehabilitation for patients with stroke-induced hemiplegia from inception to 1st August 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, metaanalysis was performed using RevMan 5.2 software. ResultsA total of 6 RCTs were included. The results of metaanalysis showed that, after 1 month of treatment, the Fugl-Meyer scores (MD=18.02, 95%CI 6.24 to 29.80, P=0.003) and BI scores (MD=32.32, 95%CI 24.28 to 40.36, P<0.000 01) in the early physical rehabilitation group were higher than that in the conventional rehabilitation group. But after 3 months of treatment, there were no statistical differences between two groups in the proportion of patients with 0-2 MRS scores, mortality and the incidence of complications. ConclusionCurrent evidence shows that early physical rehabilitation can effectively improve the limb motor function and daily living ability in patients with stroke-induced hemiplegia. However, due to the limited quantity and quality of the include studies, more large-scale, high quality RCTs are needed to verify the above conclusion.