Grading the evidence of systematic reviews on animal studies will contribute to the improvement in the feasibility of transforming the results of animal studies into clinical trials or clinical practice. High quality evidence from animal studies is more likely to be successfully applied into clinical practice (i.e. more confident). Therefore, the present study will introduce the principles, methods and challenges of the application of GRADE in systematic reviews on animal studies.
ObjectiveTo systematically investigate the registration status, methodology and reporting quality of the systematic review protocols for animal experiment registered on PROSPERO platform.MethodsSystematic review protocols of animal experiments registered on PROSPERO platform were searched up to December 31st, 2019. Two reviewers independently screened literature, extracted data, and performed a descriptive analysis of the methodological quality and reporting characteristics of the included studies.ResultsA total of 351 protocols from 50 countries were included, involving 22 diseases. The intervention measures were primarily "pharmaceutical chemicals". Only approximately 1/3 of the studies reported the search strategy from at least one database, approximately half of the studies were prepared to report heterogeneity analysis and publication bias, and only approximately 1/3 of the studies were prepared to report sensitivity analysis.ConclusionsThe quantity of systematic reviews of animal experiments registered on the PROSPERO platform is increasing annually, however, there are still some limitations in the methodology and reporting quality.
ObjectiveTo systematically review the relationship between frailty and risk of orthostatic hypotension.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect studies on the association between frailty and orthostatic hypotension from inception to July 7th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsFive cross-sectional studies involving 8 671 patients were included. The results of meta-analysis showed that prefrailty (OR=1.04, 95%CI 0.99 to 1.09, P=0.11) and frailty (OR=1.02, 95%CI=0.92 to 1.13, P=0.70) were not associated with orthostatic hypotension. The results of subgroup analysis showed that differences of sample size (<500 or ≥500), using different frailty assessment tools (Fried scale, clinical frailty scale, and frailty index), different regions (Europe, Asia, and America) and different sources of studied subjects (hospitals and communities), the risk of orthostatic hypotension were not increased with frailty.ConclusionsCurrent evidence shows that frailty does not increase the risk of orthostatic hypotension. Due to limited quality and quantity of included studies, the above conclusions are needed to be validated by more high-quality studies.
ObjectiveTo systematically review the dose-response relationship between body mass index (BMI) and all-cause mortality in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data, and CBM databases were electronically searched to collect cohort studies on the association of BMI and mortality in frail adults from inception to November 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; Stata 15.0 software was then used to analyze the dose-response analysis of BMI and mortality by restricted cubic spline function and generalized least squares method.ResultsA total of 4 cohort studies involving 12 861 frail adults were included. Meta-analysis results showed that compared with normal BMI, the frail elderly who were overweight (HR=0.80, 95%CI 0.74 to 0.88, P<0.001) and obese (HR=0.89, 95%CI 0.79 to 1.00, P=0.047) had lower all-cause mortality. The results of dose-response meta-analysis showed that there was a non-linear relationship between BMI and all-cause mortality in the elderly with frailty (P value for nonlinearity was 0.035), for which the elderly with frailty had a BMI nadir of 27.5-31.9 kg/m2. For linear trends, and when BMI was less than 27.5 kg/m2, the risk of all-cause death was reduced by 4% for every 1 kg/m2 increase in BMI (RR=0.96, 95%CI 0.90 to 1.03, P=0.320), when BMI was greater than 27.5 kg/m2, the risk of all-cause death increased by 4% for every 1 kg/m2 increase in BMI (RR=1.04, 95%CI 1.03 to 1.05, P<0.001).ConclusionsThere is a paradox of obesity and a significant nonlinear relationship between BMI and all-cause mortality in the frailty elderly, with the lowest all-cause mortality in the frailty elderly at BMI 27.5-31.9 kg/m2. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
Scoping reviews are intended to help researchers in complex and extensive fields can better address exploratory research questions, comprehensive and systematic understanding of the current development of a field. However, the current scoping review needs to be unified in the implementation process, and the emergence of the JBI scoping review execution process can solve this problem well, which combines and improves the framework of the previous execution process, and regulates the whole process of scoping review production in depth and comprehensively from the aspects of the research purpose and questions, inclusion criteria, search, screening, data extraction, and analysis of the results, etc., and it has a strong authority and professionalism. Therefore, in order to help researchers better carry out and implement the scoping reviews, this paper focuses on the JBI scoping review execution process, and through detailed interpretation of the JBI scoping review execution process and demonstration of examples, it provides references for researchers to correctly apply the JBI scoping review execution process, in order to enhance the transparency and reliability of the research results, and to promote the scientific application of scoping reviews in China.
Based on the PRISMA 2009 checklist, the study analyzed current status and reporting quality of systematic reviews of animal experiments, and consulted experts in relevant fields to form an initial entry pool of reporting checklists for systematic reviews of animal experiments in traditional Chinese medicine (PRISMA-ATCM). Then, the initial entry pool was improved through 2 rounds of Delphi expert consultation. Finally, the items were revised through the consensus meeting, and the final PRISMA-ATCM was formed. Of the 27 items on the PRISMA checklist, 12 were revised and expanded, specifically relating to TCM interventions and animal characteristics. The publication of the PRISMA-ATCM will improve the transparency and standardization of systematic reviews of animal experiments in Chinese medicine.