[Abstract]Expert consensus serves as a crucial supplement to clinical practice guidelines, offering guidance when evidence is insufficient or controversial. However, it often suffers from low reporting quality, incomplete content, and lack of transparency in processes. Reporting guideline provides a standardized framework for medical research documentation by prescribing content requirements and structural formats. As reporting guidelines for different guideline documents, the RIGHT (Reporting Items for Practice Guidelines in Healthcare) checklist emphasizes evidence quality assessment and recommendation formulation, while the ACCORD (ACcurate COnsensus Reporting Document) checklist focuses on standardizing consensus processes - each with distinct strengths and limitations. To address these gaps, this study proposes an integrated framework (TIMER-DO) to compensate for the deficiencies of individual checklists and enhance the reporting quality of consensus statements. Future efforts should develop consensus-specific methodological quality assessment tools, streamline and optimize reporting guideline, strengthen the dissemination and personnel training initiatives for consensus reporting standards, and enhance the global impact and recognition of consensus documents.
ObjectiveTo summarize the research progress of four mainstream drug-eluting beads (DEB) in transcathete arterial chemoembolization (TACE) for hepatocellular carcinoma in recent years.MethodThrough retrieving relevant literatures at home and abroad, the physicochemical properties, pharmacokinetics, effectiveness, and safety of four mainstream DEBs were reviewed.ResultsThe current mainstream DEBs on the market had the characteristics of high drug loading rate and sustained release of drugs, which could reduce the adverse reactions after the embolization to a certain extent. The safety and tolerance of patients receiving DEB-TACE were slightly higher than those receiving traditional TACE (c-TACE). There were no serious complications after the DEB-TACE, but the short-term and long-term efficacies between the two methods were not significantly different.ConclusionsAt present, most studies believe that the safety and tolerance of DEB are slightly higher than that of c-TACE, but whether the former is more effective than the latter is still controversial at home and abroad, and more high-quality multicenter randomized controlled trials are needed to confirm it.
Randomized controlled trial (RCT) are considered the "gold standard" for evaluating the causal effects of interventions on outcome measures. However, due to high research costs and ethical constraints, conducting RCT in clinical practice, especially in the surgical field, faces numerous challenges such as difficulties in subject recruitment, implementation of blinding, and standardization of interventions. In such cases, using real-world data to perform causal inference under the framework of target trial emulation (TTE), based on the principles of RCT design, helps to identify and reduce biases arising from design flaws in traditional observational studies, such as immortal time bias, confounding, selection bias, or collider bias. This approach can produce high-quality evidence comparable to that of RCT, thereby enhancing the clinical guidance value of real-world data studies. However, TTE has limitations, such as the inability to completely eliminate confounding, high quality requirements for source data, and the current lack of reporting standards. Therefore, researchers should be fully aware of these limitations to avoid making incorrect causal inferences. This article intends to provide an overview of the TTE framework, implementation points, application scope, application cases, and advantages and disadvantages of the framework.