Objective The purpose of this study, which focuses on the number of the Cochrane Systematic Review’s (CSR) full texts, protocols and registered titles from Chinese authors, is to show the development of evidence-based medicine (EBM) and promote EBM’s further development in China. Methods On the basis of The Cochrane Library (Issue 1, 2009) and the Cochrane Collaboration (March 2009) periodicals, we performed statistical analysis of different countries that released CSR’s full texts, protocols and registered titles, as well as the time, authors and distribution of the CSR’s full texts, protocols and registered titles in China. Results The publishing rates of the CSR’s full texts, protocols and registered titles in China ranked the seventh, fifth and second, respectively. Although the number of CSR’s full texts and protocols showed an increased annual trend in China, the development of area distribution was unbalanced. Moreover, China’s published articles contained 47 Cochrane collaboration groups, without effective practice and health care groups, consumers and communication groups, and methodology and multiple stenosis groups. Conclusions The current Chinese EBM situation has a great potential in writing CSR. However, there are still many problems that need to be resolved.
Background Hepatitis B virus infection is a serious health problem worldwide. Traditional Chinese medicinal herbs have been widely used to treat chronic liver diseases, and many controlled trials have been done to investigate their efficacy. Objectives To assess the efficacy and safety of traditional Chinese medicinal herbs for chronic hepatitis B infection. Search strategy Searches were applied to the following electronic databases: the CHBG Trials Register, the Cochrane Complementary Medicine Field Trials-Register, the Cochrane Library, MEDLINE, EMBASE and BIOSIS. Five Chinese journals and conference proceedings were handsearched. No language restriction was used. Selection criteria Randomized or quasi-randomized trials with at least three months follow-up. Thais of Chinese medicinal herbs (single or compound) compared with placebo, no intervention, general non-specific treatment or interferon treatment were included. Trials of Chinese medicinal herbs plus interferon versus interferon alone were also included. Trials could be double-blind, single-blind or not blinded. Data collection and analysis Data were extracted independently by two reviewers. The methodological quality of trials was evaluated using the Jadad-scale plus allocation concealment. Intention-to-treat analyses were performed. Main Resuits Nine randomized trials, including 936 patients, met the inclusion criteria. Methodological quality was considered adequate in only one trial. There was a significant funnel plot asymmetry (regression coefficient= 3.37, standard error 1.40, P=0.047). Ten different medicinal herbs were tested in the nine trials. Compared to non-specific treatment or placebo, Fuzheng Jiedu Tang (compound of herbs) showed significantly positive effects on clearance of serum HBsAg, HBeAg, and HBV DNA; Polyporus umbellatus, polysaccharide on serum HBeAg and HBV DNA; Phyllanthus amarus on serum HBeAg. Phyllanthus compound and kurorinone showed no significant effect on clearance of serum HBeAg and HBV DNA and on alanine aminotransferase normalization compared to interferon treatment. There were no significant effects of the other examined herbs. Reviewer’s conclusions Some Chinese medicinal herbs may work in chronic hepatitis B. However, the evidence too weak to recommend any single herb. Rigorously designed, randomized, double-blind, placebo-controlled trials are required.
Over the past two decades, the International Cochrane Collaboration has completely transformed the mechanism of health decision-making. Cochrane aims to collect, summarize and disseminate the best current research evidence via The Cochrane Library in order to help stakeholders making informed health care decisions. Cochrane began with just a few dozen volunteers and has, over the years, transformed into a truly global and inclusive network, with 37 000 contributors from over 130 countries. Cochrane evidence has long been recognized as high quality and trustworthy international gold standard in health care. In recent years, Cochrane has initiated a number of innovative projects to attract more researchers from different socio-cultural and educational backgrounds. This commentary introduces these new platforms and illustrates the opportunities offered to Chinese researchers by the modern-era Cochrane.
In 1993 the Cochrane Collaboration, an international non-profit organization aiming at producing, updating and disseminating systematic reviews, was founded. Several years later, in 1999, the Chinese Cochrane centre opened in Chengdu, to provide support to (1) Chinese researchers willing to produce reviews and (2) politicians and practitioners willing to start using the results in daily practice. We searched PubMed and the database of the Chinese Cochrane Centre to retrieve data on the overall number of articles and reviews produced in the Chinese language for the period 1990 to 2006. Although the number of reviews increased substantially since the year 2000, the percentage of reviews in the overall number of articles indexed in PubMed remains modest.
Objective To explore the differences between large and small studies in rare events meta-analysis. Methods Empirical data were collected from The Cochrane Systematic Review Database from January 2003 to May 2018. Meta-analyses with rare events, binary outcomes involving at least 5 studies, and at least 1 large study were screened. Peto and classical ORs were used to compare the magnitude, direction and P-value. Results A total of 214 meta-analyses were included. Among 214 pairs of ORs of large and small studies, 66 pairs (30.84%) were inconsistent in the direction of ORs based on Peto OR (Kappa =0.33), and 69 pairs (32.24%) were inconsistent in the direction of ORs based on classical OR. The Peto ORs resulted in smaller P-values compared to classic ORs in a substantial (83.18%) number of cases. Conclusion There are considerable differences between large and small studies in the results of meta-analysis of rare events.
ObjectiveTo investigate the extent of overlap between Chinese systematic reviews (SRs) and Cochrane SRs in the field of stroke. MethodsThe CNKI, WanFang Data, CBM and Cochrane Library databases were searched to collect Chinese SRs and Cochrane SRs in the field of stroke published from 2012 to 2022. By extracting population (P), intervention (I), comparison (C), and outcome (O) of all interventional SRs in the stroke field to analyse the extent of overlap of SRs. The basic information and research information of SRs with overlapping PICOs were further extracted to conduct descriptive analysis. ResultsA total of 1 303 SRs were included, involving 1 192 Chinese SRs and 111 Cochrane SRs in the field of stroke. The overlapping analysis found that 128 Chinese SRs overlapped with 29 (26.1%) of the 111 Cochrane SRs. Most (127/128, 99.2%) Chinese SRs were published later than Cochrane SRs. The year of publication of overlapping SRs showed a trend of increasing year by year. ConclusionThe SR work carried out by scholars in China has the problem of overlapping studies that cannot be ignored, and the lack of strict regulation and guidance in methods such as registration, protocol writing, and literature search has resulted in a great waste of resources. It is necessary to further strengthen regulatory constraints and guidance, adhere to problem orientation and quality awareness, strengthen SR training, and reduce overlapping research.
Objective ① To document the way in which allocation concealment is described and coded for studies included in Cochrane Reviews.②To feed back any gaps or miscodings to individual review groups.③ To suggest changes and expansions to advice on how to code and describe allocation concealment methods.Methods The coding and description of methods of allocation concealment for studies included in all 1 596 reviews on issue 1, 2003 of The Cochrane Library are being extracted.So far results are available for 10.8% (173/1 596) of reviews containing 1 844 studies, from 10 Collaborative Review Groups (CRGs).Discrepancies, and inconsistencies with the Cochrane Reviewers’ Handbook, are being documented and analysed.Results The current coding of the adequacy of allocation concealment in studies included in Cochrane reviews is not likely to be very accurate.This is due to failure to describe methods of allocation concealment (38.6% of the sample of 1 844 studies) as well as miscoding (at least an additional 9.2%).The most common method for studies coded A was some variation of envelope use (133/675-19.7% of all A codes). The most common "method" for studies coded B was method unclear or not described in the report of the study (426/665, 64% of all B codes).Conclusions Since adequate allocation concealment is so important in protecting against bias in randomised controlled trials, it needs to be accurately coded and described.We need to improve how this is done for studies included in Cochrane Reviews.Since over half the studies coded as D were likely to have been where reviewers omitted to enter a code, the default should be changed from D to "code not supplied".Structural changes to RevMan are suggested-ideally the addition of a separate new study quality assessment table with fixed headings as well as the facility to enter free text.Suggestions for improving coding in particular reviews will be fed back to CRGs in the next stages of this project.Suggestions for additions to the Cochrane Reviewers’ Handbook are also made.
Sir Iain Chalmers, the cofounder of the UK Cochrane Centre and The Cochrane Collaboration, a distinguished and talented leader, a meditative scholar, a responsive researcher, a zealous challenger, has fully devoted himself to the pursuit of better care for patients. His splendid achievements and reputations have never halted his endeavor. This biographic sketch is intended to shed light on the critical moments that have made Sir. Iain Chalmers such an extraordinary man.
Objective To detect the false-negative results of cumulative meta-analyses of Cochrane Urology Group with the trial sequential analysis (TSA). Methods The Urology Group of The Cochrane Library (Issue 6, 2016) was searched to collect meta-analyses with negative results. Two researchers independently screened literature and extracted data of included meta-analyses. Then, TSA was performed using TSA software version 0.9 beta. Results A total of 11 papers involving 12 meta-analyses were included. The results of TSA showed that, four (33%) out of 12 meta-analyses were potentially false-negative results for failing to surpass the trial sequential monitoring boundary and to reach the required information size. Conclusion Some of the negative results of systematic reviews from Cochrane Urology Group was false-negative. TSA can help researchers to identify the false-negative results of meta-analyses.
