Cochrane Review Research Articles

The effect of inhaled aromatherapy on cognitive function in patients with cognitive impairment: A systematic review and meta-analysis.

Cognitive function is the basis of human thinking and behavior. Cognitive impairment has a serious impact on each individual and imposes a financial burden to families and healthcare systems. Inhalation aromatherapy has advantages, due to its safety, convenience, lack of toxicity, and wide use in the treatment of cognitive impairment. This systematic review was conducted to provide evidence for the use of inhaled aromatherapy in patients with cognitive impairment. We searched nine databases for pertinent Chinese and English studies published through November 2024 studies using inhaled aromatherapy in patients with cognitive impairment. Literature screening and data extraction were performed independently by two researchers and evaluated using the Cochrane Collaboration's quality criteria and were then cross-checked. A meta-analysis was carried out using Cochrane's Review Manager (RevMan, version 5.4), and we followed the PRISMA guidelines. We included fourteen studies involving 888 patients with cognitive impairment in our study. Meta-analyses indicated that inhaled aromatherapy increased Mini-mental State Examination (MMSE, mean difference MD=3.89 95% CI [3.19, 4.58], P<0.00001) and Montreal Cognitive Assessment Scale (MoCA, MD=4.11, 95% CI [3.54, 4.68], P<0.00001) scores and decreased Homocysteine levels (Hcy, MD=-2.27 95% CI [-2.80, -1.74], P<0.00001) in patients with cognitive impairment compared with controls. Inhaled aromatherapy could improve global cognition and lower Hcy in patients with cognitive impairment.

Psychological interventions for depression in people with diabetes mellitus.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effects of psychological interventions for depression in people with diabetes mellitus.

Early versus delayed anticoagulation treatment for people with non-valvular atrial fibrillation-related acute ischaemic stroke.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and risks of early versus late initiation of oral anticoagulation (vitamin K antagonists or NOACs) in people with non-valvular atrial fibrillation-related ischaemic stroke.

Yoga as an adjunctive therapy for rheumatoid arthritis.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effect and safety of yoga as an adjunctive therapy for rheumatoid arthritis.

Music therapy for autistic people: a Cochrane Review

Music therapy for autistic people: a Cochrane Review

Music therapy for autism spectrum disorder: does it have a role?

SUMMARYMusic therapy attempts to facilitate communication and expression – core problems for autistic people – through the development of experiences and relationships mediated by music. This commentary assesses a Cochrane Review of the effects of music therapy, compared with placebo or standard care, for autistic people, and its conclusion that music therapy is probably associated with an increased chance of global improvement and perhaps a slight increase in quality of life and reduction in total autism symptom severity in the short to medium term. The review was not able to examine longer-term effects as the longest follow-up period was 12 months. The certainty of the evidence was graded from moderate to very low, and therefore the results need to be viewed with caution.

Is Bladder Training Effective for Treating Overactive Bladder in Adults?-A Cochrane Review Summary With Commentary.

Is Bladder Training Effective for Treating Overactive Bladder in Adults?-A Cochrane Review Summary With Commentary.

Citation patterns of Cochrane Reviews and other systematic reviews: a bibliometric analysis

Background The number of systematic reviews is increasing rapidly. Several methodologies exist for systematic reviews. Cochrane Reviews follow distinct methods to ensure they provide the most reliable and robust evidence, ideally based on rigorous evaluations of randomized controlled trials and other high-quality studies. We aimed to examine the difference in citation patterns of Cochrane Reviews and other systematic reviews. Methods We conducted a bibliometric analysis of systematic reviews indexed in PubMed from 1993 to 2022. We collected data on citations from The Lens from 1993 to 2023, thus having at least 1-year follow-up on citations. The reviews were linked through their PubMed identifier. Comparisons between the Cochrane Reviews and other systematic reviews included total citations per review, reviews with zero citations, and the time window within which they receive citations. Results We included 10,086 Cochrane Reviews and 231,074 other systematic reviews. Other systematic reviews received significantly more citations than Cochrane Reviews from 1993 to 2007. From 1993 to 1997, the median difference was 80 citations (95% CI = 79.6–80.4). From 2008 and forward, the overall number of citations was similar between Cochrane Reviews and other systematic reviews (2018–2022: median difference = 5 [95% CI = 4.9–5.1] in favor of Cochrane Reviews; p = 0.83). Systematic reviews with zero citations were rare in both groups, but it was observed more often among other systematic reviews than Cochrane Reviews. Over the last 30 years, the time window in which all reviews received citations narrowed. Conclusion In recent years, Cochrane Reviews and other systematic reviews had similar citation patterns, but other systematic reviews received more citations from 1993 to 2007. Other systematic reviews were more often never cited than Cochrane Reviews, and potentially wasted. The time window in which systematic reviews received citations has been progressively decreasing, possibly indicating a trend toward quicker recognition and uptake of these reviews within the academic community. Cochrane reviews aim to provide robust evidence, but this is not reflected in the citation metrics compared to other systematic reviews.

The safety and efficacy of anti-inflammatory-impregnated gelatin sponge in spine surgery: a systematic review and meta-analysis.

The purpose of this systematic review and meta-analysis is to evaluate the safety and efficacy of anti-inflammatory-impregnated gelatin sponges in spine surgeries. Gelatin sponges are increasingly used as delivery vehicles for anti-inflammatory and analgesic drugs during spine surgeries. However, concerns about their safety and efficacy persist. A comprehensive literature search was conducted to identify original research articles investigating the use of anti-inflammatory-impregnated gelatin sponges in spine surgeries from 2006 to 2024. Case reports, case series, animal studies, cadaveric studies, and abstract-only articles were excluded. The risk of bias was assessed using Cochrane Risk of Bias 2.0 (Cochrane, UK) for randomized controlled trials (RCTs) and the Newcastle Ottawa Scale (NOS) for observational studies. Meta-analysis was performed using Cochrane Review Manager Web. Thirteen studies (six RCTs, six cohort studies, and one case-control study) were included. Pooled analysis revealed a significant decrease in Visual Analog Scale (VAS) score for back pain (mean difference [MD], -0.62; 95% confidence intervals [CI], -0.78 to -0.46; p<0.00001), VAS score for leg pain (MD, -0.60; 95% CI, -0.87 to -0.34; p<0.00001), and length of hospital stay (MD, -0.99; 95% CI, -1.68 to -0.31; p=0.0004). Additionally, there was a significant increase in the Japanese Orthopedic Association score (MD, 0.98; 95% CI, 0.00 to 1.96; p=0.05). However, no significant difference was observed in the disability index (MD, -0.59; 95% CI, -1.88 to -0.70; p=0.37). The use of anti-inflammatory-impregnated gelatin sponges during spine surgeries decreases postoperative back pain and leg pain, reduces length of stay, and improves neurological function. Larger, prospective, randomized trials are required to obtain more robust evidence.

The impact of Cochrane Reviews that apply network meta-analysis in clinical guidelines: A systematic review.

Systematic reviews, such as those prepared by Cochrane, are the strongest evidence on which to base recommendations in clinical guidelines. Network meta-analysis (NMA) can be used to combine the results of studies to compare multiple treatments, which is advantageous over pair-wise meta-analysis (PW-MA) that compares two treatments. We aimed to summarise which, when, where, who, and why Cochrane Reviews that applied NMA were cited in guidelines; and to compare the citation of NMA reviews in guidelines with PW-MA reviews. We carried out a systematic review of Cochrane reviews that applied NMA and we summarised their citation in guidelines. The Cochrane Database of Systematic Reviews was searched (15th January 2024). Additionally, a cohort of Cochrane reviews that applied PW-MA was matched to the NMA reviews. Two authors assessed eligibility and extracted data. We summarised review and guideline characteristics, and the use of the review in guidelines. Of the 60 included NMA reviews, 26 reviews (43%) were cited in 89 guidelines (1-13 per review). 15 NMA reviews (58%) were first cited within two years of publication, with the remaining 11 reviews (42%) cited 2-6 years later. 52 guideline developers authored the guidelines. The number of citations was higher for NMA than PW-MA reviews (rate ratio 1.53 (1.08 to 2.19), p = 0.02). The number of times reviews were commissioned or cited alongside a recommendation was also higher for NMA than PW-MA reviews (rate ratio 4.40 (1.80 to 13.14), p = 0.003). NMA reviews were more likely to be cited in the text surrounding a recommendation or used for NICE guideline development (1.94 (1.08 to 3.63), p = 0.03). Cochrane NMA reviews appear to have more impact than PW-MA reviews, but many are not cited in guidelines. Further work is needed to explore the barriers to use of NMAs and promote their use.

Should we add McKenzie exercises to current guidelines for the treatment of (sub)acute non-specific low back pain? A Cochrane Review summary with commentary.

Should we add McKenzie exercises to current guidelines for the treatment of (sub)acute non-specific low back pain? A Cochrane Review summary with commentary.

Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews.

To summarise and evaluate Cochrane reviews of pharmacological therapies for adults with fibromyalgia syndrome (FMS) pain. Systematic search of Cochrane Database of Systematic Reviews to May 2024. Generic quality assessment used AMSTAR-2 criteria, validity checks of potentially critical factors in evaluation of analgesic efficacy, and assessment of susceptibility of results to publication bias. Pain outcomes were participant-reported pain relief of ≥ 30% or ≥ 50%, or PGIC much or very much improved. Twenty-one reviews (87 trials, 17,631 patients) were included. All rated moderate (15) or high-quality (6) using AMSTAR-2 and at least seven of eight critical pain criteria were met by 13 of 21 reviews. Diagnosis of FMS used recognised criteria. Seven reviews found no trials (carbamazepine, clonazepam, lamotrigine, phenytoin, oxycodone, topiramate, or valproate), seven had limited and inadequate data (antipsychotics, cannabinoids, combination therapy, gabapentin, lacosamide, monoamine oxidase inhibitors, NSAIDs), and two were subject to publication bias (amitriptyline, SSRI). Mirtazapine had moderate evidence of no effect. Duloxetine, milnacipran, and pregabalin had moderate/good evidence of substantial pain relief for 4-12 weeks in around 1 in 10 adults with moderate or severe FMS pain, without evidence of efficacy beyond six months. Serious adverse events were no more common than with placebo. There was no evidence about who might benefit or experience adverse events. There was no substantial efficacy evidence for other medicines. Duloxetine, milnacipran, and pregabalin had good evidence that about 1 person in 10 with moderate or severe pain experienced pain intensity reduction by at least 50%.

Improving Healthcare Professionals’ Reporting of Adverse Drug Reactions and Medication Errors

This article is a Russian translation of a Plain Language Summary (PLS) of a Cochrane Review previously published in the Cochrane Database of Systematic Reviews. Original publication: Shalviri G, Mohebbi N, Mirbaha F, Majdzadeh R, Yazdizadeh B, Gholami K, Grobler L, Rose CJ, Chin WY. Improving adverse drug event reporting by healthcare professionals. Cochrane Database Syst Rev. 2024;(10): CD012594. https://doi.org/10.1002/14651858.CD012594.pub2

Effectiveness of pharmacological therapies for fibromyalgia syndrome in adults: an overview of Cochrane Reviews.

To summarise and evaluate Cochrane reviews of pharmacological therapies for adults with fibromyalgia syndrome (FMS) pain. Systematic search of Cochrane Database of Systematic Reviews to May 2024. Generic quality assessment used AMSTAR-2 criteria, validity checks of potentially critical factors in evaluation of analgesic efficacy, and assessment of susceptibility of results to publication bias. Pain outcomes were participant-reported pain relief of ≥ 30% or ≥ 50%, or PGIC much or very much improved. Twenty-one reviews (87 trials, 17,631 patients) were included. All rated moderate (15) or high-quality (6) using AMSTAR-2 and at least seven of eight critical pain criteria were met by 13 of 21 reviews. Diagnosis of FMS used recognised criteria. Seven reviews found no trials (carbamazepine, clonazepam, lamotrigine, phenytoin, oxycodone, topiramate, or valproate), seven had limited and inadequate data (antipsychotics, cannabinoids, combination therapy, gabapentin, lacosamide, monoamine oxidase inhibitors, NSAIDs), and two were subject to publication bias (amitriptyline, SSRI). Mirtazapine had moderate evidence of no effect. Duloxetine, milnacipran, and pregabalin had moderate/good evidence of substantial pain relief for 4-12 weeks in around 1 in 10 adults with moderate or severe FMS pain, without evidence of efficacy beyond six months. Serious adverse events were no more common than with placebo. There was no evidence about who might benefit or experience adverse events. There was no substantial efficacy evidence for other medicines. Duloxetine, milnacipran, and pregabalin had good evidence that about 1 person in 10 with moderate or severe pain experienced pain intensity reduction by at least 50%.

Injury prevention programmes (IPPs) for preventing anterior cruciate ligament injuries.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the benefits and harms of injury prevention programmes on anterior cruciate ligament injuries.

Air versus supplemental oxygen for resuscitation of term or late preterm infants at birth.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To assess the benefits and harms of air compared with supplemental oxygen for resuscitation of term or late preterm infants at birth in reducing rates of mortality and long-term neurodevelopmental impairment (NDI). Secondary objectives To assess whether the benefits and harms of air compared with supplemental oxygen differ according to different oxygen concentrations, gestational age (GA), whether oxygen was titrated to saturation curves and the income of the study country.

An update of a systematic review and meta-analyses exploring flavours in intervention studies of e-cigarettes for smoking cessation.

To determine patterns of e-cigarette flavour use (sweet, tobacco, menthol/mint) in interventional studies of e-cigarettes for stopping smoking, and to estimate associations between flavours and smoking/vaping outcomes. Update of secondary data analyses, including meta-analyses subgrouped by flavour provision and narrative syntheses, incorporating data from January 2004 to February 2024. Eligible studies were identified from a Cochrane review. Studies provided adults who smoked cigarettes with nicotine-containing e-cigarettes for smoking cessation and provided data on e-cigarette e-liquid flavour use. Outcomes included participants' flavour use measured at any time, plus smoking abstinence, abstinence from all tobacco or commercial nicotine products and allocated product use at 6months or longer, reported as risk ratios with 95% confidence intervals. We assessed risk of bias using the Cochrane Risk of Bias 1 tool. We included 25 studies (n = 16 748); 21 contributed to subgroup meta-analyses and 18 provided flavour choices. We judged 15 studies at high, seven at low and three at unclear risk of bias. In studies where participants had a choice of flavours, some switching between flavours occurred (five studies). A preference for sweet (including fruit) flavours over tobacco and menthol was indicated (in 6 of 11 studies); however, there were differences across studies. Subgroup meta-analyses showed no clear associations between e-liquid flavours provided and smoking cessation or study product use. One included study randomised participants to two different flavour conditions and found similar cessation rates and long-term e-cigarette use between arms at 12 months. Some people using e-cigarettes to quit smoking switch between e-cigarette flavours during a quit attempt. Sweet flavours may be preferred overall, but this may differ depending on context. Based on intervention studies, there is no clear association between the use of e-cigarette flavours and smoking cessation or longer-term e-cigarette use, possibly due to a paucity of data.

Airway management and ventilation strategy among obese adult patients: a comprehensive review and analysis

Background: Difficulties with mask ventilation and intubation are more prevalent in obese patients. Hence, health care practitioners engaged in airway management of obese individuals must exercise particular vigilance and care. Ventilation strategies can potentially have a detrimental impact on postoperative pulmonary function, prolong hospital stays, and increase costs. As a result, the aim of this review was to investigate airway management technique and ventilation strategies in obese adult patients. Methods: The PubMed, HINARI, Google Scholar, and Cochrane Review databases were searched using appropriate keywords and search engines for adequate evidence from studies meeting the inclusion criteria to reveal the endpoint, which was ventilation strategy and airway management in adult obese patients. Duplicate entries were eliminated through EndNote software. Screening of literature was conducted with proper appraisal checklist. This review was reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses 2020 statement. Results: The included literature covers a wide range of topics, including preoxygenation, making the patient in a 25° head-up position, use of 10–12cmH2O of positive end-expiratory pressure (PEEP) and continuous positive airway pressure (CPAP) during induction, placing the patient in a ramping posture during intubation, high-flow oxygenation (15 L/min) through the nasopharyngeal airway or nasal cannula during laryngoscopy, using low tidal volume during surgery, a 1:1/1.5:1 I:E ratio, PEEP of 10–20 cmH2O, Fio2 reduced to make SpO2 &gt; 90, pressure-controlled (PC)/volume-controlled (VC) ventilation mode, and recruitment maneuver (RM). Following surgery, it was essential to provide oxygen therapy to maintain preoperative levels, provide CPAP/non-invasive positive pressure ventilation, place patients in semi-sitting positions, and provide thorough postanesthesia care unit monitoring in order to enhance patient outcomes with regard to morbidity and mortality among obese patients. To safely manage and overcome airway challenges in severely obese patients with a suspected difficult airway, awake fiberoptic intubation is recommended. Conclusions: Positioning the patient in a head-up position (semi-sitting), utilizing CPAP during preoxygenation, and administering oxygen via nasal cannula during intubation to prolong apnoea time and awake fibrotic for suspected difficult airway. Additionally, selecting appropriate ventilation modes (PC/VC), PEEP + RM, and positions during the intraoperative phase is crucial to improving outcomes in obese surgical patients.

The clinical applications of dual-layer spectral detector CT in digestive system diseases.

Dual-layer spectral detector CT (DLCT) has several advantages in clinical practice, this study aims to reveal the clinical applications of DLCT in digestive system diseases. We searched PubMed and Cochrane Reviews for articles published from January 1, 2010 to May 31, 2024, using the terms "dual-layer spectral detector CT" or "dual-layer CT" combined with "hepatic fat" or "hepatic fibrosis" "hepatocellular carcinoma" or "pancreatic ductal adenocarcinoma" or "pancreatic neuroendocrine tumors" or "gastric cancer" or "colorectal cancer" or "Crohn's disease" or "bowel ischemia" or "acute abdominal conditions". DLCT consists of a top layer sensitive to lower-energy photons and a bottom layer sensitive to higher-energy photons. This configuration enables simultaneous acquisition of two energy spectra from a single X-ray beam ensuring consistent spatial alignment and temporal resolution. Spectral raw images allow image post-processing to improve image quality, reduce radiation doses and contrast media doses, and generate multiple quantitative parameters. It has broad potential for early detection, accurate staging, efficacy assessment, and prognosis prediction of liver, pancreatic, and gastrointestinal diseases, as well as for the assessment of digestive system vasculature. DLCT not only provides valuable information for the clinical diagnosis and therapeutic effect evaluation of digestive system diseases but also may play a more important role in the overall management of digestive diseases and in the decision-making of individualized medicine. Question What are the advantages of DLCT compared to traditional single-energy CT in the early detection, staging, and therapeutic evaluation of digestive system diseases? Findings DLCT enhances image quality, improves tissue characterization, and allows for multi-parametric analysis, making it superior in detecting and evaluating liver, pancreatic, and gastrointestinal diseases. Clinical relevance DLCT provides high-quality, multi-parametric imaging that improves the accuracy of diagnosing digestive diseases, facilitates more precise treatment planning, and enhances monitoring of treatment response, ultimately contributing to better patient management and prognosis.

Clustering of care activities for promoting development and preventing morbidity in hospitalized preterm infants.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of clustering of care activities for promoting development and preventing morbidity in preterm infants.