Background:Perimenopausal Syndrome (PS) results from estrogen fluctuations due to ovarian dysfunction, leading to autonomic and neuropsychological symptoms. Existing therapeutic methods have certain limitations, and integrated Chinese-Western medicine (ICWM) treatment can achieve complementary advantages. Methods:We defined 16 clinical questions and outcomes for PS and searched CNKI, PubMed, the Cochrane Library, and other databases and relevant websites from inception to August 29, 2025. Relevant clinical practice guidelines/consensus statements (CPGs/CSs), systematic reviews (SRs), and randomized controlled trials (RCTs) were included, and their methodological quality was apprised using AGREE II, AMSTAR 2, and ROBUST-RCT, respectively. Data synthesis and visualization were performed using Microsoft Excel 2021 and R. Results:280 studies (5 CPGs/CSs, 38 SRs, 237 RCTs) were included, of which 84.6% were Chinese publications. Acupuncture and oral Chinese herbal medicine (CHM) had abundant evidence, some Chinese Medicine interventions had little or no evidence, and study quality varied across types. Evidence summaries showed acupuncture versus conventional Western therapy and integrated oral CHM and western medication (WM) versus WM alone were superior or equivalent in efficacy and safety for PS. Conclusions:This study mainly assesses the available evidence on acupuncture and integrated oral CHM and WM interventions for PS. Both treatment strategies demonstrate potential benefits for PS. Nevertheless, inconsistencies in the evidence base across different interventions, methodological shortcomings, and limited international applicability weaken the overall quality of current findings. Future research should target these gaps to advance evidence-based, personalized ICWM strategies, improving outcomes for women with PS worldwide.

Health economics evidence plays an important role in linking clinical value evidence with health resource allocation decisions in the development of clinical practice guidelines. It can not only effectively balance clinical effectiveness and economic feasibility but also avoid forming "idealized" recommendations that are detached from the affordability of the healthcare system or the burden-bearing capacity of patients. To promote guideline developers to use health economics evidence more standardizedly and fully, this paper conducts an in-depth analysis of the current application status, existing challenges, access channels, and application processes of health economics evidence in current guidelines, and on this basis, puts forward considerations and suggestions for strengthening and standardizing the application of health economics evidence in China's clinical practice guidelines.

BACKGROUND:This guideline aims to address key clinical questions of long COVID, and to provide evidence-based recommendations. The target population is adults with long COVID. The primary users of the guideline are clinical physicians, clinical pharmacists, nurses and general practitioners in community healthcare institutions worldwide. METHODS:The guideline was registered at the Practice guideline REgistration for transPAREncy platform (PREPARE-2024CN123) and followed a pre-specified protocol. A multidisciplinary working group was established and comprised 60 members from 10 countries and 10 areas of expertise, with a strong background in long COVID research and clinical practice, and methodology of guideline development. Through a two-step process, we determined eight PICO (Population, Intervention, Comparator, Outcome) questions focusing on prevention and treatment of long COVID. After comprehensively searching literature, conducting systematic reviews and investigating patients' values and preferences, three rounds of Delphi survey were conducted among 24 international experts to reach consensus. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach was applied to rate the certainty of evidence and determine the strength of recommendations. RESULTS:The guideline presents 10 specific recommendations, each supported by existing, updated or newly conducted systematic reviews. The key recommendations are pertinent to the following issues: 1) suggestion of vaccination or use of antiviral agents during the acute phase of COVID-19 to prevent long COVID; 2) suggestions against the use of nirmatrelvir/ritonavir and glucocorticoids (patients with persistent respiratory symptoms and olfactory disorders) for long COVID treatment; 3) suggestions supporting the use of multispecies probiotics, cognitive behavioural therapy (patients with fatigue), and personalised rehabilitation (after ruling out post-exertional malaise) for long COVID treatment. CONCLUSIONS:This guideline provides evidence-based recommendations for the prevention and treatment of long COVID. Given the limited and often low-methodological-quality evidence, all recommendations are supported by very low to moderate certainty. Further high-quality studies are needed to strengthen the evidence base.

The importance of consensus research in medical decision-making has become increasinglyprominent. However, this field has long lacked unified terminology definitions and reporting standards, leading to significant heterogeneity in study design, implementation, and result presentation that affects the credibility and reproducibility of outcomes. The ACCurate COnsensus Reporting Document (ACCORD) in the field of biomedical research provides a structured writing framework for various consensus methods such as the Delphi method and nominal group technique, aiming to enhance the completeness and transparency of study reports. Combined with specific cases, this article interprets the core items of ACCORD, offering references for the design, implementation, and reporting of high-quality consensus research in China.

Background Radiological case reports summarize the imaging characteristics of individual cases to identify patterns and valuable lessons. Their writing can be guided by the CARE reporting guidelines or the CARE-radiology reporting guidelines. However, the impact of following these guidelines, or not following them, on the quality and efficiency of radiological case reports writing remain unclear. Objective To examine whether following the CARE reporting guidelines or the CARE-radiology reporting guidelines, or not following any reporting guidelines, affects the quality and writing efficiency of radiological case reports. Protocol The purpose of this protocol is to outline the background and objectives of this study, as well as the design of a cluster randomized controlled trial (cRCT). We will design a three-arm, multicentre cRCT, targeting radiologists or radiology students from different medical institutions. The intervention include training on the CARE-radiology checklist; the second intervention involves training on the CARE checklist. The control group will follow standard procedures without any intervention. After the intervention, participants will be required to write a case report within a period of 10 days. The primary outcome measures will be the completeness and clarity of the case reports. Discussion This study aims to enhance the adherence of researchers to reporting guidelines for case reports through rigorous design. The results will be further explained and interpreted in the final trial outcomes. Registration This study has been registered with the Chinese Clinical Trial Registry, with the registration number: ChiCTR2400089973.

Objective:To analyze the disease burden of opioid use disorder (OUD) in China from 1990 to 2021 and predict its future trends. Methods:Annual data from the Global Burden of Disease (GBD 2021) database were used to describe the disease burden through metrics such as prevalence, incidence, mortality, and disability-adjusted life years (DALYs). Joinpoint regression models were employed to analyze trends in disease burden. The estimated annual percentage change (EAPC) was calculated to quantify the temporal trends in age-standardized rates (ASRs). The age-period-cohort (APC) model explored age, period, and cohort effects on the OUD burden. Health inequality analyses examined the relationship between the OUD burden and the Sociodemographic Index (SDI). The autoregressive integrated moving average (ARIMA) model was used to forecast the OUD disease burden over the next 15 years. Results:Compared to 1990, the OUD-related disease burden in China declined across various indicators by 2021, with a significant decrease in the age-standardized mortality rate (EAPC = -5.26). Meanwhile, the global disease burden of OUD increased. In China, females, individuals aged 15-24 years, and recent birth cohorts showed higher disease burdens. Over time, the relationship between DALYs and SDI gradually weakened. Projections suggest that the burden of OUD in China is expected to increase over the next 15 years. Conclusion:Opioid misuse is a significant factor contributing to the global disease burden and challenges in anesthetic and surgical care. Effective measures are urgently needed to reduce the burden of opioid dependence and promote advancements in pain-free medical care.

OBJECTIVE:To evaluate the methodological and reporting quality of clinical practice guidelines/expert consensus for ambulatory surgery centers published since 2000, combining manual assessment with large language model (LLM) analysis, while exploring LLMs' feasibility in quality evaluation. METHODS:We systematically searched Chinese/English databases and guideline repositories. Two researchers independently screened literature and extracted data. Quality assessments were conducted using AGREE II and RIGHT tools through both manual evaluation and GPT-4o modeling. RESULTS:54 eligible documents were included. AGREE II domains showed mean compliance: Scope and purpose 25.00%, Stakeholder involvement 20.16%, Rigor of development 17.28%, Clarity of presentation 41.56%, Applicability 18.06%, Editorial independence 26.39%. RIGHT items averaged: Basic information 44.44%, Background 36.11%, Evidence 14.07%, Recommendations 34.66%, Review and quality assurance 3.70%, Funding and declaration and management of interests 24.54%, Other information 27.16%. LLMs'-evaluated documents demonstrated significantly higher scores than manual assessments in both tools. Subgroup analyses revealed superior quality in documents with evidence retrieval, conflict disclosure, funding support, and LLM integration (P <0.05). CONCLUSION:Current guidelines and consensus related to day surgery need to improve their methodological quality and quality of reporting. The study validates LLMs' supplementary value in quality assessment while emphasizing the necessity of maintaining manual evaluation as the foundation.

To improve the standard screening, diagnosis, and treatment of hypertension in patients in China; realize the standardization of clinical practice of hypertension; and improve the prevention and control level of hypertension in China, it is both important and necessary to develop a clinical practice guideline for hypertension according to a recognized methodology. Jointly sponsored by the National Center for Cardiovascular Diseases, Chinese Medical Doctor Association, Hypertension Committee of the Chinese Medical Doctor Association, Chinese Society of Cardiology, and Hypertension Committee of Cross-Straits Medicine Exchange Association, the “Chinese Clinical Practice Guidelines of Hypertension” was proposed. Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences, Guideline and Standards Research Centre of Chinese Medical Association Publishing House, Lanzhou University Institute of Health Data Science, and Lanzhou University GRADE Center will provide methodological support for the guidelines.

Objective To promote the development of high-quality health standards in China and summarize the characteristics of global health standards management systems and development processes. Methods We conducted a systematic search of relevant databases and the websites of standardization institutions. A descriptive method was used to analyze the basic characteristics of the standard management systems and development processes. Results The majority of the investigated countries and organizations primarily implement voluntary standards, with the exception of Chinese and the European Committee for Standardization that enforce compulsory standards. All countries and organizations have health standards at the national, group, and enterprise levels. In China and Japan, standards authorities are subordinate to the government, while in other countries or organizations, they operate as independent civil societies. The development process for health standards generally involves five stages: 'Project/Proposal → Draft → Enquiry → Review → Publication'. However, the specific steps in the development of health standards vary across different countries and organizations. Furthermore, China ranks high in the number of both standards and health standards issued, but the proportion of health standards is only 2.06%. Conclusions There are significant differences between China and other countries in terms of the management system and development process of health standards. To promote the management and development of high-quality health standards in China, we recommend promoting the coordination mechanism for standard development, increasing efforts to publicize standards and evaluate the implementation effect, strengthening the construction of personnel for the development of health standards, optimizing the efficiency of standard development and improving the internationalization level of health standards.

The development of patient and public versions of guidelines (PVGs) in China is still in its early stages. The aim of this article is to systematically identify the PVGs published or released in China, analyse their development methods, and assess their reporting quality. We searched five major literature databases and conducted supplementary searches to identify all PVGs published or released by 8 January 2023 in China. After screening the literature according to the inclusion and exclusion criteria, we analysed the development methodology and evaluated the reporting quality of the included PVGs using the Reporting Items for Practice Guidelines in Healthcare-Public or Patient Versions of Guidelines (RIGHT-PVG). We reported this systematic review in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 3795 records were first identified, and 17 PVGs were included. Nine PVGs reported their development methodology: seven used de novo development (similar to developing clinical practice guidelines [CPGs]), and two rewrote the recommendations of an existing CPG. The reporting quality differed substantially between the PVGs. The PVGs adhered to between 8 and 16 (47.1%–94.1%) of the 17 RIGHT-PVG items, with a median of 9. All PVGs specified the topic addressed in the PVGs, introduced the target condition, described the purpose, scope and target users and had precise recommendations. In contrast, none of the PVGs listed questions for patients to ask their healthcare providers. Only few PVGs have so far been released in China. Most PVGs were developed de novo from the evidence, while some were instead rewritten from an existing CPG. In addition, we encourage PVGs developers to follow RIGHT-PVG checklist when writing the guidelines in the future.

OBJECTIVES:To investigate the frequency, determinants, stages, and barriers of patient and public involvement (PPI) in systematic reviews and to explore its association with the dissemination of reviews. STUDY DESIGN AND SETTING:We examined systematic reviews that required the inclusion of a PPI declaration, published in The BMJ between January 1, 2015, and December 31, 2022. Multivariable analysis was used to assess the association between PPI and key variables. We investigated the association between PPI and the dissemination of reviews using Altmetric scores, citations, and full-text views. RESULTS:A total of 217 systematic reviews were included, of which 56 (25.8%, 95% CI 20.0%-31.6%) included PPI, with a steady increase from 5.9% (1/17) in 2015 to 44.4% (4/35) in 2022. Of the 217 systematic reviews, 160 (73.7%) involved methodologists as co-authors. Factors significantly associated with a higher proportion of PPI included the publication year after 2019 (adjusted odds ratio [aOR] 2.46, 95% CI 1.26-4.83), the involvement of methodologist (aOR 3.08; 95% CI 1.27-7.47), and being led by researchers from high-income countries (aOR 5.47; 95% CI 1.23-24.30). Reviews that included PPI had higher Altmetric scores per month (6.6 vs 3.4, P = .002) and more monthly full-text (1048.6 vs 636.5, P < .001) and PDF (217.7 vs 129.0, P < .001) views than reviews without PPI. However, there was no difference in the monthly citations (2.2 vs 2.0, P = .365) between reviews with and without PPI. CONCLUSION:The proportion of systematic reviews reporting PPI in The BMJ has increased over time, possibly due to journal policies, but it still remains at a low level. Reviews led by researchers from high-income countries or involving methodologists are associated with a higher frequency of PPI within The BMJ. Furthermore, reviews incorporating PPI within The BMJ have a higher potential for broad dissemination.

National health standards involve all kinds of technical requirements formulated and numbered in accordance with the procedures and formats stipulated in the standardisation system for the implementation of national health and hygiene laws, regulations and policies, and the protection of human health. The establishment of health standards in China should align with our legal framework, including laws, regulations, departmental rules, and health and hygiene policies. During the development of these standards, a comprehensive approach is advocated, encompassing in-depth investigations, rigorous demonstrations, and extensive stakeholder engagement. However, the process of standard formulation may suffer from insufficient research evidence. The evidence-based concept emphasizes the significance of evidence. Therefore, integrating evidence-based concept into the process of developing health standards can enhance the quality and scientific basis of these standards. This article systematically elucidates the current status and development process of health standards in China, explores the necessity and feasibility of incorporating evidence-based concept into the development of these standards, analyzes the challenges and opportunities, and presents reflections and suggestions.

OBJECTIVES:To systematically collect and analyse diverse definitions of 'evidence' in both health and social sciences, and help users to correctly use the term 'evidence' and rethink what is the definition of 'evidence' in scientific research. DESIGN:Scoping review. METHODS:Definitions of evidence in the health sciences and social sciences were included. We have excluded the definition of evidence applied in the legal field, abstracts without full text, documents not published in either Chinese or English and so on. We established a multidisciplinary working group and systematically searched five electronic databases including Medline, Web of Science, EBSCO, the Chinese Social Sciences Citation Index and the Chinese Science Citation Database from their inception to 26 February 2022. We also searched websites and reviewed the reference lists of the identified studies. Six reviewers working in pairs, independently, selected studies according to the inclusion and exclusion criteria, and extracted information. Any differences were discussed in pairs, and if there was disagreement, it was resolved via discussion or with the help of a third reviewer. Reviewers extracted document characteristics, the original content for the definitions of 'evidence', assessed definitions as either intensional or extensional, and any citations for the given definition. RESULTS:Forty-nine documents were finally included after screening, and 68 definitions were obtained. After excluding duplicates, a total of 54 different definitions of 'evidence' were identified. There were 42 intensional definitions and 12 extensional definitions. The top three definiens were 'information', 'fact' and 'research/study'. The definition of 'evidence' differed between health and social sciences. The term 'research' appeared most frequently in the definitions. CONCLUSIONS:The definition of 'evidence' has gradually attracted the attention of many scholars and decision-makers in health and social sciences. Nevertheless, there is no widely recognised and accepted definition in scientific research. Given the wide use of the term, we need to think about whether, or under what circumstances, a standardised, clear, meaningful and widely applicable definition of 'evidence' might be helpful.

OBJECTIVES:Systematic reviews (SRs) are becoming essential evidence in the decision-making process within the field of social sciences. This study aimed to investigate how Campbell SRs were cited and explore their specific application roles. STUDY DESIGN AND SETTING:We included Campbell SRs published between 2016 and 2020 by searching the Wiley online library, and retrieved the articles and documents citing Campbell SRs from the Web of Science and Google Scholar by December 31, 2021. We described the characteristics of the SRs and citations, and formulated a set of application roles by analyzing the sentences or paragraphs where the SRs were cited. RESULTS:Sixty nine Campbell SRs were published between 2016 and 2020; they were cited in 641 articles or documents a total of 1,289 times. The primary types of articles that cited Campbell SRs were cross-sectional studies (n = 226, 35.3%), SRs (n = 112, 17.5%), randomized controlled trials (n = 77, 12.0%), and policy reports (n = 57, 8.8%). Articles utilizing Campbell SRs were predominantly led by authors from the United States (n = 184, 28.7%), the United Kingdom (n = 98, 15.3%), and Australia (n = 51, 8.0%). We formulated a set of 10 application roles for the Campbell SRs, of which the most frequent were: describing the current status in the field of interest (n = 691, 53.6%), corroboration of the results (n = 140, 10.9%), identifying research gaps (n = 130, 10.1%), and providing methodological references (n = 126, 9.8%); the role of supporting policy recommendations or decisions accounted for 6.0% (n = 77) of the citations. Approximately 12% of Campbell SRs were used to support policy recommendations or decisions. CONCLUSION:Campbell SRs are widely applied, particularly in scientific research, to describe the current status in the field of interest. Although the current application of Campbell SRs in supporting policy recommendations and decisions may not be predominant, there is a growing recognition of their value in using Campbell SRs to inform decision-making.

目的 了解甘肃省居民结核病防治知识知晓情况,并分析其影响因素,为结核病防控工作提供科学依据.方法 采用横断面研究设计,根据甘肃省各市(州)经济水平,利用多阶段分层随机抽样法,抽取甘肃省兰州市、定西市和武威市的常住居民451人为调查对象,于2021年3-4月开展面对面问卷调查.利用SPSS 26.0软件对结核病防治知识知晓率及其影响因素进行x2检验及多因素Logistic回归分析.结果 本研究共收集451份有效问卷,受访居民结核病防治知识总知晓率为76.00％.不同性别(x2=33.330)、年龄(x2=34.499)、文化程度(x2=65.553)、职业(x2=23.842)、家庭人均月收入(x2=11.320)、是否吸烟(x2=25.646)、是否饮酒(x2=15.051)、近3个月健康状况自评结果(x2=46.187)和是否具备健康素养(x2=103.211)的组间结核病防治知识总知晓率比较,差异均有统计学意义(P均＜0.05).多因素Logistic回归分析结果显示,以18～30岁年龄组为对照,41～50、51～60、＞60岁年龄组结核病防治知识知晓情况均更好,OR值分别为3.556(95％CI:1.146～11.032)、4.990(95％CI:1.573～15.827)、4.756(95％CI:1.301～17.392);以健康自评状况为"良好"的居民为对照,健康自评状况为"一般"和"差"的居民结核病防治知晓情况较差,OR值分别为0.486(95％CI:0.250～0.942)和0.254(95％CI:0.112～0.578);以不具备健康素养的居民为对照,具备健康素养的居民结核病知识知晓情况更好(OR=3.902,95％CI:1.621～9.392).结论 甘肃省居民结核病防治知识知晓率有待提高,应加强对女性、青年群体、低文化程度以及农民等人群的结核病政策宣传及健康教育,创新健康知识宣传途径和方式,注重网络新媒体与传统媒体相结合的宣传方式,提高居民健康素养,进而促进结核病防治知识知晓度提升.

Patient and public versions of guidelines (PVG) have attracted increasing attention in China, and their number is also on the rise. This article explores the methods for the development of PVG, introduces and compares different development methods, and incorporates case studies for interpretation, with the aim of providing reference for the developers of PVG and further promoting the development of PVG in China.

This study conducted a comprehensive assessment of the current state of health standards in China by systematically searching the National Health Commission's Health Standards website and variousliterature databases. By identifying key issues within the domain of health standards, this study subsequently presentstargeted strategies and recommendations. These findings serve as a valuable reference for refining China's health standard system and developing policies related to health standards.

Evidence synthesis is the synthesis of existing research using a systematic and appropriate method. Various types of evidence synthesis are currently in use. Correctly choosing and applying the best evidence synthesis method is crucial for researchers, policymakers, and stakeholders. Thus, based on summarizing the current situation, progress, and classification of evidence synthesis methods, we introduced the definition and characteristics of common evidence synthesis methods and problems in their application, and presented thoughts and suggestions for the problems in the application of evidence synthesis methods.

Background:early-stage esophageal carcinoma (EC) patients lack typical clinical signs and symptoms and are often diagnosed and treated at a late stage, leading to a poor prognosis and a high incidence of metachronous esophageal squamous cell carcinoma (MESCC) and second primary carcinoma (SPC). The aims of the review were to identify and quantify risk factors for MESCC and analysis location of SPC in postoperative patients with EC; to predict incidence of MESCC over follow-up time.Methods:an electronic search of studies reporting potential risk factors, the incidence of MESCC, and the location of SPC were performed on PubMed, Web of Science, Cochrane Library, Embase, and Scopus from inception to 10 November 2022. The Newcastle-Ottawa scale was used to assess the study quality, and the qualitative strength of evidence rating of all items was provided. The meta-regression model was used to predict the incidence of MESCC over follow-up time, the location distribution of SPC was presented using clustered column chart, while the publication bias was assessed using funnel plots and Egger's test.Results:smoking, age, history of multiple other cancer, and Lugol-voiding lesions (LVLs) were determined to be the risk factors of MESCC. LVLs were qualitatively determined as "definite" and the history of multiple other cancer as "likely." The overall pooled MESCC incidence was 20.3% (95% CI: 13.8% to 26.8%), with an increase of 0.20% for each additional year of follow-up. The head and neck were the most common locations for SPC, followed by the esophagus.Conclusion:timely investigating the age of patients, previous history of cancer and monitoring the number of LVLs in the first 5 years after operation are of great significance to identify high-risk populations of MESCC for timely medical care. Education and behavior correction about smoking are advocated. Tumor markers should be regularly detected in the head and neck, esophagus, and stomach. Endoscopic resection was associated with a higher incidence of MESCC, which provided a reference for doctors to choose the removal method.Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022377030.

Objectives: To systematically analyze the use of evidence assessment tools in systematic reviews of management and education. Study design and setting: We systematically searched selected literature databases and websites to identify systematic reviews on management and education. We extracted general information of the included studies and information about the evidence assessment tool they applied, including whether it was used for methodological quality assessment, reporting quality assessment or evidence grading, as well as the name, reference, publication year, version and original intended use of the tool, the role of the tool in the systematic review, and whether the quality determination criteria were given. Results: A total of 299 systematic reviews were included, of which only 34.8% used evidence assessment tools. A total of 66 different evidence assessment tools were used, of which Risk of Bias (ROB) and its updated version (n = 16, 15.4%) were the most frequent. The specific roles of the evidence assessment tools were reported clearly in 57 reviews, and 27 reviews used two tools. Conclusion: Evidence assessment tools were seldom used in systematic reviews in social sciences. The understanding and reporting of evidence assessment tools among the researchers and users still needs improvement.