ObjectiveTo introduce sensitivity and homogeneity tests in network meta-analysis and its implementation in R software. MethodsUsing an example, we performed sensitivity analysis by comparing the random effect model with the fixed effect model. Homogeneity analysis was performed using metaphor package and combinat package in R software. ResultsThe results of the two models were similar, and the data was steady. The results of homogeneity analysis showed that the confidential intervals in all loops were crossed over with blank value; and direct and indirect estimates of the effects in network meta-analysis were not significantly different, with good homogeneity. ConclusionNetwork meta-analysis is a kind of indirect comparison analysis method, and its sensitivity is especially important. The introduction of homogeneity makes network meta-analysis more accurate. Using R software for sensitivity and homogeneity analysis in network meta-analysis is a feasible method.
Measurement properties studies of patient-reported outcome measures (PROMs) aims to validate the measurement properties of PROMs. In the process of designing and statistical analysis of these measurement properties studies, bias will occur if there are any defects, which will affect the quality of PROMs. Therefore, the COSMIN (consensus-based standards for the selection of health measurement instruments) team has developed the COSMIN risk of bias (COSMIN-RoB) checklist to evaluate risk of bias of studies on measurement properties of PROMs. The checklist can be used to develop systematic reviews of PROMs measurement properties, and for PROMs developers, it can also be used to guide the research design in the measurement tool development process for reducing bias. At present, similar assessment tools are lacking in China. Therefore, this article aims to introduce the primary contents of COSMIN-RoB checklist and to interpret how to evaluate risk of bias of the internal structure studies of PROMs with examples.
This study sought to reveal the difference of brain functions at resting-state between subjects with sub-health and normal controls by using the functional magnetic resonance imaging (fMRI) technology. Resting-state fMRI scans were performed on 24 subjects of sub-health and on 24 healthy controls with gender, age and education matched with the sub-health persons. Compared to the healthy controls, the sub-health group showed significantly higher regional homogeneity (ReHo) in the left post-central gyrus and the right post-central gyrus. On the other hand, the sub-health group showed significantly lower ReHo in the left superior frontal gyrus, in the right anterior cingulated cortex and ventra anterior cingulate gyrus, in the left dorsolateral frontal gyrus, and in the right middle temporal gyrus. The Significant difference in ReHo suggests that thebsub-health persons have abnormalities in certain brain regions. It is proved that its specific action and meaning deserves further assessment.
目的 利用局部一致性（ReHo）方法探测创伤后应激障碍（PTSD）患者在静息状态下是否存在着大脑功能异常。 方法 2010年5月－7月对18例未经治疗的地震PTSD患者和19例同样经历地震但未患PTSD的对照者进行了静息态功能磁共振成像（Rs-fMRI） 扫描。应用ReHo方法处理Rs-fMRI数据，得出PTSD患者的异常脑区，并将患者存在组间差异的脑区ReHo值与临床用PTSD诊断量表（CAPS）、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）分别进行相关分析。 结果 ① PTSD组ReHo显著增加的脑区包括右侧颞下回、楔前叶、顶下叶、中扣带回，左侧枕中回以及左/右侧后扣带回；ReHo显著降低的脑区包括左侧海马和左/右侧腹侧前扣带回。② 异常脑区中后扣带回和右侧中扣带回ReHo与HAMD呈负相关（中扣带回r=?0.575，P=0.012；右侧后扣带回：r=?0.507，P=0.032），其余脑区ReHo与临床指标无明显相关性（P＞0.05），左侧海马与CAPS的相关性相对其他脑区较大（r=?0.430，P=0.075）。 结论 PTSD患者在静息状态下即存在着局部脑功能活动的降低和增加，ReHo方法可能有助于研究PTSD患者静息状态脑活动。
Objectives To evaluate the reporting quality of Bland-Altman method consistency evaluation in China from 2014 to 2016. Methods WanFang Data, VIP and CNKI databases were electronically searched to collect literature about the application of Bland-Altman method from 2014 to 2016 in China. Two reviewers screened literature, extracted data, and the data were then statistically analyzed by SPSS 22.0 software. Results A total of 376 articles were included. The published articles on Bland-Altman method had major flaws (not conforming to reporting standards) in the application conditions, evaluation indexes, graphic depiction and so on. Merely 11.4% of the literature set the clinically acceptable consensus values in the pre-period studies. Merely one literature (0.3%) correctly compared the 95%CI of 95%LoA with the clinically acceptable threshold which had been set previously. The offer rates of the differences between the two measurements and the 95%CI, 95%LoA and 95%CI of 95%LoA in the figure were 95.9%, 9.5%, 94.6% and 4.4%, respectively. Conclusions The reporting quality of Bland-Altman method consistency evaluation in China is of low quality, specifically not conforming to reporting standards. We should strengthen the introduction of Bland-Altman methodology to improve the reporting quality.
The aim of this paper is to reveal the change of the brain function for nicotine addicts after smoking cessation, and explore the basis of neural physiology for the nicotine addicts in the process of smoking cessation. Fourteen subjects, who have a strong dependence on nicotine, have agreed to give up smoking and insist on completing the test, and 11 volunteers were recruited as the controls. The resting state functional magnetic resonance imaging and the regional homogeneity (ReHo) algorithm have been used to study the neural activity before and after smoking cessation. A two factors mixed design was used to investigate within-group effects and between-group effects. After 2 weeks’ smoking cessation, the increased ReHo value were exhibited in the brain area of supplementary motor area, paracentral lobule, calcarine, cuneus and lingual gyrus. It suggested that the synchronization of neural activity was enhanced in these brain areas. And between-group interaction effects were appeared in supplementary motor area, paracentral lobule, precentral gyrus, postcentral gyrus, and superior frontal gyrus. The results indicate that the brain function in supplementary motor area of smoking addicts would be enhanced significantly after 2 weeks’ smoking cessation.
Objective To investigate an evaluation method of medical literature applicability to clinical work， and provide a convenient way for physicians to search for the best evidence. Methods Delphi method was used to choose appropriate evaluating indexes， analytic hierarchy process was performed to determine the weighing of each index， and the formula to calculate medical literature applicability was formed. The practicability of this formula was evaluated by consistency checking between the formula’s results and experts’ opinions on literature applicability. Results Five evaluating indexes were determined， including literature’s publishing year （X1）， whether the target questions were covered （X2）, sample size （X3）， trial category （X4）， and journal level （X5）. The formula to calculate medical literature applicability was Y=3.93 X1＋11.78 X2＋14.83 X3＋44.53 X4＋24.93 X5. The result of consistency checking showed that the formula’s results were highly consistent with experts’ opinions （Kappa=0.75， P＜0.001）. Conclusion The applicability formula is a valuable tool to evaluate medical literature applicability.
The gait acquisition system can be used for gait analysis. The traditional wearable gait acquisition system will lead to large errors in gait parameters due to different wearing positions of sensors. The gait acquisition system based on marker method is expensive and needs to be used by combining with the force measurement system under the guidance of rehabilitation doctors. Due to the complex operation, it is inconvenient for clinical application. In this paper, a gait signal acquisition system that combines foot pressure detection and Azure Kinect system is designed. Fifteen subjects are organized to participate in gait test, and relevant data are collected. The calculation method of gait spatiotemporal parameters and joint angle parameters is proposed, and the consistency analysis and error analysis of the gait parameters of proposed system and camera marking method are carried out. The results show that the parameters obtained by the two systems have good consistency (Pearson correlation coefficient r ≥ 0.9, P < 0.05) and have small error (root mean square error of gait parameters is less than 0.1, root mean square error of joint angle parameters is less than 6). In conclusion, the gait acquisition system and its parameter extraction method proposed in this paper can provide reliable data acquisition results as a theoretical basis for gait feature analysis in clinical medicine.
ObjectivesTo analyze the application value of 6-minute walking test (6MWT) in the clinical evaluation of chronic heart failure (CHF).MethodsPubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were searched online to collect randomized controlled trials (RCTs) of 6-minute walking distance (6MWD) as the CHF evaluation index. Two reviewers independently screened literature, extracted data, and then analyzed data by using SPSS 17.0 statistical software. The 6MWD with symptom, quality of life, exercise tolerance (ETT), left ventricular ejection fraction (LVEF), peak oxygen consumption (pVO2) were analyzed by Kappa consistency test, and the possible influencing factors of 6MWD were analyzed by logistic regression.ResultsA total of 158 RCTs involving 17 853 patients were included. The results of statistical analysis showed that: 6MWD was consistent with the improvement of symptoms, quality of life, ETT, LVEF and pVO2 (Kappa>0.4). Baseline 6MWD (OR=2.91, 95%CI 1.278 to 6.634,P=0.011) and NYHA Ⅲ-Ⅳ ratio (OR=2.59, 95%CI 1.091 to 6.138, P=0.031) were the independent influencing factors for 6MWD improvement separately.ConclusionsThe 6MWT is an objective and reliable indicator of CHF evaluation.