Guanjian Liu

Selenium for preventing Kashin-Beck osteoarthropathy in children: a meta-analysis

OBJECTIVE To assess the efficacy of selenium supplementation for prevention of Kashin-Beck Osteoarthropathy in children. METHODS We searched eight electronic databases and seven journals (upto July 2007) to identify randomized controlled trials (RCTs) and prospective non-RCTs comparing selenium supplementations with placebo or no intervention for preventing Kashin-Beck disease (KBD). The methodological qualities of included studies were assessed according to the guidelines of Cochrane Handbook for Systematic Reviews of Interventions for RCTs and the method described by Deeks et al. for non-RCTs. Outcomes were presented as Peto-odds ratios (Peto-ORs) with 95% confidence intervals (95% CIs) based on fixed effect model. The number needed to treat (NNT) was calculated. Meta-regression was also conducted to explore the possible impacts of potential confounding variables (place of study, age, selenium form, etc.) of included trials on the incidence of KBD. RESULTS Five RCTs and 10 non-RCTs were included in this review. The methodological quality of included studies was low. The pooled Peto-OR and NNT favoring selenium supplement was 0.13 (95% CI: 0.04-0.47) and 21 in RCTs, and 0.16 (95% CI: 0.09-0.30) and 26 in non-RCTs. Meta-regression indicated that the effect of potential confounding variables on KBD incidence was not statistically significant. One trial reported the side effects of nausea and vomiting in the process of selenium supplementation. CONCLUSIONS Current evidence supports the benefits of selenium supplementation for prevention of KBD in children. However, the evidence was limited by potential biases and confounders. Large, well-designed trials are still needed.

Quality assessment of reporting of randomization, allocation concealment, and blinding in traditional Chinese medicine RCTs: a review of 3159 RCTs identified from 260 systematic reviews.

BackgroundRandomized controlled trials (RCTs) which are of poor quality tend to exaggerate the effect estimate and lead to wrong or misleading conclusions. The aim of this study is to assess the quality of randomization methods, allocation concealment and blinding within traditional Chinese medicine (TCM) RCTs, discuss issues identified for current TCM RCTs, and provide suggestions for quality improvement.MethodsWe searched Chinese Biomedical Database (CBM, 1978 to July 31, 2009) and the Cochrane Library (Issue 2, 2009) to collect TCM systematic reviews and meta-analyses according to inclusion/exclusion criteria, from which RCTs could be identified. The quality assessment involved whether the randomization methods, allocation concealment and blinding were adequate or not based the study reported. Stratified analyses were conducted of different types of diseases published in different journals (both Chinese and foreign) using different interventions. SPSS 15.0 software was used for statistic analyses.ResultsA total of 3159 RCTs were included, of which 2580 were published in Chinese journals and 579 in foreign journals. There were 381 (12%) RCTs which used adequate randomization methods; 207 (7%) RCTs which used adequate allocation concealment and 601 (19%) which used adequate blinding; there were 130 (4%) RCTs which both used adequate randomization methods and allocation concealment; and there were only 100 (3%) RCTs which used adequate randomization methods, allocation concealment, as well as blinding. In the RCTs published in foreign journals, the adequate randomization methods, allocation concealment and blinding accounted for a relatively large proportion (25%, 26%, and 60%, respectively) and increased with years, while in the RCTs published in Chinese journals, only the adequate randomization methods improved over time. The quality of non-drug intervention (chiefly acupuncture) RCTs was higher than that of drug intervention RCTs. In drug intervention, the quality of listed drugs is higher than the others. The quality of all included RCTs of all types of diseases was generally poor and no studies that were large in size and of high quality were found.ConclusionThe quality of the current TCM RCTs as judged by their publications is generally poor, especially those published in Chinese journals. In future, researchers of TCM RCTs should attach more importance to experimental design and methodological quality, receive relevant training, and improve reporting quality using the Consolidated Standards of Reporting Trials (CONSORT) statement, so as to improve the quality of TCM clinical research and ensure truth and reliability of conclusions.

Chinese Clinical Trial Registry: mission, responsibility and operation

As a national public clinical trial registry and a recognized Primary Registry of the WHO ICTRP, the Chinese Clinical Trial Registry (ChiCTR) has responsibility to disseminate knowledge about clinical trial transparency, which is an important ethical issue for healthcare studies involving humans, and to promote the quality of healthcare studies in China. This article describes the mission, policy and operation of the ChiCTR. We discuss the need to improve the quality of clinical trials and our ideas for new developments. The registration of clinical trials is an ethical responsibility and obligation for researchers. A clinical study is a public event itself, which needs the participation of the public, and its results should also be seen as a service to the public. Therefore, the public have the right to know how a study is progressing.

Effects of sulfonylureas on lipids in type 2 diabetes mellitus: a meta-analysis of randomized controlled trials.

Previous studies suggested that dyslipidemia was potentially associated with anti‐diabetic medications of sulfonylureas (SUs). The results were, however, inconsistent. Therefore, we conducted a meta‐analysis of randomized controlled trials (RCTs) to assess the effects of SUs on the level of lipids in patients with type 2 diabetes mellitus (T2DM).

Cancer risk of sulfonylureas in patients with type 2 diabetes mellitus: A systematic review

Increasing evidence suggests that oral hypoglycemic agents used in type 2 diabetes mellitus (T2DM) may affect cancer risk. Sulfonylureas (SUs) are the most frequently used antidiabetic medications for T2DM. Whether using SUs has any effect on cancer has received considerable attention. The aim of this study was to assess the effects of SUs on cancer risk in T2DM patients.

Study design and baseline characteristics of inpatients with diabetes mellitus in a tertiary hospital in China: A database study based on electronic medical records

To describe the characteristics of inpatients with diabetes in a tertiary hospital in China using an electronic medical record (EMR)‐based database.