Safety and effectiveness of opioid use in adult patients presenting to emergency services with suspected acute appendicitis: a protocol for a systematic review of the literature and network meta-analysis.

Introduction: Acute abdominal pain is a chief complaint in emergency departments and represents 7%-10% of emergency room (ER) visits. Acute appendicitis represents 15% of the causes of abdominal pain and 62% of the causes that require surgical treatment. Opioid analgesia has been evaluated in clinical trials, and they have determined it does not impact diagnostic accuracy.

Addressing the drug development challenge for rare pediatric diseases in Japan: a case study of isotretinoin.

Drug lag in rare pediatric diseases remains a significant challenge in Japan despite its sophisticated healthcare system. We examined this issue through a case study of isotretinoin, an established standard drug for high-risk neuroblastoma (affecting 45-60 new patients annually in Japan) since the 2000s that has not been granted regulatory approval in Japan as of 2025. Analysis of regulatory documents and clinical practices revealed that while isotretinoin has demonstrated improved event-free survival rates in international trials when used as maintenance therapy for high-risk neuroblastoma, multiple barriers have hindered its domestic approval.

Fostering innovation and advancement in evidence-based practice and guidelines within the field of pediatrics: The 2024 BRIGHT declaration.

The first Better evidence and RecommendatIons for the next Generation HealTh-BRIGHT symposium was held in Chongqing, China between June 21 and 23, 2024. The symposium did not only showcase the recent progress made by multidisciplinary teams in generating and translating evidence for children's healthcare, guideline development and evaluation, and the utilization of AI applications in pediatrics but also fostered transnational and transregional cooperation to promote the advancement of high-quality evidence and guidelines in this field. The symposium contributed significantly to the future development and transformation of research endeavors in pediatrics.

Clinical practice guideline for the evaluation, treatment, and follow-up of children in contact with patients with pulmonary tuberculosis in Colombia.

Introduction: The available clinical practice guidelines on tuberculosis infection are not exclusive to the pediatric population.

Objective: To formulate evidence-based recommendations for the evaluation, treatment, and follow-up of children in contact with patients with pulmonary tuberculosis in Colombia.

Methods: A multidisciplinary development panel (composed by clinical and field experts, researchers, and methodologists who declared conflicts of interests), including patient representatives, and decision-makers formulated 10 questions and prioritized outcomes related to diagnosis (clinical evaluation, chest X-ray, and interferon-gamma release assays-IGRA), treatment (efficacy of regimens in different clinical scenarios), and follow-up (monitoring and strategies to increase adherence) for children exposed to tuberculosis.

Core GRADE 6: presenting the evidence in summary of findings tables.

This sixth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to summary of findings tables. These tables provide essential information about the effects of interventions on patient important outcomes, including relative and absolute effects, certainty of evidence, and a plain language summary. For binary outcomes calculating absolute effects requires applying relative risk estimates to baseline risks from studies representative of the target population.

Core GRADE 4: rating certainty of evidence-risk of bias, publication bias, and reasons for rating up certainty.

This fourth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to addressing risk of bias, publication bias, and rating up certainty. In Core GRADE, randomised controlled trials begin as high certainty evidence and non-randomised studies of interventions (NRSI) as low certainty. To assess certainty of evidence for risk of bias, Core GRADE users first classify individual studies as low or high risk of bias.

EAES rapid guideline: complete mesocolic excision for right-sided colon cancer-with SAGES and ESCP participation.

Background: Complete mesocolic excision (CME) is a surgical technique that aims to improve oncological outcomes of right-sided colon cancer resections. However, CME's technical complexity, surgical risks, and need for specialized training, present challenges. Also, variations in technical aspects and implementation lead to inconsistent outcomes.

A systematic review, meta-analysis and GRADE assessment of the evidence on complete mesocolic excision for right-sided colon cancer with SAGES and ESCP participation.

Background: Complete mesocolic excision (CME) is a surgical approach for right-sided colon cancer, involving the resection of the primary tumour along with an intact mesocolon, central vascular ligation, and exposure of the superior mesenteric vein. It has been postulated to improve oncologic outcomes such as disease-free survival and reduce local recurrence compared to standard right colectomy. However, the clinical benefits are still debated.

Cost-effectiveness analysis comparing QuantiFERON test and tuberculin skin test for the diagnosis of latent tuberculosis infection in immunocompetent children under 15 years of age in Colombia.

Objective: To determine the cost-effectiveness of the QuantiFERON (QFT) test versus the tuberculin skin test (TST) in diagnosing latent tuberculosis infection (LTBI) in immunocompetent children under 15 years of age who are in contact with active tuberculosis (TB) patients in the context of the Colombian healthcare system.

Design: Health economic evaluation. Decision tree over a horizon of <1 year.

Influence of time of birth in early neonatal mortality and morbidity: retrospective cohort study.

Background: A key target of the 2030 Sustainable Development Goals is to eliminate preventable deaths in newborns and children under 5. This study aimed to estimate the effect of time of birth on early neonatal mortality (ENM) and low Apgar scores at 5 min (LA5) in newborns.

Methods: A retrospective cohort study was conducted using vital statistics data on live births, maternal morbidity, congenital defects and perinatal mortality in Cauca-Colombia (2017-2021) excluding out-of-hospital, multiple and major defect cases.

Uptake of core outcome sets in paediatric clinical trials: a protocol.

Introduction: A growing number of paediatric core outcome sets (COS) have been developed in the past 20 years. Previous studies have provided many useful insights into the uptake of COS. In addition to the awareness of COS among clinical trialists, the COS development process (especially patient participation) and the actions of the developers can promote COS uptake.

Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials.

Objective: To address the comparative effectiveness of common interventional procedures for chronic non-cancer (axial or radicular) spine pain.

Design: Systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs).

Data Sources: Medline, Embase, CINAHL, CENTRAL, and Web of Science from inception to 24 January 2023.

Scoping review indicates heterogeneous methods for developing and integrating patient decision aids in the context of clinical practice guidelines.

Objectives: To review the methods used to develop and integrate patient decision aids (PDAs) based on the recommendations of clinical practice guidelines (CPGs).

Study Design And Setting: We conducted a scoping review covering bibliographic databases (PubMed, Embase; searched until December 2023), gray literature, references, and expert consultations to identify eligible documents. Documents published from 2000 onwards and describing methods related to guideline-based PDA development or linking CPGs and PDAs were included.

Pharmacologic Management of Acute Pain in Children: A Systematic Review and Network Meta-Analysis.

Importance: Several pharmacologic options exist for the management of acute pediatric pain; however, their comparative effectiveness remains uncertain.

Objective: To assess the relative benefits and harms of pharmacotherapy for acute pediatric pain through a network meta-analysis of randomized clinical trials.

Data Sources: Cochrane Database of Systematic Reviews, Medline, Embase, CINAHL, Web of Science, and Scopus to October 2023.

Fostering Shared Decision-Making Between Patients and Health Care Professionals in Clinical Practice Guidelines: Protocol for a Project to Develop and Test a Tool for Guideline Developers.

Background: Clinical practice guidelines (CPGs) are designed to assist health care professionals in medical decision-making, but they often lack effective integration of shared decision-making (SDM) principles to reflect patient values and preferences, particularly in the context of preference-sensitive CPG recommendations. To address this shortcoming and foster SDM through CPGs, the integration of patient decision aids (PDAs) into CPGs has been proposed as an important strategy. However, methods for systematically identifying and prioritizing CPG recommendations relevant to SDM and related decision support tools are currently lacking.

Short-term Dual Therapy or Mono Therapy With Acetaminophen and Ibuprofen for Fever: A Network Meta-Analysis.

Context: There is uncertainty whether acetaminophen and ibuprofen are similar in their effects and safety when used as single or dual (alternating or combined) therapies.

Objective: To assess the comparative efficacy of acetaminophen, ibuprofen alone, alternating, or combined through a systematic review and network meta-analysis.

Data Sources: Medline, Embase, and CENTRAL from inception to September 20, 2023.

Network meta-analysis: a powerful tool for clinicians, decision-makers, and methodologists.

Network Meta-analysis (NMA) is an advanced statistical method that combines direct evidence (ie, from head-to-head comparisons) and indirect evidence (ie, estimated from the direct available evidence) to obtain network estimates. NMAs are helpful to determine the comparative effectiveness of interventions that have not been directly compared and may provide more precise estimates for those comparisons that have been directly compared. NMA provides hierarchies which can be helpful for decision-making, much more in scenarios when multiple interventions exist for the same indication.

Reporting Conflicts of Interest and Funding in Health Care Guidelines: The RIGHT-COI&F Checklist.

Background: Conflicts of interest (COIs) of contributors to a guideline project and the funding of that project can influence the development of the guideline. Comprehensive reporting of information on COIs and funding is essential for the transparency and credibility of guidelines.

Objective: To develop an extension of the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement for the reporting of COIs and funding in policy documents of guideline organizations and in guidelines: the RIGHT-COI&F checklist.

Trivalent and quadrivalent seasonal influenza vaccine in adults aged 60 and older: a systematic review and network meta-analysis.

Objectives: To compare the efficacy of influenza vaccines of any valency for adults 60 years and older.

Design And Setting: Systematic review with network meta-analysis (NMA) of randomised controlled trials (RCTs). MEDLINE, EMBASE, JBI Evidence-Based Practice (EBP) Database, PsycINFO, and Cochrane Evidence -Based Medicine database were searched from inception to 20 June 20, 2022.

Fluids in the treatment of diabetic ketoacidosis in children: A systematic review.

Aim: To determine the comparative effectiveness of fluid schemes for children with diabetic ketoacidosis (DKA).

Methods: We conducted a systematic review with an attempt to conduct network meta-analysis (NMA). We searched MEDLINE, EMBASE, CENTRAL, Epistemonikos, Virtual Health Library, and gray literature from inception to July 31, 2022.