What are the benefits and risks of using a combination of treatments to manage cachexia (disease-related wasting)? Key messages: • We do not know if combinations of two or more treatments (of medication, diet, and exercise) benefit people who have or are at risk of developing cachexia (disease-related wasting). This is because there are currently not enough robust studies in this area. • We need future research to increase our confidence in the evidence by conducting better designed and larger studies. What is cachexia? Cachexia is a complex metabolic syndrome that occurs in people with...

Perceptions and experiences of the prevention, identification and management of pre-eclampsia and eclampsia: a qualitative evidence synthesis This is a protocol for a Cochrane Review (qualitative). The objectives are as follows: The overall objective of this qualitative evidence synthesis is to describe and explore the perceptions and experiences of key stakeholders who have experience with pre-eclampsia/eclampsia or its prevention, identification, or management. The key stakeholders are women who have experienced pre-eclampsia/eclampsia, people in the community, lay health workers, and...

How accurate are GAD-7 and GAD-2 questionnaires for detecting anxiety disorders? Key messages • The GAD-7 and GAD-2 questionnaires alone cannot be used to diagnose or rule out an anxiety disorder. • However, they provide an indication of whether an anxiety disorder may be present. • The interpretation of a "negative" or "positive" questionnaire finding of an individual depends on the context. What are anxiety disorders? 'Anxiety disorder' is an umbrella term which refers to mental health conditions including (but not limited to): • generalised anxiety disorder: when someone experiences...

Audit and feedback: effects on professional practice Key messages - Audit and feedback in healthcare is when a health professional's performance is evaluated and compared to professional standards (audit). Then the health professionals are given the results of the comparison (feedback), with the hope that it might help them improve their performance. - Audit and feedback helps to improve health professional performance a little to a moderate amount. It works best when it shows health professionals how they compare to top performers, focuses on important areas for improvement, and includes...

How accurate are Truenat assays for detecting pulmonary tuberculosis and rifampicin resistance in adults and adolescents? Key messages – Truenat MTB Plus was more accurate than Truenat MTB for detecting pulmonary tuberculosis. Truenat MTB misidentified many people as having tuberculosis when they did not, which raises concern. – Xpert Ultra was more accurate than Truenat MTB. – Evidence on the accuracy of Truenat assay for detecting rifampicin was limited. What is pulmonary tuberculosis? Pulmonary tuberculosis is a lung disease caused by a bacterium (a germ) that spreads through the air via...

Does selecting targeted therapies based on genetic testing of an individual's cancer prolong their life or delay disease progression in people with advanced cancer? Key messages People with advanced cancers who received matched targeted therapies, either alone or in combination with standard treatments, experienced longer periods of disease control compared to those receiving standard treatments alone. However, the evidence on whether these therapies extend overall survival remains inconsistent. Further information is needed on the potential harms of matched targeted therapy and whether...

Perioperative glucocorticoid supplementation in pituitary surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects, including benefits and harms, of perioperative glucocorticoid supplementation in people undergoing surgery for pituitary neuroendocrine tumours (PitNETs) with a preoperatively intact hypothalamic-pituitary-adrenal axis. This is a protocol....

Mitral repair with annuloplasty for moderate ischemic mitral regurgitation in people undergoing coronary artery bypass surgery This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of mitral repair with annuloplasty for moderate ischemic mitral regurgitation in people undergoing coronary artery bypass grafting. This is a protocol....

What are the effects of combined psychosocial interventions and medications for helping people who consume an excessive amount of alcohol? Key messages • Compared to psychosocial interventions alone, adding medications is probably safe and helpful for people with alcohol use disorder (AUD) in reducing alcohol use. • Due to the limited number of available studies, we do not know if combined psychosocial interventions and medications, when compared to medications alone or no treatment or usual care, is helpful for people with AUD. • More studies are needed looking at the effects of combined...

What influences people to fund, provide, and attend general health checks? Key messages • People decide to get general health checks based on several things, such as being aware of general health checks and getting reminders from family, friends, or healthcare providers. In places where general health checks and treatment are not free, resources like time and money also play a role. Some people avoid general health checks because they are afraid of bad results. • We found less information about healthcare funders and providers, so we do not fully understand what drives their decisions about...

Does the risk of death differ between female and male adult patients with pulmonary embolism (a blood clot in the lungs)? Key messages - We concluded that it is uncertain if sex (whether a patient is male or female) is an independent predictor of the risk of death in people with pulmonary embolism (a blood clot in the lungs), as our review found contradictory results. - We found a small but important reduction in death from any cause by 30 days after pulmonary embolism in female compared to male patients. However, in female patients, there may be a small but important increase in death...

Blood transfusions in people born with heart problems who require surgery on their heart Key message We found 19 studies that compared different ways of doing red blood cell transfusion in newborns and children requiring heart surgery for congenital heart disease (heart problems they were born with). However, we are unable to reach any reliable conclusions based on this evidence. More studies are required. What is congenital heart disease? Congenital heart disease is any problem with the heart's development that a person is born with. It means the heart has not formed properly. It affects...

Prognosis of surgically resected clinical stage 1A non-small cell lung cancers manifesting as a subsolid nodule on computed tomography including pure ground glass nodules This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: To quantify the risk of tumour relapse/recurrence after a surgical resection of stage 1A non-small cell lung cancer (NSCLC) as manifested on computed tomography (CT) imaging as a subsolid nodule. This is a protocol....

Are molecular tests better than blood cultures for detecting infections in the blood of newborn babies? Key messages – The studies included in this review suggest that molecular tests (based on a molecule that carries the genetic instructions used in growth, development, functioning and reproduction from bacteria) may be very helpful additional tests in detecting blood infection (sepsis) in babies because they provide rapid results. – Using molecular tests may help us stop using antibiotics in babies without a blood infection quicker because the results are faster than blood cultures (a test...

Statins for preventing preeclampsia This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the relative benefits and harms of statins for preeclampsia prevention in pregnant women. This is a protocol....

What are the benefits and harms of nonsteroidal anti-inflammatory drugs (NSAIDs) for treating acute renal colic? Key messages - Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain in adults with renal colic. - Some NSAIDs may work better than others in adults with renal colic. - The risks of NSAIDs in the treatment of renal colic are not clear. What is renal colic? Kidney (urinary) stones may cause sudden ('acute') and severe abdominal pain when they block urinary flow. This pain is known as 'renal colic'. How is renal colic treated? Different drugs are used to treat this severe...

Do different methods of nutritional support affect recovery and complications in adults after pancreaticoduodenectomy? Key messages - Enteral nutrition may not increase the risk of complications but is probably linked to a shorter hospital stay compared to parenteral nutrition. - When comparing jejunostomy feeding to oral nutrition, there may be no clear difference in complications or length of hospital stay, but the evidence is uncertain. - More evidence is needed to say with higher levels of confidence how these different types of feeding affect patients after a pancreaticoduodenectomy....

Is rituximab better for people with multiple sclerosis than other disease-modifying medicines? Key messages • We are uncertain whether rituximab prevents disability worsening in people with any form of multiple sclerosis (MS). • Rituximab may offer moderate-to-large benefit against a range of other medicines in preventing relapses in relapsing MS, both in people treated with rituximab for the first time and in those given rituximab after other medicines failed to work or became unsuitable. • Very few people given rituximab in the studies had serious unwanted/harmful events, developed cancer,...

Safety and usefulness of proton pump inhibitors for preterm infants with reflux disease Key Messages - Reflux is common in preterm infants - The current evidence neither supports nor refutes the safety and efficacy (usefulness) of proton pump inhibitors (PPIs) for the treatment of reflux in preterm infants. What is gastroesophageal reflux, and how does it differ from gastroesophageal reflux disease? Gastroesophageal reflux happens when the stomach contents flow back into the esophagus (canal joining throat to stomach). It is common in a newborn. Premature infants are more likely to...

Can a class of antidiabetic medicine help protect the brain after a severe ischemic (caused by a blocked blood vessel) stroke? Key messages 1. There is limited evidence that glyburide (a sulfonylurea, or type of medicine used for type 2 diabetes) may have little to no effect on a person's function 90 days after a stroke, or the number of deaths after 90 days. It may have little to no effect on neurological deterioration within three days, such as consciousness, speech, or weakness, and probably has little to no effect on unwanted side effects, such as heart-related problems, or pneumonia. 2....