GEM/cochrane-simplification huggingface dataset:
Abstract: Of 493 records that we identified from databases as a result of the search (excluding duplicates), we regarded 70 abstracts/titles as potentially relevant studies. Independent scrutiny of these 70 titles and abstracts identified 29 potentially relevant studies. Of the 29 potentially relevant studies, one study met the criteria for inclusion. This study was a RCT that compared participants undergoing RSI and endotracheal intubation in the context of elective surgery requiring a general anaesthetic. Forty participants were recruited, 20 of whom had cricoid pressure applied and 20 of whom had cricoid pressure simulated. The main outcomes reported were systolic arterial pressure and heart rate after laryngoscopy and tracheal intubation. We did not consider these outcomes relevant for the purposes of this systematic review. The search also identified one study that could potentially be included in an updated systematic review in the future, but was at the time of the search a proposal for a trial only and had no reported outcomes at this time. There is currently no information available from published RCTs on clinically relevant outcome measures with respect to the application of cricoid pressure during RSI in the context of endotracheal intubation. On the basis of the findings of non-RCT literature, however, cricoid pressure may not be necessary to undertake RSI safely, and therefore well-designed and conducted RCTs should nonetheless be encouraged to properly assess the safety and effectiveness of cricoid pressure.

Plain-language summary: Our search strategy was designed to identify randomized controlled trials (RCTs) where RSI was undertaken to secure an artificial airway for a general anaesthetic with or without the application of cricoid pressure. Vomiting or regurgitation of stomach contents during anaesthesia was to be assessed either by looking directly down the airway or by various laboratory and imaging (radiological) methods. We also set out to determine whether applying cricoid pressure caused any harm. We searched the databases until May 2015. Only one RCT met our inclusion criteria but unfortunately this trial did not report on any clinically relevant results. We classified one other trial as ongoing. The researchers have reported on their planned protocol for the clinical trial, where cricoid pressure applied using a measured force will be compared with cricoid pressure without measuring the force applied. The number of patients who vomit is to be monitored. This systematic review shows an absence of evidence regarding the effectiveness and risks of cricoid pressure during RSI for intubation. Little can be said therefore about whether this technique should be continued in clinical practice. One current ongoing study shows promise that it will provide useful information in the future.
Abstract: We identified 6600 references (4647 references in our initial review) and included 10 trials (3575 participants). Follow-up ranged from 30 days to one year. Nine trials provided mortality data (3218 participants, 466 events), with a risk ratio of 1.02 (95% CI 0.87 to 1.19) (low-certainty evidence). Seven trials provided hospital readmission data (2843 participants, 1043 events) with a risk ratio of 0.95 (95% CI 0.87 to 1.04) (high-certainty evidence). Four trials provided emergency department contact data (1442 participants, 244 events) with a risk ratio of 0.73 (95% CI 0.52 to 1.03) (low-certainty evidence). The estimated reduction in emergency department contacts of 27% (with a CI ranging from 48% reduction to 3% increase in contacts) corresponds to a number needed to treat for an additional beneficial outcome of 37 for a low-risk population and 12 for a high-risk population over one year. Subgroup and sensitivity analyses did not significantly alter our results. We found no evidence that medication review reduces mortality or hospital readmissions, although we did find evidence that medication review may reduce emergency department contacts. However, because of short follow-up ranging from 30 days to one year, important treatment effects may have been overlooked. High-quality trials with long-term follow-up (i.e. at least up to a year) are needed to provide more definitive evidence for the effect of medication review on clinically important outcomes such as mortality, readmissions and emergency department contacts, and on outcomes such as adverse events. Therefore, if used in clinical practice, medication reviews should be undertaken as part of a clinical trial with long-term follow-up.

Plain-language summary: We included 10 randomised controlled trials with a total of 3575 participants. We found that medication review does not seem to prevent death and hospital readmissions, but that it might reduce emergency department contacts. Our confidence in results across studies ranged from low to high. We found no evidence that medication review in hospitalised patients makes a difference towards preventing mortality (low-certainty evidence) or hospital readmissions (high-certainty evidence), but we found that medication review may have a preventive effect on reducing the number of emergency department contacts (low-certainty evidence). In the included trials, participants were followed for a short time (ranging from 30 days to one year). Therefore, important long-term treatment effects may have been overlooked. We suggest that further research with long-term patient follow-up and examination of specific methods of medication review should be undertaken before this intervention is implemented in clinical practice.
Abstract: Of 39 identified studies, four met the criteria for inclusion. Two of the included studies reported a significant decrease in paediatric burn and scald injury in the intervention compared with the control communities. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities. There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children. It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.

Plain-language summary: The efficacy of this approach is difficult to assess and there have been few research studies of good quality. The current review sought to review studies evaluating the success of community-based programmes specifically intended to reduce burn and scald injury in children. Only four studies were identified that met the inclusion criteria and two of these found a reduction in rates of burns and scalding. More high-quality research studies are needed in this area, therefore, to support the continued use of the community approach.
Abstract: Twenty-seven studies involving 11,398 participants met the eligibility and study quality criteria for inclusion. Twenty studies compared stand alone clinical pathways with usual care. These studies indicated a reduction in in-hospital complications (odds ratio (OR) 0.58; 95% confidence interval (CI) 0.36 to 0.94) and improved documentation (OR 11.95: 95%CI 4.72 to 30.30). There was no evidence of differences in readmission to hospital or in-hospital mortality. Length of stay was the most commonly employed outcome measure with most studies reporting significant reductions. A decrease in hospital costs/ charges was also observed, ranging from WMD +261 US$ favouring usual care to WMD -4919 US$ favouring clinical pathways (in US$ dollar standardized to the year 2000). Considerable heterogeneity prevented meta-analysis of length of stay and hospital cost results.  An assessment of whether lower hospital costs contributed to cost shifting to another health sector was not undertaken. Seven studies compared clinical pathways as part of a multifaceted intervention with usual care. No evidence of differences were found between intervention and control groups. Clinical pathways are associated with reduced in-hospital complications and improved documentation without negatively impacting on length of stay and hospital costs.

Plain-language summary: Twenty-seven studies involving 11,398 participants were included for analysis. The main results were a reduction in in-hospital complications and improved documentation associated with clinical pathways. Complications assessed included wound infections, bleeding and pneumonia. Most studies reported a decreased length of stay and reduction in hospital costs when clinical pathways were implemented. Considerable variation in study design and settings prevented statistical pooling of results for length of stay and hospital costs. Generally poor reporting prevented the identification of characteristics common to successful clinical pathways. The authors concluded that clinical pathways are associated with reduced in-hospital complications
Abstract: We included data from two studies (619 eyes of 401 participants) that compared FA implants with standard-of-care therapy. Both studies used similar standard-of-care therapy that included administration of prednisolone and, if needed, immunosuppressive agents. The studies included participants from Australia, France, Germany, Israel, Italy, Portugal, Saudi Arabia, Spain, Switzerland, Turkey, the United Kingdom, and the United States. We assessed both studies at high risk of performance and detection bias. Only one study reported our primary outcome, recurrence of uveitis at any point during the study through 24 months. The evidence, judged as moderate-quality, showed that a FA implant probably prevents recurrence of uveitis compared with standard-of-care therapy (risk ratio (RR) 0.29, 95% confidence interval (CI) 0.14 to 0.59; 132 eyes). Both studies reported safety outcomes, and moderate-quality evidence showed increased risks of needing cataract surgery (RR 2.98, 95% CI 2.33 to 3.79; 371 eyes) and surgery to lower intraocular pressure (RR 7.48, 95% CI 3.94 to 14.19; 599 eyes) in the implant group compared with standard-of-care therapy through two years of follow-up. No studies compared dexamethasone implants with standard-of-care therapy. After considering both benefits and harms reported from two studies in which corticosteroids implants were compared with standard-of-care therapy, we are unable to conclude that the implants are superior to traditional systemic therapy for the treatment of non-infectious uveitis. These studies exhibited heterogeneity in design and outcomes that measured efficacy. Pooled findings regarding safety outcomes suggest increased risks of post-implant surgery for cataract and high intraocular pressure compared with standard-of-care therapy.

Plain-language summary: We included two randomized controlled trials that compared fluocinolone acetonide implants with standard-of-care therapy. These studies included 401 participants from Australia, France, Germany, Israel, Italy, Portugal, Saudi Arabia, Spain, Switzerland, Turkey, the United Kingdom, and the United States who were 6 years old or older and were followed for two years. The evidence is current to 6 November 2015. Since the two studies were designed to answer slightly different questions about the fluocinolone implant, we were not able to combine data from both studies to compare how well the medications worked. However, we were able to do a combined analysis of the common side effects, which suggest that participants in the steroid implant group had more surgery for cataract (clouding of the lens of the eye) and for high eye pressure than participants in the non-implant group. We were unable to determine whether the steroid implants were better than standard-of-care therapy. The overall quality of the presently available published evidence was moderate. This finding indicates that future published research is likely to have an important impact on the conclusions currently provided in this review.
Abstract: We identified four trials involving 1314 children. Three trials investigated the use of amoxicillin/clavulanic acid to prevent otitis and one investigated ampicillin to prevent pneumonia. The use of amoxicillin/clavulanic acid compared to placebo to prevent otitis showed a risk ratio (RR) of 0.70 (95% confidence interval (CI) 0.45 to 1.11, three trials, 414 selected children, moderate-quality evidence). Methods of random sequence generation and allocation concealment were not clearly stated in two trials. Performance, detection and reporting bias could not be ruled out in three trials. Ampicillin compared to supportive care (continuation of breastfeeding, clearing of the nose and paracetamol for fever control) to prevent pneumonia showed a RR of 1.05 (95% CI 0.74 to 1.49, one trial, 889 selected children, moderate-quality evidence). The trial was non-blinded. Random sequence generation and allocation concealment methods were not clearly stated, so the possibility of reporting bias could not be ruled out. Harm outcomes could not be analysed as they were expressed only in percentages. We found no studies assessing mastoiditis, quinsy, abscess, meningitis, hospital admission or death. There is insufficient evidence for antibiotic use as a means of reducing the risk of otitis or pneumonia in children up to five years of age with undifferentiated ARIs. Further high-quality research is needed to provide more definitive evidence of the effectiveness of antibiotics in this population.

Plain-language summary: In the trials treating otitis media, the quality of the evidence was moderate as the methods for avoiding bias were not clearly stated. Furthermore, in one trial a pharmaceutical company prepared the placebo syrup used in the trial. In the study treating pneumonia, we classified the quality of the evidence as moderate, because the families previously knew if their children were receiving antibiotics or not. Furthermore, the methods for avoiding bias were not clearly stated by the trial authors. Further high-quality research is needed to provide more definitive evidence of the effectiveness of antibiotics in this population.
Abstract: We included 20 RCTs with 1574 participants in this updated review. All trials were published in Chinese language journals. We included 14 trials that we had excluded in the previous version of the review after we added a new outcome in this update. Time windows within which the participants were randomised ranged from 4.5 hours to 10 days. Ischaemic stroke was confirmed by computerised tomography (CT) or magnetic resonance imaging (MRI) in 18 trials. Meta-analysis of two trials with 164 participants showed that treatment with puerarin did not reduce death or dependency at final follow-up (RR 0.79, 95% CI 0.45 to 1.36). One trial with 83 participants reported that the mean value of the Barthel Index in the puerarin group was below that in the control group. Meta-analysis of 16 trials with 1305 participants showed that puerarin reduced the proportion of participants without improvement of neurological deficit at the end of follow-up (RR 0.42, 95% CI 0.33 to 0.55). None of the included trials reported serious adverse effects.The quality of evidence was low due to incomplete reporting of the methods and short-term follow-up. There is not enough evidence to evaluate the effect of puerarin on survival or dependency in people with ischaemic stroke. High quality and large-scale RCTs with long-term follow-up are needed to assess its efficacy.

Plain-language summary: We searched for trials up to August 2015 and included 20 randomised controlled trials involving 1574 participants, of puerarin for people with ischaemic stroke. Only two trials reported death or dependency at the end of follow-up. The remaining studies followed participants for less than one month. We included 20 RCTs with 1574 participants in this updated review; five trials were new. Treatment with puerarin did not reduce death or dependency at final follow-up. Puerain improved neurological deficit at the end of treatment. The included trials did not report serious adverse effects. The quality of evidence was low due to incomplete reporting of the methods and short-term follow-up.
Abstract: Three trials randomly allocating people with age-related cataract to MSICS or ECCE were included in this review (n = 953 participants). Two trials were conducted in India and one in Nepal. Trial methods, such as random allocation and allocation concealment, were not clearly described; in only one trial was an effort made to mask outcome assessors. The three studies reported follow-up six to eight weeks after surgery. In two studies, more participants in the MSICS groups achieved unaided visual acuity of 6/12 or 6/18 or better compared to the ECCE group, but overall not more than 50% of people achieved good functional vision in the two studies. 10/806 (1.2%) of people enrolled in two trials had a poor outcome after surgery (best-corrected vision less than 6/60) with no evidence of difference in risk between the two techniques (risk ratio (RR) 1.58, 95% confidence interval (CI) 0.45 to 5.55). Surgically induced astigmatism was more common with the ECCE procedure than MSICS in the two trials that reported this outcome. In one study there were more intra- and postoperative complications in the MSICS group. One study reported that the costs of the two procedures were similar. There are no other studies from other countries other than India and Nepal and there are insufficient data on cost-effectiveness of each procedure. Better evidence is needed before any change may be implemented. Future studies need to have longer-term follow-up and be conducted to minimize biases revealed in this review with a larger sample size to allow examination of adverse events.

Plain-language summary: We found three randomised controlled trials. The searches are up to date to September 23rd 2014. A total of 953 people with age-related cataract in India and Nepal were randomly allocated to MSICS and ECCE in these trials. The data were limited. People whose lens was removed with MSICS were more likely to achieve good functional vision, however, overall not more than 50% of people achieved good functional vision in the two studies. 1.2% of people enrolled in two trials had a poor outcome after surgery with best-corrected vision less than 6/60. There was no evidence of any difference between the two groups with respect to this outcome. Surgically induced astigmatism was more common with the ECCE procedure than MSICS in the two trials that reported this outcome. In one study there were more intra- and postoperative complications in the MSICS group. One study reported that the costs of the two procedures were similar. We judged the quality of the evidence to be low or very low. There were only three studies and we could not combine the data because of differences in reporting and inconsistency between trials which meant that some of the results were imprecise.
Abstract: Three randomised clinical trials (307 patients) that followed patients for three months or more after the end of treatment were included. The methodological quality was poor. The herbal compound 'Jianpi Wenshen recipe' had significant effects on viral markers compared to interferon: relative risk 2.40 (95% CI 1.01 to 5.72) for clearance of serum HBsAg, 2.03 (95% CI 0.98 to 4.20) for clearance of HBeAg, and 2.54 (95% CI 1.13 to 5.70) for seroconversion of HBeAg to anti-HBe. Phyllanthus amarus and Astragalus membranaceus showed no significant antiviral effect compared with placebo. Analysis of pooling eight randomised clinical trials with less than three months follow-up did not show a significant benefit of Chinese medicinal herbs on viral markers. Data on long-term clinical outcomes and quality of life were lacking. Based on one low quality trial, the medicinal herb 'Jianpi Wenshen recipe' may have an antiviral activity in asymptomatic carriers of hepatitis B virus. However, rigorous randomised, double-blind, placebo-controlled trials are needed before herbs should be used for this condition.

Plain-language summary: Three randomised clinical trials were included. Due to their poor methodologic quality and the existing small number of trials, there is currently insufficient evidence for treating asymptomatic hepatitis B virus carriers with Chinese medicinal herbs like the herbal compound 'Jianpi Wenshen recipe', Phyllanthus amarus and Astragalus membranaceus. Methodologically better and larger randomised trials are needed comparing medicinal herbs versus placebo.
Abstract: A single randomised controlled trial enrolling 92 participants was eligible for this review. Researchers have not reported long-term neurodevelopmental outcomes, including the primary outcome of this review - death or long-term major neurodevelopmental disability in infancy (18 months to three years of age). Cooling plus xenon was not associated with reduced mortality at latest follow-up, based upon low quality evidence. Investigators noted no substantial differences between groups for other secondary outcomes of this review, such as biomarkers of brain damage assessed with magnetic resonance imaging and occurrence of seizures during primary hospitalisation. Available data do not show an increased adverse event rate in the cooling plus xenon group compared with the cooling alone group. Current evidence from one small randomised controlled pilot trial is inadequate to show whether cooling plus xenon is safe or effective in near-term and term newborns with HIE. Further trials reporting long-term neurodevelopmental outcomes are needed.

Plain-language summary: This review found a single randomised controlled trial that examined the short-term effects of cooling plus xenon for infants with HIE. This trial enrolled 92 participants. Cooling plus xenon did not improve clinical outcomes before discharge from the hospital compared with cooling alone. Data on long-term development were not provided. Current low quality evidence is inadequate to show whether cooling plus xenon improves survival and development of newborn babies with HIE. Evidence is up-to-date as of August 2017.