Background Systematic reviews allow health decisions to be informed by the best available research evidence. However, their number is proliferating quickly, and many skills are required to identify all the relevant reviews for a specific question. Methods and findings We screen 10 bibliographic databases on a daily or weekly basis, to identify systematic reviews relevant for health decision-making. Using a machine-based approach developed for this project we select reviews, which are then validated by a network of more than 1000 collaborators. After screening over 1,400,000 records we have identified more than 300,000 systematic reviews, which are now stored in a single place and accessible through an easy-to-use search engine. This makes Epistemonikos the largest database of its kind. Conclusions Using a systematic approach, recruiting a broad network of collaborators and implementing automated methods, we developed a one-stop shop for systematic reviews relevant for health decision making.
OBJECTIVE: To assess the therapeutic effects of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis. DESIGN: This is the protocol of a systematic review. DATA SOURCES: Searches will be conducted in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), trial registries, grey literature and in a centralized repository in L-OVE (Living OVerview of Evidence). L-OVE is a platform that maps PICO questions to evidence from Epistemonikos database. ELIGIBILITY CRITERIA FOR SELECTING STUDIES AND METHODS: We will include randomized controlled trials evaluating therapeutic use of cannabis, cannabis-derived products and synthetic cannabinoids for rheumatoid arthritis. Our primary interest will be in trials comparing the intervention with placebo or no treatment (intervention plus optimal treatment vs placebo plus optimal treatment or optimal treatment alone) in patients receiving optimal treatment for rheumatoid arthritis. Optimal treatment will be defined as disease modifying anti-rheumatic drugs. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use Grading of Recommendations Assessment, Development and Evaluation (GRADE) to assess the certainty of the evidence for each outcome. ETHICS AND DISSEMINATION: The Scientific Ethics Committee of the Pontificia Universidad Católica de Chile granted ethical exemption for the realization of this study. Results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media and will be sent to relevant international organizations discussing this topic.
ObjectiveTo determine the relative impact of the use of chloroquine and hydroxychloroquine on outcomes important to patients with COVID 19. DesignThis is the protocol of a living systematic review.We will follow a common protocol for multiple parallel systematic reviews, already published and submitted to PROSPERO (awaiting ID allocation). We will include randomised controlled trials evaluating the effect of chloroquine and hydroxychloroquine -as monotherapy or in combination with other drugs -versus placebo or no treatment in patients with COVID-19. Randomised trials evaluating chloroquine and hydroxychloroquine in infections caused by other coronaviruses, such as MERS-CoV and SARS-CoV, and non-randomised studies in COVID-19 will be searched in case no direct evidence from randomised trials is found, or if the direct evidence provides low-or very low-certainty for critical outcomes. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will perform random-effects meta-analyses and use GRADE to assess the certainty of the evidence for each outcome.
Background: Symptom management in rheumatoid arthritis (RA) remains a complex challenge. Widespread use of cannabis-based medicines for a myriad of symptoms has fostered rheumatology patients' interest. However, their safety and efficacy in RA remain unclear.Objective: The aim of this study was to perform a structured summary of the body of evidence in order to determine whether cannabis, cannabis-derived products, and synthetic cannabinoids are an effective treatment for rheumatoid arthritis.Methods: An electronic search in Epistemonikos database was performed to identify systematic reviews and their primary studies that addressed our clinical question. The body of evidence was collected in a pivot table in Epistemonikos. Information and data from the primary studies were extracted from the identified reviews. Finally, extracted data were reanalyzed, and a summary of findings table was generated using the Grading of Recommendations Assessment, Development and Evaluation approach.Results: Twenty-six systematic reviews were identified which included in total only 1 randomized trial assessing our clinical question.Conclusions: Cannabis, cannabis-derived products and synthetic cannabinoids may slightly reduce disease activity in patients with RA. Its use may result in little to no difference in pain reduction and may slightly increase nervous system adverse events. The evidence is very uncertain about the effect of cannabis, cannabis-derived products, and synthetic cannabinoids on serious adverse events risk.
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. 5. The treatments used in patients with COVID-19 are based on reducing viral reproduction and inflammation (such as 4aminoquinolone antimalarial agents). However, these drugs could cause cardiotoxicity, with systolic dysfunction and prolongation of the QT interval. 6 Therefore, early markers are required to prevent irreversible cardiotoxicity. In conclusion, the preventative and therapeutic strategies for COVID-19 will improve with markers that identify those patients with greater pathological, genetic or pharmacological susceptibility to infection with SARS-CoV-2 (ACE2 regulation) and that monitor the mechanisms involved in disease progression (cardiac damage, thrombosis, and cardiotoxicity).
Objective This living systematic review aims to provide a timely, rigorous and continuously updated summary of the evidence available on the role of pulmonary rehabilitation in the treatment of patients with COVID-19. Design This is the protocol of a living systematic review. Data sources We will conduct searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that maps PICO questions to a repository maintained through regular searches in electronic databases, preprint servers, trial registries and other resources relevant to COVID-19. No date or language restrictions will be applied. Eligibility criteria for selecting studies and methods We adapted an already published common protocol for multiple parallel systematic reviews to the specificities of this question. We will include randomized trials evaluating the effect of pulmonary rehabilitation as monotherapy or in combination with other interventions-versus sham or no treatment in patients with COVID-19. Two reviewers will independently screen each study for eligibility, extract data, and assess the risk of bias. We will pool the results using meta-analysis and will apply the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the certainty of the evidence for each outcome. Ethics and dissemination No ethics approval is considered necessary. The results of this review will be widely disseminated via peer-reviewed publications, social networks and traditional media.
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