Liang Du

Sichuan University, Hua-yang, Sichuan, China

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Publications (39)79.66 Total impact

  • Yifei Lin · Senlin Yin · Jin Huang · Liang Du
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    ABSTRACT: Background and objectives: Pay-for-performance is a financial incentive which links physicians' income to the quality of their services. Although Pay-for-performance(P4P) is suggested to be an effective payment method in many pilot countries (i.e. the United Kingdom) and enjoys a wide application in primary health care, researches on it are yet to reach an agreement. Thus a systematic review was conducted on the evidence of impact of P4P on behavior of primary care physicians and patient outcomes aiming to provide a comprehensive and objective evaluation of P4P for decision makers. Methods: Studies were identified by searching PubMed, EMbase and The Cochrane Library. Electronic search was conducted in the fourth week of January, 2013. As the included studies had significant clinical heterogeneity, a descriptive analysis was conducted. Quality Index was adopted for quality assessment of evidences. Results: Database searches yielded 651 candidate articles, of which 44 studies fulfilled the inclusion criteria. An overall positive effect was found on the management of disease, which varied in accordance with the baseline medical quality and the practice size. Meanwhile, it could bring about new problems regarding the inequity, patients' dissatisfaction and increasing medical cost. Conclusions: Decision makers should consider the baseline conditions of medical quality and the practice size before new medical policies are enacted. Furthermore, most studies are retrospective and observational with high level of heterogeneity though, the descriptive analysis is still of significance. This article is protected by copyright. All rights reserved.
    No preview · Article · Dec 2015 · Journal of Evidence-Based Medicine
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    ABSTRACT: Objective: After 38 years of development, the procedure of selection and evaluation of the World Health Organization Essential Medicine List (WHO EML) is increasingly scientific and formal. However, peer review for the applications of World Health Organization Essential Medicine List is always required in a short period. It is necessary to build up a set of methods and processes for rapid review. Method: We identified the process of evidenced-based rapid review on WHO EML application for peer reviews according to 11 items which were required during reporting of the peer review results of the proposals. Results: The most important items for the rapid review of World Health Organization Essential Medicine List peer reviewers are (1) to confirm the requirements and identify the purposes; (2) to establish the research questions and translate the questions into the 'Participants, Interventions, Comparators, Outcomes, Study design' (PICOS) format; (3) to search and screen available evidence, for which high-level evidence is preferred, such as systematic reviews or meta-analyses, health technology assessment, clinical guidelines; (4) to extract data, where we extract primary information based on the purposes; (5) to synthesize data by qualitative methods, assess the quality of evidence, and compare the results; (6) to provide the answers to the applications, quality of evidences and strength of recommendations. Conclusions: Our study established a set of methods and processes for the rapid review of World Health Organization Essential Medicine List peer review, and our findings were used to guide the reviewers to fulfill the 19(th) World Health Organization Essential Medicine List peer review. The methods and processes were feasible and met the necessary requirements in terms of time and quality. Continuous improvement and evaluation in practice are warranted.
    No preview · Article · Nov 2015 · Journal of Evidence-Based Medicine
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    ABSTRACT: Previous studies suggested that dyslipidemia was potentially associated with anti-diabetic medications of sulfonylureas (SUs). The results were, however, inconsistent. 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). We searched PubMed, EMBASE and CENTRAL databases for RCTs that addressed the effects of second- and/or third-generation SUs on T2DM patients and reported lipids profiles with study duration of at least 12 weeks. Two reviewers independently screened literature, collected data, and assessed methodological quality of included studies. The meta-analysis was performed by using the RevMan5.1 software. A total of 59 RCTs were included, of which 52 were included for final meta-analysis. The results suggested that SUs statistically increased the levels of FFA (SMD = 0.24, 95%CI 0.06 to 0.42) and TG (MD = 0.06, 95%CI 0.02 to 0.10), but decreased HDL-C (MD = -0.07, 95%CI -0.11 to -0.04) and LDL-C (MD = -0.11, 95%CI -0.17 to -0.04); but the SUs had no effect on TC (MD = 0.01, 95%CI -0.05 to 0.08), ApoA1 (MD = 0.01, 95%CI -0.03 to 0.04), and Apo B (MD = -0.01, 95%CI -0.05 to 0.03). When compared to metformin, SUs could increase TC and LDL-C; compared to glinides, SUs increased TC and lowered HDL-C; compared to thiazolidinediones, SUs reduced TC, LDL-C, HDL-C, and increase TG. SUs have a small effect on lipids, although they may statistically increase the level of FFA and TG, and decrease LDL-C and HDL-C. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    No preview · Article · Jun 2015 · Journal of Evidence-Based Medicine
  • Min Chen · Jia He · Yonggang Zhang · Liang Du
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    ABSTRACT: Background The literature retrievals are still the main problems which limit the quality of SRs for Traditional Chinese Medicine (TCM), and there were still no comprehensive analyses for these problems. The aim of the current study is to analyze these problems to guide future SRs for TCM.Methods The Cochrane Library (Issue 2, 2009) and the Chinese Biomedical Database (CBM, 1978- 2009.7.31) were comprehensively searched to identify the SRs of TCM. The native literature retrieval rate of the first author, the characteristics of the included databases, the number of the included database, the reporting of literature retrieval strategy, the reporting of adjuvant search for both the SRs from the CBM and Cochrane Library were analyzed.ResultsA total of 341 SRs were included in our analyses, including 245 from the CBM and 96 from the CL. The Chinese-authored SRs ranked the first in median retrieval rate (100%). The Cochrane SRs were significant superior than the CBM SRs: more searched databases (media: 4 vs. 6, P<0.001), more precision of retrieval time, more conducting grey literatures searches (47.92% vs. 20.41%) and handing searches (57.29% vs. 54.69%) and more reported retrieval strategies (66.67% vs. 8.16%).Conclusions There were significant problems in the literature retrieval of SRs for TCM. In future, when performing any SRs for TCM, sufficient and proper databases, clearly searching strategies and times, proper adjuvant retrievals should be reported. Cochrane SRs might be a better choice.This article is protected by copyright. All rights reserved.
    No preview · Article · Feb 2015 · Journal of Evidence-Based Medicine
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    ABSTRACT: The associations between the Arg399Gln polymorphism in X-ray repair cross-complementing gene 1 (XRCC1) gene and the risk of hematological malignancies have been extensively investigated. However, the results were inconsistent. The objective of the current study is to investigate the association by meta-analysis. We searched PubMed database, Embase database, CNKI database, Wanfang database, and Weipu database, covering all studies until August 7, 2013. Statistical analysis was performed by using the Revman4.2 software and the Stata10.0 software. A total of 27 case-control studies concerning the Arg399Gln polymorphism were included from 26 articles. The results suggested that the Arg399Gln polymorphism was not associated with an increased/decreased risk of hematological malignancies in total analysis (OR = 1.15, 95 % confidence interval (CI) = 0.97-1.35, P = 0.10 for Arg/Gln + Gln/Gln vs. Arg/Arg). In the subgroup analysis by ethnicity and cancer types, significant association was found in Asians (OR = 1.35, 95 % CI = 1.04-1.75, P = 0.03) but not in Europeans (OR = 1.07, 95 % CI = 0.86-1.33, P = 0.56), and in leukemia (OR = 1.25, 95 % CI = 1.02-1.54, P = 0.03) but not in lymphoma (OR = 0.98, 95 % CI = 0.80-1.20, P = 0.84) or myeloma (OR = 1.13, 95 % CI = 0.23-5.69, P = 0.88). The current meta-analysis indicated that the Arg399Gln polymorphism in the XRCC1 gene might be a risk factor for hematological malignancies in Asians or for leukemia. In future, more large-scale case-control studies are needed to validate these results.
    No preview · Article · Jan 2015 · Tumor Biology
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    ABSTRACT: To systematic reviewed the methodological assessment tools for pre-clinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline. We searched the PubMed, Cochrane Handbook, Joanna Briggs Institute (JBI) Reviewers Manual, the websites of Google, Centre for Reviews and Dissemination, Critical Appraisal Skills Programme (CASP), Scottish Intercollegiate Guidelines Network (SIGN), and the National Institute for Clinical Excellence (NICE) up to May 20, 2014. Two authors screening the publications and extracted data, then quantitative analysis method was used to summary the information of included tools. Finally, we included 21 tools for analysis. Some tools were developed by academic organizations, and some were only developed by one or two more scholars. The JBI contains the most number of tools, the CASP was the secondary. The number of tools for assessing randomized controlled trial (RCT) was the most, whereas zero for some study. In summary, the Cochrane Collaboration's tool is the best for assessing RCT, the NOS is the best for cohort and case-control study, the MINORS is suitable for non-randomized interventional study, the ARHQ methodology checklist can be used for cross-sectional study; the QUADAS-2 tool is recommended for diagnostic accuracy study, the SYRCLE's risk of bias tool is recommended for animal study, the AMSTAR tool is the best for systematic review and meta-analysis, the Moga's tool is suitable for case series, and the AGREE II instrument is well accepted for clinical practice guidelines. However, great efforts remain necessary in the developing appraisal tools, due to many fields (such as genetic and cell study) lack of tools and some filed need to update tools (such as nested case-control study and case report). Last but not least, we must realize that all appraisal tools are subjective and how to avoid performance bias from users is very important. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    No preview · Article · Jan 2015 · Journal of Evidence-Based Medicine
  • Jin Fu · Jia He · Liang Du · Guanjian Liu
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    ABSTRACT: Multilevel models are applicable to both the quantitative data and categorical variables. We used the methods, including the multilevel models, analysis of covariance and CMH chi-square test, to analyse different types of data, to explore the application of multilevel models in the analysis of the multicenter clinical trial center effect. The results showed that the analysis of covariance is more sensitive to find the center effect for quantitative data, while multilevel models are more sensitive to categorical variables. It can be seen that results with different analytical methods for center effect are not the same, and the most appropriate method should be selected in accordance with the characteristics of data, the objective of research, and the applicable conditions of the various methods in practical use.
    No preview · Article · Jun 2014 · Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi
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    ABSTRACT: Objective To evaluate the production and utilization of Cochrane systematic reviews(CSRs) and to analyze its influential factors, so as to improve the capacity of translating CSRs into practice.Methods All CSRs and protocols were retrieved from the Cochrane Library ISSUE 2, 2011 and citation data were retrieved from SCI database. Citation analysis was used to analyze the situation of CSRs production and utilization.ResultsCSR publication had grown from an annual average of 32 to 718 documents. Only one developing country was among the ten countries with the largest amount of publications. High income countries accounted for 83% of CSR publications and 90.8% of cited counts. 34.7% of CSRs had a cited count of 0, while only 0.9% had been cited more than 50 times. Highly cited CSRs were published in England, Australia, Canada, USA and other high income countries. The countries with a Cochrane center or a Cochrane methodology group had a greater capability of CSRs production and citing than others. The CSRs addressing the topics of diseases were more than those targeted at public health issues. There was a big gap in citations of different interventions even for the same topic.Conclusion The capability of CSR production and translation grew rapidly, but varied among countries and institutions, which was affected by several factors such as the capability of research, the resourcesand the applicability of the evidence. It is important to improve evidence translation through educating, training and prioritizing the problems based on real demands of end user.This article is protected by copyright. All rights reserved.
    No preview · Article · May 2014 · Journal of Evidence-Based Medicine
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    ABSTRACT: The Glu298Asp polymorphism in the NOS3 gene has been implicated as a risk factor for prostate cancer. To date, several studies have evaluated the associations between the Glu298Asp polymorphism and prostate cancer risk; however, the results were inconclusive. The aim of the current study was to perform a meta-analysis to investigate the association between the polymorphism and the risk of prostate cancer. A total of 3,206 cases and 3,880 controls from eight case-control studies were included for data synthesis. The overall results suggested no significant association between the polymorphism and the risk of prostate cancer (OR=1.01, 95 % CI=0.92-1.11, p = 0.83 for Asp/Asp+Glu/Asp vs. Glu/Glu). In the stratified analysis according to ethnicity, no significant associations were observed in Asians and Europeans. The current meta-analysis suggested that the Glu298Asp polymorphism of the NOS3 gene might not contribute to the risk of prostate cancer.
    No preview · Article · Feb 2014 · Tumor Biology
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    ABSTRACT: The -786T > C polymorphism in NOS3 gene may affect the DNA repair pathways and be associated with risk of cancer. However, the results of previous studies are inconsistent. The objective of this study is to investigate the association between the -786T > C polymorphism in NOS3 and risk of cancer by meta-analysis. We searched PubMed, Embase, CNKI, and Wanfang databases and the last search was updated on Sept. 20, 2013. Statistical analysis was performed using Revman4.2 and Stata10.0 software. A total of 9 case-control studies concerning 4,089 cases and 3,847 controls were included. The results suggested a significant association between the -786T > C polymorphism in NOS3 and cancer risk (CC vs. TT + CT; OR = 1.30, 95 % CI = 1.07-1.57, P = 0.007) in total analysis. In the subgroup analysis by ethnicity and cancer types, significant associations were found in the breast cancer subgroup (OR 1.51, 95 % CI 1.07-2.12; P = 0.02) and European subgroup (OR 1.26, 95 % CI 1.01-1.58; P = 0.04). The current meta-analysis suggested that the -786T > C polymorphisms in NOS3 may be a risk factor for cancer. In the future, more case-control studies are needed to validate our results.
    No preview · Article · Jan 2014 · Tumor Biology
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    ABSTRACT: The Arg188His polymorphism in the XRCC2 gene has been suggested as a risk factor for cancer with inconclusive results. The aim of the current study is to investigate the association between the polymorphism with of cancer by meta-analysis. A total of 33 case-control studies from 27 publications were included for data analyses. The results suggested that the Arg188His polymorphism was not associated with increased/decreased risk of cancer in total analysis (Arg/His+His/His vs. Arg/Arg: OR = 0.98, 95 % CI = 0.91-1.06). In the subgroup analysis by ethnicity, no statistical significant association was found in Europeans. In the subgroup analysis by cancer types, statistical significant association was found in ovarian cancer but not in other cancers. The current meta-analysis indicated that the Arg188His polymorphism in the XRCC2 gene might be a risk factor for ovarian cancer. In the future, more large-scale case-control studies are needed to validate our results.
    No preview · Article · Jan 2014 · Tumor Biology

  • No preview · Article · Dec 2013 · Diabetes Obesity and Metabolism
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    ABSTRACT: The Thr241Met polymorphism in XRCC3 gene may affect the DNA repair pathways and be associated with the risk of cancer. However, the results of previous studies are inconsistent in Chinese mainland populations. The objective of this study is to investigate the association between the Thr241Met polymorphism in XRCC3 gene and risk of cancer for the Chinese Mainland populations by meta-analysis. We searched PubMed database, Embase database, CNKI database, and Wanfang database, and the last search was updated on July 24, 2013. Statistical analysis was performed using RevMan4.2 and Stata10.0 software. Finally, a total of 23 case-control studies in 23 articles were included. The results suggested a significant association between the Thr241Met polymorphism in XRCC3 gene and cancer risk in Chinese mainland populations (Met/Met + Thr/Met vs. Thr/Thr: OR = 1.25, 95 % CI = 1.02-1.54, P = 0.04). In the subgroup analyses by cancer types, significant associations were found in cervical cancer and nasopharyngeal cancer. The current meta-analysis suggested that the Thr241Met polymorphism in the XRCC3 gene may be a risk factor for cancer in Chinese mainland populations. In the future, more case-control studies are needed to validate these results.
    No preview · Article · Nov 2013 · Tumor Biology
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    ABSTRACT: To review and synthesize published evidence of pay-for-performance (P4P) effects on management of diabetes. Databases including Ovid MEDLINE, EMbase, PubMed, The Cochrane Library (Issue 3, 2012) were comprehensively searched for the effects of P4P programs in terms of patient outcomes and physician behaviors. Studies covering detailed data were included and synthesized. The quality of the body of evidence for each quality indicator was determined using Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Among 742 identified articles, 12 interrupted time series studies, 7 controlled before-after studies, and 2 cross-sectional studies were included. Additionally, 12 studies were further included for quantitative analysis. Results of meta-analysis showed that P4P produced generally positive effects in most indicators (eg, patients with records of total cholesterol or blood pressure). However, these results were inconsistent. The percentage of patients with HbA1c ≤ 7% or 53 mmol/mol showed a pooled odds ratio of 0.98 in patients, but a pooled mean difference of 19.71% in the physician groups. The odds ratios of receiving tests/reaching an outcome level were also diverse in patients (odds ratios ranged from 0.98 to 3.32). Besides, process indicators had higher rates of improvement than outcome indicators. P4P programs have variable impacts on patient outcomes of diabetes as well as physician behaviors, with various effects from negligible to strongly beneficial. Considering the low quality of the included studies, this conclusion should be cautiously interpreted.
    No preview · Article · Aug 2013 · Journal of Evidence-Based Medicine
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    ABSTRACT: Polymorphisms in the MGMT gene have been implicated in susceptibility to cancer, but the published studies have reported inconclusive results. The objective of the current study was to investigate the genetic risk of polymorphisms in the MGMT gene for cancer. A meta-analysis was carried out to analyze the association between polymorphisms in the MGMT gene and cancer risk. Five polymorphisms (Leu84Phe, Leu53Leu, Ile143Val, Lys178Arg, and -485C/A) with 98 case-control studies from 49 articles were analyzed. The results indicated that individuals who carried the Phe/Phe homozygote genotype of Leu84Phe had a 31 % increased risk of cancer compared with the Leu allele (Leu + Leu/Phe) carriers (odds ratio [OR] = 1.32, 95 % confidence interval [CI] = 1.15-1.52, P < 0.0001 for Phe/Phe vs. Phe/Leu + Leu/Leu). However, there was no significant association between the risk of cancer and the other four polymorphisms (Leu53Leu, Ile143Val, Lys178Arg, and -485C/A). In further stratified analyses for the Leu84Phe and Ile143Val polymorphisms, the increased risk of cancer remained in subgroups of Caucasians, patients with esophageal cancer for the Leu84Phe polymorphism, and patients with lung cancer for the Ile143Val polymorphism. Results from the current meta-analysis suggested that Leu84Phe and Ile143Val in the MGMT gene are risk factors for cancer. In the future, more studies should be performed to validate our results.
    Full-text · Article · Jun 2013 · Tumor Biology
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    ABSTRACT: The Cdx-2 polymorphism in VDR gene has been extensively investigated for association with cancer risk, however, results of different studies have been inconsistent. The objective of this study is to assess the relationship of the Cdx-2 polymorphism in VDR and cancer risk by meta-analysis. All eligible case-control studies were searched in Pubmed, Embase, CNKI and Wanfang databases. Odds ratios (OR) with the 95 % confidence intervals (CI) were used to assess the association. A total of 12,906 cases and 13,700 controls in 18 case-control studies were included. The results indicated that the AA homozygote carriers had a 16 % increased risk of cancer, when compared with the homozygote GG and heterozygote AG (OR = 1.16, 95 % CI 1.05-1.29 for AA vs. GG+AG). In the subgroup analysis by ethnicity, significant elevated risks were associated with AA homozygote carriers in Caucasians (OR = 1.16, 95 % CI 1.01-1.33, and P = 0.04) and African Americans (OR = 1.31, 95 % CI 1.07-1.61, and P = 0.01). In the subgroup analysis by cancer types, the polymorphism was associated with increased risk of breast cancer (OR = 1.23, 95 % CI 1.04-1.46, and P = 0.02). This meta-analysis suggested that the Cdx-2 polymorphism of VDR gene would be a risk factor for cancer. To further evaluate gene-to-gene and gene-to-environmental interactions between polymorphisms of VDR gene and cancer risk, more studies with large groups of patients are required.
    No preview · Article · May 2013 · Molecular Biology Reports
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    ABSTRACT: Background The associations between the polymorphisms in Cytotoxic T lymphocyte-associated molecule-4 (CTLA-4) gene and Graves’ disease (GD) have been extensively investigated in Chinese population. However, the results were inconsistent. The objective of this study is to investigate the associations between the polymorphisms in CTLA-4 gene and the risk of GD by meta-analysis. Methods We searched Pubmed database, Medline (Ovid) database, CNKI database and Wanfang database, covering all studies until August 11, 2012. Statistical analysis was performed by using the Revman4.2 software and the Stata10.0 software. Results A total of 28 case–control studies concerning the most widely studied three polymorphisms [+49A/G(rs231775), -318C/T(rs5742909) and CT60(rs3087243)] for Chinese population in 21 publications were included. The results suggested that the G allele carriers (GG+GA) might have an increased risk of GD when compared with the AA homozygote carriers for the +49A/G polymorphism (GG+GA vs. AA: OR = 2.57, 95%CI = 1.87-3.52). However, as to the -318C/T polymorphism and CT60 polymorphism, the results indicated that the variant allele carriers might have decreased risks of GD when compared with the homozygote carriers (−318C/T: TT+TC vs. CC: OR = 0.78, 95%CI = 0.62-0.97; CT60: AA+AG vs. GG: OR = 0.64, 95%CI = 0.52-0.78). Conclusions The current meta-analysis indicated that the polymorphisms in the CLTA-4 gene might be risk factors for GD in the Chinese population. In future, more large-scale case–control studies are needed to validate these results.
    Full-text · Article · Apr 2013 · BMC Medical Genetics
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    ABSTRACT: The poly(A) polymorphism (L/S) in the VDR gene has been implicated in susceptibility of cancer, but a number of studies have reported inconclusive results. The aim of this study is to investigate the relationship between the poly(A) polymorphism in the VDR gene and cancer risk by meta-analysis. We searched PubMed database, EMBASE database, CNKI database, and Wanfang database, covering all studies until January 22, 2013. Statistical analysis was performed by using the software Revman4.2 and STATA 10.0. A total 8,186 cancer cases and 8,685 controls in 19 case-control studies from 15 studies were identified for data analysis. The results suggested that the S allele carriers (SS + SL) did not have an increased or decreased risk of cancer when compared with the homozygote LL carriers (odds ratio (OR) = 0.96, 95 % CI = 0.87-1.06, P = 0.43 for SS + SL vs. LL). In addition, in the subgroup analysis by ethnicity and cancer type, no significant association was found among Caucasians, African-Americans, prostate cancer, or breast cancer. This current meta-analysis suggested that the poly(A) polymorphism in the VDR gene may not contribute to the risk of cancer. Future studies are needed to validate our findings.
    Full-text · Article · Mar 2013 · Tumor Biology
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    ABSTRACT: To evaluate the production and utilization of Cochrane systematic reviews (CSRs) and to analyze its influential factors, so as to improve the capacity of translating CSRs into practice. All CSRs and protocols were retrieved from the Cochrane Library (Issue 2, 2011) and citation data were retrieved from SCI database. Citation analysis was used to analyze the situation of CSRs production and utilization. CSR publication had grown from an annual average of 32 to 718 documents. Only one developing country was among the ten countries with the largest amount of publications. High-income countries accounted for 83% of CSR publications and 90.8% of cited counts. A total 34.7% of CSRs had a cited count of 0, whereas only 0.9% had been cited more than 50 times. Highly cited CSRs were published in England, Australia, Canada, USA and other high-income countries. The countries with a Cochrane center or a Cochrane methodology group had a greater capability of CSRs production and citing than others. The CSRs addressing the topics of diseases were more than those targeted at public health issues. There was a big gap in citations of different interventions even on the same topic. The capability of CSR production and utilization grew rapidly, but varied among countries and institutions, which was affected by several factors such as the capability of research, resources and the applicability of evidence. It is important to improve evidence translation through educating, training and prioritizing the problems based on real demands of end users.
    Preview · Article · Feb 2013 · Journal of Evidence-Based Medicine
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    Liang Du · Yaolong Chen · Jin Huang · Youping Li
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    ABSTRACT: Background: The numbers of systematic reviews (SRs) and meta-analyses (MAs) published in China have dramatically increased in recent years. Comprehensive analysis of their citation status may prove beneficial to the production and integration of high quality research, thereby increasing the quality of medical policy-making, research, and clinical practice. Methods and finds: The Chinese Medical Citation Index (up to February 2010) was searched to identify SRs/MAs. Data were input using Microsoft Excel 2007 and statistical analysis was performed using SPSS 15.0 software. A total of 2224 SRs/MAs were included. Among the 591 different publications distributed from 1994 to 2009, the median publication count per publication was two (1-270). The total citation count was 2796, with an average of 1.26 citations per publication (0-57 citation). SRs/MAs that were never cited amounted to 1380 papers (62.1%), distributed in 272 journals (46.0%). MAs were easier to find than SRs. The major conditions affecting citation were whether or not the report was published in a Western field (r = 0.287, P = 0.000); whether or not the report was published in an "evidence-based" titled journal (r =-0.480, P = 0.002); and the length of time since publication (r = 0.455, P = 0.000). Since 2004, publication of SRs/MAs has exhibited a downward trend, forming a negative correlation with publication count. Conclusions: Over half of the SRs/MAs included had never been cited by the time research had concluded. In many other cases these reports exhibited extremely low citation rates. Citation of traditional Chinese medicine SRs/MAs exceeded that of Western medicine studies. This indirectly suggests that the quality of SRs/MAs usage is relatively low in China. This may be a result of various reasons and suggests that emphasis should be placed on raising the quality of SRs/MAs and significance of practical application.
    Preview · Article · May 2012 · Journal of Evidence-Based Medicine