Postgraduate Program in Rehabilitation and Functional Performance, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil.
PLoS One. 2022 Oct 3;17(10):e0274406. doi: 10.1371/journal.pone.0274406. eCollection 2022.
INTRODUCTION: Although several non-pharmacological interventions have been tested in the management of Fibromyalgia (FM), there is little consensus regarding the best options for the treatment of this health condition. The purpose of this network meta-analysis (NMA) is to investigate the comparative efficacy and acceptability of non-pharmacological interventions for FM, in order to assist clinical decision making through a ranking of interventions in relation to the most important clinical outcomes in these patients. METHODS AND ANALYSIS: We will perform a systematic search to identify randomised controlled trials of non-pharmacological interventions endorsed in guidelines and systematic reviews. Information sources searched will include major bibliographic databases without language or date restrictions (MEDLINE, Cochrane Library, EMBASE, AMED, PsycINFO and PEDro). Our primary outcomes will be pain intensity, patient-reported quality of life (QoL), and acceptability of treatment will be our secondary outcome. Risk of bias of the included trials will be assessed using the Cochrane risk of bias tool (RoB2). For each pairwise comparison between the different interventions, we will present mean differences (MDs) for pain intensity and QoL outcomes and Relative Risks (RRs) for acceptability, both with respective 95% confidence intervals (CIs). Initially, standard pairwise meta-analyses will be performed using a DerSimonian-Laird random effects model for all comparisons with at least two trials and then we will perform a frequentist NMA using the methodology of multivariate meta-analysis assuming a common heterogeneity parameter, using the mvmeta command and network suite in STATA. In the NMA, two different types of control group, such as placebo/sham and no intervention/waiting list will be combined as one node called "Control". The competing interventions will be ranked using the P-score, which is the frequentist analogue of surface under the cumulative ranking curve (SUCRA) for the outcomes of interest at immediate- (intervention duration of up to 2 weeks), short- (over 2 weeks up to 12 weeks) and long-terms (over 12 weeks). The confidence in the results from NMA will be assessed using the Confidence in Network Meta-analysis (CINeMA) framework. ETHICS AND DISSEMINATION: This work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal. REGISTRATION: OSF (DOI: 10.17605/OSF.IO/7MS25) and registered in the PROSPERO database (CRD42020216374).
简介:尽管已经测试了几种非药物干预措施来治疗纤维肌痛(FM),但对于这种健康状况的最佳治疗方法仍存在共识。本网络荟萃分析(NMA)的目的是调查非药物干预措施治疗 FM 的相对疗效和可接受性,以便通过对这些患者最重要的临床结局的干预措施进行排名,为临床决策提供帮助。
方法和分析:我们将进行系统搜索,以确定指南和系统评价中推荐的非药物干预措施的随机对照试验。搜索的信息来源将包括主要的书目数据库,没有语言或日期限制(MEDLINE、Cochrane 图书馆、EMBASE、AMED、PsycINFO 和 PEDro)。我们的主要结局将是疼痛强度、患者报告的生活质量(QoL)和治疗的可接受性,我们的次要结局将是疼痛强度和 QoL 结局的平均差异(MDs)和可接受性的相对风险(RRs)。将使用 Cochrane 偏倚风险工具(RoB2)评估纳入试验的偏倚风险。对于不同干预措施之间的每一对比较,我们将呈现疼痛强度和 QoL 结局的均值差异(MDs)和可接受性的相对风险(RRs),并分别给出各自的 95%置信区间(CI)。最初,对于至少有两项试验的所有比较,将使用 DerSimonian-Laird 随机效应模型进行标准成对荟萃分析,然后我们将使用假设共同异质性参数的多变量荟萃分析方法进行概率 NMA,使用 mvmeta 命令和 STATA 中的网络套件。在 NMA 中,将把两种不同类型的对照组(安慰剂/假治疗和无干预/等待名单)合并为一个称为“对照组”的节点。将使用 P 分数对竞争干预措施进行排名,P 分数是感兴趣结局的即时(干预持续时间不超过 2 周)、短期(超过 2 周至 12 周)和长期(超过 12 周)的累积排序曲线下面积(SUCRA)的概率学类似物。使用置信网络荟萃分析(CINeMA)框架评估 NMA 结果的可信度。
伦理与传播:本工作综合了先前发表研究的证据,不需要伦理审查或批准。描述研究结果的手稿将提交给同行评议的科学期刊发表。
注册:OSF(DOI:10.17605/OSF.IO/7MS25)和 PROSPERO 数据库(CRD42020216374)。
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