Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
BMJ Open. 2023 Apr 6;13(4):e066853. doi: 10.1136/bmjopen-2022-066853.
Novel oral anticoagulants (NOACs) have been used in antithrombotic therapy in patients with cancer, and their efficacy and safety have been evaluated in several meta-analyses. Although a large body of findings has accumulated to support the benefit of NOACs for the treatment and prevention of cancer-associated thromboembolism, there is no convincing evidence because of inconsistent results across studies and questionable data quality. Its efficacy and safety remain controversial, especially with regard to the risk of bleeding.
We will search PubMed, Embase and Web of science, Cochrane Library on 19 April 2022 (searches will be updated until complete) to identify systematic reviews, meta-analyses and pooled analyses of the efficacy and safety of NOACs for the treatment of cancer-associated venous thromboembolism. The quality of eligible systematic evaluations will be measured by A Measurement Tool to Assess Systematic Reviews. For each outcome, if a random effects model is not used, we will extract the data and estimate a 95% CI using the random effects model approach. For each random effects estimate, a 95% prediction interval is calculated. Heterogeneity between studies will be quantified using the I metric. In addition, if an assessment contains at least three articles, we will reanalyse the assessment using Egger's asymmetry test to detect and visualise possible publication bias in the articles.
No formal ethical approval is required since we will use publicly available data. We will disseminate the findings of the umbrella review through publication in a peer-reviewed journal and conference presentations.
CRD42022342053.
新型口服抗凝剂（NOACs）已用于癌症患者的抗血栓治疗，其在几项荟萃分析中评估了疗效和安全性。尽管有大量研究结果支持 NOAC 治疗和预防癌症相关血栓栓塞的益处，但由于研究结果不一致和数据质量存在疑问，尚无令人信服的证据。其疗效和安全性仍存在争议，特别是出血风险。
我们将在 2022 年 4 月 19 日（搜索将持续更新至完成）搜索 PubMed、Embase 和 Web of Science、Cochrane Library，以确定新型口服抗凝剂治疗癌症相关静脉血栓栓塞的疗效和安全性的系统评价、荟萃分析和汇总分析。合格系统评价的质量将通过 A 测量工具评估系统评价进行测量。对于每个结局，如果未使用随机效应模型，我们将提取数据并使用随机效应模型方法估计 95%CI。对于每个随机效应估计值，计算 95%预测区间。使用 I 度量量化研究之间的异质性。此外，如果评估包含至少三篇文章，我们将使用 Egger 的不对称检验重新分析评估，以检测和可视化文章中可能存在的发表偏倚。
由于我们将使用公开可用的数据，因此不需要正式的伦理批准。我们将通过在同行评审期刊上发表和会议报告来传播伞式综述的结果。
PROSPERO 注册号：CRD42022342053。
