Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea.
Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Korea.
PLoS One. 2024 Sep 6;19(9):e0308410. doi: 10.1371/journal.pone.0308410. eCollection 2024.
Obesity, characterized by excessive fat accumulation, poses a significant public health challenge globally. Recent advancements in medical technology have heralded the emergence of endoscopic bariatric treatments (EBTs) as innovative alternatives to conventional obesity interventions. Despite previous systematic reviews and network meta-analyses, they also highlighted discrepancies in outcomes and efficacy among different EBTs. Here, we will update a systematic review and network meta-analysis of randomized controlled trials (RCTs) focusing on EBTs and presents a protocol for the reproducibility and transparency.
The core protocol of this study was registered at PROSPERO database (CRD42024514249) on Jan 2024. Core databases including MEDLINE through PubMed, Embase, and Cochrane library will be searched relevant studies, and a systematic review with network meta-analysis will be performed. Two evaluators (EJ Gong and CS Bang) will independently screen the titles and abstracts following the eligibility criteria; (1) RCTs investigated the compared the efficacy of EBTs and controls; (2) studies published in English; and (3) studies in full-text format. We will exclude studies meeting the following criteria; (1) studies that did not report the treatment outcomes, such as percent excess weight loss or percent total body weight loss; (2) case reports and review articles; (3) ineligible research objects, for example, animals or children; and (4) insufficient data regarding treatment outcome. The primary outcomes will be the common efficacy metric found after systematic review of relevant studies, such as percent excess weight loss or percent total body weight loss with a follow-up of at least 6 months. Narrative (descriptive) synthesis is planned and quantitative synthesis will be used if the included studies are sufficiently homogenous. The quality of the identified studies will be assessed using the Cochrane Risk of Bias assessment tool version 2.0 (ROB 2.0). All the systematic review and network meta-analysis process will be undertaken keeping the principles of the Preferred Reporting Items for a Systematic Review and Meta-analysis for systematic review protocols (PRISMA-P) and PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions (PRISMA-NMA).
This updated systematic review and network meta-analysis will provide information about comparative efficacy of various EBTs and this will help physicians in the decision-making process for the selection of treatment modalities in the clinical practice.
肥胖症以脂肪过度积累为特征，是全球面临的重大公共卫生挑战。近年来，医学技术的进步带来了内镜减重治疗（EBT），成为传统肥胖干预手段的创新替代方案。尽管之前的系统评价和网络荟萃分析也强调了不同 EBT 之间的结果和疗效存在差异。在这里，我们将更新一项针对 EBT 的随机对照试验（RCT）的系统评价和网络荟萃分析，并介绍该研究的重现性和透明度方案。
本研究的核心方案于 2024 年 1 月在 PROSPERO 数据库（CRD42024514249）中注册。将通过 PubMed 的 MEDLINE、Embase 和 Cochrane 图书馆等核心数据库搜索相关研究，并进行系统评价和网络荟萃分析。两位评估者（EJ Gong 和 CS Bang）将独立根据纳入标准筛选标题和摘要；（1）RCT 研究了 EBT 与对照组的疗效比较；（2）发表在英语期刊上的研究；（3）全文格式的研究。我们将排除符合以下标准的研究；（1）未报告治疗结果的研究，例如过量体重减轻百分比或总体重减轻百分比；（2）病例报告和综述文章；（3）不适合的研究对象，例如动物或儿童；（4）关于治疗结果的数据不足。主要结局将是对相关研究进行系统评价后发现的常见疗效指标，例如随访至少 6 个月后的过量体重减轻百分比或总体重减轻百分比。如果纳入研究足够同质，将进行叙述（描述）综合，如果纳入研究足够同质，将进行定量综合。使用 Cochrane 偏倚风险评估工具 2.0（ROB 2.0）评估确定研究的质量。所有系统评价和网络荟萃分析过程都将遵循系统评价和荟萃分析的首选报告项目（PRISMA-P）和纳入医疗干预网络荟萃分析的系统评价报告扩展声明（PRISMA-NMA）的原则进行。
这项更新的系统评价和网络荟萃分析将提供关于各种 EBT 的相对疗效的信息，这将有助于医生在临床实践中为治疗方式的选择做出决策。
