systemic review课件

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1、Systemicreview--CAMforeyeproblems--1.Antioxidantvitaminsandmineralsupplementstopreventthedevelopmentofage-relatedmaculardegenerationEvansJR,LawrensonJG.PublishedOnline:June13,2012Background:Thereisinconclusiveevidencefromobservationalstudiestosuggesttha

2、tpeoplewhoeatadietrichinantioxidantvitamins(carotenoids,vitaminsCandE)orminerals(seleniumandzinc)maybelesslikelytodevelopage-relatedmaculardegeneration(AMD).Objectives:Toexaminetheevidenceastowhetherornottakingantioxidantvitaminormineralsupplementspreven

3、tsthedevelopmentofAMD.Searchstrategy:WesearchedCENTRAL(whichcontainstheCochraneEyesandVisionGroupTrialsRegister)(TheCochraneLibrary2011,Issue12)MEDLINE(January1950toJanuary2012)EMBASE(January1980toJanuary2012)OpenGrey(SystemforInformationonGreyLiterature

4、inEurope)(www.opengrey.eu/)themetaRegisterofControlledTrials(mRCT)(www.controlled-trials.com)ClinicalTrials.gov(www.clinicaltrials.gov)WHOInternationalClinicalTrialsRegistryPlatform(ICTRP)(www.who.int/ictrp/search/en).Therewerenodateorlanguagerestriction

5、sintheelectronicsearchesfortrials.Theelectronicdatabaseswerelastsearchedon26January2012.Selectioncriteria:Weincludedallrandomisedcontrolledtrials(RCTs)comparinganantioxidantvitaminand/ormineralsupplement(aloneorincombination)tocontrol.Datacollectionandan

6、alysis:Bothreviewauthorsindependentlyassessedriskofbiasintheincludedstudiesandextracteddata.OneauthorentereddataintoRevMan5andtheotherauthorcheckedthedataentry.Wepooleddatausingafixed-effectmodel.Mainresults:WeincludedfourRCTsinthisreview;62,520peoplewer

7、eincludedintheanalyses.ThetrialswereconductedinAustralia,FinlandandtheUSAandinvestigatedvitaminEandbeta-carotenesupplements.Overallthequalityoftheevidencewashigh.Peoplewhotookthesesupplementswerenotatdecreased(orincreased)riskofdevelopingAMD.Thepooledris

8、kratioforanyantioxidantsupplementinthepreventionofanyAMDwas0.98(95%confidenceinterval0.89to1.08)andforadvancedAMDwas1.05(95%CI0.80to1.39).Similarresultswereseenwhentheanalyseswererestrictedtobeta-caroteneandalpha-tocophero