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首页> 外文期刊>Journal of Gastrointestinal Oncology >Comparative effectiveness of chemopreventive interventions for colorectal cancer: protocol for a systematic review and network meta-analysis of randomised controlled trials
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Comparative effectiveness of chemopreventive interventions for colorectal cancer: protocol for a systematic review and network meta-analysis of randomised controlled trials

机译：化学预防干预措施对结直肠癌的比较有效性：系统评价和随机对照试验网络荟萃分析的方案

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Background: Colorectal cancer (CRC) is the third most common cancer worldwide and is associated with substantial socioeconomic burden. Despite considerable research, including numerous randomised controlled trials (RCTs) and systematic reviews assessed the effect of various chemopreventive interventions for CRC, there remains uncertainty regarding the comparative effectiveness of these agents. No network meta-analytic study has been published to evaluate the efficacies of these agents for CRC. Therefore, the aim of this study is to summarise the direct and indirect evidence for these interventions to prevent CRC in average-high risk individuals, and to rank these agents for practical consideration. Methods: We will acquire eligible studies through a systematic search of MEDLINE, EMBASE, the Cochrane Central Registry of Controlled Trials, CINAHL plus, IPA and clinicaltrials.gov website. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primary outcomes are the incidence of CRC, the incidence/recurrence of any adenoma or change in polyp burden (number or size). Quantitative synthesis or meta-analysis will be considered. We will also construct a network meta-analysis (NMA) to improve precision of the comparisons among chemo-preventive interventions by combining direct and indirect evidence. The probability of each treatment being the best and/or safest, the number-needed-to-treat [NNT; 95% credible interval (CrIs)], and the number-needed-to-harm (NNH; 95% CrIs) will be calculated to provide measures of treatment efficacy. The GRADE approach will be used to rate the quality of evidence of estimates derived from NMA. Results: This protocol has been registered (registration number: CRD42015025849) with the PROSPERO (International Prospective Register of Systematic Reviews). The procedures of this systematic review and NMA will be conducted in accordance with the PRISMA-compliant guideline. The results of this systematic review and NMA will be submitted to a peer-reviewed journal for publication. Conclusions: To the best of our knowledge, this study will be the first NMA to identify the comparative effectiveness of interventions for the prevention of CRC. The results of our study will update evidence for chemoprevention of CRC, identify key areas for future research, and provide a framework for conducting large systematic reviews involving indirect comparisons.
机译：背景：结直肠癌（CRC）是全球第三大常见癌症，与巨大的社会经济负担相关。尽管进行了大量研究，包括众多随机对照试验（RCT）和系统评价评估了各种化学预防干预措施对CRC的效果，但这些药物的相对疗效仍存在不确定性。尚未发表网络荟萃分析研究来评估这些药物对CRC的疗效。因此，本研究的目的是总结这些干预措施的直接和间接证据，以预防普通高危人群中的CRC，并对这些药物进行分级以供实际考虑。方法：我们将通过系统搜索MEDLINE，EMBASE，Cochrane对照试验中央注册中心，CINAHL plus，IPA和Clinicaltrials.gov网站来获得合格的研究。 Cochrane偏倚风险工具将用于评估纳入研究的质量。主要结局是CRC的发生率，任何腺瘤的发生/复发或息肉负担（数量或大小）的变化。将考虑定量合成或荟萃分析。我们还将构建网络荟萃分析（NMA），以通过结合直接证据和间接证据来提高化学预防措施之间比较的准确性。每种治疗是最好和/或最安全的几率，即需要治疗的数量[NNT; 95％可信区间（CrIs）]和所需伤害数（NNH; 95％CrIs）将被计算出来，以提供治疗效果的度量。 GRADE方法将用于评估NMA得出的估计证据的质量。结果：该协议已在PROSPERO（国际系统评价前瞻性注册）中注册（注册号：CRD42015025849）。系统审查和NMA的程序将按照PRISMA兼容指南进行。该系统评价和NMA的结果将提交给经过同行评审的期刊以供发表。结论：据我们所知，本研究将是第一个确定相对预防CRC效果的NMA。我们的研究结果将更新CRC化学预防的证据，确定未来研究的关键领域，并为进行涉及间接比较的大型系统评价提供框架。

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