The Nordic Nutrition Recommendations 2022 – handbook for qualified systematic reviews

Arnesen, Erik; Christensen, Jacob J.; Andersen, Rikke; Eneroth, Hanna; Erkkola, Maijaliisa; Høyer, Anne; Lemming, Eva Warensjö; Meltzer, Helle Margrete; Halldórsson, Thorhallur I.; Þórsdóttir, Inga; Schwab, Ursula; Trolle, Ellen; Blomhoff, Rune

doi:10.29219/fnr.v64.4404

Cited by 25 publications

(51 citation statements)

References 27 publications

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“…The aim of this paper is to describe the basic structure of the SRs conducted in the field of medical and nutritional sciences, and the rationale underlying each methodological step. The detailed methodology for SRs performed as part of the NNR2022 project is described in Arnesen et al (2).…”

Section: Development Of Guidance For Srsmentioning

confidence: 99%

“…This will assess the clarity and understanding of the eligibility criteria and the search strategy. If good agreement is not achieved, the eligibility criteria will be refined or clarified (2).…”

Section: Screening and Selection Of Eligible Studiesmentioning

confidence: 99%

“…Risk of bias assessment is more complicated with nonrandomized studies, such as prospective cohort studies (32). However, selection bias, performance bias, detection bias, attrition bias, and reporting bias should be assessed (2). Especially, the potential for selection bias is likely higher in most nonrandomized studies, such that the exposed and non-exposed groups are imbalanced when it comes to prognostic factors.…”

Section: Assessment Of Risk Of Biasmentioning

confidence: 99%

“…Structure and rationale of qualified systematic reviews (this article), and 3. Handbook for qualified systematic reviews (2).…”

mentioning

confidence: 99%

“…The present paper, paper 2, describes aspects of the methodology related to SRs in NNR2022. It provides explanations for the stepwise guidance described in paper 3 (2). The three papers should be considered as a unity.…”

mentioning

confidence: 99%

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The Nordic Nutrition Recommendations 2022 – structure and rationale of qualified systematic reviews

Arnesen

Christensen

Andersen

et al. 2020

Food & Nutrition Research

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Section: Development Of Guidance For Srsmentioning

confidence: 99%

Section: Screening and Selection Of Eligible Studiesmentioning

confidence: 99%

Section: Assessment Of Risk Of Biasmentioning

confidence: 99%

“…Structure and rationale of qualified systematic reviews (this article), and 3. Handbook for qualified systematic reviews (2).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Nordic Nutrition Recommendations 2022 – structure and rationale of qualified systematic reviews

Arnesen

Christensen

Andersen

et al. 2020

Food & Nutrition Research

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Efficacy and Safety of Compound Kushen Injection for Advanced Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with Trial Sequential Analysis

Wu,

Ma,

Wang

et al. 2024

Integr Cancer Ther

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Backgrounds: Colorectal cancer (CRC) is one of the common malignant tumors, with a gradually increasing incidence. Due to late detection and poor sensitivity to chemotherapy, it has become a difficult problem in tumor prevention and treatment at present. Exploring or discovering new combinations is a significant strategy for the treatment of CRC. Compound kushen injection (CKI) is a traditional Chinese medicine injection extracted from Sophora flavescens Ait. and Smilax glabra Roxb., which is widely used in the comprehensive treatment of CRC in China. This systematic review is aimed to ascertain the clinical efficacy and safety of CKI combined with chemotherapy in the treatment of advanced CRC based on available data. On this basis, the specific application of CKI in combination with chemotherapy in clinical practice is further discussed. Methods: PubMed, Web of Science, the Cochrane Library, EMBASE, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Wanfang Database, Chinese Biomedicine Database Searches, the Chinese Clinical Trial Registry, and ClinicalTrials.gov were searched systematically, from inception to April 20, 2024. We adopted the ROB2 tool to assess quality of the included trials, Stata 16 for data analysis, and evaluated the publication bias with the funnel plot and Egger’s test. The quality of the evidence was justified according to GRADE. We also used trial sequential analysis (TSA) to calculate the final required sample size in this meta-analysis and to verify whether the results present a reliable conclusion. The protocol for this systematic review was registered on PROSPERO (CRD42022380106) and has been published. Results: Sixteen trials that examined 1378 patients were included in this study. Meta-analysis revealed that compared with chemotherapy, objective response rate (ORR, RR = 1.30, 95% CI: 1.18-1.44), disease control rate (DCR, RR = 1.08, 95% CI: 1.03-1.13), and KPS score improvement rate were improved (RR = 1.18, 95% CI: 1.07-1.31) by the combination of CKI and chemotherapy in patients with advanced CRC. Additionally, CKI combined with chemotherapy was associated with lower adverse reactions such as leukopenia (RR = 0.74, 95% CI: 0.62-0.87), thrombocytopenia (RR = 0.68, 95% CI: 0.49-0.94), gastrointestinal reactions (RR = 0.72, 95% CI: 0.55-0.94), and liver damage (RR = 0.48, 95% CI: 0.30-0.79), higher CD4+ ratio (MD = 9.70, 95% CI:8.73-10.68) and CD4+/CD8+ ratio (MD = 0.25, 95% CI: 0.22-0.28), and lower CD8+ T cell ratio (MD = −5.25, 95% CI: −5.94 to −4.56). Subgroup analysis demonstrated that ORR and DCR in patients with advanced CRC were improved when CKI combined with FOLFOX and 5Fu + L-OHP. Both 15 and 20 ml/day of CKI combined with FOLFOX provided a significant effect in ORR. Moreover, ORR was improved when the accumulated CKI dose reached 280 ml per course and 420 ml in total. 7 days/course as well as 14 days/course of CKI combined with FOLFOX were effective durations in ORR. As for DCR, 7 days/course of CKI combined with FOLFOX could improve efficacy. Furthermore, CKI + FOLFOX may be useful in ORR and DCR for at least 4 cycles of combination therapies. The TSA showed that firm results in ORR and DCR were established and additional trials were unlikely to change the results. Conclusion: CKI combined with chemotherapy provides a statistically significant and clinically important effect in the improvement of ORR, DCR, performance status, ADR reduction, and immune function in patients with CRC. However, more rigorously designed, large-scale, and multi-center RCTs are needed in the future.

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Evidence and lifestyle – New nordic recommendations about nutrition and diet – emphasis on sustainability

Þórsdóttir,

Þórisdóttir,

Ramel

et al. 2023

LBL

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Evaluation of research as basis for recommendations about lifestyle is discussed and especially recommendations about nutrition. Nordic recommendations on nutrients and diet with emphasis on sustainability are published 2023. Randomized trials, the strongest background for evidence based knowledge, are sometimes not possible to use when studying the influence of lifestyle on health. A tool applied in the Nordic recommendations 2023 evaluates the strength of relation between exposures (nutrients and food groups) and outcomes (health and environment), where research methods are observed and an organized quality control applied. The Interngovernmental Panel on Climate Change (IPCC) estimates the share of food systems in global anthropogenic GHG emissions is 31% (23%-42%). Nations now work on cutting GHG emissions from food systems by strengthening food based dietary guidelines and including sustainability, which benefits both health and environment. The recommendations about nutrients 2023 use harmonized methods and new data on body size in the Nordics. The food based dietary guidelines 2023 meet people‘s requirements for nutrients and are healthy for the environment. Physicians and other health professions will have the possibility to stimulate people´s interest to adhere to the recommendations about nutrition and diet built on a stronger and broader basis than before.

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The Nordic Nutrition Recommendations 2022 – handbook for qualified systematic reviews

Cited by 25 publications

References 27 publications

The Nordic Nutrition Recommendations 2022 – structure and rationale of qualified systematic reviews

The Nordic Nutrition Recommendations 2022 – structure and rationale of qualified systematic reviews

Efficacy and Safety of Compound Kushen Injection for Advanced Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with Trial Sequential Analysis

Evidence and lifestyle – New nordic recommendations about nutrition and diet – emphasis on sustainability

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