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      Effect of different interventions on the treatment of high-risk human papillomavirus infection: a systematic review and network meta-analysis

      systematic-review

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          Abstract

          Background

          Persistent infection with high-risk human papillomavirus (HR-HPV) can lead to cervical intraepithelial neoplasia and cancer. At present, there is no medication that specifically targets HR-HPV infection.

          Objective

          This study aimed to evaluate the effectiveness of different interventions in promoting HR-HPV regression using a MeSH meta-analysis method.

          Methods

          A search for randomized controlled trials (RCTs) reporting different interventions for the treatment of HR-HPV infection included PubMed, Web of Science, Embase and Cochrane Library from the inception of the databases to March 8, 2023. Two researchers independently screened the articles, extracted data, and evaluated the quality. The literature that met the inclusion criteria was selected, the quality and risk of bias of the included studies were assessed according to the Cochrane 5.1 manual, and NMA was performed using Stata 16.0. The area under the cumulative ranking probability graph (SUCRA) represented the probability that each treatment would be the best intervention.

          Results

          Nine studies involving 961 patients and 7 treatment options were included in the analysis. The results of the network meta-analysis indicated the following rank order in terms of promoting HR-HPV conversion: Anti-HPV biological dressing > vaginal gel > imiquimod > REBACIN® > interferon > probiotics > observation/placebo > Polyphenon E.

          Conclusion

          Anti-HPV biological dressing treatment was found to be significantly effective in promoting HR-HPV conversion. However, further validation of the findings is necessary due to the limited number and quality of studies included in the analysis.

          Systematic review registration

          https://www.crd.york.ac.uk/prospero/, identifier CRD42023413917.

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          Most cited references39

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          The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials

          Flaws in the design, conduct, analysis, and reporting of randomised trials can cause the effect of an intervention to be underestimated or overestimated. The Cochrane Collaboration’s tool for assessing risk of bias aims to make the process clearer and more accurate
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            SPIRIT 2013 statement: defining standard protocol items for clinical trials.

            The protocol of a clinical trial serves as the foundation for study planning, conduct, reporting, and appraisal. However, trial protocols and existing protocol guidelines vary greatly in content and quality. This article describes the systematic development and scope of SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013, a guideline for the minimum content of a clinical trial protocol.The 33-item SPIRIT checklist applies to protocols for all clinical trials and focuses on content rather than format. The checklist recommends a full description of what is planned; it does not prescribe how to design or conduct a trial. By providing guidance for key content, the SPIRIT recommendations aim to facilitate the drafting of high-quality protocols. Adherence to SPIRIT would also enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, sponsors, funders, research ethics committees or institutional review boards, peer reviewers, journals, trial registries, policymakers, regulators, and other key stakeholders.
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              The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations.

              The PRISMA statement is a reporting guideline designed to improve the completeness of reporting of systematic reviews and meta-analyses. Authors have used this guideline worldwide to prepare their reviews for publication. In the past, these reports typically compared 2 treatment alternatives. With the evolution of systematic reviews that compare multiple treatments, some of them only indirectly, authors face novel challenges for conducting and reporting their reviews. This extension of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement was developed specifically to improve the reporting of systematic reviews incorporating network meta-analyses. A group of experts participated in a systematic review, Delphi survey, and face-to-face discussion and consensus meeting to establish new checklist items for this extension statement. Current PRISMA items were also clarified. A modified, 32-item PRISMA extension checklist was developed to address what the group considered to be immediately relevant to the reporting of network meta-analyses. This document presents the extension and provides examples of good reporting, as well as elaborations regarding the rationale for new checklist items and the modification of previously existing items from the PRISMA statement. It also highlights educational information related to key considerations in the practice of network meta-analysis. The target audience includes authors and readers of network meta-analyses, as well as journal editors and peer reviewers.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2312279/overviewRole: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2645117/overviewRole: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/2645091/overviewRole: Role:
                URI : https://loop.frontiersin.org/people/2645101/overviewRole: Role:
                URI : https://loop.frontiersin.org/people/2645050/overviewRole: Role: Role:
                URI : https://loop.frontiersin.org/people/2645108/overviewRole: Role:
                Journal
                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                2296-858X
                14 February 2024
                2024
                : 11
                : 1274568
                Affiliations
                [1] 1Department of Gynecology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences , Jinan, China
                [2] 2Key Laboratory of Laparoscopic Technology, department of Gynecology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital , Jinan, China
                [3] 3Department of Gynecology, Tengzhou Maternal and Child Health Hospital , Tengzhou, China
                [4] 4School of Public Health, Weifang Medical University , Weifang, China
                Author notes

                Edited by: Long Sui, Fudan University, China

                Reviewed by: Laurentiu Cornel Pirtea, Victor Babes University of Medicine and Pharmacy, Romania

                Martin Weiss, University Hospital Tübingen, Germany

                *Correspondence: Li Yan, yanliqy@ 123456163.com

                These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fmed.2024.1274568
                10899477
                38420364
                44955eea-aead-4266-ac17-72d81c83dd72
                Copyright © 2024 Wang, Cui, Zhang, Fan, Qiu and Yan.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 08 August 2023
                : 24 January 2024
                Page count
                Figures: 5, Tables: 2, Equations: 0, References: 39, Pages: 9, Words: 5799
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Scientific Research Fund of Shandong Province Medical Association (YXH2022ZX02148) and the Project of the Research Hospital Association of Shandong Province (2022001).
                Categories
                Medicine
                Systematic Review
                Custom metadata
                Obstetrics and Gynecology

                hr-hpv,conversion rate,comparison,network meta-analysis,randomized controlled trial

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