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自从meta分析传入中国后，中国人写的meta分析就出现了爆炸性增长。随着时间的推移，大家会发现可以做meta的题目越来越少了。于是，meta分析被认为是生产SCI的机器，有人可以一年发十几篇，太可怕了，有些单位开始取消对meta分析的奖励和评职称。那什么会这样呢？原因很简单，很多人认为这是在灌水，meta分析是发论文的工具，会给单位抹黑。难道meta分析真的没有用吗？答案是否定的，其实meta分析对临床指南的制定起着至关重要的决定，能为临床医生和患者提供重要的参考信息。不过，meta分析需要我们用心去做，用自己的良心去做，本着为医学做贡献的心态去做，而不是只是简单地为了毕业、评职称、领奖金，做到这些，可以说自己的是高质量meta分析。在十年之前，meta分析随便都能发3-5分的文章，甚至可以轻松地发10+，但是现在不行了，因为物以稀为贵。 ......split...... 林林总总地说了很多，今天在这里给大家分享一篇高分文章，来自BMJ。 题目：Immune-related adverse events for anti-PD-1 and anti-PD-L1 drugs: systematic review and meta-analysis ABSTRACT OBJECTIVE To evaluate rates of serious organ specific immunerelated adverse events, general adverse events related to immune activation, and adverse events consistent with musculoskeletal problems for anti-programmed cell death 1 (PD-1) drugs overall and compared with control treatments. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, Embase, Cochrane Library, Web of Science, and Scopus searched to 16 March 2017 and combined with data from ClinicalTrials.gov. STUDY SELECTION Eligible studies included primary clinical trial data on patients with cancer with recurrent or metastatic disease. DATA EXTRACTION Three independent investigators extracted data on adverse events from ClinicalTrials.gov and the published studies. Risk of bias was assessed using the Cochrane tool by three independent investigators. RESULTS 13 relevant studies were included; adverse event data were available on ClinicalTrials.gov for eight. Studies compared nivolumab (n=6), pembrolizumab (5), or atezolizumab (2) with chemotherapy (11), targeted drugs (1), or both (1). Serious organ specific immunerelated adverse events were rare, but compared with standard treatment, rates of hypothyroidism (odds ratio 7.56, 95% confidence interval 4.53 to 12.61), pneumonitis (5.37, 2.73 to 10.56), colitis (2.88, 1.30 to 6.37), and hypophysitis (3.38, 1.02 to 11.08) were increased with anti-PD-1 drugs. Of the general adverse events related to immune activation, only the rate of rash (2.34, 2.73 to 10.56) increased. Incidence of fatigue (32%) and diarrhea (19%) were high but similar to control. Reporting of adverse events consistent with musculoskeletal problems was inconsistent; rates varied but were over 20% in some studies for arthraligia and back pain. CONCLUSIONS Organ specific immune-related adverse events are uncommon with anti-PD-1 drugs but the risk is increased compared with control treatments. General adverse events related to immune activation are largely similar. Adverse events consistent with musculoskeletal problems are inconsistently reported but adverse events may be common. 大家可以发现在BMJ可以发现，meta是做为论著的，而不是综述。 总结：对于免疫疗法治疗肿瘤疗效的meta分析几年之前就被人家做烂了，就我们中国人写的就有很多篇。但是为什么它现在能发如此高分的期刊？我只看了一眼题目就知道了答案，那就是作者创新能力非常强，别人是把疗效给做烂了，但是关于免疫相关的不良事件很少人关注，作者就想到这个，于是就发了这篇文章。 有些学员总是说自己找不到题目，所有题目都被做了。在这里教大家一点，别人是做了很多药物的疗效，但是你可以做一些不起眼的不良事件 ，就是创新了。希望本文能对大家有所帮助。 ......split...... 也许你对一下有兴趣： |
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