 英语晨读 · 山东省立医院疼痛科英语晨读已经坚持10余年的时间了，每天交班前15分钟都会精选一篇英文文献进行阅读和翻译。一是可以保持工作后的英语阅读习惯，二是可以学习前沿的疼痛相关知识。我们会将晨读内容与大家分享，助力疼痛学习。 本次文献选自List EB, Krijgh DD, Martin E, Coert JH. Prevalence of residual limb pain and symptomatic neuromas after lower extremity amputation: a systematic review and meta-analysis. Pain. 2021;162(7):1906-1913. 本次学习由王珺楠副主任医师主讲。 2. Methods 2.1. Literature search A systematic literature review was performed in April 2020 searching PubMed and Embase databases for published literature. The search was executed in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA). A search string was built with the help of a professional librarian using search terms related to “Amputation,” “RLP,” and “Neuroma.” The exact search syntaxes for PubMed and Embase are shown in Supplementary File 1 (available at http://links./PAIN/B270). Articles were screened for relevance by 2 independent researchers (E.L. and D.K.). All cohort studies reporting the prevalence of RLP or symptomatic neuroma in patients, aged $ 18 years, who have had lower extremity amputation were included. In addition, articles were excluded in case of animal studies, a publication date before 2000, articles in any language other than English, Dutch, or German, sample sizes smaller than 40 patients, a mean follow-up of less than 6 months, no full-text availability, and duplicate data. 2.方法 2.1.文献检索 2020年4月对PubMed和Embase数据库中已发表的文献进行了系统的文献综述。搜索按照系统回顾和荟萃分析的首选报告项目(PRISMA)执行。在一名专业图书管理员的帮助下， 使用与“截肢”、 “RLP”和“神经瘤”相关的搜索词，构建一个搜索字符串。PubMed和Embase的确切搜索语法显示在补充文件1中(可在http://links./PAIN/B270上获得)。检索由2名独立的研究人员(E.L.和D.K.)完成。将所有年龄大于18岁，且下肢截肢的RLP或症状性神经瘤患病率的队列研究均包括在内。此外，动物研究、2000年之前发表的、英语、荷兰语或德语以外的、样本量小于40、平均随访小于6个月、无全文可用性和重复数据的文章均被剔除。 2.2. Data extraction The following data were extracted using a standardized form: title, authors, year of publication, study design, country, sample size, average age of participants, sex distribution, follow-up time, reason for amputation, level of amputation, data collection method, and RLP and symptomatic neuroma prevalence. Data extraction was performed by 2 independent researchers (E.L. and D.K.). Any uncertainties or disagreements were resolved by discussion among the authors. 2.2.数据提取 采用标准化表格提取以下数据：标题、作者、发表年份、研究设计、国别、样本量、参与者平均年龄、性别分布、随访时间、截肢原因、截肢水平、数据收集方法、RLP和症状性神经瘤患病率。数据提取由2名独立的研究人员进行(E.L.和D.K.)。任何不确定或分歧都通过作者之间的讨论来解决。 2.3. Quality assessment Risk of bias of the included studies was assessed using a tool based on a modified version of the Newcastle–Ottawa scale used in other prevalence systematic reviews and meta-analyses. The articles were assessed for their quality in terms of representativeness, sample size, comparability between respondents and nonrespondents, outcome ascertainment, and descriptive statistics. Studies were classified as a low risk of bias (≥3 points) or high risk of bias (＜3 points). The modified Newcastle–Ottawa scoring guide is shown in Supplementary File 2 (available at http://links./PAIN/B270). 2.3.质量评估 纳入研究的偏倚风险基于在其他流行率的系统回顾和荟萃分析中使用的Newcastle- Ottawa量表的工具进行评估。本文从代表性、样本量、受访者与非受访者之间的可比性、结果确定性和描述性统计等方面进行质量评估。研究被分为低偏倚风险（≥3分）或高偏倚风险（＜3分）。修改后的Newcastle–Ottawa评分量表见补充文件2(http://links. /PAIN/B270)。 2.4. Statistical analysis Random-effects meta-analyses of proportions were performed on all included studies to quantify the prevalence of RLP and symptomatic neuromas after lower extremity amputation. Forest plots were constructed to visualize heterogeneity between studies. Subgroup analyses were performed using randomeffects models. Studies were grouped according to the characteristics age, geographic location, reason for amputation, level of amputation, data collection method, and follow-up. Subgroup analyses were performed whenever more than 10 studies were included for meta-analyses because smaller samples may lead to biased outcomes due to higher rates of false positive differences. All statistical analyses were performed using R version 4.0 (R Core Team, 2020). 2.4.统计分析 对所有纳入的研究进行了患病率的随机效应荟萃分析，以量化下肢截肢后RLP和症状性神经瘤的患病率。构建森林地块使各研究之间的异质性可视化。采用随机效应模式进行亚组分析。根据年龄、地理位置、截肢原因、截肢水平、数据收集方法和随访等特征进行分组。当纳入超过10项研究进行荟萃分析时，就进行亚组分析，因为小样本可能导致较高的假阳性而导致结果偏倚。所有统计分析均采用R4.0版本(R Core Team，2020)处理。 往期回顾： |
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