Treatment strategies for new-onset atrial fibrillation in critically ill patients: Protocol for a systematic review

Research status of internet-delivered cognitive behavioral therapy in cancer patients

The latest global cancer burden data released by the International Agency for Research on Cancer of the World Health Organization in 2020 shows that there were 19.29 million new cancer cases worldwide, with 4.57 million in China, ranking first. The number of cancer survivors is increasing, with a 5-year survival rate exceeding 85%, but there are emotional disorders. Cognitive behavioral therapy (CBT) can improve negative emotions and has significant effects on patients. However, there is a limited number of physicians and high costs, so internet interventions have become a solution. The feasibility of web-based interventions for breast cancer patients has been proven. Research on internet-delivered CBT is also increasing. The purpose of this study was to review the concept of web-based CBT and its application status in cancer survivors, in order to provide relevant intervention for scholars and provide reference and supplement for patients to provide psychological therapy.

Treatments of new-onset atrial fibrillation in critically ill patients: a systematic review with meta-analysis

BACKGROUND

New-onset atrial fibrillation (NOAF) is common in hospitalised patients with critical illness and associated with worse outcomes. Several interventions are available in the management of NOAF, but the overall effectiveness and safety of these interventions compared with placebo or no treatment are unknown.

METHODS

We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) of randomised clinical trials (RCT) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses, the Cochrane Collaboration, and Grading of Recommendations Assessment, Development and Evaluation statements. We searched RCTs assessing any pharmacological and non-pharmacological treatment compared with placebo or no treatment in critically ill hospitalised patients with NOAF. The primary outcomes were all-cause mortality, adverse events, and health-related quality of life.

RESULTS

We included 16 trials (n = 1891) evaluating seven interventions. All trials were adjudicated 'some concerns' or 'high risk' of bias. The evidence is very uncertain for mortality (RR 0.53, 95% CI 0.03-8.30), adverse events (RR 1.28, 95% CI 0.85-1.92), and treatment efficacy i.e. rhythm control (RR 1.54, 95% CI 1.20-1.97; TSA-adjusted CI 0.56-4.53) between pharmacological treatment and placebo/no treatment (very low certainty evidence). There were no data for health-related quality of life or most of our secondary outcomes.

CONCLUSIONS

The existing data are insufficient to firmly conclude on effects of any intervention against NOAF on any outcome in hospitalised patients with critical illness. Randomised trials of the most frequently used interventions against NOAF are warranted in these patients.