Objective To determine the incidence and prevalence of dementia in a nationally representative cohort of US Medicare beneficiaries, stratified by important subgroups. Design Population based study. Setting Nationwide study between 2015 and 2021. Participants Fee-for-service Medicare beneficiaries aged 66 or older with at least one year of continuous enrollment. Main outcome measures Incidence and prevalence

Objective To determine the effect of a novel brief general practitioner (GP)-led narrative exposure intervention on post-traumatic stress disorder (PTSD) symptoms after intensive care. Design Multicentre, observer blind, randomised controlled trial (PICTURE). Setting Primary care in 319 general practices across Germany. Participants 319 adults (18-85 years) who have survived critical illness with symptoms

Objective To estimate the effect of gabapentinoid treatment on self-harm. Design A population based self-controlled case series study. Setting UK Clinical Practice Research Datalink Aurum database linked to the Hospital Episode Statistics and Office for National Statistics databases. Participants 10 002 adults (aged ≥18 years), with gabapentinoid prescriptions, who had an incident event of self-harm

Objective To assess the three year outcomes of the no-touch vein harvesting technique in coronary artery bypass grafting surgery compared with the conventional approach. Design Three year extended follow-up of the randomised PATENCY (graft patency between the no-touch vein harvesting technique and conventional approach in coronary artery bypass graft surgery) trial. Setting Seven cardiac surgery centres

Objective To investigate the impact of retracted trials on the production and use of healthcare evidence in the evidence ecosystem. Design Retrospective cohort study based on forward citation searching. Data sources Retraction Watch up to 5 November 2024. Study selection Randomised controlled trials in humans that were retracted for any reason. Methods Forward citation searching via Google Scholar

Objective To take advantage of the arbitrarily timed increase in firearm and ammunition availability brought on by the start of deer hunting seasons to study its impact on hunting, and importantly, non-hunting related firearm incidents. Design Quasi-experimental analysis using start of hunting season in United States. Setting Populations of US states with highest number of hunting accidents reported

Objective To investigate the reporting and evolution of patient and public involvement (PPI) in randomised controlled trials published over time in major medical journals and in their trial protocols. Design Meta-epidemiological evaluation. Data source PubMed was searched for articles reporting randomised controlled trials published since 2015 in four major medical journals and their corresponding

Objectives To investigate whether a less intense antiplatelet regimen could be used for people receiving drug coated balloons. Design Multicentre, randomised, open label, assessor blind, non-inferiority trial (REC-CAGEFREE II). Setting 41 hospitals in China between 27 November 2021 and 21 January 2023. Participants 1948 adults (18-80 years) with acute coronary syndrome who received treatment exclusively

Objective To determine the effects of intensive blood pressure treatment on orthostatic hypertension. Design Systematic review and individual participant data meta-analysis. Data sources MEDLINE, Embase, and Cochrane CENTRAL databases through 13 November 2023. Inclusion criteria Population: ≥500 adults, age ≥18 years with hypertension or elevated blood pressure; intervention: randomized trials of more

Objective To assess whether perioperative management guided by near-infrared spectroscopy to determine tissue oxygen saturation and haemodynamic monitoring reduces postoperative complications after off-pump coronary artery bypass grafting. Design Assessor blinded, single centre, randomised controlled trial (Bottomline-CS trial). Setting A tertiary teaching hospital in China. Participants 1960 patients

Objective To evaluate the effectiveness and safety of sonolysis using a low intensity 2 MHz pulsed wave ultrasound beam during carotid endarterectomy. Design Multicentre, phase 3, double blind, randomised controlled trial. Setting 16 European centres. Participants 1004 patients (mean age 68 years; 312 (31%) female) were enrolled in the study between 20 August 2015 and 14 October 2020 until the interim

Objective To describe the extent of late adverse event reporting by manufacturers to the US Food and Drug Administration’s (FDA) Manufacturer And User Facility Device Experience (MAUDE) database as well as the distribution of late reporting among manufacturers and associations with device characteristics. Design Cross sectional study. Setting The FDA MAUDE database, a central postmarket safety surveillance

Objective To summarise research on the efficacy and safety of UK physician associates and anaesthetic associates in the context of an ongoing policy review. Design Rapid systematic review. Search strategy Keyword and author search of three databases; citation tracking; search of previous systematic reviews. Eligible studies Empirical research (any design) on physician associates/anaesthetic associates

Objective To predict the global, regional, and national prevalence of Parkinson’s disease by age, sex, year, and Socio-demographic Index to 2050 and quantify the factors driving changes in Parkinson’s disease cases. Design Modelling study. Data source Global Burden of Disease Study 2021. Main outcome measures Prevalent number, all age prevalence and age standardised prevalence of Parkinson’s disease

Objective To determine whether the use of glucagon-like peptide-1 (GLP-1) receptor agonists is associated with an increased risk of suicidal ideation, self-harm, and suicide among patients with type 2 diabetes compared with the use of dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Design Active comparator, new user cohort study. Setting Primary care

Objective To determine which primary endovascular revascularisation strategy represents the most clinically effective treatment for patients with chronic limb threatening ischaemia who require endovascular femoro-popliteal, with or without infra-popliteal, revascularisation. Design Three arm, open label, pragmatic, multicentre, randomised, phase 3 superiority trial (BASIL-3). Setting 35 UK NHS vascular

Objectives To assess the discrepancies between real-world data and the Global Burden of Disease (GBD) 2021 estimates for six neglected tropical diseases in China. Additionally, to evaluate the applicability of the GBD model within the Chinese context and to assess the effectiveness of China's historical prevention and control policies for neglected tropical diseases. Design Comparative study of real-world

Objective To address the comparative effectiveness of common interventional procedures for chronic non-cancer (axial or radicular) spine pain. Design Systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs). Data sources Medline, Embase, CINAHL, CENTRAL, and Web of Science from inception to 24 January 2023. Study selection RCTs that enrolled patients with chronic non-cancer

Objective To assess the effect of dapagliflozin plus calorie restriction on remission of type 2 diabetes. Design Multicentre, double blind, randomised, placebo controlled trial. Setting 16 centres in mainland China from 12 June 2020 to 31 January 2023. Participants 328 patients with type 2 diabetes aged 20-70 years, with body mass index >25 and diabetes duration of <6 years. Interventions Calorie restriction

Objective To estimate the relative efficacy of individual and combinations of prehabilitation components (exercise, nutrition, cognitive, and psychosocial) on critical outcomes of postoperative complications, length of stay, health related quality of life, and physical recovery for adults who have received surgery. Design Systematic review with network and component network meta-analyses of randomised

Objective To evaluate whether the immunomodulatory drug thymosin α1 reduces mortality in adults with sepsis. Design Multicentre, double blinded, placebo controlled phase 3 trial. Setting 22 centres in China, September 2016 to December 2020. Participants 1106 adults aged 18-85 years with a diagnosis of sepsis according to sepsis-3 criteria and randomly assigned in a 1:1 ratio to receive thymosin α1

Objective To report on complications of conisation and its effects on fertility and stenosis. Design Register based nationwide cohort study on routinely collected data using several linked databases. Setting Primary and secondary care in Denmark, 2006-18. Population The conisation cohort comprised 48 048 conisations on women aged 23-65 who had undergone conisation within 120 days of a cervical biopsy

Objective To assess whether intra-arterial tenecteplase administered after successful endovascular recanalisation improves outcomes in patients with acute arterial occlusion of the posterior circulation. Design Multicentre randomised controlled trial. Setting 31 hospitals in China, 24 January 2023 to 24 August 2023. Participants 208 patients with successful recanalisation (grade 2b50-3 on the extended

Objective To summarise available evidence on time to nursing home admission and death among people with dementia, and to explore prognostic indicators. Design Systematic review and meta-analysis. Data sources Medline, Embase, Web of Science, Cochrane, and Google Scholar from inception to 4 July 2024. Eligibility criteria for selecting studies Longitudinal studies on survival or nursing home admission

Objective To evaluate the effectiveness of multiple decision aid strategies in promoting high quality shared decision making for prevention of stroke in patients with non-valvular atrial fibrillation. Design Cluster randomized controlled trial. Setting Six academic medical centers in the United States. Participants Patient participants were aged ≥18 with a diagnosis of non-valvular atrial fibrillation

Objective To compare the effectiveness and safety of budesonide-glycopyrrolate-formoterol, a twice daily metered dose inhaler, and fluticasone-umeclidinium-vilanterol, a once daily dry powder inhaler, in patients with chronic obstructive pulmonary disease (COPD) treated in routine clinical practice. Design New user cohort study. Setting Longitudinal commercial US claims data. Participants New initiators

Objective To identify clusters of women with similar trajectories of breast density change over four longitudinal assessments and to examine the association between these trajectories and the subsequent risk of breast cancer. Design Retrospective cohort study. Setting Data from the national breast cancer screening programme, which is embedded in the National Health Insurance Service database in Korea

Objective To evaluate the cognitive abilities of the leading large language models and identify their susceptibility to cognitive impairment, using the Montreal Cognitive Assessment (MoCA) and additional tests. Design Cross sectional analysis. Setting Online interaction with large language models via text based prompts. Participants Publicly available large language models, or “chatbots”: ChatGPT versions

Objectives To compare the manual dexterity and composure under pressure of people in different hospital staff roles using a buzz wire game. Design Prospective, observational, comparative study (Tremor study). Setting Leeds Teaching Hospitals NHS Trust, Leeds, UK, during a three week period in 2024. Participants 254 hospital staff members comprising of 60 physicians, 64 surgeons, 69 nurses, and 61 non-clinical

Objective To assess whether training provided to an inexperienced clinician just before performing a high stakes procedure can improve procedural care quality, measuring the first attempt success rate of trainees performing infant orotracheal intubation. Design Randomized clinical trial. Setting Single center, quaternary children’s hospital in Boston, MA, USA. Participants A non-crossover, prospective

Objective To analyze mortality attributed to Alzheimer’s disease among taxi drivers and ambulance drivers, occupations that demand frequent spatial and navigational processing, compared with other occupations. Design Population based cross-sectional study. Setting Use of death certificates from the National Vital Statistics System in the United States, which were linked to occupation, 1 January 2020-31

Objective To assess the effect of electrically heated mittens on physical hand function in people with osteoarthritis of the hands compared with control mittens. Design Randomised controlled trial. Setting Osteoarthritis outpatient clinic, Copenhagen, Denmark. Participants 200 people with hand osteoarthritis aged 42-90 years. 100 participants were assigned to the intervention group and 100 to the control

Objective To quantify changes in inequalities in uptake of childhood vaccination during a period of steadily declining overall childhood vaccination rates in England. Design Longitudinal study. Setting General practice data for five vaccines administered to children (first and second doses of the measles, mumps, and rubella vaccine (MMR1 and MMR2, respectively), rotavirus vaccine, pneumococcal conjugate

Objectives To test whether haemochromatosis HFE C282Y homozygotes have increased risk of diabetes, liver disease, and heart disease even when they have normal plasma iron, transferrin saturation, or ferritin concentrations and to test whether C282Y homozygotes with diabetes, liver disease, or heart disease have increased mortality compared with non-carriers with these diseases. Design Prospective cohort

Objective To prospectively investigate the associations between dark, milk, and total chocolate consumption and risk of type 2 diabetes (T2D) in three US cohorts. Design Prospective cohort studies. Setting Nurses’ Health Study (NHS; 1986-2018), Nurses’ Health Study II (NHSII; 1991-2021), and Health Professionals Follow-Up Study (HPFS; 1986-2020). Participants At study baseline for total chocolate analyses

Objectives To evaluate the clinical effectiveness and safety of a perioperative algorithm for cardiac output-guided haemodynamic therapy in patients undergoing major gastrointestinal surgery. Design Multicentre randomised controlled trial. Setting Surgical services of 55 hospitals worldwide. Participants 2498 adults aged ≥65 years with an American Society of Anesthesiologists physical status classification

Objective To assess the effect of contemporary menopausal hormone therapy on the risk of cardiovascular disease according to the route of administration and combination of hormones. Design Nationwide register based emulated target trial. Setting Swedish national registries. Participants 919 614 women aged 50-58 between 2007 and 2020 without hormone therapy use in the previous two years, identified

Objective To compare the effectiveness of interventions for the management of long covid (post-covid condition). Design Living systematic review. Data sources Medline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials from inception to December 2023. Eligibility criteria Trials that randomised adults (≥18 years) with long covid

Objective To investigate the association between monthly turnover rates of hospital nurses and senior doctors and patient health outcomes (mortality and unplanned hospital readmissions). Design Retrospective longitudinal study. Setting All 148 NHS acute trusts in England (1 April 2010 to 30 March 2019), excluding specialist and community NHS hospital trusts. Participants Yearly records on 236 000 nurses

Objective To prospectively assess the effect of endometriosis and uterine fibroids on the long term risk of premature mortality (younger than 70 years). Design Prospective cohort study Setting The Nurses’ Health Study II, United States (1989-2019). Participants 110 091 women aged 25-42 years in 1989 without a history of hysterectomy before endometriosis or fibroids diagnosis, cardiovascular diseases

Publications of living systematic reviews (LSRs) are increasing rapidly. Guidance facilitating transparent, complete, and accurate reporting of LSRs is needed. This paper reports the development of an extension of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement for LSRs (PRISMA-LSR). The PRISMA-LSR extension includes the PRISMA-LSR checklist, the PRISMA-LSR

Objectives To assess the efficacy and safety of the non-hormonal, neurokinin 3 receptor antagonist, fezolinetant, to treat moderate-severe vasomotor symptoms associated with menopause in individuals unsuitable for hormone therapy. Design Phase 3b randomised controlled trial. Setting 16 countries. Participants 453 individuals aged 40-65 years with moderate-severe vasomotor symptoms associated with menopause

Objectives To estimate the frequency, severity, and preventability of adverse events associated with perioperative care, and to describe the setting and professions concerned. Design Multicenter retrospective cohort study. Setting 11 US hospitals. Participants 1009 patients from a randomly selected sample of 64 121 adults admitted for surgery during 2018. Main outcome measures Adverse events during

Objective To investigate the association between sodium-glucose cotransporter-2 (SGLT-2) inhibitor use and risk of all cause mortality among patients with heart failure with reduced ejection fraction. Design Linked database study. Setting National registers in Denmark, July 2020 to June 2023. Participants Patients with heart failure, aged ≥45 years, with left ventricular ejection fraction ≤40%. Main

Objective To emulate target trials comparing recurrence of nephrolithiasis among patients with pre-existing nephrolithiasis (overall and stratified by concomitant gout) initiating sodium-glucose cotransporter-2 (SGLT-2) inhibitors versus an active comparator. Design Target trial emulation studies. Setting Canadian population database, January 2014 to June 2022. Participants 20 146 patients with nephrolithiasis

Objectives To assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China’s poorest rural counties. Design Six consecutive cross sectional surveys were conducted annually. Setting The study was conducted in 116 counties in 19 provinces from 2016 to 2021, representing China’s 832 poorest counties. Participants A total of 210 088 participants were

Objective To evaluate the feasibility of using a multigene signature to tailor individualised adjuvant therapy for patients with operable triple negative breast cancer. Design Randomised, multicentre, open label, phase 3 trial. Setting 7 cancer centres in China between 3 January 2016 and 17 July 2023. Participants Female patients aged 18-70 years with early triple negative breast cancer after definitive

Objectives To assess the short term temporal variations in suicide risk related to the day of the week and national holidays in multiple countries. Design Multicountry, two stage, time series design. Setting Data from 740 locations in 26 countries and territories, with overlapping periods between 1971 and 2019, collected from the Multi-city Multi-country Collaborative Research Network database. Participants

Objective To assess whether use of glucagon-like peptide-1 (GLP-1) receptor agonists before upper gastrointestinal endoscopy is associated with increased risk of pulmonary aspiration or discontinuation of the procedure compared with sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Design Cohort study. Setting Two deidentified US commercial healthcare databases. Participants 43 365 adults (≥18 years)

Objective To evaluate the association between paternal metformin use and risk of congenital malformations in offspring. Design Population based, cross national cohort study. Setting Norway and Taiwan. Participants 619 389 offspring with paternal data during the period of sperm development (three months before pregnancy) in the Norwegian cohort during 2010-21 and 2 563 812 in the Taiwanese cohort during

Objective To quantify the predictive value of unexpected weight loss for cancer according to patient’s age, sex, smoking status, and concurrent clinical features (symptoms, signs, and abnormal blood test results). Design Diagnostic accuracy study (update). Setting Data from Clinical Practice Research Datalink electronic health records linked to the National Cancer Registration and Analysis Service

Objective To evaluate whether the intense simplified strategy, which comprises short term intensive insulin therapy (SIIT) followed by subsequent oral antihyperglycaemic regimens, could improve long term glycaemic outcomes in patients with newly diagnosed type 2 diabetes mellitus and severe hyperglycaemia. Design Multicentre, open label, randomised trial. Setting 15 hospitals in China between December

Objective To assess changes in key measures of kidney care using data reported in 2019 and 2023. Design Cross sectional survey in 148 countries. Setting Surveys from International Society of Nephrology Global Kidney Health Atlas between 2019 and 2023 that included participants from countries in Africa (n=36), Eastern and Central Europe (n=16), Latin America (n=18), the Middle East (n=11), Newly Independent

Objective To examine the associations between characteristics of daily rainfall (intensity, duration, and frequency) and all cause, cardiovascular, and respiratory mortality. Design Two stage time series analysis. Setting 645 locations across 34 countries or regions. Population Daily mortality data, comprising a total of 109 954 744 all cause, 31 164 161 cardiovascular, and 11 817 278 respiratory deaths

Objective To review the international literature and assess the ways healthcare systems are mitigating and can mitigate their carbon footprint, which is currently estimated to be more than 4.4% of global emissions. Design Systematic review of empirical studies and grey literature to examine how healthcare services and institutions are limiting their greenhouse gas (GHG) emissions. Data sources Eight

Objective To evaluate whether an integrated mental health video consultation approach (PROVIDE model) can improve symptoms compared with usual care in adults with depression and anxiety disorders attending primary care. Design Assessor masked, multicentre, randomised controlled trial (PROVIDE-C). Setting In 29 primary care practices in Germany, working remotely online from one trial hub. Participants

Objectives To investigate whether health insurance generated improvements in cardiovascular risk factors (blood pressure and hemoglobin A1c (HbA1c) levels) for identifiable subpopulations, and using machine learning to identify characteristics of people predicted to benefit highly. Design Secondary analysis of randomized controlled trial. Setting Medicaid insurance coverage in 2008 for adults on low

Objective To compare all licensed drug interventions as oral monotherapy for the acute treatment of migraine episodes in adults. Design Systematic review and network meta-analysis. Data sources Cochrane Central Register of Controlled Trials, Medline, Embase, ClinicalTrials.gov, EU Clinical Trials Register, WHO International Clinical Trials Registry Platform, as well as websites of regulatory agencies

The timing of embryo transfer, which aligns with different stages of embryo development, is an important element of in vitro fertilisation (IVF). This article briefly describes the main phases of IVF treatment, embryo development and transfer policies, cumulative live birth rates, and the key findings of the authors’ research. In vitro fertilisation (IVF) is a well established treatment for infertility

Objectives To evaluate whether embryo transfers at blastocyst stage improve the cumulative live birth rate after oocyte retrieval, including both fresh and frozen-thawed transfers, and whether the risk of obstetric and perinatal complications is increased compared with cleavage stage embryo transfers during in vitro fertilisation (IVF) treatment. Design Multicentre randomised controlled trial. Setting