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Background The evidence base addressing transcranial magnetic stimulation (TMS) for behavioral health conditions other than treatment-resistant depression is not well established. This systematic review evaluated the efficacy and safety of TMS for persons with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). Methods PubMed, the Cochrane Library, and PsycINFO were searched for English language studies published from inception through July 7, 2025. Eligibility criteria included randomized, sham-controlled trials (RCTs) enrolling participants with GAD, OCD, and PTSD and measuring outcomes included remission, response, change in disease severity, and adverse events (AEs). One reviewer extracted data, and a senior reviewer checked for accuracy. Two reviewers completed independent risk-of-bias and strength-of-evidence (SOE) assessments. We conducted quantitative syntheses when appropriate. Results We identified 20 RCTs of TMS evaluating efficacy and 18 RCTs evaluating safety. Few studies reported follow-up beyond 12 weeks and several trials had high risk-of-bias. For remission, we found no evidence of benefit for TMS compared with sham for any condition. However, compared to sham, active TMS produced greater clinical response for OCD (Pooled RR, 1.74 [95% CI 1.06 to 2.84; 11 RCTs]; moderate SOE) and improvements in symptom severity for all three conditions ( low SOE). There was no difference between active and sham TMS for serious AEs ( low SOE ) or total AEs ( moderate SOE) . Few studies reported follow-up beyond 12 weeks and many trials had high risk of bias and small sample sizes. Conclusions TMS probably improves clinical response in OCD and may improve symptom severity in GAD, OCD, and PTSD. Further research should determine optimal brain targets and TMS treatment parameters and assess the durability of outcomes at longer term follow-up times, to better support clinical decision making and coverage determinations. Clinical trial number Not applicable.

Introduction Plain language summaries (PLSs) make complex healthcare evidence accessible to patients and the public. Large language models (LLMs) may assist in generating accurate, readable PLSs. This study explored using the LLM Claude 2 to create PLSs of evidence reviews from the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program. Methods We selected 10 evidence reviews published from 2021 to 2023, representing a range of methods and topics. We iteratively developed a prompt to guide Claude 2 in creating PLSs which included specifications for plain language, reading level, length, organizational structure, active voice, and inclusive language. PLSs were assessed for adherence to prompt specifications, comprehensiveness, accuracy, readability, and cultural sensitivity. Results All PLSs met the word count. We judged one PLS as fully comprehensive; seven mostly comprehensive. We judged two PLSs as fully capturing the PICO elements; five with minor PICO errors. We judged three PLSs as accurately reporting the results; and four with minor result errors. We judged three PLSs as having major result errors for incorrectly reporting total participants. Five PLSs met the target 6th to 8th grade reading level. Passive voice use averaged 16%. All PLSs used inclusive language. Conclusions LLMs show promise for assisting in PLS creation but likely require human input to ensure accuracy, comprehensiveness, and the appropriate nuances of interpretation. Iterative prompt refinement may improve results and address the needs of specific reviews and audiences. As text‐only summaries, the AI‐generated PLSs could not meet all consumer communication criteria, such as textual design and visual representations. Further testing should include consumer reviewers and explore how to best leverage LLM support in drafting PLS text for complex evidence reviews.

Objective To map the availability of information on a major clinical outcome—chronic lung disease—across the randomized controlled trials in systematic reviews of an entire specialty, specifically interventions in preterm infants.Design Survey of systematic reviews.Data sources Cochrane Database of Systematic Reviews.Study selection and methods All Cochrane systematic reviews (as of November 2013) that had evaluated interventions in preterm infants. We identified how many of those systematic reviews had looked for information on chronic lung disease, how many reported on chronic lung disease, and how many of the randomized controlled trials included in the systematic reviews reported on chronic lung disease. We also randomly selected 10 systematic reviews that did not report on chronic lung disease and 10 that reported on any such outcomes and identified whether any information on chronic lung disease appeared in the primary reports of the randomized controlled trials but not in the systematic reviews.Main outcome measures Whether availability of chronic lung disease outcomes differed by type of population and intervention and whether additional non-extracted data might have been available in trial reports.Results 174 systematic reviews with 1041 trials exclusively concerned preterm infants. Of those, 105 reviews looked for chronic lung disease outcomes, and 79 reported on these outcomes. Of the 1041 included trials, 202 reported on chronic lung disease at 28 days and 200 at 36 weeks postmenstrual; 320 reported on chronic lung disease with any definition. The proportion of systematic reviews that looked for or reported on chronic lung disease and the proportion of trials that reported on chronic lung disease was larger in preterm infants with respiratory distress or support than others (P<0.001) and differed across interventions (P<0.001). Even for trials on children with ventilation interventions, only 56% (48/86) reported on chronic lung disease. In the random sample, 45 of 84 trials (54%) had no outcomes on chronic lung disease in the systematic reviews, and only 9/45 (20%) had such information in the primary trial reports.Conclusions Most trials included in systematic reviews of interventions on preterm infants are missing information on one of the most common serious outcomes in this population. Use of standardized clinical outcomes that would have to be collected and reported by default in all trials in a given specialty should be considered.

Background In the USA, access to quality healthcare varies greatly across racial and ethnic groups, resulting in significant health disparities. A new term, “racial health equity” (RHE), is increasingly reported in the medical literature, but there is currently no consensus definition of the term. Additionally, related terms such as “health disparities,” “health inequities,” and “equality” have been inconsistently used when defining RHE. Methods The primary purpose of this scoping review is to investigate the current use and underlying concepts used to define racial health equity. The study will address two key questions: (1) “What terminology and definitions have been used to characterize RHE?” and (2) “What knowledge gaps and challenges are present in the current state of RHE research and theory?” The review will collect and analyze data from three sources: (1) websites from key national and international health organizations, (2) theoretical and narrative published articles, and (3) evidence synthesis studies addressing interventions targeting racial health equity and minority stakeholder engagement. Discussion Defining “racial health equity” and related terminology is the first step to advancing racial health equity within the USA. This review aims to offer an improved understanding of RHE constructs and definitions, bringing greater unity to national racial health equity research efforts across disciplines. Systematic review registration This protocol is registered with the Open Science Framework at https://osf.io/7pvzq .

To inform methods for centering racial health equity in syntheses, we explored (1) how syntheses that assess health-related interventions and explicitly address racial health inequities have engaged interest holders and (2) guidance for engaging racially and ethnically diverse interest holders. We systematically identified evidence syntheses (searches limited to January 1, 2020, through January 25, 2023) and guidance documents (no search date limits) for this overview. From syntheses we extracted data on engagement rationale and processes and extracted approaches suggested from guidance documents. We summarized findings qualitatively. Twenty-nine of the 157 (18%) eligible syntheses reported using engagement. Syntheses typically lacked robust detail on why and how to use and structure engagement and outcomes/effects of engagement, though syntheses involving Indigenous populations typically included more detail. When reported, engagement typically occurred in early and later synthesis phases. We did not identify guidance documents that specifically intended to provide guidance for engaging racially/ethnically diverse individuals in syntheses; some related guidance described broader equity considerations or engagement in general. This review highlights gaps in understanding of the use of engagement in racial health equity-focused syntheses and in guidance specifically addressing engaging racially and ethnically diverse populations. Syntheses and guidance materials we identified reported limited data addressing the whys, hows, and whats (ie, rationale for, approaches to, resources needed and effects of) of engagement, and we lack information for understanding whether engagement makes a difference to the conduct and findings of syntheses and when and how engagement of specific populations may contribute to centering racial health equity. A more informed understanding of these issues, facilitated by prospective and retrospective descriptions of engagement of diverse interest holders, may help advance actionable guidance and reviews. We identified evidence syntheses (a kind of research that identifies and summarizes findings of individual studies or publications to address research questions) that looked at studies of interventions to improve differences in effects on health for racial or ethnic populations to see (1) if and how they incorporated perspectives of interest holders, people with an interest in the subject being studied; (2) what guidance for how to engage or involve racially or ethnically diverse interest holders exists. We found that 29 of 157 syntheses addressing interventions to improve differences in effects on health reported involving interest holders but typically did not provide much detail about how to involve people. Syntheses that involved Indigenous people usually had more information, but overall, the syntheses did not have much information about how to involve people and what the impact of involving them may be. We did not find guidance information that specifically set out to provide information about engaging racially/ethnically diverse individuals in syntheses; some related guidance described considerations about involving people in syntheses in general. This review highlights gaps in understanding of how to engage people in racial health equity-focused syntheses and in guidance specifically addressing engaging racially and ethnically diverse populations. Syntheses and guidance materials we identified reported limited information about whys, hows, and whats (ie, reasons to use, how to do, and resources needed and effects of) related to engagement, and we lack information to help understand whether engagement makes a difference in doing syntheses and when and how engagement of specific populations may help to address racial health equity. [Display omitted]