Rating certainty when the target threshold is the null and the point estimate is close to the null.

When one initially targets the null effect and the point estimate falls close to the null, two challenges exist in rating certainty of evidence. First, when the point estimate is near the null and the data, therefore, suggests little or no effect, rating certainty in a benefit or harm is misleading. Second, since in general the narrower the confidence interval (CI) the more precise the estimate, if the CI is narrow, rating down for imprecision due simply to crossing the null is inappropriate.

Gender affirming hormone therapy for individuals with gender dysphoria aged <26 years: a systematic review and meta-analysis.

Objective: In this systematic review and meta-analysis, we assessed and summarised the certainty of the evidence about the effects of gender affirming hormone therapy (GAHT) in individuals with gender dysphoria (GD).

Methods: We searched Medline, Embase, PsychINFO, Social Sciences Abstracts, LGBTQ+ Source and Sociological Abstracts from inception to September 2023. We included studies comparing GAHT with no GAHT in individuals aged <26 years with GD.

Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis.

Aim: Gender dysphoria (GD) refers to the psychological distress associated with the incongruence between one's sex and one's gender identity. To manage GD, individuals may delay the development of primary and secondary sex characteristics with the use of puberty blockers. In this systematic review, we assess and summarise the certainty of the evidence about the effects of puberty blockers in individuals experiencing GD.

Confidence intervals of the relative risk and odds ratio can predict when the optimal information size in a meta-analysis is not met.

Objectives: We sought to empirically evaluate whether the width of confidence interval (CI) of the relative risk (RR) and odds ratio (OR) can obviate the need for calculating the optimal information size (OIS) when making Grading of Recommendations Assessment, Development and Evaluation imprecision judgments.

Study Design And Setting: We analyzed a convenience sample of meta-analyses extracted from the Cochrane Database of Systematic Reviews. From each meta-analysis, we calculated OIS based on relative risk reductions (RRRs) of 15%-50% and evaluated the ratio of upper to lower 95% CI boundaries of RR (RR CI ratio) and OR (OR CI ratio).

Inhaled Reliever Therapies for Asthma: A Systematic Review and Meta-Analysis.

Importance: The optimal inhaled reliever therapy for asthma remains unclear.

Objective: To compare short-acting β agonists (SABA) alone with SABA combined with inhaled corticosteroids (ICS) and with the fast-onset, long-acting β agonist formoterol combined with ICS for asthma.

Data Sources: The MEDLINE, Embase, and CENTRAL databases were searched from January 1, 2020, to September 27, 2024, without language restrictions.