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Scope

Key Words
Evidence Based Practice; Trustworthy Clinical Guidelines; Network Meta analysis (NMA); GRADE; Rare Diseases; Chronic Diseases; Aging; Alternative Medicine
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Research Interests

  1. Health research methods on clinical guideline development, evidence synthesis (effectiveness on multiple interventions), and cohort studies

  2. Incorporating AI technology in living guideline development and evidence synthesis

  3. Health research on rare diseases and chronic diseases (e.g., insomnia, chronic pain)

  4. Alternative medicine (TCM, acupuncture, et al)

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Projects

  1. Rapid recommendations for chronic Insomnia, PTSD, Chronic Fatigue, fibromyalgia

  2. Loops consideration for indirect evidence in NMA

  3. Holiday effect for hospital admission and surgery

  4. AI-assisted evidence synthesis and living guidelines

Research Vision

Vision

Vision

Our Team, the AdvanCing Health through Intelligent Evidence and liVing guidelines Enhancement (ACHIEVE), is a research group dedicated to advancing health through intelligent evidence and living guidelines enhancement. Our research aims to bridge the gap between clinical evidence and practice, enhancing patient outcomes and quality of life through reliable evidence synthesis and trustworthy guideline development.​​

 

We are passionate about advancing health through intelligent evidence and living guidelines enhancement. Our team is committed to conducting high-quality research on clinical guideline development and living evidence synthesis. We aim to make a significant impact in the field of healthcare by providing valuable insights and contributing to evidence-based practices. ACHIEVE stands out for its dedication to excellence and innovation, and we are always looking for opportunities to collaborate with like-minded individuals and organizations.

Selected Publications

1. Evidence vs Consensus Guidelines

This study investigated whether the alignment of strength of recommendations with quality of evidence differs in consensus-based versus evidence-based guidelines. The study included 12 ACC/AHA guidelines that generated 1,434 recommendations and 69 ASCO guidelines that generated 1,094 recommendations. ​

The findings suggest consensus-based guidelines produce more recommendations violating the principles of evidence-based medicine than evidence-based guidelines. Ensuring the appropriate alignment of quality of evidence with the strength of recommendations is key to the development of “trustworthy” guidelines. This work, for the first time, highlighted the importance of assessing the appropriateness of strong recommendations and provided guidance on how to address it.

Yao L, Ahmed MM, Guyatt GH, Yan P, Hui X, Wang Q, Yang K, Tian J, Djulbegovic B. Discordant and inappropriate discordant recommendations in consensus and evidence based guidelines: empirical analysis. BMJ. 2021 Nov 25;375:e066045. doi: 10.1136/bmj-2021-066045. PMID: 34824101; PMCID: PMC8613613.​​

2. Inappropriate Strong Recommendations

Screenshot 2024-08-14 at 4.11.16 PM.png

Some organizations—including the ACC/AHA and ASCO—explicitly classify their guidelines as evidence-based when much of the supporting evidence is deemed to be moderate or high quality, and classify their guidelines as consensus based when it is not.

Our findings suggest when facing low or very low-quality evidence, guidelines should avoid issuing inappropriate discordant recommendations. Abandoning consensus-based guidelines is likely to facilitate this goal.

Yao L, Guyatt GH, Djulbegovic B. Can we trust strong recommendations based on low quality evidence? BMJ. 2021 Nov 25;375:n2833. doi: 10.1136/bmj.n2833. PMID: 34824089; PMCID: PMC8769229.

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3. Management of Chronic TMD Pain

To support the guideline development for chronic pain secondary to Temporomandibular Disorders (TMD), I led a team and conducted a complex network meta-analysis with a huge amount of work, involving over 200 RCTs and comparing 59 pharm and non-pharm treatments the same time (see the right figure).

In this network, we were able to propose innovative methodologies including ranking the interventions by considering both statistics and certainty of evidence, considering the MID for interpretation, and calculating the possibility of achieving MID for measuring the outcomes. We finally identified 8 interventions proving effective for patients with TMD chronic pain. Our findings from the network meta-analysis informed 21 recommendations by the guideline panel. This work has become a trusted reference point for decision-makers in TMD

Yao L, Sadeghirad B, Li M, Li J, Wang Q, Crandon HN, Martin G, Morgan R, Florez ID, Hunskaar BS, Wells J, Moradi S, Zhu Y, Ahmed MM, Gao Y, Cao L, Yang K, Tian J, Li J, Zhong L, Couban RJ, Guyatt GH, Agoritsas T, Busse JW. Management of chronic pain secondary to temporomandibular disorders: a systematic review and network meta-analysis of randomised trials. BMJ. 2023 Dec 15;383:e076226. doi: 10.1136/bmj-2023-076226. Erratum in: BMJ. 2024 Jan 30;384:q253. doi: 10.1136/bmj.q253. PMID: 38101924.​

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Evidence Synthesis (Meta-analysis, NMA, et al.) (Selected)

  1. Wang X, Martin G, Sadeghirad B, Chang Y, Florez I D, Couban R J...Yao L*... et al. Common interventional procedures for chronic non-cancer spine pain: a systematic review and network meta-analysis of randomised trials BMJ 2025; 388 :e079971 doi:10.1136/bmj-2024-079971

  2. Shang W, Hui X, Li M, Ren J, Huang X, Li J, Wang X, Wang Q, Ma Y, Madrid E, Bracchiglione J, Jiang L, Yang K, Yao L. Pharmacological treatments for adults with overweight and obesity without diabetes. Cochrane Database Syst Rev (IF=8.4) 2024 Apr 18;2024(4):CD015861. doi: 10.1002/14651858.CD015861. PMCID: PMC11025493.

  3. Li X, Li R, Li M, Yao L, Van Spall H, Zhao K, Chen Y, Xiao F, Fu Q, Xie F. A Systematic Review and Quality Assessment of Cardiovascular Disease-Specific Health Related Quality of Life Instruments Part I: Instrument Development and Content Validity. Value Health (IF=6.2). 2024 Apr 10:S1098-3015(24)02331-3. doi: 10.1016/j.jval.2024.04.001. Epub ahead of print. PMID: 38608875.

  4. Ma M, Yao L, Li M, Qin Y, Yang M, Guo K, Duan Y, Liu B, Yang K. Granulopoiesis‐stimulating factors to prevent adverse effects in the treatment of solid tumors. Cochrane Database Syst Rev (IF=8.4). 2024 Jan 16;2024(1):CD015656. doi: 10.1002/14651858.CD015656. PMCID: PMC10790332.

  5. Yao L, Sadeghirad B, Li M, Li J, Wang Q, Crandon HN, Martin G, Morgan R, Florez ID, Hunskaar BS, Wells J, Moradi S, Zhu Y, Ahmed MM, Gao Y, Cao L, Yang K, Tian J, Li J, Zhong L, Couban RJ, Guyatt GH, Agoritsas T, Busse JW. Management of chronic pain secondary to temporomandibular disorders: a systematic review and network meta-analysis of randomised trials. BMJ (IF=107.7); 2023, 383:e076226. doi: 10.1136/bmj-2023-076226.

  6. Li J#, Hui X#, Yao L#, Shi A, Yan P, Yao Y, Wang Q, Ma Y, Wei D, Lan L, Chen L, Yan L, Fang F, Li H, Feng X, Wu J, Qiao Y, Zhang W, Esill J, Qiao C, Yang K. The relationship of publication language, study population, risk of bias, and treatment effects in acupuncture related systematic reviews: a meta-epidemiologic study. BMC Med Res Methodol (IF=7.0). 2023 Apr 20;23(1):96. doi: 10.1186/s12874-023-01904-w. PMID: 37081403; PMCID: PMC10120256.

  7. Wang Q, Wu J, Ma Y, Zhu Y, Song X, Xie S, Liang F, Gimzewska M, Li M, Yao L. Totally percutaneous versus surgical cut-down femoral artery access for elective bifurcated abdominal endovascular aneurysm repair. Cochrane Database Syst Rev (IF=8.4). 2023 Jan 11;1(1):CD010185. doi: 10.1002/14651858.CD010185.pub4. PMID: 36629152; PMCID: PMC9832535.

  8. Liang F, Liu S, Liu G, Liu H, Song B, Wang Q, Yao L. Remote ischaemic preconditioning versus no remote ischaemic preconditioning for vascular and endovascular surgical procedures. Cochrane Database Syst Rev (IF=8.4). 2023 Jan 16;1(1):CD008472. doi: 10.1002/14651858.CD008472.pub3. PMID: 36645250; PMCID: PMC9841888.

  9. Wang X, Ma Y, Hui X, Li M, Li J, Tian J, Wang Q, Yan P, Li J, Xie P, Yang K, Yao L. Oral direct thrombin inhibitors or oral factor Xa inhibitors versus conventional anticoagulants for the treatment of deep vein thrombosis. Cochrane Database Syst Rev (IF=8.4),2023, Issue 4. Art. No.: CD010956. DOI: 10.1002/14651858.CD010956.pub3.

  10. Li M, Li J, Wang X, Hui X, Wang Q, Xie S, Yan P, Tian J, Li J, Xie P, Yang K, Yao L. Oral direct thrombin inhibitors or oral factor Xa inhibitors versus conventional anticoagulants for the treatment of pulmonary embolism. Cochrane Database Syst Rev (IF=8.4),2023, Issue 4. Art. No.: CD010957. DOI: 10.1002/14651858.CD010957.pub3.

  11. Hammond NE, Myburgh J, Seppelt I, Garside T, Vlok R, Mahendran S, Adigbli D, Finfer S, Gao Y, Goodman F, Guyatt G, Santos JA, Venkatesh B, Yao L, Di Tanna GL, Delaney A. Association Between Selective Decontamination of the Digestive Tract and In-Hospital Mortality in Intensive Care Unit Patients Receiving Mechanical Ventilation: A Systematic Review and Meta-analysis. JAMA (IF=120.7). 2022 Nov 15;328(19):1922-1934. doi: 10.1001/jama.2022.19709. PMID: 36286098; PMCID: PMC9607997. (ESI high cited paper)

  12. Pereira TV, Jüni P, Saadat P, Xing D, Yao L, Bobos P, Agarwal A, Hincapié CA, da Costa BR. Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis. BMJ (IF=107.7). 2022 Jul 6;378:e069722. doi: 10.1136/bmj-2022-069722. PMID: 36333100; PMCID: PMC9258606.

  13. Li M, Yao L, Wang Q, Wang X, Yang K. Ranking treatments in the network meta-analysis should consider the certainty of evidence. Lancet Gastroenterol Hepatol (IF=35.7). 2022 Apr;7(4):287-288. doi: 10.1016/S2468-1253(21)00470-2. PMID: 35278397.

  14. Cao L, Yao L, Hui X, Li J, Zhang X, Li M, Feng Z, Ren M, Xian K, Sun Y. Clinical Epidemiology in China series. Paper 3: The methodological and reporting quality of systematic reviews and meta-analyses published by China'researchers in English-language is higher than those published in Chinese-language. J Clin Epidemiol (IF=7.4). 2021;140:178-88. doi: 10.1016/j.jclinepi.2021.08.014. PMID: 34418547.

  15. Cao L, Li M, Yao L, Yan P, Wang X, Yang Z, Lao Y, Li H, Yang K, Li K. Siponimod for multiple sclerosis. Cochrane Database Syst Rev (IF=8.4) 2021 Nov 16;11(11):CD013647. doi: 10.1002/14651858.CD013647.pub2. PMID: 34783010; PMCID: PMC8592914.

  16. Siemieniuk RA, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A, Kum E, Pardo-Hernandez H, Qasim A, Martinez JPD, Rochwerg B, Lamontagne F, Han MA, Liu Q, Agarwal A, Agoritsas T, Chu DK, Couban R, Cusano E, Darzi A, Devji T, Fang B, Fang C, Flottorp SA, Foroutan F, Ghadimi M, Heels-Ansdell D, Honarmand K, Hou L, Hou X, Ibrahim Q, Khamis A, Lam B, Loeb M, Marcucci M, McLeod SL, Motaghi S, Murthy S, Mustafa RA, Neary JD, Rada G, Riaz IB, Sadeghirad B, Sekercioglu N, Sheng L, Sreekanta A, Switzer C, Tendal B, Thabane L, Tomlinson G, Turner T, Vandvik PO, Vernooij RW, Viteri-García A, Wang Y, Yao L, Ye Z, Guyatt GH, Brignardello-Petersen R. Drug treatments for covid-19: living systematic review and network meta-analysis. BMJ (IF=107.7). doi: 10.1136/bmj.m2980. 2020 Jul 30;370:m2980. Last update in: BMJ. 2021 Mar 31;372:n858. (ESI high cited paper)

  17. Bartoszko JJ, Siemieniuk RAC, Kum E, Qasim A, Zeraatkar D, Ge L, Han MA, Sadeghirad B, Agarwal A, Agoritsas T, Chu DK, Couban R, Darzi AJ, Devji T, Ghadimi M, Honarmand K, Izcovich A, Khamis A, Lamontagne F, Loeb M, Marcucci M, McLeod SL, Motaghi S, Murthy S, Mustafa RA, Neary JD, Pardo-Hernandez H, Rada G, Rochwerg B, Switzer C, Tendal B, Thabane L, Vandvik PO, Vernooij RWM, Viteri-García A, Wang Y, Yao L, Ye Z, Guyatt GH, Brignardello-Petersen R. Prophylaxis against covid-19: living systematic review and network meta-analysis. BMJ (IF=107.7). 2021 Apr 26;373:n949. doi: 10.1136/bmj.n949. PMID: 33903131; PMCID: PMC8073806.

  18. Hu Z, Li M, Yao L, Wang Y, Wang E, Yuan J, Wang F, Yang K, Bian Z, Zhong LLD. The level and prevalence of depression and anxiety among patients with different subtypes of irritable bowel syndrome: a network meta-analysis. BMC Gastroenterol (IF=3.0). 2021 Jan 7;21(1):23. doi: 10.1186/s12876-020-01593-5. PMID: 33413140; PMCID: PMC7791666.

  19.  Liang F, Song B, Wang Q, Wang X, Yao L. Certainty in Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients. JACC (IF=24.0); 2020,75(2):242-43. doi: 10.1016/j.jacc.2019.10.055. PMID: 31948658.

  20. Qin H-y, Yao L, Wang X, Wang Q, Tian J, Kwong JS, Wu T, Xiang BZ. 5‐aminosalicylic acid analogues for treatment of irritable bowel syndrome. Cochrane Database Syst Rev (IF=8.4) 2020 (9). DOI: 10.1002/14651858.CD013723.

  21. Ye Z, Wang Y, Colunga-Lozano LE, Prasad M, Tangamornsuksan W, Rochwerg B, Yao L, Motaghi S, Couban RJ, Ghadimi M, Bala MM, Gomaa H, Fang F, Xiao Y, Guyatt GH. Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis. CMAJ (IF=17.4). 2020 Jul 6;192(27):E756-E767. doi: 10.1503/cmaj.200645. Epub 2020 May 14. PMID: 32409522; PMCID: PMC7828900. (ESI high cited paper)

  22. Wang X, Chen Y, Yao L, Zhou Q, Wu Q, Estill J, Wang Q, Yang K, Norris SL. Reporting of declarations and conflicts of interest in WHO guidelines can be further improved. J Clin Epidemiol (IF=7.4). 2018 Jun;98:1-8. doi: 10.1016/j.jclinepi.2017.12.021. Epub 2017 Dec 30. PMID: 29292204.

  23. Yao L, Sun R, Chen Y-L, Wang Q, Wei D, Wang X, Yang K. The quality of evidence in Chinese meta-analyses needs to be improved. J Clin Epidemiol (IF=7.4). 2016;74:73-79. doi: 10.1016/j.jclinepi.2016.01.003. Epub 2016 Jan 11. PMID: 26780259. (ESI high cited paper)


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