This study provides an overview of the literature on the cost-effectiveness of homecare services compared to in-hospital care for adults and older adults. A systematic review was performed using Medline, Embase, Scopus, Web of Science, CINAHL and CENTRAL databases from inception to April 2022. The inclusion criteria were as follows: (i) (older) adults; (ii) homecare as an intervention; (iii) hospital care as a comparison; (iv) a full economic evaluation examining both costs and consequences; and (v) economic evaluations arising from randomized controlled trials (RCTs). Two independent reviewers selected the studies, extracted data and assessed study quality. Of the 14 studies identified, homecare, when compared to hospital care, was cost-saving in seven studies, cost-effective in two and more effective in one. The evidence suggests that homecare interventions are likely to be cost-saving and as effective as hospital. However, the included studies differ regarding the methods used, the types of costs and the patient populations of interest. In addition, methodological limitations were identified in some studies. Definitive conclusions are limited and highlight the need for better standardization of economic evaluations in this area. Further economic evaluations arising from well-designed RCTs would allow healthcare decision-makers to feel more confident in considering homecare interventions.

Background: Herbal medicine is a low-cost treatment and has been increasingly applied in obesity treatment. Gut microbiota (GM) is strongly associated with obesity pathogenesis. Methods: We conducted a systematic review guided by the question: “Does the use of herbal medicine change the GM composition in obese individuals?” Randomized clinical trials with obese individuals assessing the effects of herbal medicine intervention in GM were retrieved from the Medline, Embase, Scopus, Web of Science, and Cochrane Library databases, including the Cochrane Controlled Trials Register. Two reviewers independently extracted data using standardized piloted data extraction forms and assessed the study-level risk of bias using an Excel template of the Cochrane “Risk of bias” tool 2—RoB 2. Results: We identified 1094 articles in the databases. After removing duplicates and reading the title and abstract, 14 publications were fully evaluated, of which seven publications from six studies were considered eligible. The herbs analyzed were Moringa oleifera, Punica granatum, Scutellaria baicalensis, Schisandra chinensis, W-LHIT and WCBE. The analysis showed that Schisandra chinensis and Scutellaria baicalensis had significant effects on weight loss herbal intervention therapy composed by five Chinese herbal medicines Ganoderma lucidum, Coptis chinensis, Astragalus membranaceus, Nelumbo nucifera gaertn, and Fructus aurantii (W-LHIT) and white common bean extract (WCBE) on GM, but no significant changes in anthropometry and laboratory biomarkers. Conclusions: Herbal medicine modulates GM and is associated with increased genera in obese individuals.

Systematic reviews (SRs) and meta-analyses (MAs) on oral magnesium supplementation have increased, yet the completeness of their reporting and methodological quality reflect a lack of trustworthiness, and the certainty of evidence from these syntheses has not been systematically assessed. The sustainability practices of the primary randomised controlled trials (RCTs) underpinning these syntheses remain unevaluated, despite growing concern over research waste. This protocol describes a meta-research study to assess the completeness of reporting, methodological quality, and risk of bias of SRs and MAs, and to evaluate conflict of interest and sustainability practices in the primary RCTs. The study aims to identify critical gaps in magnesium research, provide recommendations to enhance its quality and sustainability, and inform nutrition research practices. It comprises three phases: (1) identification, selection, and assessment of SRs/MAs using PRISMA 2020, AMSTAR 2, and ROBIS; (2) evaluation of conflict of interest among included RCTs using the TACIT tool; and (3) assessment of sustainability practices (environmental and methodological) in these trials. Findings will inform researchers, editors, and funders.• Evaluates completeness of reporting, methodological quality, and risk of bias of SRs and MAs on oral magnesium supplementation.• Assesses conflict of interest and sustainability practices in primary RCTs.