Chinese herbal injections for heart failure: A protocol for systematic review and network meta-analyses

BACKGROUND: Chinese herbal injections (CHIs) are commonly used for the treatment of heart failure in China. Due to the variety of CHIs used in clinic, selecting a suitable CHI for patients with heart failure is vital. This study aims to assess and compare the effect of different CHIs for heart failure using network meta-analysis (NMA). METHODS: Six electronic databases, including PubMed, the Cochrane Central Register of Controlled Trials, Embase, China National Knowledge Infrastructure, Wanfang, and Chinese Biomedical Literature Database will be search from inception to January 2018. Randomized controlled trial (RCT) comparing CHI with another CHI will be included. The primary outcome will be changes in heart function classification and left ventricular ejection fraction. Risk of bias assessment of the included RCTs will be conducted according to the Cochrane Handbook 5.1.0. A Bayesian NMA will be performed using WinBUGS 14 software and the result figures will be generated using Stata 13 software. GRADE will be used to explore the quality of evidence. RESULTS: The results of this NMA will be published in a peer-reviewed journal. CONCLUSION: Our study will generate evidence of CHIs for patients with heart failure and provide suggestions for Chinese medicine clinical practice or guideline. ETHICS AND DISSEMINATION: Ethics approval and patient consent are not required because this study is an NMA based solely on the published literature. The results of this NMA will be submitted to a peer-reviewed journal. PROTOCOL REGISTRATION NUMBER: PROSPERO CRD 42018086740