Meta-IMU: A R Shiny App to Conduct Meta-Analysis in Systematic Review and Umbrella Reviews Many tools exist for conducting meta-analyses in systematic reviews, but they are often expensive or difficult for beginners to use. This challenge arises because most tools either fail to address all aspects of meta-analysis comprehensively or lack sufficient guidance for navigating their features. To address these limitations, we developed Meta-IMU, a free R-based Shiny application tailored specifically for beginners. Unlike many existing tools that focus solely on standard systematic reviews, Meta-IMU supports both systematic reviews and umbrella reviews, offering a more versatile approach. To ensure accessibility, Meta-IMU includes built-in instructional videos that guide users step by step, from navigating the application to interpreting the results produced. This guidance ensures users can confidently perform analyses without prior expertise. Meta-IMU encompasses a comprehensive range of features covering key aspects of meta-analysis, such as defining review questions, developing search terms, retrieving studies from various databases, assessing risk of bias, creating tables and plots, analysing small-study effects, performing meta-regression and subgroup analyses, conducting sensitivity analyses, assessing the certainty of evidence, summarizing findings, and generating PRISMA checklist reports. By integrating these functionalities into a single platform, Meta-IMU provides a user-friendly, all-in-one solution. In summary, Meta-IMU is a comprehensive, free application designed to simplify the process of meta-analysis for both systematic reviews and umbrella reviews, making advanced analytical techniques accessible to researchers at any level of experience.

Introduction: Chinese medicine (CM) external therapy is commonly used to treat rheumatoid arthritis (RA) in combination with conventional drug. This study aims to provide a comprehensive synthesis on the efficacy of CM external therapy combined with conventional drug treatment in RA. Methods: Randomised controlled trials (RCTs) experimenting the efficacy of CM external therapy (acupuncture, moxibustion and CM fumigation) combined with conventional drug in comparison with conventional drug only in RA patients were collected from PubMed, Medline, Cochrane Central of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI), and Wanfang databases. Quality was assessed using the Cochrane Risk of Bias Tool. The outcome measures which include Disease Activity Score-28 (DAS28), Visual Analogue Scale (VAS), Swollen Joint Count (SJC), Tumour Necrosis Factor (TNF-α), serum levels of C-reactive Protein (CRP) and Erythrocyte Sedimentation Rate (ESR) were analysed using Review Manager 5.4.1 and GRADEpro GDT online software. Results: Fifty RCTs fulfilling the criteria were included. Although some level of efficacy was statistically noted on the use of CM external therapies, their certainty levels are mixed, ranging only in between moderate and low. Conclusions Mixed levels of certainty has hindered the drawing of conclusion. The addition of CM external therapies to conventional drug treatment may provide some benefits in RA. Further clinical trials with considerations in minimising the risk of bias are recommended to provide more high-quality evidence in the effect of CM external therapies as a complementary treatment in RA.
Medicine, Chinese Traditional ; Fumigation ; Meta-Analysis [Publication Type] ; Moxibustion ; Arthritis, Rheumatoid ; Systematic Review [Publication Type]