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Objective: To evaluate the literature on off-label drug use of levocarnitine injection by the Jadad scale, so as to assess the medication rationality of levocarnitine injection in Ruijin Hospital Affiliated to School of Medicine, Shanghai Jiaotong University. Methods: All the literature on off-label drug use of levocarnitine injection were included and evaluated by the modified Jadad Scale, Literature with scores of more than 4 were selected as evidence for off-label drug use. Totally 360 prescriptions using levocarnitine injection were randomly selected to analyze the medication rationality of levocarnitine injection in this hospital. Results: Levocarnitine injection was usually used for nutrition myocardium, stablization of cardiac function, improvement of myocardial metabolism and so on in the literature selected by Jadad scale. Prescription reviews revealed that there were 309 cases of supernumerary indication drug use, accounting for 85.83%. Levocarnitine injection was mainly used as adjuvant drugs after cardiac surgery and resection of thoracic tumor, and no adverse drug reactions were reported. Conclusion: It would be a new tool that modified Jadad scale could be used for assessment of medication rationality by screening high quality literature. [ABSTRACT FROM AUTHOR]

PURPOSE: To compare the effectiveness of the tools on assessing quality and risk of bias between Jadad scale and Cochrane collaboration' s tool for assessing risk of bias in randomized controlled trials (RCTs). METHODS: A systematic literature search on induction chemotherapy for head and neck squamous cell carcinoma using the database of MEDLINE and EMBASE was performed as an example for evaluating the quality and risk of bias of RCTs. The Jadad scale and the Cochrane collaboration' s tool for assessing risk of bias were used for evaluating the RCTs, respectively. The different RCTs evaluated by the two kinds of tools were further analyzed on their quality and risk of bias. RESULTS: Thirty-seven RCTs were eligible for this analysis. Using the Jadad scale, 23 trials should be excluded because of the low quality of RCTs; while using the Cochrane collaboration's tool for assessing risk of bias, 7 trials should be exclude because of the high bias of RCTs. Among the 16 low bias RCTs, which were scored as low quality of RCTs by Jadad scale, the most common reasons for exclusion were no description of the blindness and generation of the allocation sequence. However, the quality of these RCTs was good enough for systemic analysis. CONCLUSIONS: In order to improve the quality of systemic analysis, proper tools of assessing quality and risk of bias should be considered, and the Cochrane collaboration' s tool for assessing risk of bias is recommended, especially for open RCTs. [ABSTRACT FROM AUTHOR]