Digital versus face-to-face gut-directed psychotherapy for irritable bowel syndrome: a protocol of systematic review and network meta-analysis.

Abstract

<h4>Introduction</h4>Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder worldwide. Although not life-threatening, its chronic and recurrent nature greatly impacts patients' quality of life. There is strong evidence that gut-directed psychotherapies (GDPs) help improve IBS symptoms. With technological advances, digital GDP is increasingly used as an alternative to traditional face-to-face GDP. This study will compare the clinical effectiveness of digital versus face-to-face GDP for IBS through network meta-analysis.<h4>Methods and analysis</h4>We will search English databases (PubMed, Cochrane Library, EMBASE and Web of Science) and Chinese databases (China National Knowledge Infrastructure, Wanfang, VIP and Chinese Biomedical Database) for randomised controlled trials (RCTs) of digital or face-to-face GDP for IBS. The search will cover the period from database inception to May 2025. We will perform multivariate network meta-analyses within a frequentist framework, using the mvmeta command in STATA V.16 software, and traditional pairwise meta-analysis using the DerSimonian-Laird random-effects model. The Cochrane Risk of Bias (RoB) tool (V.2) will be used to assess the RoB of each RCT, and the Confidence in Network Meta-Analysis (CINeMA) tool will be used to evaluate the certainty of the evidence.<h4>Ethics and dissemination</h4>Ethical approval is not required for this systematic review, as it involves the collection and synthesis of data from previously published primary studies.<h4>Osf registration</h4>Open Science Framework (OSF) registration: DOI 10.17605/OSF.IO/87463.