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Characteristics of interventions that address racism in the United States and opportunities to integrate equity principles: a scoping review. 美国解决种族主义问题的干预措施的特点以及纳入公平原则的机会:范围审查。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-23 DOI: 10.1186/s13643-024-02679-x
Brooke DiPetrillo, Paris B Adkins-Jackson, Ruqaiijah Yearby, Crystal Dixon, Terri D Pigott, Ryan J Petteway, Ana LaBoy, Aliza Petiwala, Margaret Leonard

Background: As a driver of racial and health inequities, racism is deeply ingrained in the interconnected systems that affect health and well-being. Currently, no common frame is employed across researchers, interventionists, and funders to design, implement, and evaluate comprehensive interventions to address racism. Consequently, there is a need to examine the characteristics of interventions implemented in the United States that address racism across social and structural determinants of health and socio-ecological levels. Additionally, we utilized a Health Equity Action Research (HEART) framework to assess how interventions integrate equity principles.

Methods: This scoping review examined the characteristics of multi-level interventions that addressed racism and appraised the interventions using a Health Equity Action Research frame. A comprehensive search strategy was conducted across nine electronic databases between 24 October 2022 through 15 November 2022. Records were included if they were available in English, discussed or evaluated a multi-level intervention or program conducted in the United States, and discussed or evaluated the intervention or program regarding the health and well-being of racialized and ethnically minoritized groups.

Results: A total of 13,391 records were identified, of which 91 met the eligibility criteria and were included in the analysis. Most records reported the racialized group impacted by an intervention, of which the majority were racialized as African American or Black (n = 42) and Hispanic or Latino/a/x (n = 18). Eighty-one (89%) of interventions reported health outcomes and concentrated on the individual level. Most funders reported across the records, and 86 (51%) were a federal agency or department. A further 43 (25%) were private foundations, 12 (7%) were nonprofit organizations, 10 (6%) were private universities, and 4 (2%) were public universities. Regarding alignment with the HEART framework, 14% of interventions reported a mixed-methods approach, 45% reported community engagement, and less than 1% reported researcher self-reflection.

Conclusions: Most interventions prioritized people who are racialized as Black and report health outcomes. Since intervention designs, objectives, and methodological approaches vary, no standard frame defines racism and health equity. Applying the HEART framework offers a standard approach for interventionists and researchers to examine power, integrate community voice, and self-reflect to advance health equity.

背景:作为种族和健康不平等的驱动因素,种族主义在影响健康和福祉的相互关联的系统中根深蒂固。目前,研究人员、干预者和资助者在设计、实施和评估应对种族主义的综合干预措施时没有采用共同的框架。因此,我们有必要研究在美国实施的干预措施的特点,这些干预措施涉及健康的社会和结构性决定因素以及社会生态层面,旨在解决种族主义问题。此外,我们还利用健康公平行动研究(HEART)框架来评估干预措施如何整合公平原则:本范围界定综述研究了针对种族主义的多层次干预措施的特点,并利用健康公平行动研究框架对干预措施进行了评估。在 2022 年 10 月 24 日至 2022 年 11 月 15 日期间,对九个电子数据库进行了全面检索。只要记录是英文的,讨论或评估了在美国进行的多层次干预或计划,并讨论或评估了有关种族化和少数族裔群体的健康和福祉的干预或计划,就会被收录:共找到 13,391 条记录,其中 91 条符合资格标准并纳入分析。大多数记录报告了受干预措施影响的种族化群体,其中大多数种族化群体为非洲裔美国人或黑人(n = 42)和西班牙裔或拉丁裔/a/x(n = 18)。81项(89%)干预措施报告了健康结果,并集中在个人层面。大多数资助者的报告都是跨记录的,其中 86 个(51%)是联邦机构或部门。另有 43 个(25%)是私人基金会,12 个(7%)是非营利组织,10 个(6%)是私立大学,4 个(2%)是公立大学。关于与 HEART 框架的一致性,14% 的干预措施报告了混合方法,45% 报告了社区参与,不到 1%报告了研究人员的自我反思:结论:大多数干预措施都优先考虑被种族化为黑人并报告健康结果的人。由于干预措施的设计、目标和方法各不相同,因此没有一个标准框架来定义种族主义和健康公平。应用 HEART 框架为干预者和研究人员提供了一种标准方法,以检查权力、整合社区声音并进行自我反思,从而促进健康公平。
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引用次数: 0
The relationship between implicit motives and physical activity: a scoping review. 内隐动机与体育锻炼之间的关系:范围综述。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-18 DOI: 10.1186/s13643-024-02678-y
Julian Brummer, Nikkil Sudharsanan, Martin G Köllner

Background: Interventions that leverage implicit motives - affect-based, non-conscious motivational dispositions - may increase physical activity by making physical activity more pleasurable. However, there is no evidence synthesis of the empirical data linking the major implicit motives (achievement, affiliation, and power motives) and physical activity. We aimed to close this research gap.

Methods: Following a systematic literature search in the PsycInfo, PubMed, and Web of Science databases until August 2024, we performed a scoping review. We included German- or English-language publications in peer-reviewed journals or books that followed an observational or intervention study design. Studies had to link ≥ 1 major implicit motive measured via a well-established method to physical activity behavior. We critically appraised the methodological quality of the included studies using an adaptation of the JBI critical appraisal checklist for analytical cross-sectional studies and synthesized the evidence qualitatively.

Results: Out of 1047 potentially relevant records, five publications (seven studies, N = 550) were included. All eligible studies were observational (six cross-sectional, one prospective longitudinal). The achievement motive was researched the most. The data indicated a relatively consistent positive association between physical activity and the achievement motive, particularly in athletes and in sports-specific settings. The associations with the affiliation and power motives were more mixed. Most studies were conducted in sports-specific settings. All studies elicited methodological concerns, to varying degrees.

Conclusions: The available data indicate a positive association between achievement motive strength and physical activity. However, important limitations, especially the lack of intervention studies and the use of non-gold standard assessment methods, limit the confidence in the findings. More, methodologically sound research is needed to better understand the link between implicit motives and physical activity, especially in the general population.

Systematic review registration: PROSPERO CRD42023392198.

背景:利用内隐动机(以情感为基础的、非自觉的动机倾向)进行干预,可以使体育锻炼更有乐趣,从而增加体育锻炼量。然而,目前还没有将主要的内隐动机(成就动机、从属动机和权力动机)与体育锻炼联系起来的实证数据综合起来。我们旨在填补这一研究空白:方法:我们在 PsycInfo、PubMed 和 Web of Science 数据库中进行了系统的文献检索,直至 2024 年 8 月。我们收录了同行评审期刊或书籍中采用观察性或干预性研究设计的德语或英语出版物。研究必须将≥一种通过成熟方法测量的主要隐性动机与体育锻炼行为联系起来。我们采用针对分析性横断面研究的 JBI 临界评估清单,对纳入研究的方法学质量进行了严格评估,并对证据进行了定性综合:在 1047 条可能相关的记录中,共纳入了 5 篇出版物(7 项研究,N = 550)。所有符合条件的研究均为观察性研究(六项横断面研究,一项前瞻性纵向研究)。对成就动机的研究最多。数据显示,体育锻炼与成就动机之间存在相对一致的正相关关系,尤其是在运动员和特定运动环境中。至于与从属动机和权力动机之间的关系,则喜忧参半。大多数研究都是在特定运动环境下进行的。所有研究都在不同程度上引起了方法学方面的关注:现有数据表明,成就动机强度与体育锻炼之间存在正相关。然而,一些重要的局限性,特别是缺乏干预研究和使用非黄金标准的评估方法,限制了研究结果的可信度。要想更好地了解内隐动机与体育锻炼之间的联系,尤其是在普通人群中,还需要更多方法合理的研究:系统综述注册:prospero crd42023392198。
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引用次数: 0
Academic partnerships in transforming nursing and midwifery education in Africa: a systematic scoping review protocol. 非洲护理和助产教育改革中的学术伙伴关系:系统性范围界定审查协议。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-18 DOI: 10.1186/s13643-024-02664-4
Claudine Muraraneza, Donatilla Mukamana, Godfrey Katende, Oliva Bazirete, Liz Wolvaardt

Background: In recent decades, the literature on global partnerships in nursing and midwifery education, to enhance the quality of education and produce competent graduates in the labor market, is on the rise in Africa. However, there is a gap regarding the best practices and barriers in the African context. This systematic scoping review aims to map the evidence on academic partnerships in transforming nursing and midwifery education in Africa.

Methods: The review will be guided by Arksey and O'Malley's methodology framework through five stages: (1) Identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collecting, summarizing, and reporting the results. A search will be conducted with the use of the following electronic databases: Cumulative Index to Nursing and Applied Health Literature (CINAHL), PubMed, ScienceDirect, and Google Scholar. Additional gray literature will be searched via the World Health Organization's website to locate relevant policies and guidelines. The search will be limited to work published in English from 2014 to 2023. All located resources will be exported to EndNote X8. All duplicates will be removed during when the abstracts are screened. Two independent reviewers will screen and extract the full text of the selected articles. Thematic analysis will be used to analyze data from this systematic scoping review.

Discussion: Mapping the evidence on global partnerships in transforming nursing and midwifery education in Africa will outline the best practices and preferences for sustainable collaboration. The review will also highlight knowledge gaps and limitations that could inform future research projects.

Systematic review registration: https://osf.io/h83cy.

背景:近几十年来,关于护理和助产教育全球伙伴关系的文献在非洲不断增加,目的是提高教育质量,为劳动力市场培养合格的毕业生。然而,在非洲的最佳实践和障碍方面还存在差距。本系统性范围界定综述旨在对非洲护理和助产教育改革中学术合作的证据进行摸底:综述将以 Arksey 和 O'Malley 的方法框架为指导,分为五个阶段:(1) 确定研究问题,(2) 确定相关研究,(3) 选择研究,(4) 绘制数据图表,(5) 收集、总结和报告结果。将使用以下电子数据库进行检索:护理和应用健康文献累积索引》(CINAHL)、PubMed、ScienceDirect 和 Google Scholar。还将通过世界卫生组织网站搜索其他灰色文献,以查找相关政策和指南。搜索范围仅限于 2014 年至 2023 年发表的英文文献。所有找到的资源都将导出到 EndNote X8 中。筛选摘要时将删除所有重复内容。两名独立审稿人将筛选并提取所选文章的全文。专题分析将用于分析本系统范围界定综述的数据:对非洲护理和助产教育改革中全球伙伴关系的证据进行分析,将概述可持续合作的最佳实践和偏好。综述还将强调知识差距和局限性,为未来的研究项目提供参考。系统综述注册:https://osf.io/h83cy。
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引用次数: 0
Risk of cancer development associated with disease-modifying therapies for multiple sclerosis: study protocol for a systematic review and meta-analysis of randomised and non-randomised studies. 与多发性硬化症疾病修饰疗法相关的癌症发病风险:随机和非随机研究的系统回顾和荟萃分析研究方案。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-18 DOI: 10.1186/s13643-024-02677-z
Ferrán Catalá-López, Laura Tejedor-Romero, Jane A Driver, Brian Hutton, Joan Vicent Sánchez-Ortí, Manuel Ridao, Adolfo Alonso-Arroyo, Patricia Correa-Ghisays, Jaume Forés-Martos, Vicent Balanzá-Martínez, Alfonso Valencia, Inmaculada Cobos, Rafael Tabarés-Seisdedos

Background: The association between cancer and multiple sclerosis has long been investigated. Several studies and reviews have examined the risk of cancer among patients with multiple sclerosis treated with disease-modifying therapies (DMTs) but with conflicting results. This study will aim to investigate the association between DMTs for multiple sclerosis and subsequent cancer risk using research synthesis methods.

Methods/design: We designed and registered a study protocol for a systematic review and meta-analysis. We will include randomised and non-randomised trials, prospective or retrospective cohort studies, and case-control studies of treatment with DMTs compared with placebo, no treatment, or another active agent. The primary outcome will be the risk of cancer (all-malignant neoplasms) in association with the exposure of DMTs. Secondary outcomes will include site-specific cancers (e.g. breast cancer). Literature searches will be conducted in multiple electronic databases (from their inception onwards), including the following: PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). Two researchers will screen all citations, full-text articles, and abstract data independently. The risk of bias (quality) of individual studies will be appraised using an appropriate tool. If feasible, we will use a two-stage approach to evidence synthesis: (1) Peto's method for meta-analysis of data from randomised trials alone; and (2) Random-effects model for meta-analysis adding data from non-randomised studies. We will calculate odds ratios and their associated 95% confidence intervals. Potential sources of heterogeneity will be explored in additional analyses (e.g. subgroups considering different DMTs individually, mechanism of action, type of control, length of follow-up, mode of treatment).

Discussion: This systematic review and meta-analysis of randomised and non-randomised studies will provide an updated synthesis of the risk of cancer associated with DMTs for adult patients with multiple sclerosis. This study will also examine some factors that may explain potential variations across studies. The findings will be published in a peer-reviewed journal.

Systematic review registration: Open Science Framework ( https://osf.io/v4sez ).

背景:癌症与多发性硬化症之间的关联研究由来已久。一些研究和综述探讨了接受疾病改变疗法(DMTs)治疗的多发性硬化症患者罹患癌症的风险,但结果相互矛盾。本研究旨在采用研究综述方法,调查多发性硬化症 DMTs 与后续癌症风险之间的关联:我们设计并注册了一项系统综述和荟萃分析的研究方案。我们将纳入随机和非随机试验、前瞻性或回顾性队列研究,以及DMTs治疗与安慰剂、无治疗或另一种活性药物治疗的病例对照研究。主要研究结果将是与接触 DMTs 相关的癌症(所有恶性肿瘤)风险。次要结果将包括特定部位的癌症(如乳腺癌)。文献检索将在多个电子数据库中进行(从开始时起),包括以下数据库:PubMed/MEDLINE、EMBASE 和 Cochrane 对照试验中央注册中心 (CENTRAL)。两名研究人员将独立筛选所有引文、全文和摘要数据。我们将使用适当的工具对各项研究的偏倚风险(质量)进行评估。在可行的情况下,我们将采用两阶段方法进行证据综合:(1) Peto 方法,仅对随机试验数据进行荟萃分析;(2) 随机效应模型,加入非随机研究数据进行荟萃分析。我们将计算几率比及其相关的 95% 置信区间。我们还将在其他分析中探讨潜在的异质性来源(如单独考虑不同 DMTs 的亚组、作用机制、对照类型、随访时间、治疗模式):这项对随机和非随机研究进行的系统综述和荟萃分析将为成年多发性硬化症患者提供与DMTs相关的癌症风险的最新综述。这项研究还将探讨一些可能解释不同研究之间潜在差异的因素。研究结果将发表在同行评审期刊上:开放科学框架 ( https://osf.io/v4sez )。
{"title":"Risk of cancer development associated with disease-modifying therapies for multiple sclerosis: study protocol for a systematic review and meta-analysis of randomised and non-randomised studies.","authors":"Ferrán Catalá-López, Laura Tejedor-Romero, Jane A Driver, Brian Hutton, Joan Vicent Sánchez-Ortí, Manuel Ridao, Adolfo Alonso-Arroyo, Patricia Correa-Ghisays, Jaume Forés-Martos, Vicent Balanzá-Martínez, Alfonso Valencia, Inmaculada Cobos, Rafael Tabarés-Seisdedos","doi":"10.1186/s13643-024-02677-z","DOIUrl":"10.1186/s13643-024-02677-z","url":null,"abstract":"<p><strong>Background: </strong>The association between cancer and multiple sclerosis has long been investigated. Several studies and reviews have examined the risk of cancer among patients with multiple sclerosis treated with disease-modifying therapies (DMTs) but with conflicting results. This study will aim to investigate the association between DMTs for multiple sclerosis and subsequent cancer risk using research synthesis methods.</p><p><strong>Methods/design: </strong>We designed and registered a study protocol for a systematic review and meta-analysis. We will include randomised and non-randomised trials, prospective or retrospective cohort studies, and case-control studies of treatment with DMTs compared with placebo, no treatment, or another active agent. The primary outcome will be the risk of cancer (all-malignant neoplasms) in association with the exposure of DMTs. Secondary outcomes will include site-specific cancers (e.g. breast cancer). Literature searches will be conducted in multiple electronic databases (from their inception onwards), including the following: PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). Two researchers will screen all citations, full-text articles, and abstract data independently. The risk of bias (quality) of individual studies will be appraised using an appropriate tool. If feasible, we will use a two-stage approach to evidence synthesis: (1) Peto's method for meta-analysis of data from randomised trials alone; and (2) Random-effects model for meta-analysis adding data from non-randomised studies. We will calculate odds ratios and their associated 95% confidence intervals. Potential sources of heterogeneity will be explored in additional analyses (e.g. subgroups considering different DMTs individually, mechanism of action, type of control, length of follow-up, mode of treatment).</p><p><strong>Discussion: </strong>This systematic review and meta-analysis of randomised and non-randomised studies will provide an updated synthesis of the risk of cancer associated with DMTs for adult patients with multiple sclerosis. This study will also examine some factors that may explain potential variations across studies. The findings will be published in a peer-reviewed journal.</p><p><strong>Systematic review registration: </strong>Open Science Framework ( https://osf.io/v4sez ).</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local inconsistency detection using the Kullback-Leibler divergence measure. 使用 Kullback-Leibler 发散度量进行局部不一致性检测。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-17 DOI: 10.1186/s13643-024-02680-4
Loukia M Spineli

Background: The standard approach to local inconsistency assessment typically relies on testing the conflict between the direct and indirect evidence in selected treatment comparisons. However, statistical tests for inconsistency have low power and are subject to misinterpreting a p-value above the significance threshold as evidence of consistency.

Methods: We propose a simple framework to interpret local inconsistency based on the average Kullback-Leibler divergence (KLD) from approximating the direct with the corresponding indirect estimate and vice versa. Our framework uses directly the mean and standard error (or posterior mean and standard deviation) of the direct and indirect estimates obtained from a local inconsistency method to calculate the average KLD measure for selected comparisons. The average KLD values are compared with a semi-objective threshold to judge the inconsistency as acceptably low or material. We exemplify our novel interpretation approach using three networks with multiple treatments and multi-arm studies.

Results: Almost all selected comparisons in the networks were not associated with statistically significant inconsistency at a significance level of 5%. The proposed interpretation framework indicated 14%, 66%, and 75% of the selected comparisons with an acceptably low inconsistency in the corresponding networks. Overall, information loss was more notable when approximating the posterior density of the indirect estimates with that of the direct estimates, attributed to indirect estimates being more imprecise.

Conclusions: Using the concept of information loss between two distributions alongside a semi-objectively defined threshold helped distinguish target comparisons with acceptably low inconsistency from those with material inconsistency when statistical tests for inconsistency were inconclusive.

背景:局部不一致性评估的标准方法通常依赖于检验选定治疗比较中直接证据与间接证据之间的冲突。然而,对不一致性进行统计检验的能力较低,而且容易将高于显著性阈值的 p 值误解为一致性的证据:我们提出了一个简单的框架来解释局部不一致性,其基础是用相应的间接估计值近似直接估计值和间接估计值的平均库尔贝克-莱布勒分歧(KLD),反之亦然。我们的框架直接使用从局部不一致性方法中获得的直接和间接估计值的平均值和标准误差(或后验均值和标准偏差)来计算选定比较的平均 KLD 度量。将平均 KLD 值与半客观阈值进行比较,以判断不一致性是可接受的低值还是实质性的。我们使用三个具有多种治疗方法和多臂研究的网络来示范我们的新解释方法:结果:在 5%的显著性水平下,网络中几乎所有选定的比较都与具有统计学意义的不一致性无关。提出的解释框架表明,14%、66% 和 75% 的选定比较在相应网络中的不一致性较低,可以接受。总体而言,当用直接估计值近似间接估计值的后验密度时,信息损失更为显著,这是因为间接估计值更为不精确:结论:在对不一致性进行统计检验未得出结论时,使用两个分布之间的信息损失概念以及半客观定义的阈值,有助于区分不一致性低到可接受程度的目标比较和不一致性高的目标比较。
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引用次数: 0
Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies. 非洲镰状细胞病患者的肝脏和肾脏生化特征:病例对照研究的系统回顾和荟萃分析。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-15 DOI: 10.1186/s13643-024-02662-6
Silvia Awor, Felix Bongomin, Mark Mohan Kaggwa, Francis Pebalo Pebolo, Jackie Epila, Geoffrey Maxwell Malinga, Christine Oryema, Proscovia Nnamuyomba, Benard Abola, Acaye Ongwech, David Musoke

Background: Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa.

Methods: The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords "liver function", "renal function", "sickle cell disease", and "Africa" on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2.

Results: Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI - 2.99-20.23, I2 = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI - 0.16-15.80, I2 = 99%, p < 0.01) and alkaline phosphatase (ALP) - 2.54 (95% CI - 64.72 - 59.64, I2 = 99%, p < 0.01) compared to controls. The pooled mean difference for the renal biochemical profiles creatinine - 3.15 (95% CI - 15.02; 8.72, I2=99%, p < 0.01) with a funnel plot asymmetry of t = 1.09, df = 9, p = 0.3048 and sample estimates bias of 6.0409. The pooled mean difference for serum urea was - 0.57 (95% CI - 3.49; 2.36, I2 = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95% CI 10.89-28.68 mL/min/1.73 m2, I2 = 87%, p < 0.01) compared to controls.

Conclusion: People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates compared to controls in Africa. With all the heterogeneity (I2) > 50%, there was substantial variation in the reported articles' results.

Systematic review registration: PROSPERO CRD42022346771.

背景:镰状细胞病(SCD)是一种遗传性血液疾病,其特征是由于红细胞在毛细血管中镰状化而导致的令人痛苦的血管闭塞危象。其并发症通常会导致肝脏和肾脏功能障碍,从而增加发病率和死亡率,尤其是 5 岁以下儿童。本系统综述和荟萃分析旨在评估非洲 SCD 患者(HbSS)与非 SCD 患者(HbAA)的肝肾功能比较:该研究方案已在 PROSPERO 注册(CRD42022346771)。我们于 2023 年 5 月 6 日在 PubMed、Embase、Web of Science 和 Google Scholar 上以 "肝功能"、"肾功能"、"镰状细胞病 "和 "非洲 "为关键词,检索同行评审过的英文摘要文章。我们纳入了比较 SCD(HbSS)与无血红蛋白病(HbAA)对照组的病例对照研究。我们在 RStudio 4.2.2 版中使用随机效应模型计算了 SCD 患者血液检测的汇总平均值:共分析了来自五个非洲国家的 17 篇文章,涉及 1312 名 SCD 患者和 1558 名对照者。肝酶天门冬氨酸转氨酶(AST)的汇总平均差异为 8.62(95% CI - 2.99-20.23,I2 = 97.0%,P 2 = 99%,P 2 = 99%,P 2 = 99%,P 2 = 99%,P 2,I2 = 87%,P 结论:与非洲的对照组相比,SCD 患者的肝酶和肾小球滤过率略有升高。由于所有文章的异质性(I2)均大于50%,因此报告的结果存在很大差异:系统综述注册:prospero crd42022346771。
{"title":"Liver and renal biochemical profiles of people with sickle cell disease in Africa: a systematic review and meta-analysis of case-control studies.","authors":"Silvia Awor, Felix Bongomin, Mark Mohan Kaggwa, Francis Pebalo Pebolo, Jackie Epila, Geoffrey Maxwell Malinga, Christine Oryema, Proscovia Nnamuyomba, Benard Abola, Acaye Ongwech, David Musoke","doi":"10.1186/s13643-024-02662-6","DOIUrl":"10.1186/s13643-024-02662-6","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) is a genetic blood disorder characterized by a painful vaso-occlusive crisis due to the sickling of red blood cells in capillaries. Complications often lead to liver and renal dysfunctions, contributing to morbidity and mortality, particularly for children under 5. This systematic review and meta-analysis aimed to evaluate the liver and renal functions of people with SCD (HbSS) compared to those without it (HbAA) in Africa.</p><p><strong>Methods: </strong>The protocol was registered with PROSPERO (CRD42022346771). We searched PubMed, Embase, Web of Science, and Google Scholar using the keywords \"liver function\", \"renal function\", \"sickle cell disease\", and \"Africa\" on 6th May 2023 for peer-reviewed articles with abstracts in English. We included case-control studies comparing SCD (HbSS) with controls without hemoglobinopathies (HbAA). We used the random-effect model to calculate the pooled average values for the blood tests of people with SCD in RStudio version 4.2.2.</p><p><strong>Results: </strong>Overall, 17 articles were analyzed from five African countries involving 1312 people with SCD and 1558 controls. The pooled mean difference of liver enzymes aspartate transaminase (AST) was 8.62 (95% CI - 2.99-20.23, I<sup>2</sup> = 97.0%, p < 0.01), alanine transaminase (ALT) 7.82 (95% CI - 0.16-15.80, I<sup>2</sup> = 99%, p < 0.01) and alkaline phosphatase (ALP) - 2.54 (95% CI - 64.72 - 59.64, I<sup>2</sup> = 99%, p < 0.01) compared to controls. The pooled mean difference for the renal biochemical profiles creatinine - 3.15 (95% CI - 15.02; 8.72, I<sup>2</sup>=99%, p < 0.01) with a funnel plot asymmetry of t = 1.09, df = 9, p = 0.3048 and sample estimates bias of 6.0409. The pooled mean difference for serum urea was - 0.57 (95% CI - 3.49; 2.36, I<sup>2</sup> = 99%, p < 0.01), and the estimated glomerular filtration (eGFR) rate was 19.79 (95% CI 10.89-28.68 mL/min/1.73 m<sup>2</sup>, I<sup>2</sup> = 87%, p < 0.01) compared to controls.</p><p><strong>Conclusion: </strong>People with SCD have slightly elevated liver enzymes and estimated glomerular filtration rates compared to controls in Africa. With all the heterogeneity (I<sup>2</sup>) > 50%, there was substantial variation in the reported articles' results.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022346771.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Protocol for a systematic review and meta-analysis of interventions aimed at delabeling low-risk penicillin allergies with consideration for sex and gender. 对旨在消除低风险青霉素过敏标签的干预措施进行系统回顾和荟萃分析,并考虑性别因素。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-14 DOI: 10.1186/s13643-024-02671-5
Mira Maximos, Sameer Elsayed, Colleen Maxwell, Sherilyn K D Houle, Ryan Pelletier, Brie McConnell, Andrew Pylypiak, John-Michael Gamble

Background: Approximately, 10% of people report a penicillin allergy; however, more than 90% can safely undergo delabeling after a detailed history, oral challenge, or other investigations such as penicillin skin testing (PST). Although PST is the gold standard, the results can be heterogeneous, and awaiting specialist assessment may take an inordinate amount of time. Therefore, oral provocation challenge has become acceptable for individuals with low-risk penicillin allergy histories. There also appears to be an association with increased prevalence of adverse drug reaction reporting in female individuals, which may translate to penicillin allergy prevalence; however, the evidence has not been assessed through a sex and gender lens. This systematic review will identify and synthesize the findings from studies that report measures of effectiveness and safety of interventions aimed at delabeling penicillin allergies in low-risk individuals. Information related to sex and gender will be extracted, where available, to understand potential differences in allergy reporting and patient outcomes.

Methods: The Cochrane Handbook for Systematic Reviews of Interventions and the Centre for Review and Dissemination's Guidance for Undertaking Reviews in Health Care will be used as frameworks for conducting this systematic review. The literature search will be conducted by a medical librarian (B. M. M.) and will consist of a search strategy to identify and retrieve published studies that meet our inclusion criteria. Studies that require penicillin skin testing (PST) as a step prior to other interventions will be excluded. Integrated knowledge translation involving co-design was carried out for this systematic review protocol creation. Data extraction will be conducted at four levels: (1) study level, (2) patient level, (3) intervention level, and (4) outcome level. A narrative descriptive synthesis of results and risk of bias of all included studies will be provided, and, if relevant, a meta-analysis will be performed.

Discussion: The dissemination of findings from this knowledge synthesis to various stakeholders is intended to inform on options for evidence-based interventions to aid in delabeling penicillin allergies in individuals with a low risk of experiencing a hypersensitivity reaction. Detailed reporting on the characteristics of delabeling interventions as well as the effectiveness of similar interventions will benefit policy makers considering the implementation of a penicillin allergy delabeling protocol. Additionally, findings from this systematic review will report on the current evidence regarding the role of sex and gender in both the prevalence and outcomes associated with the presence of penicillin allergies.

Systematic review registration: PROSPERO CRD42022336457.

背景:约有 10% 的人报告对青霉素过敏;然而,经过详细询问病史、口服试验或其他检查(如青霉素皮试 (PST))后,90% 以上的人可以安全地接受脱敏治疗。虽然青霉素皮试是金标准,但其结果可能不尽相同,而且等待专家评估可能会耗费大量时间。因此,对于青霉素过敏史风险较低的患者来说,口服激惹试验已被接受。女性药物不良反应报告率的增加似乎也与青霉素过敏的发生率有关,但尚未从性别角度对证据进行评估。本系统性综述将确定并综合报告旨在消除低风险人群青霉素过敏的干预措施的有效性和安全性的研究结果。在可能的情况下,还将提取与性别相关的信息,以了解过敏报告和患者结果的潜在差异:方法:将以 Cochrane《干预措施系统综述手册》和审查与传播中心的《医疗保健领域综述指南》为框架,开展此次系统综述。文献检索将由医学图书管理员(B. M. M.)进行,将采用检索策略来识别和检索符合纳入标准的已发表研究。需要将青霉素皮试 (PST) 作为其他干预措施之前的一个步骤的研究将被排除在外。在制定系统综述方案时,进行了涉及共同设计的综合知识转化。数据提取将在四个层面进行:(1) 研究层面;(2) 患者层面;(3) 干预层面;(4) 结果层面。将对所有纳入研究的结果和偏倚风险进行叙述性描述综合,如果相关,还将进行荟萃分析:向各利益相关者传播本知识综述的研究结果,旨在为基于证据的干预方案提供信息,以帮助发生过敏反应风险较低的个体解除青霉素过敏标签。详细报告脱敏干预措施的特点以及类似干预措施的有效性将有利于考虑实施青霉素过敏脱敏方案的政策制定者。此外,本系统综述的研究结果还将报告目前有关性和性别在青霉素过敏发生率和相关结果中的作用的证据:系统综述注册:PREMCORD42022336457。
{"title":"Protocol for a systematic review and meta-analysis of interventions aimed at delabeling low-risk penicillin allergies with consideration for sex and gender.","authors":"Mira Maximos, Sameer Elsayed, Colleen Maxwell, Sherilyn K D Houle, Ryan Pelletier, Brie McConnell, Andrew Pylypiak, John-Michael Gamble","doi":"10.1186/s13643-024-02671-5","DOIUrl":"10.1186/s13643-024-02671-5","url":null,"abstract":"<p><strong>Background: </strong>Approximately, 10% of people report a penicillin allergy; however, more than 90% can safely undergo delabeling after a detailed history, oral challenge, or other investigations such as penicillin skin testing (PST). Although PST is the gold standard, the results can be heterogeneous, and awaiting specialist assessment may take an inordinate amount of time. Therefore, oral provocation challenge has become acceptable for individuals with low-risk penicillin allergy histories. There also appears to be an association with increased prevalence of adverse drug reaction reporting in female individuals, which may translate to penicillin allergy prevalence; however, the evidence has not been assessed through a sex and gender lens. This systematic review will identify and synthesize the findings from studies that report measures of effectiveness and safety of interventions aimed at delabeling penicillin allergies in low-risk individuals. Information related to sex and gender will be extracted, where available, to understand potential differences in allergy reporting and patient outcomes.</p><p><strong>Methods: </strong>The Cochrane Handbook for Systematic Reviews of Interventions and the Centre for Review and Dissemination's Guidance for Undertaking Reviews in Health Care will be used as frameworks for conducting this systematic review. The literature search will be conducted by a medical librarian (B. M. M.) and will consist of a search strategy to identify and retrieve published studies that meet our inclusion criteria. Studies that require penicillin skin testing (PST) as a step prior to other interventions will be excluded. Integrated knowledge translation involving co-design was carried out for this systematic review protocol creation. Data extraction will be conducted at four levels: (1) study level, (2) patient level, (3) intervention level, and (4) outcome level. A narrative descriptive synthesis of results and risk of bias of all included studies will be provided, and, if relevant, a meta-analysis will be performed.</p><p><strong>Discussion: </strong>The dissemination of findings from this knowledge synthesis to various stakeholders is intended to inform on options for evidence-based interventions to aid in delabeling penicillin allergies in individuals with a low risk of experiencing a hypersensitivity reaction. Detailed reporting on the characteristics of delabeling interventions as well as the effectiveness of similar interventions will benefit policy makers considering the implementation of a penicillin allergy delabeling protocol. Additionally, findings from this systematic review will report on the current evidence regarding the role of sex and gender in both the prevalence and outcomes associated with the presence of penicillin allergies.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42022336457.</p>","PeriodicalId":22162,"journal":{"name":"Systematic Reviews","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adipose derived or bone-marrow derived mesenchymal stem cell treatment for hyposalivation: protocol for a systematic review and network meta-analysis. 脂肪或骨髓间充质干细胞治疗唾液分泌过少:系统综述和网络荟萃分析方案。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-12 DOI: 10.1186/s13643-024-02674-2
Joachim Hansen, Amanda-Louise Fenger Carlander, Kathrine Kronberg Jakobsen, Christian Grønhøj, Christian von Buchwald

Background: Salivary hypofunction leads to debilitating oral symptoms and has major complications for overall quality of life. Two of the most frequent causes of xerostomia are radiotherapy in the head and neck and Sjögren's syndrome. Only symptomatic treatment is available today. An increasing number of both preclinical and clinical studies have suggested that mesenchymal stem cell (MSC) transplantation treatment can increase the salivary flow rate and ameliorate symptoms of xerostomia. However, both adipose-derived and bone marrow-derived MSCs are used, although they differ in important ways. The primary objective of this study is an indirect comparison of the change in the unstimulated salivary flow rate after intervention between patients treated with adipose-derived or bone marrow-derived MSCs.

Methods: This systematic review and network meta-analysis will search for eligible studies in the MEDLINE, EMBASE, and Cochrane CENTRAL register of Controlled Trials. Eligible studies are as follows: clinical studies including human patients with salivary hypofunction due to either radiotherapy or Sjogren's syndrome who were subsequently treated with either adipose-derived MSCs or bone marrow-derived MSCs. Studies with no control group will be excluded. The search phrase has been peer-reviewed following the PRESS guidelines. The primary outcome is the change in the unstimulated salivary flow rate after treatment with either adipose-derived or bone marrow-derived MSCs. Secondary outcomes are as follows: change in patient reported outcomes, methods of intervention administration, number of injected MSCs, and safety. Data from included studies will be pooled and compared with a fixed-effects or random effects model dependent on signs of heterogeneity, presented with a forest plot, and indirectly compared with a meta-regression in a network meta-analysis. Risk of bias will be assessed with the tools ROBINS-I or RoB-2 depending on type of study.

Discussion: Both adipose-derived and bone marrow-derived MSCs are used today for experimental treatment of salivary hypofunction in humans as no direct or indirect comparisons have been made. Therefore, an evaluation of the effect of adipose-derived vs bone marrow-derived MSC treatment is needed to support future decision-making on the type of MSC used in a clinical trial.

Systematic review registration: PROSPERO ID CRD42024527183.

背景:唾液腺功能减退会导致令人衰弱的口腔症状,并对整体生活质量产生重大影响。头颈部放射治疗和斯约格伦综合征是造成唾液分泌过少的两个最常见原因。目前只能进行对症治疗。越来越多的临床前和临床研究表明,间充质干细胞(MSC)移植治疗可以增加唾液流量,改善口臭症状。然而,间充质干细胞既可用于脂肪来源,也可用于骨髓来源,但两者在一些重要方面存在差异。本研究的主要目的是间接比较接受脂肪间充质干细胞或骨髓间充质干细胞治疗的患者在干预后非刺激唾液流速的变化:本系统综述和网络荟萃分析将在 MEDLINE、EMBASE 和 Cochrane CENTRAL 对照试验登记簿中搜索符合条件的研究。符合条件的研究如下:包括因放疗或Sjogren综合征导致唾液功能减退的人类患者的临床研究,这些患者随后接受了脂肪间充质干细胞或骨髓间充质干细胞治疗。没有对照组的研究将被排除在外。检索词组已按照 PRESS 指南进行了同行评审。主要结果是使用脂肪间充质干细胞或骨髓间充质干细胞治疗后非刺激性唾液流速的变化。次要结果如下:患者报告结果的变化、干预给药方法、注射间充质干细胞的数量以及安全性。纳入研究的数据将进行汇总,并根据异质性迹象采用固定效应或随机效应模型进行比较,以森林图展示,并在网络荟萃分析中采用元回归进行间接比较。偏倚风险将根据研究类型使用 ROBINS-I 或 RoB-2 工具进行评估:讨论:目前,脂肪间充质干细胞和骨髓间充质干细胞都被用于人类唾液功能低下的实验性治疗,但尚未进行直接或间接的比较。因此,需要对脂肪间充质干细胞与骨髓间充质干细胞的治疗效果进行评估,以支持未来在临床试验中使用何种间充质干细胞的决策:系统综述注册:PROCMO ID CRD42024527183。
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引用次数: 0
Efficacy of pharmacological interventions for ADHD: protocol for an updated systematic review and dose-response network meta-analysis. 药物干预多动症的疗效:最新系统综述和剂量反应网络荟萃分析方案。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-12 DOI: 10.1186/s13643-024-02675-1
Mikail Nourredine, Lucie Jurek, Georgia Salanti, Andrea Cipriani, Fabien Subtil, Orestis Efthimiou, Tasnim Hamza, Samuele Cortese

Background: Attention-deficit/hyperactivity disorder (ADHD) affects approximately 5% of children globally, with symptoms often persisting into adulthood. While pharmacological interventions are commonly employed for management, understanding the optimal dosing for efficacy and tolerability remains crucial. This study aims to conduct a dose-response network meta-analysis to estimate the efficacy of pharmacological treatments across different doses, aiming to inform clinical decision-making and improve treatment outcomes.

Methods: This updated systematic review will include randomized controlled trials evaluating ADHD medication efficacy in children, adolescents, and adults. An updated search from a 2018 NMA will be conducted across multiple electronic databases with no language restrictions, using specific eligibility criteria focused on randomized controlled trials. The primary outcome will assess the severity of ADHD core symptoms, while secondary outcomes will consider treatment tolerability. A dose-response Bayesian hierarchical model will be used to estimate dose-response curves for each medication, identifying optimal dosing strategies.

Discussion: With this dose-response network meta-analysis, we aim to better understand the dose-response relationship of pharmacological treatment in ADHD, which could help clinician to the identification of optimal doses.

Systematic review registration: OSF https://doi.org/10.17605/OSF.IO/3MY4A .

背景:全球约有 5% 的儿童患有注意力缺陷/多动症 (ADHD),症状往往持续到成年。虽然药物干预是治疗的常用方法,但了解疗效和耐受性的最佳剂量仍然至关重要。本研究旨在进行剂量-反应网络荟萃分析,以估算不同剂量药物治疗的疗效,从而为临床决策提供依据并改善治疗效果:这项更新的系统综述将包括评估儿童、青少年和成人多动症药物疗效的随机对照试验。将在多个电子数据库中对 2018 年的 NMA 进行更新检索,没有语言限制,采用特定的资格标准,重点关注随机对照试验。主要结果将评估多动症核心症状的严重程度,次要结果将考虑治疗耐受性。将使用剂量反应贝叶斯分层模型来估计每种药物的剂量反应曲线,从而确定最佳剂量策略:通过这项剂量-反应网络荟萃分析,我们旨在更好地了解多动症药物治疗的剂量-反应关系,从而帮助临床医生确定最佳剂量:OSF https://doi.org/10.17605/OSF.IO/3MY4A 。
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引用次数: 0
Teledermatology: an evidence map of systematic reviews. 远程皮肤病学:系统回顾证据图。
IF 6.3 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-12 DOI: 10.1186/s13643-024-02655-5
Aloysius Chow, Helen Elizabeth Smith, Lorainne Tudor Car, Jing Wen Kong, Kay Wee Choo, Angeline Ai Ling Aw, Marie Ann Mae En Wong, Christian Apfelbacher
<p><strong>Background: </strong>Although the number of teledermatology studies is increasing, not all variables have been researched in equal depth, so there remains a lack of robust evidence for some teledermatology initiatives. This review describes the landscape of teledermatology research and identifies knowledge gaps and research needs. This evidence map can be used to inform clinicians about the current knowledge about teledermatology and guide researchers for future studies.</p><p><strong>Methods: </strong>Our evidence map was conducted according to the Campbell Collaboration checklist for evidence and gap maps. Eight databases were searched (CINAHL, Embase, PubMed, Scopus, Web of Science, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, and OpenGray), and only included systematic reviews of teledermatology involving humans published in English; while excluding non-systematic reviews (i.e., abstracts, conference proceedings, editorials, commentaries, or letters). From 909 records, 14 systematic reviews published between 2004 and 2022 were included. Our analysis focused on the systematic reviews' characteristics, dermatological conditions studied, rate of overlap and quality assessment of primary studies reviewed, and main findings reported.</p><p><strong>Results: </strong>Teledermatology was reportedly comparable with clinic dermatology and generally accepted by patients as a mode of care delivery for dermatological conditions. However, there are concerns about privacy, communication, completeness of information transmitted, familiarity with the technology, and technical problems. Healthcare professionals were generally satisfied with teledermatology but found telemedicine consultations longer than face-to-face consultations, and less confident in asynchronous teledermatology than conventional consultations. Teledermatology was reportedly more cost-effective than clinic dermatology; especially considering the distance traveled by patients, referral volume to teledermatology, and clinic dermatology costs. Although patients and providers are satisfied with teledermatology, face-to-face dermatology has higher diagnostic and management accuracy. Teledermatology was also used for training medical professionals. Regarding the validity and reliability of teledermatology outcome measures, no significant discussions were found.</p><p><strong>Conclusions: </strong>COVID-19 spotlighted telemedicine in clinical care, and we must ensure telemedicine continually improves with robust research. Further research is necessary for establishing a standardized outcome set, enhancing accuracy, concordance, cost-effectiveness, and safety, comparing teledermatology with non-dermatologist care, examining its effectiveness in non-Western low and middle-income countries, and incorporating patient involvement for improved study design.</p><p><strong>Systematic review registration: </strong>https://www.researchregistry.com/ (Unique Iden
背景:尽管远程皮肤病学研究的数量在不断增加,但并非所有变量都得到了同样深入的研究,因此某些远程皮肤病学项目仍然缺乏有力的证据。本综述描述了远程皮肤病学研究的现状,并指出了知识差距和研究需求。这份证据地图可用于向临床医生介绍有关远程皮肤病学的现有知识,并为研究人员今后的研究提供指导:我们的证据图是根据坎贝尔合作组织的证据和差距图清单绘制的。我们检索了八个数据库(CINAHL、Embase、PubMed、Scopus、Web of Science、Cochrane Library、JBI Systematic Reviews Database of Systematic Reviews and Implementation Reports 和 OpenGray),仅包括以英语发表的涉及人类的远程皮肤病学系统性综述,同时排除了非系统性综述(即摘要、会议论文集、社论、评论或信件)。从 909 条记录中,我们纳入了 2004 年至 2022 年间发表的 14 篇系统综述。我们的分析重点是系统综述的特点、研究的皮肤病、主要研究的重叠率和质量评估,以及报告的主要发现:据报道,远程皮肤病学与诊所皮肤病学具有可比性,并被患者普遍接受为治疗皮肤病的一种方式。然而,人们对隐私、沟通、传输信息的完整性、对技术的熟悉程度以及技术问题表示担忧。医护人员普遍对远程皮肤病学感到满意,但认为远程医疗会诊时间比面对面会诊长,对异步远程皮肤病学的信心也不如传统会诊。据报道,远程皮肤病学比诊所皮肤病学更具成本效益;特别是考虑到患者的旅行距离、远程皮肤病学的转诊量以及诊所皮肤病学的成本。尽管患者和医疗服务提供者都对远程皮肤病学感到满意,但面对面皮肤病学的诊断和管理准确性更高。远程皮肤病学还被用于培训医疗专业人员。关于远程皮肤病学结果测量的有效性和可靠性,没有发现明显的讨论:COVID-19聚焦了远程医疗在临床护理中的应用,我们必须确保远程医疗通过强有力的研究不断改进。进一步的研究对于建立标准化的结果集,提高准确性、一致性、成本效益和安全性,比较远程皮肤科与非皮肤科医生的护理,检查其在非西方中低收入国家的有效性,以及纳入患者参与以改进研究设计都是必要的。系统综述注册:https://www.researchregistry.com/(唯一识别码:reviewregistry878)。
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