Systematic Reviews最新文献

Background: Patient-reported outcome measures (PROMs) measure people's views of their health status whereas patient-reported experience measures (PREMs) are questionnaires measuring perceptions of their experience whilst receiving healthcare. PROMs/PREMs have the potential to enable children and young people (CYP) to be involved in decisions about their care and improve the quality of their care but it is not clear how often PROMs/PREMs are incorporated as part of standard care of CYP in the hospital setting. The aims of this scoping review were to understand the extent of the literature and map available evidence on the use, benefits, barriers and facilitators of PROMs/PREMs as part of standard care and treatment of CYP in hospitals.

Methods: The Joanna Briggs Institute review process was used to map existing evidence on the use of PROMs/PREMs in routine care of CYP in different hospital settings worldwide. Key search terms were developed and Ovid (Emcare, Embase MEDLINE, APA PsychInfo), Scopus and Web of Science were searched. Data were analysed using frequency counts and basic content analysis for thematic mapping according to the research questions. We undertook an initial search in February 2021 and updated this in April 2023.

Results: The search yielded 68,004 studies, 388 were eligible for full text review and 172 met the inclusion criteria. PROMs were more commonly used than PREMs in routine care of CYP in hospitals; these were mostly collected using electronic collection and concentrated in specific specialities, settings, contexts and countries. The findings mapped the use of PROMs/PREMs, including how data are applied in clinical practice and used for service development, but this was not consistently reported. There are specific challenges in the implementation of PROMs/PREMs in routine care of CYP that need to be considered.

Conclusion: PROMs/PREMs have the potential to improve care for CYP in hospital settings contributing to different aspects of care. A better understanding of their use, how results can be applied in clinical practice and contribute to service development will enable meaningful employment. The popularity of electronically collected and captured PROMS/PREMs warrants further investigation to enable their meaningful use in routine care of CYP.

Systematic review registration: Not pre-registered.

Background: Biosimilar etanercept presents itself as an innovative therapeutic opportunity for inflammatory and autoimmune diseases, however, its efficacy, safety, and immunogenicity in relation to the reference biological agent for the treatment of rheumatoid arthritis is still questioned. With this in mind, this study aimed to verify the efficacy, safety, and immunogenicity of the use of the biosimilar etanercept in relation to the reference biologic in patients over 18 years of age with rheumatoid arthritis.

Methods: A systematic review with meta-analysis was performed in accordance with the parameters of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) selecting only Phase III randomized clinical trials. The search strategy was constructed with the MeSH terms "Etanercept", "Biological Products", "Arthritis, Rheumatoid", "Biosimilar Pharmaceuticals" and was performed in Medline via PubMed, Embase, the Cochrane Library, Web of Science, EBSCO and Lilacs in January 2023. The analysis measures were relative risk (RR) for dichotomous data and mean difference (MD) for continuous data. The statistical analysis for preparing meta-analyses was developed by the Review Manager 5.1.4 software.

Results: This systematic review selected 6 eligible studies with a sample population of n = 2355. The main efficacy outcomes showed that both drugs did not present statistically significant differences in ACR20, ACR50, and ACR70 responses within 6 months (RR 1.00; 95% CI = 0.94 to 1.07; RR 1.09; 95% CI = 0.94 to 1.26; RR 1.04; 95% CI = 0.82 to 1.31, respectively), with I² ranging from 55 to 63% and 0.04 ≤ P ≥ 0.08. Adverse events were mostly mild or moderate, and serious adverse events were not statistically significant. Regarding immunogenicity, only 5.4% of the ADA-positive biosimilar group had positive neutralizing antibodies.

Conclusions: Thus, this review found that biosimilar etanercept had efficacy, safety, and immunogenicity similar to those for the biological reference.

Systematic review registration: This systematic review was registered on the PROSPERO platform under number CRD42020166610.

The eighth meeting of the International Collaboration for the Automation of Systematic Reviews (ICASR) was held on September 7 and 8, 2023, at the University College London, London, England. ICASR is an interdisciplinary group whose goal is to maximize the use of technology for conducting rapid, accurate, and efficient evidence synthesis, e.g., systematic reviews, evidence maps, and scoping reviews of scientific evidence. In 2023, the major themes discussed were understanding the benefits and harms of automation tools that have become available in recent years, the advantages and disadvantages of large language models in evidence synthesis, and approaches to ensuring the validity of tools for the proposed task.

Background: Offspring of parents with a mental disorder are at high risk of a range of adverse outcomes, highlighting the need for preventive interventions. However, a comprehensive overview of the beneficial and harmful effects of preventive interventions for parents with mental disorders on offspring outcomes are uncertain. The main objective of this systematic review will be to assess the effects of preventive interventions versus any control intervention for parents with a mental disorder on offspring outcomes.

Methods/design: We will conduct a systematic review with meta-analysis and report it as recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), bias will be assessed with the Cochrane Risk of Bias tool-version 2 (ROB2), an eight-step procedure will be used to assess if the thresholds for clinical significance are crossed, trial sequential analysis will be conducted to control for random errors, and the certainty of the evidence will be assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. To identify relevant trials, we will search for published trials in several electronic databases from their inception to the present. We will also search for unpublished trials and grey literature. Two review authors will independently screen the articles, extract data, and perform a risk of bias assessment. We will include any published or unpublished randomized clinical trial comparing a psychological preventive intervention versus any control intervention for parents with any mental disorder. The primary outcomes will be quality of life and incidence of a mental disorder. Secondary outcomes will include internalizing symptoms, externalizing symptoms, serious adverse events, out-of-home placement, and absence from school or daycare. Exploratory outcomes include trauma, socioemotional development, and language development. All outcomes will be assessed in offsping only.

Discussion: There is an urgent need for a comprehensive, updated systematic review of the beneficial and harmful effects of preventive interventions for children of parents with a mental disorder. The findings of this systematic review are expected to provide evidence-based information for policymakers, clinicians, and researchers to help them make informed decisions about the most effective interventions and guide future research for this highly prevalent population.

Systematic review registration: PROSPERO CRD42023463421.

Background: This study will be the first scoping review dedicated to investigating screening strategies for eating disorders specifically performed in the primary health care setting, as no comprehensive examination has been performed to date. Our primary aim is to explore the available literature and assess and identify validated screening strategies for eating disorders in adolescents and adults within the primary care context.

Methods: The study protocol was developed following the guidance outlined by the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols and the Joanna Briggs Institute methodology for scoping reviews. This study will adhere to the PRISMA extension for scoping reviews to report review data. The protocol was registered on the Open Science Framework. The review will include studies that involve validated screening strategies for eating disorders in adolescents and adults utilising primary health care services. Experimental, quasiexperimental, observational, qualitative, and mixed-methods study designs and reviews will be eligible without language or publication year restrictions. Six databases (MEDLINE-PubMed, Embase, LILACS, CINAHL, Web of Science, PsycINFO) and grey literature will be searched. Studies will be selected and extracted by two independent reviewers via online Covidence. The results will be presented in narrative form and through tables and graphs. When possible, descriptive qualitative content analysis will be conducted.

Discussion: The expected results of this scoping review will shed light on validated strategies for screening for eating disorders in primary health care. This will equip health care professionals with well-substantiated empirical evidence. Moreover, it is anticipated to uncover research gaps, nurturing the ongoing development and refinement of screening strategies for eating disorders in primary health care. The results will be widely disseminated to the scientific community, policy-makers, service providers, and the general public.

Systematic review registration: This protocol has been registered on the Open Science Framework ( https://osf.io/pybvf ).

Background: The management of procedural pain in pediatric patients under 1 year old is crucial but often inadequately addressed in clinical practice. Despite proven evidence-based interventions like skin-to-skin contact, sweet solutions, and breastfeeding, their implementation remains sporadic. This systematic review aims to uncover the barriers and facilitators to adopting these interventions, leveraging the Consolidated Framework for Implementation Research (CFIR) to provide a structured analysis.

Methods: This review will examine primary studies identifying barriers or facilitators to the use of procedural pain treatments in pediatric patients under 1 year old, imposing no restrictions on the publication year or language. A thorough search will cover databases such as MEDLINE (Ovid), Embase, CINAHL, PsycINFO, Web of Science, and Scopus. The Mixed Methods Appraisal Tool (MMAT) will be utilized for quality assessment. The CFIR framework will serve to categorize and analyze the identified barriers and facilitators, using narrative synthesis for data integration.

Discussion: Applying the CFIR framework allows for a comprehensive and systematic review of the factors influencing the implementation of procedural pain management strategies in pediatric care. By identifying key barriers and facilitators through this lens, the review will guide the development of targeted interventions aimed at enhancing the adoption of evidence-based pain treatments. Such strategic interventions are essential for bridging the gap between research findings and clinical practice, potentially improving the effectiveness and efficiency of pain management for pediatric patients.

Systematic review registration: PROSPERO CRD42022322319.

Introduction: Strengthening and reforming the urban primary healthcare (PHC) system is essential to efficiently deliver need-based healthcare services to the rapidly increasing urban poor population. Such reforms of PHC system need to emphasize the opinion of patients in co-designing services in order that delivery of services can be accessed effectively by the urban population in a timely and low-cost way. Hence, it is important to identify the preference of urban population while choosing healthcare providers. The aim of this proposed protocol is to summarize a planned systematic review of existing evidence on the attributes considered for choosing PHC providers in urban settings of low- and middle-income countries (LMICs), as classified by the World Bank. METHODS AND ANALYSES: An inclusive literature search will be conducted in electronic databases including Pubmed/MEDLINE, Embase, Global Health, Cochrane Library, Web of Science, and Scopus. Databases will be searched from the earliest date of entry until March 30, 2024. Database search will be supplemented by manual search of citations, reference lists, and grey literature sources. Following the pre-set inclusion and exclusion criterion, two researchers will independently screen all the retrieved studies in Covidence. Any discrepancies will be resolved through a discussion between two researchers, and if disagreements persist, a third reviewer will be consulted. The methodological quality of included studies will be appraised using checklist for Conjoint Analysis studies and the Mixed Methods Appraisal Tool (MMAT). An Excel-based data extraction table will be developed, piloted, and refined during the review process. Preference attributes will be identified and analyzed according to their types. The systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines.

Discussion: The identification of attributes, their influence on preference, and heterogeneity with socioeconomic characteristics of the population will help the policymakers and researchers to design targeted PHC interventions. Such evidence will be also useful to design choice experiment studies to quantify the preferred attributes of PHC providers in urban context of LMICs.

Systematic review registration: PROSPERO CRD42023409720.

Background: While shared decision making is a cornerstone of orthopedic care, orthopedic surgeons face challenges in tailoring their advice and expectation management to individual shoulder arthroplasty patients due to the lack of systematically summarized evidence-based knowledge. This systematic review aims to provide an overview of current knowledge on independent predictive effects of patient-related factors on functional and pain-related outcomes after shoulder arthroplasty.

Methods: We included longitudinal cohort studies including patients receiving total or reverse shoulder arthroplasty or hemiarthroplasty for primary osteoarthritis or cuff tear arthropathy. Studies with only univariable analyses were excluded. MEDLINE, Embase, and CINAHL databases were last searched on June 27, 2023. Risk of bias was evaluated using the QUIPS tool. For the analyses, we divided outcomes into three domains (Functional Recovery, Pain, and Functional Recovery & Pain) and four time points (short term, medium-short term, medium-long term and long term). When appropriate, meta-analyses were conducted to pool regression coefficients or odds ratios. Otherwise, results were summarized in a qualitative analysis. We used the GRADE approach to rate the certainty of the evidence.

Results: Thirty-three studies analyzing over 6900 patients were included; these studied 16 PROMs and 52 prognostic factors. We could perform meta-analyses for six combinations of prognostic factor, domain, and time point. Only the meta-analysis for medium-long term poor ASES scores indicated worse outcomes for previous shoulder surgery (OR (95%CI) of 2.10 (1.33-3.33)). The majority of reported factors showed unclear or neutral independent effects on functional outcomes.

Conclusions: Methodological heterogeneity and selective/incomplete reporting prevented us from pooling most results, culminating in a largely qualitative analysis. Depression, preoperative opioid use, preoperative ASES and SST scores, surgery on the dominant side, previous surgery, male gender, no. of patient-reported allergies, back pain, living alone, CTA vs OA, diabetes, and greater preoperative external ROM predicted neutral to worse or worse outcomes. In contrast, higher electrical pain threshold on the operative side, OA/RCA vs other diagnosis, and private insurance vs Medicaid/Medicare predicted neutral to better or better outcomes. These results can help orthopedic surgeons tailor their advice and better manage expectations.

Systematic review registration: PROSPERO CRD42021284822.