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A systematic review of the effectiveness of nurse coordinated transitioning of care on readmission rates for patients with heart failure. 系统回顾护士协调过渡护理对心力衰竭患者再入院率的影响。
Pub Date : 2010-10-13 DOI: 10.11124/01938924-201109150-00001
J. Slyer, C. Concert, A. M. Eusebio, M. E. Rogers, J. Singleton
Review question/objective: The objective is to identify the best available evidence on effectiveness of nurse coordinated transitioning of care between hospital and home on all hospital readmission rates in hospitalized adult patients with heart failure. Inclusion criteria: Types of participants: This review will consider studies that include adult patients, 18 years of age or older, hospitalised with heart failure being discharged to home. Types of intervention(s)/phenomena of interest: This review will consider studies that evaluate all models of nurse coordinated transitioning of care from hospital to home, limited to inpatient care coupled with post-discharge home-based and/or telephone education and support by a nurse. Types of outcomes: This review will consider studies that include the following outcome measures: all hospital readmission rates with a focus on 30 day readmissions.
综述问题/目的:目的是确定护士协调的医院和家庭之间护理过渡对住院成年心力衰竭患者所有再入院率的有效性的最佳现有证据。纳入标准:受试者类型:本综述将纳入18岁及以上因心力衰竭住院并出院回家的成年患者。干预类型/感兴趣的现象:本综述将考虑评估护士协调护理从医院到家庭的所有模式的研究,仅限于住院护理加上出院后家庭和/或电话教育和护士的支持。结局类型:本综述将考虑包括以下结局指标的研究:所有医院再入院率,重点是30天再入院率。
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引用次数: 3
The systematic review of the effectiveness and meaningfulness of telephone pre-operative assessment for adults. 成人术前电话评估的有效性和意义的系统评价。
Pub Date : 2010-09-30 DOI: 10.11124/JBISRIR-2010-605
S. Ireland, B. Kent
Questions: 1. Is telephone preoperative assessment as effective as face‐to‐face preadmission clinic visits in terms of preparing the patient for elective surgery? 2. What are the perioperative experiences of adult patients who have received telephone based preoperative preparation prior to elective surgery? Objectives: This review will examine the best available evidence in regard to preoperative telephone patient assessment and preparation to determine the impact of this intervention on patient knowledge and expectations of their surgery and anaesthesia, compliance with preoperative and postoperative preparations, their levels of fear and anxiety, reduction in cancellations on day of surgery in comparison to face‐to‐face assessment. This review will also examine the patient experiences and satisfaction with this method of assessment. Thus both the evidence related to effectiveness and meaningfulness of telephone preoperative preparation on patient preparedness for elective surgery will be explored and synthesized. This will include a comparison of telephone assessment with face to face consultation in the preoperative preparation of the adult patient in day of surgery admission patients. Inclusion Criteria: Types of Participants: For both the quantitative and qualitative components this review will consider studies that include adult (> 18 years) patients having elective day or inpatient surgery in a hospital setting who have had a telephone preoperative consultation or face‐to‐face preadmission clinic visit. Emergency surgery is to be excluded. Phenomena of interest: The qualitative component of this review will focus on the experiences of patients who have utilised telephone based preoperative assessment. The quantitative component will focus on the comparison of effect of telephone‐based patient preparation for elective surgery with face‐to‐face preparation. Type of outcome: The quantitative component of the review will consider studies that include the following outcome measures related to the patient preparation for surgery including: • patient understanding and expectations of postoperative pain, nausea, anxiety, medication management and discharge planning • knowledge of procedure and anaesthetic, and informed consent • informed consent • anxiety • pain management • medication management • patient understanding and compliance with preoperative and postoperative activities
问题:1。电话术前评估是否与面对面的入院前门诊访问一样有效?2. 择期手术前接受电话术前准备的成年患者围手术期经验如何?目的:本综述将检查关于术前电话患者评估和准备的最佳证据,以确定这种干预对患者对手术和麻醉的了解和期望、术前和术后准备的依从性、他们的恐惧和焦虑水平、与面对面评估相比减少手术当日取消的影响。这篇综述也将检查患者的经验和满意度对这种评估方法。因此,电话术前准备对患者择期手术准备的有效性和意义的相关证据将被探索和综合。这将包括电话评估与面对面咨询的比较,在术前准备的成年患者的手术入院患者的一天。纳入标准:受试者类型:对于定量和定性两方面,本综述将纳入在医院进行择期日间手术或住院手术的成人(bb0 - 18岁)患者,这些患者术前有电话咨询或入院前面对面门诊就诊。不包括紧急手术。感兴趣的现象:本综述的定性部分将集中在使用基于电话的术前评估的患者的经验。定量部分将侧重于电话为基础的选择性手术患者准备与面对面准备的效果比较。结果类型:评价的定量部分将考虑包括以下与患者手术准备相关的结果指标的研究,包括:•患者对术后疼痛、恶心、焦虑、药物管理和出院计划的理解和期望•程序和麻醉的知识,以及知情同意•知情同意•焦虑•疼痛管理•药物管理•患者对术前和术后活动的理解和遵守
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引用次数: 0
COMMUNITY HEALTH WORKERS IN THE CONTROL OF MALARIA AND NEGLECTED TROPICAL DISEASES IN SUB SAHARAN AFRICA: A SYSTEMATIC REVIEW. 撒哈拉以南非洲控制疟疾和被忽视的热带病的社区卫生工作者:系统审查。
Pub Date : 2010-08-11 DOI: 10.11124/JBISRIR-2010-580
Ivan Emil, K. Njunwa, J. Ntaganira
Review Objective This review comprises of a quantitative and a qualitative component, which together aim to examine the role of CHWs in the control of malaria and NTDs. More specifically, the review question(s) are: Quantitative • Are the services provided by CHWs effective in the control of NTDs in comparison with those provided by trained healthcare professionals in sub-Saharan Africa? • Are the services provided by CHWs effective in the control of malaria in comparison with those provided by trained healthcare professionals in sub-Saharan Africa? Qualitative What are the experiences of CHWs in delivering tools and drugs for the control of malaria and NTDs in sub-Saharan Africa? Criteria for considering studies for this review Types of participants Quantitative This component of the review will consider studies that include the effectiveness of services provided by CHWs living in sub Saharan Africa Qualitative This component of the review will consider studies that include CHWs living in sub Saharan Africa Types of interventions/Phenomena of Interest Quantitative This component of the review will consider studies that include the following interventions provided by CHWs: • Antimalarial interventions such as distribution of Artemisinin based combination therapy (ACTs). • Distribution of insecticide-treated nets to household level. • Administration of Chemoprophylaxis and intermittent preventive treatment. • Sensitization for insecticide residual house spraying Qualitative This component of the review will consider studies that include the experiences of CHWs in delivering antimalarial and NTD treatments in sub Saharan Africa. Types of outcome measures/anticipated outcomes Quantitative This component of the review may anticipate outcomes that impact on a whole population or may impact on an individual level as follows: Population outcomes may include: Incidence or prevalence of malaria and/or NTDs, morbidity/mortality rates, use of insecticide treated nets, acceptability and coverage of residual house spraying, use of intermittent presumptive treatment, reduced number of people who complete preventive treatment for malaria and NTD cases, anaemia rates, parasite density, parasite rates and fever rates. Proportion of under-5 malaria cases proportion of cases receiving correct dose, community awareness of educational messages of antimalarial and NTDs, TRUNCATED AT 350 WORDS
本综述包括定量和定性两部分,目的是研究卫生工作者在控制疟疾和被忽视热带病中的作用。更具体地说,审查问题是:定量•与撒哈拉以南非洲训练有素的保健专业人员提供的服务相比,保健员提供的服务在控制被忽视的热带病方面是否有效?•与撒哈拉以南非洲训练有素的保健专业人员提供的服务相比,保健员提供的服务在控制疟疾方面是否有效?卫生工作者在撒哈拉以南非洲提供控制疟疾和被忽视热带病的工具和药物方面有什么经验?本综述研究的考虑标准参与者类型定量本综述的这一部分将考虑包括生活在撒哈拉以南非洲的卫生保健员所提供服务的有效性的研究定性本综述的这一部分将考虑包括生活在撒哈拉以南非洲的卫生保健员的研究干预措施类型/感兴趣的现象定量本综述的这一部分将考虑包括以下干预措施的研究卫生工作者:•抗疟疾干预措施,如分发以青蒿素为基础的联合疗法。•向家庭分发驱虫蚊帐。•化学预防和间歇性预防治疗的管理。本审查的这一部分将考虑包括卫生工作者在撒哈拉以南非洲提供抗疟疾和非传染性疾病治疗的经验在内的研究。结果测量/预期结果的类型定量评估的这一部分可能会预测影响整个人群或可能影响个人水平的结果如下:人群结果可能包括:疟疾和/或被忽视热带病的发病率或流行率、发病率/死亡率、杀虫剂处理过的蚊帐的使用、室内残留喷洒的可接受性和覆盖率、间歇性推定治疗的使用、完成疟疾和被忽视热带病预防性治疗的人数减少、贫血率、寄生虫密度、寄生虫率和发烧率。5岁以下疟疾病例比例,接受正确剂量的病例比例,社区对抗疟和被忽视热带病教育信息的认识
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引用次数: 0
A systematic review of the effectiveness of Evidence Based Practice (EBP) programs for allied health professionals. 基于证据的实践(EBP)程序的有效性的系统审查,为专职卫生专业人员。
Pub Date : 2010-06-11 DOI: 10.11124/JBISRIR-2010-850
J. Dizon, L. Lizarondo
Review Objectives: The objective of this review is to find, a ssess and synthesize the evidence on EBP programs in enhancing the EBP knowledge, skills and attitudes of allied health practitioners. Review questions: What is the effectiveness of using EBP programs for allied health practitioners in improving the EBP knowledge, skills and attitudes Inclusion criteria: Types of participants: This review will include as participants allied health practitioners (physiotherapists, occupational therapists etc) who participated in any EBP educational program or part of an EBP program (formulating clinical questions, searching the literature, critical appraisal skills program etc). Types of interventions: The intervention of interest in this review is any EBP training program defined as any formal program facilitating the search and use of evidence in practice. The contents (lectures only or lectures with actual demonstrations and practice), length (hours, days, weeks) and manner of delivery (face to face, face to face with supplementary materials etc) of the program may vary in each of the studies to be included as there is no standard EBP training program. Types of Outcome: The main outcomes measured are the EBP domains of knowledge, skills, attitudes and behaviour as a result of participating in the EBP program or a component of it. Specific measures may include but not limited to the use of the adapted Fresno questionnaire (22) to assess knowledge, skills and attitudes to EBP. The adapted Fresno question has good psychometric properties and is especially fitting novice rehabilitation professionals undergoing EBP training.
综述目的:本综述的目的是寻找、评估和综合有关EBP项目在提高专职医疗从业者的EBP知识、技能和态度方面的证据。回顾问题:联合医疗从业者使用EBP项目在提高EBP知识、技能和态度方面的有效性是什么?纳入标准:参与者类型:本综述将包括参加任何EBP教育项目或部分EBP项目(制定临床问题、检索文献、批判性评估技能项目等)的联合医疗从业者(物理治疗师、职业治疗师等)作为参与者。干预措施类型:本综述中关注的干预措施是任何EBP培训计划,定义为任何有助于在实践中寻找和使用证据的正式计划。由于没有标准的EBP培训计划,课程的内容(讲座或实际演示和练习的讲座),长度(小时,天,周)和交付方式(面对面,面对面的补充材料等)可能在每个学习中有所不同。结果类型:测量的主要结果是参与EBP计划或其组成部分的知识,技能,态度和行为的EBP领域。具体措施可能包括但不限于使用经改编的弗雷斯诺问卷(22)来评估对EBP的知识、技能和态度。修正弗雷斯诺问题具有良好的心理测量性质,特别适合接受EBP训练的康复专业新手。
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引用次数: 2
Benefits and associated risks of using allograft, autograft and synthetic bone fusion material for patients and service providers - A Systematic Review. 对患者和服务提供者使用同种异体移植物、自体移植物和合成骨融合材料的益处和相关风险——系统综述
Pub Date : 2010-06-11 DOI: 10.11124/JBISRIR-2010-851
G. Aitken, Gordon Hill
Review Questions/Objectives: Review objective: The review objective is to determine the benefits and associated risks of using autograft, allograft and synthetic bone fusion material for patients and service providers relating to spinal fusion. Review questions are: • What are the benefits to patients relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? • What are the associated risks to patients relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? • What are the benefits to service providers relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? • What are the associated risks to service providers relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? Inclusion Criteria: Types of participants: The review will consider studies that include adult (16 and over) patients who have undergone a spinal fusion procedure, for any reason, using autograft, allograft or synthetic bone fusion material and service providers for spinal fusion procedure. Types of interventions: Spinal fusion procedure, for any reason, using autograft, allograft or synthetic bone fusion material for adult (16 and over) patients. Types of outcomes: Benefits to patients, benefits to service providers, associated risks to patients, associated risks to service providers, such as but not limited to (measured using all the methods, instruments, scales used/specified by authors of primary research studies): • Length of hospitalisation post operatively • Postoperative pain • Patient mobility • Post operative infection • Quality of Life / Functional ability • Treatment satisfaction.
回顾问题/目的:回顾目的:回顾目的是确定与脊柱融合相关的患者和服务提供者使用自体移植物、同种异体移植物和合成骨融合材料的益处和相关风险。回顾问题是:•脊柱融合术中使用自体移植物、同种异体移植物或合成骨融合材料对患者有什么好处?•脊柱融合术中使用自体移植物、同种异体移植物或合成骨融合材料对患者的相关风险是什么?•在进行脊柱融合术时,使用自体移植物、同种异体移植物或合成骨融合材料对服务提供者有什么好处?•在进行脊柱融合术时,使用自体移植物、同种异体移植物或合成骨融合材料对服务提供者有哪些相关风险?纳入标准:参与者类型:本综述将纳入成人(16岁及以上)患者,这些患者因任何原因接受了脊柱融合术,使用自体移植物、同种异体移植物或合成骨融合材料和脊柱融合术的服务提供者。干预类型:脊柱融合手术,任何原因,使用自体移植物,同种异体移植物或合成骨融合材料的成人(16岁及以上)患者。结果类型:对患者的益处、对服务提供者的益处、对患者的相关风险、对服务提供者的相关风险,例如但不限于(使用原始研究作者使用/指定的所有方法、仪器、量表进行测量):•术后住院时间•术后疼痛•患者活动能力•术后感染•生活质量/功能能力•治疗满意度。
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引用次数: 7
The perceived benefits and associated risks of using allograft, autograft and synthetic bone fusion material: the experiences of patients and service providers - A Systematic Review. 使用同种异体骨移植、自体骨移植和合成骨融合材料的获益和相关风险:患者和服务提供者的经验-系统综述
Pub Date : 2010-06-11 DOI: 10.11124/JBISRIR-2010-852
Gordon Hill, L. Kilbride
Review Questions/Objectives: The Review objective is: to determine the perceived benefits and associated risks of using autograft, allograft and synthetic bone fusion material by investigating the experiences of patients and service providers relating to spinal fusion. The review questions are: • What are the experiences of patients relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? • What are the associated risks experienced by patients relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? • What are the experiences of service providers relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? • What are the associated risks experienced by service providers relating to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion? Inclusion Criteria: Types of participants: The review will consider studies that include service providers using autograft, allograft or synthetic bone fusion material and adult (16 and over) patients who have undergone a spinal fusion procedure, for any reason, using autograft, allograft or synthetic bone fusion material. Phenomena of Interest: • the patients experiences and subjective accounts of benefits and risks related to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion • the service providers experiences and subjective accounts of benefits and risks related to the use of autograft, allograft or synthetic bone fusion material when undergoing spinal fusion
回顾问题/目的:回顾的目的是:通过调查患者和服务提供者与脊柱融合相关的经验,确定使用自体移植物、同种异体移植物和合成骨融合材料的获益和相关风险。回顾的问题是:•患者在脊柱融合术中使用自体移植物、同种异体移植物或合成骨融合材料的经验是什么?•患者在脊柱融合术中使用自体移植物、同种异体移植物或合成骨融合材料有哪些相关风险?•服务提供者在脊柱融合术中使用自体移植物、同种异体移植物或合成骨融合材料的经验是什么?•服务提供者在进行脊柱融合术时使用自体移植物、同种异体移植物或合成骨融合材料有哪些相关风险?纳入标准:参与者类型:本综述将考虑的研究包括使用自体移植物、同种异体移植物或合成骨融合材料的服务提供者,以及因任何原因使用自体移植物、同种异体移植物或合成骨融合材料进行脊柱融合手术的成人(16岁及以上)患者。感兴趣的现象:•患者在接受脊柱融合术时对使用自体移植物、同种异体移植物或合成骨融合材料的获益和风险的体验和主观描述•服务提供者在接受脊柱融合术时对使用自体移植物、同种异体移植物或合成骨融合材料的获益和风险的体验和主观描述
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引用次数: 0
The meaningfulness and appropriateness of using human patient simulation manikins as a teaching and learning strategy in undergraduate nursing education: a systematic review. 在本科护理教育中使用人体病人模拟模型作为教学策略的意义和适当性:系统综述。
Pub Date : 2010-05-14 DOI: 10.11124/01938924-201008081-00021
Samuel Lapkin, T. Levett-Jones, H. Bellchambers
Review question/objective Objective The aim of this review is to identify the best available evidence on the meaningfulness and appropriateness of integrating human patient simulation manikins (HPSMs) into undergraduate nursing education. Review Questions This review will systematically examine the evidence to answer the following questions: 1. What are the perspectives and experiences of students and academics on the appropriateness and meaningfulness of the use of HPSMs in undergraduate nursing education? 2. What teaching and learning practices with HPSM are considered appropriate and meaningful by students and academics? Inclusion criteria Types of participants  The review will consider studies that include undergraduate nursing students and academics who are involved in  undergraduate education. Studies that consider other allied health care professionals will be excluded unless data for undergraduate nursing students are included and analysed separately. Types of intervention(s)/phenomena of interest The review will consider as phenomena of interest the experiences, values, opinions, beliefs and interpretations of undergraduate nursing students and academics using HPSM for teaching and learning purposes.
回顾问题/目的目的本综述的目的是确定关于将人体病人模拟人体模型(hpms)纳入本科护理教育的意义和适当性的最佳现有证据。本综述将系统地检查证据以回答以下问题:1。学生和学者对本科护理教育中使用hpsm的适当性和意义的观点和经验是什么?2. 学生和学者认为什么样的教学和学习实践是合适的和有意义的?纳入标准参与者类型本综述将考虑包括本科护理学生和参与本科教育的学者的研究。考虑其他联合医疗保健专业人员的研究将被排除,除非包括本科护理学生的数据并单独分析。干预类型/感兴趣的现象本综述将考虑本科护理学生和学者在教学和学习目的中使用HPSM的经验、价值观、观点、信仰和解释。
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引用次数: 1
The accuracy of Influenza A (H1N1) "swine flu" laboratory testing: A systematic review of diagnostic test accuracy. 甲型H1N1流感的准确性“猪流感”实验室测试:诊断测试准确性的系统回顾。
Pub Date : 2010-05-10 DOI: 10.11124/JBISRIR-2011-330
S. White, T. Schultz, C. Tufanaru
Review question/objective The aim of this systematic review is to comprehensively search the available literature and to synthesise the best available evidence to determine the diagnostic accuracy of currently available laboratory tests for swine flu (H1N1), using viral culture as a reference test. Inclusion Criteria Types of participants Studies will be considered for inclusion in the review if the participants are human patients exhibiting influenza-like symptoms who have been tested for swine flu (H1N1) using both a diagnostic and reference test. There will be no exclusion based on age, gender or co-morbidities, but subgroup analysis will be conducted if there is sufficient data and if appropriate. Phenomenon of interest The phenomenon of interest is the correct identification of H1N1 infection. This review will consider studies that compare the accuracy of laboratory tests aiming to diagnose swine flu (H1N1) in patients presenting with influenza-like symptoms, in comparison to viral culture. Outcome measures The accuracy of diagnostic tests will be determined by how well the test correctly gives positive results for patients with confirmed swine flu (H1N1) and negative results for patients without, as determined by viral culture. It is anticipated that data will be presented as raw test results or sensitivities and specificities of the test compared with viral culture will be presented. Other statistics to elaborate on diagnostic test accuracy may include likelihood ratios and/or predictive values.
本系统综述的目的是全面检索现有文献并综合现有的最佳证据,以病毒培养作为参考检测,确定目前可用的猪流感(H1N1)实验室检测的诊断准确性。纳入标准参与者类型如果参与者是表现出流感样症状的人类患者,并且使用诊断和参考测试对猪流感(H1N1)进行了检测,则研究将被考虑纳入本综述。没有基于年龄、性别或合并症的排除,但如果有足够的数据和适当的情况下,将进行亚组分析。感兴趣现象是对H1N1感染的正确识别。这篇综述将考虑比较旨在诊断出现流感样症状患者的猪流感(H1N1)的实验室检测与病毒培养的准确性的研究。结果测量诊断测试的准确性将取决于该测试在多大程度上正确地为确诊的猪流感(H1N1)患者提供阳性结果,而为未确诊的患者提供阴性结果,这是由病毒培养确定的。预计数据将以原始测试结果的形式呈现,或者将展示该测试与病毒培养相比较的敏感性和特异性。详细说明诊断试验准确性的其他统计可能包括似然比和/或预测值。
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引用次数: 2
The meaningfulness of experiences of adults surviving lung cancer two or more years: A systematic review. 成人肺癌存活两年或两年以上经验的意义:一项系统综述。
Pub Date : 2010-05-05 DOI: 10.11124/JBISRIR-2010-846
D. Rhea, S. Lockwood
Review Objectives/Questions The objective of the review is to identify and synthesise the best available evidence on the meaningfulness of surviving lung cancer in adults over the age of 18, two or more years after diagnosis. The specific review question is: What is the experience of adult over the age of 18 surviving lung cancer two or more years after diagnosis? Inclusion Criteria Types of participants This review will consider adult lung cancer survivors who received the cancer diagnosis two or more years before. Both male and female patients who are at the age of 18 years or older will be included. Phenomena of interest The phenomenon of interest will consist of the experiences of any 18 years and older male or female adult surviving lung cancer two years or more years post diagnosis. The setting will be all locations where adult lung cancer patients have been studied. The context will be adult (18+ years) onset lung cancer patients and their experiences with the disease for two or more years.
本综述的目的是确定并综合现有的最佳证据,以证明18岁以上成人肺癌患者在确诊后两年或两年以上存活的意义。具体的复习问题是:18岁以上的成年人在肺癌确诊后两年或两年以上存活的经历是什么?纳入标准参与者类型本综述将考虑在两年或两年以上前接受癌症诊断的成年肺癌幸存者。年龄在18岁或以上的男性和女性患者都将被包括在内。感兴趣的现象将包括任何18岁及以上的男性或女性成年肺癌患者在诊断后两年或两年以上的经历。实验地点将是所有研究过成年肺癌患者的地方。研究对象为成年(18岁以上)起病的肺癌患者及其患病两年或两年以上的经历。
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引用次数: 0
Self‐monitoring of blood glucose in type 2 diabetes mellitus: systematic review of economic evidence 2型糖尿病患者血糖的自我监测:经济证据的系统回顾
Pub Date : 2010-04-14 DOI: 10.11124/JBISRIR-2010-116
R. de Verteuil, W. Tan
Background Self‐monitoring of Blood Glucose (SMBG) is purported to improve glycaemic control, measured by glycosylated haemoglobin (HbA1c). The effectiveness of SMBG in type 2 diabetes mellitus (T2DM) is well‐documented though no systematic review of the economic evidence surrounding the use of SMBG in T2DM has been performed. Objectives To perform a systematic review of economic evaluations of SMBG in T2DM patients. Inclusion criteria All adult patients suffering from T2DM were included. Outcomes of differing treatment groups, where specified, were also recorded. Studies which examined SMBG as an intervention to control blood glucose were considered. To be included, studies must have made a formal attempt to relate cost to outcome data in a cost‐effectiveness or cost utility analysis. Types of outcomes The main outcomes were in terms of cost‐effectiveness and cost‐utility. Search strategy Extensive electronic searches were conducted. Searching was carried out, for the time period 1990 to January 2009, for full text papers and conference abstracts. Methodological quality Methodological quality of included studies was assessed by two reviewers using the standard critical appraisal tools from the JBI‐Actuari (Joanna Briggs Institute‐Analysis of Cost, Technology and Utilisation Assessment and Review Instrument). Included modelling studies were also assessed using the review criteria of economic models set out by Phillips and colleagues. Data collection Data from included studies were extracted using the JBI‐Actuari extraction tool. Data synthesis Studies were grouped by outcome measure and summarised using tabular and narrative formats. Results Five studies met the review criteria. Three were model‐based analyses assessing long‐term cost‐effectiveness of SMBG, all of which concluded that SMBG was cost‐effective. Two further primary economic evaluations assessed short‐term cost‐effectiveness. Their results found SMBG to be associated with increased cost and no significant reduction in HbA1c. The studies examined subgroups in terms of their treatment protocols and SMBG was considered more likely to be cost‐effective in drug and insulin treated groups compared to diet and exercise groups. Conclusions Economic evidence surrounding SMBG in T2DM remains unclear. For the most part, included studies found SMBG to be cost‐effective though analyses are extremely sensitive to relative effects, time‐frame of analyses and model assumptions. Whilst large uncertainty exists, SMBG may be cost‐effective in certain subgroups e.g. drug and insulin‐treated patients. Implication for practice No strong evidence to recommend the regular use of SMBG in well‐controlled diabetes patients, treated only with diet and exercise programmes, exists. The evidence does offer support for SMBG in drug and insulin treated T2DM. It is recommended that clinicians select appropriate patients for SMBG, from these groups, based on their domain expertise. Implications for research Large‐scal
背景自我血糖监测(SMBG)旨在通过糖化血红蛋白(HbA1c)来改善血糖控制。SMBG治疗2型糖尿病(T2DM)的有效性已被充分证明,但尚未对T2DM患者使用SMBG的经济证据进行系统回顾。目的对T2DM患者SMBG的经济评估进行系统回顾。纳入标准:所有成年T2DM患者均纳入。不同治疗组的结果,如有规定,也被记录。研究检验了SMBG作为控制血糖的干预措施。要被纳入,研究必须在成本效益或成本效用分析中正式尝试将成本与结果数据联系起来。主要的结果是成本-效果和成本-效用。搜查策略进行了广泛的电子搜查。检索了1990年至2009年1月期间的全文论文和会议摘要。纳入研究的方法学质量由两名审稿人使用来自JBI‐Actuari (Joanna Briggs Institute‐Analysis of Cost, Technology and utilization Assessment and Review Instrument)的标准关键评估工具进行评估。纳入的模型研究也使用菲利普斯及其同事制定的经济模型审查标准进行评估。使用JBI‐Actuari提取工具提取纳入研究的数据。数据综合研究按结果测量分组,并使用表格和叙述格式进行总结。结果5项研究符合评价标准。其中三个是基于模型的分析,评估了SMBG的长期成本效益,所有这些分析都得出了SMBG具有成本效益的结论。两项进一步的初步经济评估评估了短期成本效益。他们的结果发现,SMBG与成本增加有关,而HbA1c没有显著降低。这些研究根据治疗方案检查了亚组,与饮食和运动组相比,药物和胰岛素治疗组的SMBG被认为更有可能具有成本效益。结论:T2DM患者中SMBG的经济证据尚不清楚。在大多数情况下,纳入的研究发现SMBG具有成本效益,尽管分析对相对效应、分析的时间框架和模型假设非常敏感。虽然存在很大的不确定性,但SMBG在某些亚组中可能具有成本效益,例如药物和胰岛素治疗的患者。实践意义没有强有力的证据建议在控制良好的糖尿病患者中定期使用SMBG,仅通过饮食和运动计划进行治疗。这些证据确实为药物和胰岛素治疗T2DM的SMBG提供了支持。建议临床医生根据他们的专业知识,从这些群体中选择合适的SMBG患者。对SMBG的大规模前瞻性随机对照试验,特别是在药物和胰岛素治疗的患者中,与他们一起进行良好的经济评估,将能够更准确地估计SMBG的成本效益。SMBG的最佳频率和管理仍然未知,这是另一个值得进一步研究的领域。
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引用次数: 3
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JBI library of systematic reviews
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