Shah Anupa, Blackhall Karen, Ker Katharine, Patel Daksha
Cochrane Eyes and Vision Group, ICEH, London School of Health & Tropical Medicine, Keppel Street, London, UK, WC1E 7HT.
Cochrane Database Syst Rev. 2009 Oct 7;2009(4):CD006527. doi: 10.1002/14651858.CD006527.pub3.
Ocular injury is a preventable cause of blindness, yet it remains a significant disabling health problem that affects all age groups. Injuries may occur in the home, in the workplace, during recreational activities or as a result of road crashes. Types of injuries vary from closed globe (contusion or lamellar laceration) to an open globe injury, which includes penetration and even perforation of the globe. To date, the main strategy to prevent these injuries has been to educate people to identify high-risk situations and to take correct action to avoid danger.
To assess the evidence for the effectiveness of educational interventions for the prevention of eye injuries.
We searched the Cochrane Injuries and the Cochrane Eyes & Vision Group Specialised Registers, CENTRAL (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, Current Controlled Trials metaRegister (now includes National Research Register), AgeInfo, HMIC Health Management Information Consortium, WHOLIS (World Health Organization Library Information System), LILACS (Latin American and Caribbean Health Sciences), MEDCARIB (Caribbean Health Sciences Literature), ISI Web of Science: (Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI) Conference Proceedings Citation Index-Science (CPCI-S)), ERIC, ZETOC and SPORTdiscus. We also checked reference lists of relevant papers and contacted study authors in an effort to identify published, unpublished and ongoing trials. Searches were last updated in August 2008.
We included any randomised controlled trials (RCTs) and controlled before-and-after studies which evaluated any educational intervention aimed at preventing eye injuries.
Four authors independently screened the electronic search results and data extracted. Three authors entered data into RevMan 5. As we judged there to be substantial heterogeneity between participants and interventions, we did not pool the studies' results, but have reviewed the results narratively.
We included two RCTs and three controlled before-and-after studies in this review. One study reported eye injuries as an outcome and four studies reported change in behaviour or knowledge.
AUTHORS' CONCLUSIONS: The included studies do not provide reliable evidence that educational interventions are effective in preventing eye injuries. There is a need for well-conducted RCTs with adequate allocation concealment and masking (blinding). Studies should have a longer follow-up time and more studies need to be conducted in low and middle-income countries.
眼外伤是导致失明的一个可预防因素,但它仍然是一个严重的致残性健康问题,影响着所有年龄组。损伤可能发生在家中、工作场所、娱乐活动期间或道路交通事故中。损伤类型从闭合性眼球损伤(挫伤或板层裂伤)到开放性眼球损伤不等,后者包括眼球穿通伤甚至眼球穿孔伤。迄今为止,预防这些损伤的主要策略是教育人们识别高风险情况并采取正确行动以避免危险。
评估教育干预措施预防眼外伤有效性的证据。
我们检索了Cochrane损伤组和Cochrane眼与视觉组专业注册库、CENTRAL(Cochrane图书馆2008年第3期)、MEDLINE、EMBASE、当前受控试验元注册库(现包括国家研究注册库)、AgeInfo、HMIC健康管理信息联盟、WHOLIS(世界卫生组织图书馆信息系统)、LILACS(拉丁美洲和加勒比卫生科学)、MEDCARIB(加勒比卫生科学文献)、ISI科学网:(科学引文索引扩展版(SCI-EXPANDED)、社会科学引文索引(SSCI)、会议论文引文索引-科学版(CPCI-S))、ERIC、ZETOC和SPORTdiscus。我们还检查了相关论文的参考文献列表并联系了研究作者,以努力识别已发表、未发表和正在进行的试验。检索最后更新于2008年8月。
我们纳入了任何评估旨在预防眼外伤的教育干预措施的随机对照试验(RCT)和前后对照研究。
四位作者独立筛选电子检索结果并提取数据。三位作者将数据录入RevMan 5。由于我们判断参与者和干预措施之间存在实质性异质性,因此未汇总研究结果,而是对结果进行了叙述性综述。
本综述纳入了两项RCT和三项前后对照研究。一项研究将眼外伤作为结局指标报告,四项研究报告了行为或知识的变化。
纳入的研究未提供可靠证据表明教育干预措施在预防眼外伤方面有效。需要开展实施良好的RCT,具备充分的分配隐藏和设盲。研究应具有更长的随访时间,并且需要在低收入和中等收入国家开展更多研究。