Hong Brian Younho, Giang Raymond, Mbuagbaw Lawrence, Larche Maggie, Thabane Lehana
Bachelor of Health Sciences (Honours) Program, McMaster University, Hamilton, ON, Canada.
Syst Rev. 2014 Oct 13;3:115. doi: 10.1186/2046-4053-3-115.
Scleroderma affects the gastrointestinal (GI) tract in 90% of all cases. Malnutrition, diarrhea, and constipation are some GI complications that can stem from scleroderma, and they contribute considerably to impairment in quality of life. Reports of haphazard clusters of high prevalence suggest that environmental exposure is a risk factor for scleroderma. However, it is largely uncertain whether the GI involvement secondary to scleroderma is influenced by these environmental factors. This study will review the association between GI involvement (unintentional weight loss, choking, early satiety, etc.) and environmental exposure in patients with scleroderma.
METHODS/DESIGN: Any available observational studies that report GI problems in patients with scleroderma along with the associated risk factors will be selected. We will search CINAHL, EMBASE, LILACS, MEDLINE, and Web of Science for relevant articles written in English from June 1884 to May 2014. Identified articles will be screened in duplicate, and full text for selected articles will be retrieved. Data extraction will be done in duplicate on sociodemographic characteristics of participants, diagnosis of scleroderma, diagnosis of risk of GI problem, risk factors reported, etc. Discrepancies will be resolved by consensus or by consulting a third author. We will assess the participants, methods, and intervention effects of included studies for heterogeneity. Any identified clinical or statistical heterogeneity will be explored visually or using the chi-square test. Data will be pooled statistically using the DerSimmonian and Laird random effects method if we have a measure of relative risk and its precision. Our findings will be reported according to the Meta-Analyses and Systematic Review of Observational Studies (MOOSE) guideline.
Our findings may help patients with scleroderma and health care professionals in preventing GI morbidity. Knowing that the cost of care for patients with scleroderma increases with more organ involvement, study findings can inform policy developers to identify ways to curb health care costs.
CRD42014010707.
硬皮病在所有病例中有90%会累及胃肠道（GI）。营养不良、腹泻和便秘是硬皮病可能引发的一些胃肠道并发症，它们对生活质量的损害相当大。关于高患病率随机集群的报告表明，环境暴露是硬皮病的一个风险因素。然而，硬皮病继发的胃肠道受累是否受这些环境因素影响在很大程度上尚不确定。本研究将回顾硬皮病患者胃肠道受累（非故意体重减轻、呛噎、早饱等）与环境暴露之间的关联。
方法/设计：将选择任何报告硬皮病患者胃肠道问题及相关危险因素的现有观察性研究。我们将在CINAHL、EMBASE、LILACS、MEDLINE和科学网中搜索1884年6月至2014年5月期间用英文撰写的相关文章。对识别出的文章进行双人筛选，并检索选定文章的全文。将对参与者的社会人口学特征、硬皮病诊断、胃肠道问题风险诊断、报告的危险因素等进行双人数据提取。差异将通过协商一致或咨询第三位作者来解决。我们将评估纳入研究的参与者、方法和干预效果的异质性。任何识别出的临床或统计异质性将通过直观检查或使用卡方检验进行探究。如果我们有相对风险及其精确度的测量值，将使用DerSimmonian和Laird随机效应方法对数据进行统计学合并。我们的研究结果将根据观察性研究的Meta分析和系统评价（MOOSE）指南进行报告。
我们的研究结果可能有助于硬皮病患者和医护人员预防胃肠道疾病。鉴于硬皮病患者的护理成本会随着更多器官受累而增加，研究结果可为政策制定者提供信息，以确定控制医疗保健成本的方法。
PROSPERO：CRD42014010707
