Descatha Alexis, Albo Francesco, Leclerc Annette, Carton Matthieu, Godeau Diane, Roquelaure Yves, Petit Audrey, Aublet-Cuvelier Agnès
AP-HP, University Hospital of West Suburb of Paris, Poincaré, Garches, and Versailles St-Quentin University, INSERM, Villejuif, France.
AP-HP, University Hospital of West Suburb of Paris, Poincaré, Garches, France.
Arthritis Care Res (Hoboken). 2016 Nov;68(11):1681-1687. doi: 10.1002/acr.22874.
In view of recent published studies, a meta-analysis was undertaken on prospective studies in order to assess any association between lateral epicondylitis and physical exposure at work.
Using the key words "lateral epicondylitis" AND "occupational" AND ("cohort" OR "longitudinal," OR "incidence") without limitations on the language or year of publication, original prospective studies were selected from 4 databases (PubMed, Scopus, Web of Science, and Base de Données de Santé Publique) after 2 rounds (valid design, valid association reported, and valid work exposure). Relevant associations between physical exposure at work and incident lateral epicondylitis were extracted from the articles, and a meta-risk was calculated using the generic variance approach (meta-odds ratios [meta-ORs]).
From 2001 to 2014, 5 prospective studies were included. Among 6,922 included subjects (and 3,449 who were followed), 256 cases of incident lateral epicondylitis were diagnosed 2.5-6 years after baseline. All the published studies found a significant estimation of relative risk for a positive association between combined biomechanic exposure involving the wrist and/or elbow and incidence of lateral epicondylitis. The overall meta-OR was 2.6 (95% confidence interval 1.9-3.5), with a low heterogeneity (Q = 1.4, P > 0.05). Funnel plots and Egger's test did not suggest major publication bias.
The results of this meta-analysis strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis.
鉴于近期发表的研究,开展一项前瞻性研究的荟萃分析,以评估外侧上髁炎与工作中的身体暴露之间的任何关联。
使用关键词“外侧上髁炎”、“职业性”以及(“队列研究”或“纵向研究”或“发病率”),对语言或发表年份无限制,在两轮筛选(有效设计、报告有效关联以及有效工作暴露)后,从4个数据库(PubMed、Scopus、科学网和公共卫生数据库)中选择原始前瞻性研究。从文章中提取工作中的身体暴露与新发外侧上髁炎之间的相关关联,并使用通用方差法(meta-比值比[meta-ORs])计算荟萃风险。
2001年至2014年,纳入5项前瞻性研究。在纳入的6922名受试者(以及随访的3449名受试者)中,基线后2.5至6年诊断出256例新发外侧上髁炎病例。所有已发表的研究均发现,涉及手腕和/或肘部的联合生物力学暴露与外侧上髁炎发病率之间的正相关的相对风险估计具有显著性。总体meta-OR为2.6(95%置信区间1.9 - 3.5),异质性较低(Q = 1.4,P > 0.05)。漏斗图和埃格检验未提示存在重大发表偏倚。
这项荟萃分析的结果有力地支持了工作中涉及手腕和/或肘部的生物力学暴露与外侧上髁炎发病率之间存在关联的假设。