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生育干预的声明:对英国生育中心网站上声明的系统评估。

Claims for fertility interventions: a systematic assessment of statements on UK fertility centre websites.

作者信息

Spencer E A, Mahtani K R, Goldacre B, Heneghan C

机构信息

Nuffield Department of Primary Care Health Sciences, Centre for Evidence-Based Medicine, University of Oxford, Oxford, UK.

出版信息

BMJ Open. 2016 Nov 27;6(11):e013940. doi: 10.1136/bmjopen-2016-013940.

Abstract

OBJECTIVES

Fertility services in the UK are offered by over 200 Human Fertilisation and Embryology Authority (HFEA)-registered NHS and private clinics. While in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) form part of the National Institute for Health and Care Excellence (NICE) guidance, many further interventions are offered. We aimed to record claims of benefit for interventions offered by fertility centres via information on the centres' websites and record what evidence was cited for these claims.

METHODS

We obtained from HFEA a list of all UK centres providing fertility treatments and examined their websites. We listed fertility interventions offered in addition to standard IVF and ICSI and recorded statements about interventions that claimed or implied improvements in fertility in healthy women. We recorded which claims were quantified, and the evidence cited in support of the claims. Two reviewers extracted data from websites. We accessed websites from 21 December 2015 to 31 March 2016.

RESULTS

We found 233 websites for HFEA-registered fertility treatment centres, of which 152 (65%) were excluded as duplicates or satellite centres, 2 were andrology clinics and 5 were unavailable or under construction websites. In total, 74 fertility centre websites, incorporating 1401 web pages, were examined for claims. We found 276 claims of benefit relating to 41 different fertility interventions made by 60 of the 74 centres (median 3 per website; range 0 to 10). Quantification was given for 79 (29%) of the claims. 16 published references were cited 21 times on 13 of the 74 websites.

CONCLUSIONS

Many fertility centres in the UK offer a range of treatments in addition to standard IVF procedures, and for many of these interventions claims of benefit are made. In most cases, the claims are not quantified and evidence is not cited to support the claims. There is a need for more information on interventions to be made available by fertility centres, to support well-informed treatment decisions.

摘要

目的

英国有200多家人类受精与胚胎学管理局(HFEA)注册的国民保健服务(NHS)及私人诊所提供生育服务。虽然体外受精(IVF)和卵胞浆内单精子注射(ICSI)是英国国家卫生与临床优化研究所(NICE)指南的一部分,但许多其他干预措施也在提供。我们旨在通过生育中心网站上的信息记录这些中心所提供干预措施的益处声明,并记录这些声明所引用的证据。

方法

我们从HFEA获取了所有提供生育治疗的英国中心的名单,并检查了它们的网站。我们列出了除标准IVF和ICSI之外提供的生育干预措施,并记录了关于这些干预措施在健康女性中声称或暗示可提高生育能力的声明。我们记录了哪些声明进行了量化,以及支持这些声明所引用的证据。两名评审员从网站中提取数据。我们访问网站的时间为2015年12月21日至2016年3月31日。

结果

我们找到了233个HFEA注册的生育治疗中心的网站,其中152个(65%)因重复或为卫星中心而被排除,2个是男科诊所,5个网站无法访问或正在建设中。总共检查了74个生育中心网站,包含1401个网页以查看声明。我们发现74个中心中的60个(每个网站中位数为3个;范围为0至10个)针对41种不同的生育干预措施提出了276项益处声明。79项(29%)声明进行了量化。在74个网站中的13个网站上,16篇已发表的参考文献被引用了21次。

结论

英国许多生育中心除了标准IVF程序外还提供一系列治疗,并且针对其中许多干预措施都有关于益处的声明。在大多数情况下,这些声明没有量化,也没有引用证据来支持这些声明。生育中心需要提供更多关于干预措施的信息,以支持做出明智的治疗决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba43/5168515/a5d1a72e2066/bmjopen2016013940f01.jpg

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