慢性伤口的人文和经济负担：一项系统评价方案
The humanistic and economic burden of chronic wounds: a protocol for a systematic review.
作者信息
Järbrink Krister, Ni Gao, Sönnergren Henrik, Schmidtchen Artur, Pang Caroline, Bajpai Ram, Car Josip
机构信息
Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921, Singapore.
Department of Dermatology, Skåne University Hospital, Lasarettsgatan 15, 221 85, Lund, Sweden.
出版信息
Syst Rev. 2017 Jan 24;6(1):15. doi: 10.1186/s13643-016-0400-8.
BACKGROUND
Chronic non-healing wounds present a substantial economic burden to healthcare system; significant reductions in quality of life for those affected, and precede often serious events such as limp amputations or even premature deaths. This burden is also likely to increase with a larger proportion of elderly and increasing prevalence of life-style diseases such as obesity and diabetes. Reviews of the evidence on the burden of illness associated with chronic wounds have not been comprehensive in scope and have not provided an assessment of the distribution of the health care costs across categories of resource use.
METHODS/DESIGN: This study is a systematic review of multiple databases for studies on adult patients with chronic wounds and with the primary objective to assess the impact on health-related quality of life by category of ulcers, and associated direct and indirect costs. Eligible studies will primary be empirical studies evaluating, describing or comparing measurement of quality of life and economic impact. Two reviewers will independently screen titles and abstracts and select studies involving adults with chronic wounds. These investigators will also independently extract data using a pre-designed data extraction form. Differences in applied methodologies and uncertainties will clearly be accounted for. Conservative valuations of costs and impact on health-related quality of life will be prioritised. Variations that may depend on age distribution, the categorisation of ulcer, healthcare system etc. will be described clearly.
DISCUSSION
The proposed systematic review will yield a comprehensive assessment of the humanistic and economic burden of chronic wounds in an adult population. A better understanding of the humanistic and economic burden of chronic wounds is essential for policy and planning purposes, to monitor trends in disease burden and not at least in order to estimate the real-world cost-effectiveness of new treatments and therapies.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016037496.
背景
慢性难愈合伤口给医疗系统带来了巨大的经济负担；给患者的生活质量造成显著下降，且常常引发诸如肢体截肢甚至过早死亡等严重事件。随着老年人口比例的增加以及肥胖和糖尿病等生活方式疾病患病率的上升，这一负担可能还会加重。关于慢性伤口相关疾病负担的证据综述在范围上并不全面，也未对各类资源使用的医疗保健成本分布进行评估。
方法/设计：本研究是对多个数据库进行的系统综述，针对成年慢性伤口患者的研究，主要目的是按溃疡类别评估对健康相关生活质量的影响以及相关的直接和间接成本。符合条件的研究主要为评估、描述或比较生活质量测量及经济影响的实证研究。两名评审员将独立筛选标题和摘要，并选择涉及成年慢性伤口患者的研究。这些研究人员还将使用预先设计的数据提取表独立提取数据。将明确考虑所应用方法的差异和不确定性。将优先对成本及对健康相关生活质量的影响进行保守估值。将清楚描述可能因年龄分布、溃疡分类、医疗系统等因素而产生的差异。
讨论
拟进行的系统综述将对成年人群中慢性伤口的人文和经济负担进行全面评估。更好地了解慢性伤口的人文和经济负担对于政策制定和规划、监测疾病负担趋势至关重要，至少对于估计新治疗方法和疗法在现实世界中的成本效益也是必不可少的。
系统综述注册
PROSPERO CRD42016037496。
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