哪些因素决定了乳腺癌筛查的效果和成本？系统评价综述的方案。
What determines the effects and costs of breast cancer screening? A protocol of a systematic review of reviews.
机构信息
Early Detection and Prevention Section, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France.
Institute of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands.
出版信息
Syst Rev. 2017 Jun 28;6(1):122. doi: 10.1186/s13643-017-0510-y.
BACKGROUND
Multiple reviews demonstrated high variability in effectiveness and cost-effectiveness outcomes among studies on breast cancer screening (BCS) programmes. No study to our knowledge has summarized the current evidence on determinants of effectiveness and cost-effectiveness of the most used BCS approaches or tried to explain differences in conclusions of systematic reviews on this topic. Based on published reviews, this systematic review aims to assess the degree of variability of determinants for (a) effectiveness and (b) cost-effectiveness of BCS programmes using mammography, clinical breast examination, breast self-examination, ultrasonography, or their combinations among the general population.
METHODS
We will perform a comprehensive systematic literature search in Cochrane, Scopus, Embase, and Medline (via Pubmed). The search will be supplemented with hand searching of references of the included reviews, with hand searching in the specialized journals, and by contacting prominent experts in the field. Additional search for grey literature will be conducted on the websites of international cancer associations and networks. Two trained research assistants will screen titles and abstracts of publications independently, with at least random 10% of all abstracts being also screened by the principal researcher. The full texts of the systematic reviews will then be screened independently by two authors, and disagreements will be solved by consensus. The included reviews will be grouped by publication year, outcomes, designs of original studies, and quality. Additionally, for reviews published since 2011, transparency in reporting will be assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for the review on determinants of effectiveness and a modified PRISMA checklist for the review on determinants for cost-effectiveness. The study will apply the Assessing the Methodological Quality of Systematic Reviews checklist to assess the methodological quality of systematic reviews. We will report the data extracted from the systematic reviews in a systematic format. Meta-meta-analysis of extracted data will be conducted when feasible.
DISCUSSION
This systematic review of reviews will examine the degree of variability in the effectiveness and cost-effectiveness of BCS programmes.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016050764 and CRD42016050765.
背景
多项综述表明，乳腺癌筛查（BCS）计划的有效性和成本效益结果存在高度变异性。据我们所知，尚无研究总结目前关于最常用 BCS 方法的有效性和成本效益决定因素的证据，也未尝试解释该主题系统评价结论之间的差异。基于已发表的综述，本系统评价旨在评估使用乳房 X 光摄影、临床乳房检查、乳房自我检查、超声或其组合对一般人群进行 BCS 计划的（a）有效性和（b）成本效益的决定因素的变异性程度。
方法
我们将在 Cochrane、Scopus、Embase 和 Medline（通过 Pubmed）中进行全面的系统文献检索。将通过纳入综述的参考文献的手工搜索、专门期刊的手工搜索以及与该领域知名专家的联系来补充搜索。还将在国际癌症协会和网络的网站上进行灰色文献的额外搜索。两名经过培训的研究助理将独立筛选出版物的标题和摘要，至少随机选择 10%的摘要由主要研究人员进行筛选。然后，两名作者将独立筛选系统评价的全文，如果存在分歧，则通过协商解决。将根据出版物年份、结果、原始研究设计和质量对纳入的综述进行分组。此外，对于 2011 年以后发表的综述，将使用评估有效性决定因素的系统评价和荟萃分析的首选报告项目（PRISMA）清单以及修改后的 PRISMA 清单评估成本效益决定因素的综述的报告透明度。该研究将使用系统评价方法学质量评估检查表来评估系统评价的方法学质量。我们将以系统格式报告从系统评价中提取的数据。在可行的情况下，将对提取的数据进行元荟萃分析。
讨论
本综述性系统评价将检查 BCS 计划的有效性和成本效益的变异性程度。
系统评价注册
PROSPERO CRD42016050764 和 CRD42016050765。
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