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肿瘤护理路径在初级和二级保健中对患者、专业人员和卫生系统结果的影响:系统评价和荟萃分析方案。

Effects of oncological care pathways in primary and secondary care on patient, professional, and health systems outcomes: protocol for a systematic review and meta-analysis.

机构信息

Department Health Technology and Services Research (HTSR), University of Twente, P.O. Box 217, 7500 AE, Enschede, the Netherlands.

Netherlands Comprehensive Cancer Organisation (IKNL), P.O. Box 19079, 3501 DB, Utrecht, the Netherlands.

出版信息

Syst Rev. 2018 Mar 27;7(1):49. doi: 10.1186/s13643-018-0693-x.

Abstract

BACKGROUND

The high impact of a cancer diagnosis on patients and their families and the increasing costs of cancer treatment call for optimal and efficient oncological care. To improve the quality of care and to minimize healthcare costs and its economic burden, many healthcare organizations introduce care pathways to improve efficiency across the continuum of cancer care. However, there is limited research on the effects of cancer care pathways in different settings.

METHODS

The aim of this systematic review and meta-analysis described in this protocol is to synthesize existing literature on the effects of oncological care pathways. We will conduct a systematic search strategy to identify all relevant literature in several biomedical databases, including Cochrane library, MEDLINE, Embase, and CINAHL. We will follow the methodology of Cochrane Effective Practice and Organisation of Care (EPOC), and we will include randomized trials, non-randomized trials, controlled before-after studies, and interrupted time series studies. In addition, we will include full economic evaluations (cost-effectiveness analyses, cost-utility analyses, and cost-benefit analyses), cost analyses, and comparative resource utilization studies, if available. Two reviewers will independently screen all studies and evaluate those included for risk of bias. From these studies, we will extract data regarding patient, professional, and health systems outcomes. Our systematic review will follow the PRISMA set of items for reporting in systematic reviews and meta-analyses.

DISCUSSION

Following the protocol outlined in this article, we aim to identify, assess, and synthesize all available evidence in order to provide an evidence base on the effects of oncological care pathways as reported in the literature.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017057592 .

摘要

背景

癌症诊断对患者及其家庭的影响巨大,且癌症治疗成本不断增加,这都要求提供最佳和高效的肿瘤学护理。为了提高护理质量,尽量减少医疗保健成本及其经济负担,许多医疗保健组织引入了护理路径,以改善癌症护理连续体中的效率。然而,在不同环境下,癌症护理路径的效果研究有限。

方法

本方案中描述的系统评价和荟萃分析旨在综合现有关于肿瘤学护理路径效果的文献。我们将进行系统搜索策略,以确定在几个生物医学数据库中所有相关的文献,包括 Cochrane 图书馆、MEDLINE、Embase 和 CINAHL。我们将遵循 Cochrane 有效实践和护理组织(EPOC)的方法,并将包括随机试验、非随机试验、对照前后研究和中断时间序列研究。此外,如果有,我们还将包括全经济评估(成本效益分析、成本效用分析和成本效益分析)、成本分析和比较资源利用研究。两位审查员将独立筛选所有研究,并评估纳入研究的偏倚风险。从这些研究中,我们将提取有关患者、专业人员和卫生系统结果的数据。我们的系统评价将遵循 PRISMA 系统综述和荟萃分析报告的项目。

讨论

按照本文概述的方案,我们旨在确定、评估和综合所有现有证据,以便根据文献中报告的肿瘤学护理路径的效果提供证据基础。

系统评价注册

PROSPERO CRD42017057592 。

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