关于骨科干预措施有效性的现有系统评价有哪些？
What Systematic Reviews Exist for the Effectiveness of Orthopaedic Interventions.
作者信息
Wright James G, Davies Jacqueline, Barwick Melanie A, Hawker Gillian A, Prieto-Alhambra Daniel, Coyte Peter C
机构信息
Nuffield Department of Orthopaedics (Dr. Wright), Rheumatology, and Musculoskeletal Science, University of Oxford, Oxford, UK; the Hospital for Sick Children (Dr. Wright), Toronto, ON, Canada; the Botnar Research Center (Ms. Davies), Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Oxford, UK; the Research Institute, Hospital for Sick Children (Dr. Barwick); the Department of Medicine, University of Toronto, (Dr. Hawker); the Institute of Health Policy (Dr. Hawker), Management, and Evaluation, University of Toronto, Toronto, ON, Canada; the Centre for Statistics in Medicine (Dr. Prieto-Alhambra), Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Oxford, UK; and the Institute of Health Policy (Dr. Coyte), Management and Evaluation, School of Public Health, University of Toronto, Toronto, ON, Canada.
出版信息
J Am Acad Orthop Surg Glob Res Rev. 2019 Feb 5;3(2):e098. doi: 10.5435/JAAOSGlobal-D-18-00098. eCollection 2019 Feb.
INTRODUCTION
Orthopaedics procedures are frequent and expensive, but highly cost effective in improving the quality of life. The purpose of this study was to determine the number and topics of systematic overviews on the effectiveness of orthopaedic interventions.
METHODS
We performed a review of PubMed, Ovid Embase, Scopus, OrthoEvidence, and the Cochrane Library for dates of publication from January 1, 2006, to February 3, 2017, to identify systematic overviews of randomized clinical trials for the effectiveness of therapeutic interventions involving orthopaedic surgeons. Abstracts were excluded based on the following sequentially applied criteria: (1) the systematic review did not include an intervention for an orthopaedic condition; the intervention was not therapeutic; the intervention was not likely to be applied or influenced by an orthopaedic surgeon; (2) the study was not a systematic review or the study was a single randomized controlled trial, and/or it included nonhuman studies; (3) the systematic review included nonrandomized studies; and (4) the systematic review did not state moderate or strong evidence in support of the study conclusion(s).
RESULTS
Of the 6,864 abstracts found in the searches, 6,145 were excluded yielding 719 systematic overviews. Contrary to conventional wisdom, this study identified 719 reviews of randomized controlled trials of therapeutic orthopaedic interventions. The interventions were classified as surgical in 383 (55%), medication in 245 (34%), and rehabilitation in 42 (6%), and other nonsurgical interventions in 39 (5%).
DISCUSSION
This study identified many systematic overviews of orthopaedic interventions. The findings of this study could both influence clinical practice and, given the frequency of orthopaedic procedures, have a major public health impact.
引言
骨科手术频繁且费用高昂，但在改善生活质量方面具有很高的成本效益。本研究的目的是确定关于骨科干预效果的系统综述的数量和主题。
方法
我们检索了PubMed、Ovid Embase、Scopus、OrthoEvidence和Cochrane图书馆，检索时间为2006年1月1日至2017年2月3日，以确定涉及骨科医生的治疗性干预效果的随机临床试验的系统综述。根据以下依次应用的标准排除摘要：（1）系统综述未包括骨科疾病的干预措施；干预措施不是治疗性的；干预措施不太可能由骨科医生应用或影响；（2）该研究不是系统综述，或者该研究是单一的随机对照试验，和/或包括非人类研究；（3）系统综述包括非随机研究；（4）系统综述未表明有中度或有力证据支持研究结论。
结果
在检索到的6864篇摘要中，排除6145篇，得到719篇系统综述。与传统观念相反，本研究确定了719篇关于骨科治疗性干预随机对照试验的综述。干预措施分类为手术的有383篇（55%），药物治疗的有245篇（34%），康复治疗的有42篇（6%），其他非手术干预的有39篇（5%）。
讨论
本研究确定了许多关于骨科干预的系统综述。本研究的结果既可能影响临床实践，又鉴于骨科手术的频繁性，可能对公共卫生产生重大影响。
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