基于互联网的自助干预措施减少自杀意念的有效性：系统评价与荟萃分析方案
The Effectiveness of Internet-Based Self-Help Interventions to Reduce Suicidal Ideation: Protocol for a Systematic Review and Meta-Analysis.
作者信息
Büscher Rebekka, Torok Michelle, Sander Lasse
机构信息
Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany.
Black Dog Institute, University of New South Wales, Sydney, Australia.
出版信息
JMIR Res Protoc. 2019 Jul 29;8(7):e14174. doi: 10.2196/14174.
BACKGROUND
Suicidal ideation is a highly prevalent condition. There are several barriers for individuals to seek treatment that may be addressed by providing internet-based self-help interventions (ISIs). Current evidence suggests that ISIs for mental disorders may only be effective in reducing suicidal ideation if they specifically target suicidal thoughts or behaviors.
OBJECTIVE
The aim of this systematic review and meta-analysis is to investigate the effectiveness of ISIs that directly target suicidal thoughts or behaviors.
METHODS
We will conduct a sensitive systematic literature search in PsycINFO, MEDLINE, the Cochrane Central Register of Controlled Trials, and the Centre for Research Excellence of Suicide Prevention databases. Only randomized controlled trials evaluating the effectiveness of ISIs for suicide prevention will be included. Interventions must be delivered primarily in a Web-based setting; mobile-based interventions and interventions targeting gatekeepers will be excluded. Suicide ideation will be the primary outcome; secondary outcomes will be completed suicides, suicide attempts, depressiveness, anxiety, and hopelessness. Study quality will be assessed using the Cochrane Risk of Bias tool. We will provide a narrative synthesis of included studies. If studies are sufficiently homogenous, we will conduct a meta-analysis of the effectiveness on suicide ideation and, if possible, we will evaluate publication bias using funnel plots. We will evaluate the cumulative evidence in accordance with the Grading of Recommendations Assessment, Development and Evaluation framework.
RESULTS
This review is in progress, with findings expected by August 2019.
CONCLUSIONS
This systematic review and meta-analysis focuses on the effectiveness of ISIs for suicidal thoughts and behaviors. It will provide guidance to clinical practice and encourage further research by synthesizing the best available evidence.
TRIAL REGISTRATION
International Prospective Register of Systematic Reviews (PROSPERO) CRD42019130253; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130253.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/14174.
背景
自杀意念是一种非常普遍的情况。个体寻求治疗存在多种障碍，而基于互联网的自助干预措施（ISIs）可能有助于解决这些障碍。目前的证据表明，针对精神障碍的ISIs只有在专门针对自杀想法或行为时，才可能有效减少自杀意念。
目的
本系统评价和荟萃分析的目的是研究直接针对自杀想法或行为的ISIs的有效性。
方法
我们将在PsycINFO、MEDLINE、Cochrane对照试验中央注册库和自杀预防卓越研究中心数据库中进行全面的系统文献检索。仅纳入评估ISIs预防自杀有效性的随机对照试验。干预措施必须主要通过基于网络的方式提供；基于移动设备的干预措施和针对守门人的干预措施将被排除。自杀意念将作为主要结局；次要结局将包括自杀死亡、自杀未遂、抑郁、焦虑和绝望。将使用Cochrane偏倚风险工具评估研究质量。我们将对纳入的研究进行叙述性综合分析。如果研究具有充分的同质性，我们将对自杀意念的有效性进行荟萃分析，并在可能的情况下，使用漏斗图评估发表偏倚。我们将根据推荐意见分级评估、制定和评价框架评估累积证据。
结果
本评价正在进行中，预计2019年8月得出结果。
结论
本系统评价和荟萃分析聚焦于针对自杀想法和行为的ISIs的有效性。它将通过综合现有最佳证据为临床实践提供指导，并鼓励进一步研究。
试验注册
国际前瞻性系统评价注册库（PROSPERO）CRD42019130253；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=130253。
国际注册报告识别号（IRRID）：PRR1-10.2196/14174。
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