生活质量和腰椎管狭窄症的客观功能障碍：系统评价和调节因素荟萃分析的方案。
Quality of life and objective functional impairment in lumbar spinal stenosis: a protocol for a systematic review and meta-analysis of moderators.
机构信息
Department of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital of Siena, Siena, Italy.
Health Service Management Board, Santa Maria alle Scotte University Hospital, Siena, Italy.
出版信息
BMJ Open. 2019 Nov 21;9(11):e032314. doi: 10.1136/bmjopen-2019-032314.
BACKGROUND
Lumbar spinal stenosis (LSS) is a common degenerative spine disease associated with a strong impairment in various quality of life areas, particularly the ability to perform work-related activity. Depression is a condition frequently associated. There is no comprehensive review on quality of life and objective functional impairment in LSS. This paper presents the protocol of the first systematic review and meta-analysis summarising evidence about quality of life and functional impairment in patients with LSS compared with healthy controls. Comorbid depressive disorders, age, gender, LSS duration, disability, pain severity and study methodological quality will be investigated as moderators.
METHODS
The protocol is reported according to PRISMA-P guidelines. Studies will be included if they were conducted on patients aged 18 years old or older with primary LSS and if they reported data on differences in the levels of quality of life or objective functional impairment between patients with LSS and healthy controls. Independent reviewers will search published/unpublished studies through electronic databases and additional sources, will extract the data and assess the methodological quality. Random-effects meta-analysis will be carried out by calculating effect sizes as Cohen's indices. Heterogeneity will be examined by the and the statistics. Moderators will be investigated through meta-regression.
CONCLUSIONS
A summary of the evidence on quality of life and functional impairment in LSS may suggest clinical and occupational health medicine strategies aimed to timely detect and prevent these outcomes. Higher percentages of patients with LSS with depression may be expected to be related to poorer quality of life. Depressive comorbidity might impact negatively on quality of life because it is associated with dysfunctional coping, disability and psychophysiological symptoms.
ETHICS AND DISSEMINATION
The current review does not require ethics approval. The results will be disseminated through publications in peer-reviewed journals.
REVIEW REGISTRATION
CRD42019132209.
背景
腰椎管狭窄症（LSS）是一种常见的退行性脊柱疾病，与多个生活质量领域的严重受损有关，尤其是与工作相关活动的能力。抑郁症是一种常见的相关疾病。目前尚无关于 LSS 患者生活质量和客观功能障碍的综合综述。本文介绍了首次系统综述和荟萃分析的方案，该分析总结了与健康对照组相比，LSS 患者生活质量和功能障碍的证据。共病性抑郁障碍、年龄、性别、LSS 持续时间、残疾、疼痛严重程度和研究方法学质量将作为调节因素进行研究。
方法
本方案按照 PRISMA-P 指南进行报告。如果研究对象为年龄在 18 岁及以上的原发性 LSS 患者，并且报告了 LSS 患者与健康对照组之间生活质量或客观功能障碍差异的数据，则将其纳入研究。独立审查员将通过电子数据库和其他来源搜索已发表/未发表的研究，提取数据并评估方法学质量。将通过计算 Cohen's 指数作为效应大小进行随机效应荟萃分析。通过 和 统计量检查异质性。通过元回归研究调节因素。
结论
对 LSS 患者生活质量和功能障碍的证据进行总结，可能提示临床和职业健康医学策略，旨在及时发现和预防这些结果。预计 LSS 患者中伴有抑郁的患者比例较高，可能与生活质量较差有关。抑郁共病可能会对生活质量产生负面影响，因为它与功能失调的应对方式、残疾和心理生理症状有关。
伦理与传播
本次综述无需伦理批准。研究结果将通过发表在同行评议期刊上进行传播。
综述注册
CRD42019132209。
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