Department Health Technology & Services Research, University of Twente, Enschede, the Netherlands.
Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
Syst Rev. 2020 Oct 25;9(1):246. doi: 10.1186/s13643-020-01498-0.
Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify and synthesize existing literature on the effects of pathways in oncological care.
All patients diagnosed with cancer in primary and secondary/tertiary care whose treatment can be characterized as the strategy "care pathways" are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding patients, professionals, and system level were extracted from each study.
Out of 13,847 search results, we selected 158 articles eligible for full text assessment. One hundred fifty studies were excluded and the remaining eight studies represented 4786 patients. Most studies were conducted in secondary/tertiary care. Length of stay (LOS) was the most common used indicator, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (weighted mean difference (WMD)): - 2.75, CI: - 4.67 to - 0.83) and gynecological cancer (WMD: - 1.58, CI: - 2.10 to - 1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups.
Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary/tertiary care regarding the positive effects of LOS in favor of cancer care pathways.
PROSPERO CRD42017057592.
途径经常被用于改善癌症患者的护理。然而，关于肿瘤学护理中使用的途径的效果，证据很少。因此，我们进行了一项系统评价和荟萃分析，旨在确定并综合现有关于肿瘤学护理中途径效果的文献。
本综述纳入了所有在初级和二级/三级保健中被诊断患有癌症的患者，其治疗可以被描述为“护理途径”策略。我们在七个数据库中进行了系统搜索以收集证据。两位独立的评审员筛选了研究。从每项研究中提取了关于患者、专业人员和系统层面的研究结果。
在 13847 个搜索结果中，我们选择了 158 篇符合全文评估标准的文章。排除了 150 篇研究，其余 8 项研究代表了 4786 名患者。大多数研究在二级/三级保健中进行。住院时间（LOS）是最常用的指标，有五项研究报告了该指标。基于亚组的荟萃分析显示，胃癌（加权均数差（WMD）：-2.75，CI：-4.67 至-0.83）和妇科癌症（WMD：-1.58，CI：-2.10 至-1.05）的 LOS 总体更短。有六项研究报告了成本，大多数研究报告了途径组的成本更低。
尽管纳入的研究之间存在差异，但我们能够为二级/三级保健中进行的癌症护理途径提供证据基础，证明途径在缩短 LOS 方面具有积极效果，有利于癌症护理。
PROSPERO CRD42017057592。
