系统评价方案：全髋关节和膝关节置换术决策用患者决策辅助工具
Protocol for systematic review: patient decision aids for total hip and knee arthroplasty decision-making.
机构信息
School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, Canada.
Population Health, Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
出版信息
Syst Rev. 2021 Jan 4;10(1):8. doi: 10.1186/s13643-020-01549-6.
BACKGROUND
Total hip and knee arthroplasty are a highly performed surgery; however, patient satisfaction with surgery results and patient involvement in the decision-making process remains low. Patient decision aids (PtDAs) are tools used in clinical practices to facilitate active patient involvement in healthcare decision-making. Nonetheless, PtDA effects have not been systematically evaluated for hip and knee total joint arthroplasty (TJA) decision-making. The aim of this systematic review is to determine the effect of patient decision aids compared to alternative of care on quality and process of decision-making when provided to adults with hip and knee osteoarthritis considering primary elective TJA.
METHODS
This systematic review will follow the Cochrane Handbook for Systematic Reviews. This protocol was reported based on the PRISMA-P checklist guidelines. Studies will be searched in CINAHL, MEDLINE, Embase, PsycINFO, and Web of Science. Eligible studies will be randomized control trial (RCT) evaluating the effect of PtDA on TJA decision-making. Descriptive and meta-analysis of outcomes will include decision quality (knowledge and values-based choice), decisional conflict, patient involvement, decision-making process satisfaction, actual decision made, health outcomes, and harm(s). Risk of bias will be evaluated with Cochrane's risk of bias tool for RCTs. Quality and strength of recommendations will be appraised with Grades of Recommendation, Assessment, Development and Evaluation (GRADE).
DISCUSSION
This review will provide a summary of RCT findings on PtDA effect on decision-making quality and process of adults with knee and hip osteoarthritis considering primary elective TJA. Further, it will provide evidence comparing different types of PtDA used for TJA decision-making. This review is expected to inform further research on joint replacement decision-making quality and processes and on ways PtDAs facilitate shared decision-making for orthopedic surgery.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42020171334.
背景
全髋关节和膝关节置换术是一种高执行率的手术；然而，患者对手术结果的满意度和患者在决策过程中的参与度仍然较低。患者决策辅助工具（PtDA）是用于临床实践的工具，旨在促进患者积极参与医疗保健决策。尽管如此，对于髋关节和膝关节全关节置换术（TJA）决策，PtDA 的效果尚未系统评估。本系统评价的目的是确定与替代护理相比，PtDA 对考虑初次择期 TJA 的髋膝关节骨关节炎成人的决策质量和过程的影响。
方法
本系统评价将遵循 Cochrane 系统评价手册。本方案是根据 PRISMA-P 清单指南报告的。研究将在 CINAHL、MEDLINE、Embase、PsycINFO 和 Web of Science 中进行搜索。合格的研究将是评估 PtDA 对 TJA 决策影响的随机对照试验（RCT）。结果的描述性和荟萃分析将包括决策质量（基于知识和价值观的选择）、决策冲突、患者参与度、决策过程满意度、实际决策、健康结果和伤害。将使用 Cochrane 的 RCT 偏倚风险工具评估偏倚风险。将使用推荐评估、制定与评价（GRADE）的等级来评估推荐的质量和强度。
讨论
本综述将总结关于 PtDA 对考虑初次择期 TJA 的膝髋关节炎成人决策质量和过程影响的 RCT 结果。此外，它将提供比较用于 TJA 决策的不同类型 PtDA 的证据。该综述有望为关节置换决策质量和过程以及 PtDA 促进骨科手术共同决策的方式提供进一步的研究信息。
系统评价注册
PROSPERO CRD42020171334。
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