NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK.
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
BMJ Open. 2021 Mar 2;11(3):e045598. doi: 10.1136/bmjopen-2020-045598.
Many healthcare facilities in low-income and middle-income countries are inadequately resourced and may lack optimal organisation and governance, especially concerning surgical health systems. COVID-19 has the potential to decimate these already strained surgical healthcare services unless health systems take stringent measures to protect healthcare workers (HCWs) from viral exposure and ensure the continuity of specialised care for patients. The objective of this broad evidence synthesis is to identify and summarise the available literature regarding the efficacy of different personal protective equipment (PPE) in reducing the risk of COVID-19 infection in health personnel caring for patients undergoing trauma surgery in low-resource environments.
We will conduct several searches in the L·OVE (Living OVerview of Evidence) platform for COVID-19, a system that performs automated regular searches in PubMed, Embase, Cochrane Central Register of Controlled Trials and over 30 other sources. The search results will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. This review will preferentially consider systematic reviews of experimental and quasi-experimental studies, as well as individual studies of such designs, evaluating the effect of different PPE on the risk of COVID-19 infection in HCWs involved in emergency trauma surgery. Critical appraisal of eligible studies for methodological quality will be conducted. Data will be extracted using the standardised data extraction tool in Covidence. Studies will, when possible, be pooled in a statistical meta-analysis using JBI SUMARI. The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed and a summary of findings will be created.
Ethical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.
CRD42020198267.
许多中低收入国家的医疗保健机构资源不足，组织和治理可能不尽理想，尤其是在外科卫生系统方面。除非卫生系统采取严格措施保护医护人员免受病毒暴露，并确保为患者提供专业护理的连续性，否则 COVID-19 有可能摧毁这些已经紧张的外科医疗保健服务。本广泛证据综合的目的是确定和总结有关不同个人防护设备 (PPE) 在降低资源匮乏环境中照顾创伤手术患者的卫生人员感染 COVID-19 风险方面的有效性的现有文献。
我们将在 L·OVE（证据综合平台）中针对 COVID-19 进行多次搜索，该系统在 PubMed、Embase、Cochrane 中央对照试验注册库和其他 30 多个来源中进行自动定期搜索。搜索结果将根据系统评价和荟萃分析的首选报告项目流程图呈现。本综述将优先考虑针对实验和准实验研究的系统评价，以及评估不同 PPE 对参与紧急创伤手术的 HCWs 感染 COVID-19 风险的此类设计的个体研究。将对合格研究进行方法学质量的批判性评估。将使用 Covidence 中的标准化数据提取工具提取数据。在可能的情况下，将使用 JBI SUMARI 对研究进行统计荟萃分析。将遵循推荐分级、评估、发展和评估方法对证据确定性进行分级，并创建发现摘要。
本综述不需要伦理批准。传播计划是在同行评议的期刊上发表综述结果，并在有相关利益攸关方参与的高级别会议上展示研究结果。
PROSPERO 注册号：CRD42020198267。
