美国子宫内膜癌诊断和治疗及时性的差异及干预措施：范围综述方案
Disparities and interventions in the timeliness of endometrial cancer diagnosis and treatment in the United States: a scoping review protocol.
机构信息
Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
出版信息
Syst Rev. 2021 Apr 13;10(1):107. doi: 10.1186/s13643-021-01649-x.
BACKGROUND
Disparities in the stage at diagnosis of endometrial cancer (EC) account for a significant proportion of the disparities in morbidity and mortality experienced by vulnerable groups in the USA. Evidence suggests that disparities in timeliness of care and treatment play a significant role in stage at diagnosis. Despite an increase in literature on EC disparities, the issue remains largely unchanged. The objectives of this review will be to synthesize the evidence to identify important remaining research questions and inform future interventions to reduce the disparity in stage at diagnosis of EC in the USA.
METHODS
This scoping review protocol will use the five-step framework developed by Arksey and O'Malley. A literature search will be conducted from January 2000 onwards in PubMed, EMBASE, Scopus, and Cochrane CENTRAL databases. Studies on delays in care of EC will be included if they were published in English and reported findings for the US population. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality and bias will be appraised using appropriate tools. A narrative summary of findings will be conducted. Data analysis will involve quantitative (e.g., frequencies) and qualitative (e.g., content and thematic analysis) methods. The literature search, data extraction, and evidence synthesis will be informed by the Pathway to Treatment Model, which divides time to cancer care initiation into appraisal, help-seeking, diagnostic, and pre-treatment intervals. Results will be reported in accordance with the PRISMA statement.
DISCUSSION
EC disparities research is currently benefitting form a growing expectation that studies have a real impact on disparities. Patient, healthcare, and disease factors impact the amount of time patients spend in different intervals of the Pathway to Treatment Model, so research and interventions aimed at reducing disparities in EC survival should be designed with cognizance to how these factors impact their target population. Reviews on disparities in stage at diagnosis of EC exist but do not provide a comprehensive picture of the pathway to treatment. This review will seek to provide an expanded bedrock of evidence for future studies to build on as they aim to more actively reduce EC disparities.
TRIAL REGISTRATION
Open Science Framework ( osf.io/v2zxy ).
背景
在美国，弱势群体在子宫内膜癌（EC）诊断时的分期差异导致发病率和死亡率存在显著差异，这一差异占很大比例。有证据表明，护理和治疗及时性方面的差异在诊断时的分期中起着重要作用。尽管关于 EC 差异的文献有所增加，但这一问题仍然基本没有改变。本综述的目的是综合证据，确定重要的遗留研究问题，并为未来减少美国 EC 诊断分期差异的干预措施提供信息。
方法
本范围综述将使用 Arksey 和 O'Malley 开发的五步框架。将从 2000 年 1 月开始在 PubMed、EMBASE、Scopus 和 Cochrane CENTRAL 数据库中进行文献检索。如果研究发表于英文且报告了美国人群的发现，则将包括 EC 护理延迟的研究。两名评审员将独立筛选所有引文、全文文章和摘要数据。将使用适当的工具评估研究方法学质量和偏倚。将进行发现的叙述性总结。数据分析将涉及定量（例如，频率）和定性（例如，内容和主题分析）方法。文献检索、数据提取和证据综合将遵循治疗途径模型，该模型将癌症护理开始时间分为评估、寻求帮助、诊断和治疗前间隔。结果将按照 PRISMA 声明报告。
讨论
EC 差异研究目前受益于一种日益增长的期望，即研究对差异有真正的影响。患者、医疗保健和疾病因素影响患者在治疗途径模型的不同间隔中花费的时间，因此旨在减少 EC 生存差异的研究和干预措施应在设计时考虑到这些因素如何影响其目标人群。关于 EC 诊断分期差异的综述已经存在，但没有提供治疗途径的全面情况。本综述将试图为未来的研究提供更广泛的证据基础，以便他们在努力更积极地减少 EC 差异时可以在此基础上进行研究。
试验注册
开放科学框架（osf.io/v2zxy）。
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