心脏康复对糖尿病患者与非糖尿病患者死亡率和发病率的影响：系统评价与荟萃分析方案
Impact of cardiac rehabilitation on mortality and morbidity in diabetic versus non-diabetic patients: protocol for a systematic review and meta-analysis.
作者信息
Dababneh Emad Hanna, Saha Sumanta, Östlundh Linda, Al-Rifai Rami H, Oulhaj Abderrahim
机构信息
Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.
Academic Affairs, Tawam Hospital, Al Ain, UAE.
出版信息
BMJ Open. 2021 Apr 13;11(4):e047134. doi: 10.1136/bmjopen-2020-047134.
BACKGROUND
Cardiac rehabilitation (CR) decreases the morbidity and mortality risk among patients with cardiac diseases; however, the impact of CR on patients with diabetes remains underexplored. This is a protocol for a systematic review and meta-analysis methodology to explore if the effect of CR on mortality and morbidity is the same in patients with type 2 diabetes compared with patients without diabetes.
METHODS AND ANALYSIS
Interventional and non-interventional studies comparing the effect of CR, for at least 1 month, on all-cause mortality and cardiovascular outcomes including fatal and non-fatal myocardial infarction, revascularisation and rehospitalisation in adults with cardiac diseases will be deemed eligible for inclusion. Studies published between 1990 and 2020 will be searched in PubMed, Embase, Cochrane, CINAHL, Scopus and in registries for randomised controlled trials. Eligible studies will be selected using the Covidence software, and their salient details regarding the design, population, tested interventions and outcomes of interest will be gathered. The quality of studies to be deemed eligible and reviewed will be assessed using the Cochrane Collaboration and National Heart, Lung, and Blood Institute's tools. The appraisal process will be based on the study design (interventional and non-interventional). In the meta-analysis step, the pooled effect of CR on the outcomes will be estimated. All meta-analyses will be done using the random-effects model approach (inverse-variance method). and p value of χ statistics will guide the heterogeneity assessment. Subgroup analyses will also be performed. The small study effect will be investigated by generating the funnel plots. The symmetry of the latter will be tested by performing Egger's test.
ETHICS AND DISSEMINATION
The systematic review will use data from published literature; hence, no ethical approval will be required. Findings of the systematic review and meta-analysis will be published in peer-reviewed international journals and will be disseminated in local and international scientific meetings.
PROSPERO REGISTRATION NUMBER
CRD42020148832.
背景
心脏康复（CR）可降低心脏病患者的发病和死亡风险；然而，CR对糖尿病患者的影响仍未得到充分研究。这是一项关于系统评价和荟萃分析方法的方案，旨在探讨CR对2型糖尿病患者与非糖尿病患者的死亡率和发病率的影响是否相同。
方法与分析
比较CR（至少1个月）对心脏病成年患者全因死亡率和心血管结局（包括致命和非致命性心肌梗死、血运重建和再次住院）影响的干预性和非干预性研究将被视为符合纳入标准。将在PubMed、Embase、Cochrane、CINAHL、Scopus以及随机对照试验注册库中检索1990年至2020年间发表的研究。将使用Covidence软件选择符合条件的研究，并收集其关于设计、人群、测试干预措施和感兴趣结局的突出细节。将使用Cochrane协作网和美国国立心肺血液研究所的工具评估符合条件并进行综述的研究质量。评估过程将基于研究设计（干预性和非干预性）。在荟萃分析步骤中，将估计CR对结局的合并效应。所有荟萃分析将使用随机效应模型方法（逆方差法）进行。χ统计量的p值将指导异质性评估。还将进行亚组分析。将通过生成漏斗图来研究小研究效应。将通过进行Egger检验来测试后者的对称性。
伦理与传播
该系统评价将使用已发表文献中的数据；因此，无需伦理批准。系统评价和荟萃分析的结果将发表在同行评审的国际期刊上，并将在本地和国际科学会议上传播。
PROSPERO注册号：CRD42020148832。
Zotero 插件