Griswold Dylan, Gempeler Andrés, Rosseau Gail, Kaseje Neema, Johnson Walter D, Kolias Angelos, Hutchinson Peter J, Rubiano Andres M
National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom.
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.
JMIR Res Protoc. 2021 May 6;10(5):e25207. doi: 10.2196/25207.
Many health care facilities in low- and middle-income countries are inadequately resourced. COVID-19 has the potential to decimate surgical health care services unless health systems take stringent measures to protect health care workers from viral exposure and ensure the continuity of specialized care for patients. Among these measures, the timely diagnosis of COVID-19 is paramount to ensure the use of protective measures and isolation of patients to prevent transmission to health care personnel caring for patients with an unknown COVID-19 status or contact during the pandemic. Besides molecular and antibody tests, chest computed tomography (CT) has been assessed as a potential tool to aid in the screening or diagnosis of COVID-19 and could be valuable in the emergency care setting.
This paper presents the protocol for an umbrella review that aims to identify and summarize the available literature on the diagnostic accuracy of chest CT for COVID-19 in trauma surgery patients requiring urgent care. The objective is to inform future recommendations on emergency care for this category of patients.
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 PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis). This review will preferentially consider systematic reviews of diagnostic test accuracy studies, as well as individual studies of such design, if not included in the systematic reviews, that assessed the sensitivity and specificity of chest CT in emergency trauma surgery patients. Critical appraisal of the included studies for risk of bias will be conducted. Data will be extracted using a standardized data extraction tool. Findings will be summarized narratively, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to grade the certainty of evidence.
Ethics approval is not required for this systematic review, as there will be no patient involvement. The search for this systematic review commenced in October 2020, and we expect to publish the findings in early 2021. The plan for dissemination is to publish the findings in a peer-reviewed journal and present our results at conferences that engage the most pertinent stakeholders.
During the COVID-19 pandemic, protecting health care workers from infection is essential. Up-to-date information on the efficacy of diagnostic tests for detecting COVID-19 is essential. This review will serve an important role as a thorough summary to inform evidence-based recommendations on establishing effective policy and clinical guideline recommendations.
PROSPERO International Prospective Register of Systematic Reviews CRD42020198267; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=198267.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25207.
低收入和中等收入国家的许多医疗保健机构资源不足。除非卫生系统采取严格措施保护医护人员免受病毒感染，并确保为患者提供专科护理的连续性，否则新冠疫情有可能使外科医疗服务遭受重创。在这些措施中，及时诊断新冠病毒对于确保采取防护措施以及隔离患者以防止病毒传播给在疫情期间护理新冠病毒感染状况不明或有接触史患者的医护人员至关重要。除了分子检测和抗体检测外，胸部计算机断层扫描（CT）已被评估为辅助筛查或诊断新冠病毒的潜在工具，在急诊环境中可能具有重要价值。
本文介绍了一项伞状综述的方案，旨在识别和总结关于胸部CT对需要紧急护理的创伤外科患者新冠病毒诊断准确性的现有文献。目的是为这一类患者的未来急诊护理建议提供依据。
我们将在L·OVE（循证实时综述）平台上针对新冠病毒进行多次检索，该系统会在PubMed、Embase、Cochrane对照试验中心注册库以及其他30多个来源进行自动定期检索。检索结果将按照PRISMA（系统综述和Meta分析的首选报告项目）呈现。本综述将优先考虑诊断试验准确性研究的系统综述，以及此类设计的个别研究（若未包含在系统综述中），这些研究评估了胸部CT在急诊创伤外科患者中的敏感性和特异性。将对纳入研究的偏倚风险进行严格评估。将使用标准化数据提取工具提取数据。研究结果将进行叙述性总结，并采用推荐分级、评估、制定与评价（GRADE）方法对证据的确定性进行分级。
由于本系统综述不涉及患者参与，因此无需伦理批准。本系统综述的检索于2020年10月开始，预计2021年初公布研究结果。传播计划是在同行评审期刊上发表研究结果，并在与最相关利益相关者相关的会议上展示我们的结果。
在新冠疫情期间，保护医护人员免受感染至关重要。获取关于检测新冠病毒诊断试验有效性的最新信息至关重要。本综述将作为全面总结发挥重要作用，为制定有效政策和临床指南建议提供循证依据。
PROSPERO国际前瞻性系统综述注册库CRD42020198267；https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=198267。
国际注册报告识别号（IRRID）：PRR1-10.2196/25207。
