Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
Faculty of Science, University of Ottawa, Ottawa, Canada.
Int J Equity Health. 2021 Jun 10;20(1):136. doi: 10.1186/s12939-021-01477-4.
Osteoarthritis generates substantial health and socioeconomic burden, which is particularly marked in marginalized groups. It is imperative that practitioners have ready access to summaries of evidence-based interventions for osteoarthritis that incorporate equity considerations. Summaries of systematic reviews can provide this. The present study surveyed experts to prioritize a selection ofinterventions, from which equity focused summaries will be generated. Specifically, the prioritized interventions will be developed into Cochrane Evidence4Equity (E4E) summaries.
Twenty-seven systematic reviews of OA interventions were found. From these, twenty-nine non-surgical treatments for osteoarthritis were identified, based on statistically significant findings for desired outcome variables or adverse events. Key findings from these studies were summarised and provided to 9 experts in the field of osteoarthritis.. Expert participants were asked to rate interventions based on feasibility, health system effects, universality, impact on inequities, and priority for translation into equity based E4E summaries. Expert participants were also encouraged to make comments to provide context for each rating. Free text responses were coded inductively and grouped into subthemes and themes.
Expert participants rated the intervention home land-based exercise for knee OA highest for priority for translation into an E4E summaries, followed by the interventions individual land-based exercise for knee OA, class land-based exercise for knee OA, exercise for hand OA and land-based exercise for hip OA. Upon qualitative analysis of the expert participants' comments, fifteen subthemes were identified and grouped into three overall themes: (1) this intervention or an aspect of this intervention is unnecessary or unsafe; (2) this intervention or an aspect of this intervention may increase health inequities; and (3) experts noted difficulties completing rating exercise.
The list of priority interventions and corresponding expert commentary generated information that will be used to direct and support knowledge translation efforts.
骨关节炎会产生大量的健康和社会经济负担，在弱势群体中尤为明显。从业者必须能够随时获得纳入公平考虑因素的骨关节炎循证干预措施摘要。系统评价摘要可以提供这方面的信息。本研究调查了专家，以确定一系列干预措施的优先级，从中生成关注公平问题的摘要。具体来说，这些优先级干预措施将被开发为 Cochrane Evidence4Equity（E4E）摘要。
共发现 27 篇骨关节炎干预措施的系统评价。在此基础上，根据对预期结局变量或不良事件有统计学意义的发现，确定了 29 种非手术治疗骨关节炎的方法。从这些研究中总结关键发现，并提供给 9 名骨关节炎领域的专家。专家参与者被要求根据可行性、卫生系统效果、普遍性、对不公平的影响以及转化为基于公平的 E4E 摘要的优先级对干预措施进行评分。还鼓励专家参与者发表意见，为每个评分提供背景。对自由文本回复进行归纳编码，并分为子主题和主题。
专家参与者对家庭为基础的膝关节骨关节炎运动干预措施的优先级最高，认为最适合转化为 E4E 摘要，其次是个体为基础的膝关节骨关节炎运动干预措施、集体为基础的膝关节骨关节炎运动干预措施、手部骨关节炎运动干预措施和髋关节骨关节炎的地面运动干预措施。通过对专家参与者意见的定性分析，确定了 15 个子主题，并分为三个总体主题：（1）该干预措施或其某个方面是不必要或不安全的；（2）该干预措施或其某个方面可能会增加健康不公平现象；（3）专家注意到完成评分练习存在困难。
优先级干预措施列表和相应的专家评论提供了信息，将用于指导和支持知识转化工作。
Zotero 插件
