Paediatric Bioethics Centre, Great Ormond Street Hospital for Children, London, UK
Centro de Bioética, Universidad del Desarrollo, Santiago, Chile.
BMJ Open. 2022 Apr 8;12(4):e057867. doi: 10.1136/bmjopen-2021-057867.
Clinical ethics support services (CESS) have been developing worldwide with growing interest in evaluating their quality. Paediatric-specific CESSs (p-CESS) have received little attention, and evidence from adult services might not be generalisable. Evidence on service models and practices is crucial to inform further research and debate on quality evaluation and minimum standards for p-CESSs. We aim to systematically identify, appraise and synthesise evidence for p-CESS structures, processes and outcomes.
We will conduct a mixed-studies systematic review including peer-reviewed empirical studies published in English or Spanish language providing data on the evaluation and/or impact on any aspect of p-CESS. We will search seven electronic databases: MEDLINE, Philosopher's Index, EMBASE, PsycINFO, LILACS, Web of Science and CINHAL, without filters applied. Search terms will be related to "clinical ethics support" AND "paediatrics" AND "structure/process/outcome". Reference and citation list of included studies will be handsearched. A 10% random sample of retrieved titles/abstracts and all full texts will be independently dual-screened. We will conduct narrative and thematic synthesis for quantitative and qualitative data, respectively, following sequential explanatory synthesis guided by Donabedian's framework of structure, process and outcomes. Quality will be assessed using the Mixed-Methods Appraisal Tool (2018). The review will be reported using the adapted Preferred Reporting Items for Systematic Reviews and Meta-Analyses for reporting systematic reviews of qualitative and quantitative evidence template. Stakeholders will be involved twice in the review process; prior to data extraction and synthesis and after preliminary results.
As a systematic review of published data, no ethical approval is necessary. Results will be published in a relevant academic peer-reviewed journal.
CRD42021280978.
临床伦理支持服务（CESS）在全球范围内得到了发展，人们对评估其质量的兴趣日益浓厚。儿科特定的 CESS（p-CESS）受到的关注较少，而来自成人服务的证据可能不具有普遍性。关于服务模式和实践的证据对于进一步研究和辩论 p-CESS 的质量评估和最低标准至关重要。我们旨在系统地识别、评估和综合 p-CESS 结构、过程和结果的证据。
我们将进行一项混合研究系统评价，包括发表在英语或西班牙语的同行评审实证研究，提供关于任何方面的 p-CESS 评估和/或影响的数据。我们将在七个电子数据库中进行搜索：MEDLINE、Philosopher's Index、EMBASE、PsycINFO、LILACS、Web of Science 和 CINHAL，不应用过滤器。搜索词将与“临床伦理支持”和“儿科学”以及“结构/过程/结果”相关。将对纳入研究的参考文献和引文列表进行手工搜索。检索标题/摘要和所有全文的 10%随机样本将由独立的双屏幕进行筛选。我们将根据 Donabedian 的结构、过程和结果框架，分别对定量和定性数据进行叙事和主题综合。使用混合方法评估工具（2018 年）评估质量。该综述将根据适用于定性和定量证据的系统评价和荟萃分析的报告系统综述的改编模板进行报告。利益相关者将在审查过程中两次参与；在数据提取和综合之前以及初步结果之后。
作为对已发表数据的系统评价，不需要伦理批准。结果将发表在相关的学术同行评审期刊上。
PROSPERO 注册号：CRD42021280978。
