British Columbia Women's Hospital and Health Centre, Women's Health Research Institute, Vancouver, British Columbia, Canada.
Faculty of Medicine, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
Fam Med Community Health. 2022 May;10(2). doi: 10.1136/fmch-2021-001541.
Understanding the side effects and acceptability of thermal ablation (TA) is necessary before large-scale application in screen-and-treat programmes can be justified in low-income and middle-income countries (LMICs).
Articles were selected for inclusion by two independent reviewers. Risk of bias was assessed using the Downs and Black's criteria. Summary data were extracted, and authors contacted for data when necessary. Proportions of interest and 95% CIs were estimated using a random effects model. Subgroup analysis was performed based on place of treatment and timing of post-treatment follow-up. Heterogeneity was estimated using the I.
Studies that reported one or more side effects or patient acceptability measures after treatment of the cervix using TA in women living in LMICs who completed a cervical cancer screening test. Included articles were clinical trials or observational studies available in English and published before 18 December 2020.
Ovid MEDLINE, EMBASE, CINAHL, CAB Global Health and WHO Global Index Medicus were searched for this systematic review and meta-synthesis.
A total of 1590 abstracts were screened, 84 full text papers reviewed and 15 papers selected for inclusion in the qualitative review, 10 for meta-synthesis (N=2039). Significant heterogeneity was found in screening tests used to identify women eligible for TA and in methods to ascertain side effects. The most commonly reported side effect during treatment was pain (70%, 95% CI 52% to 85%; I=98.01%) (8 studies; n=1454). No women discontinued treatment due to pain. At treatment follow-up, common side effects included vaginal discharge (72%, 95% CI 18% to 100%; I=99.55%) (5 studies; n=771) and bleeding (38%, 95% CI 15% to 64%; I=98.14%) (4 studies; n=856). Satisfaction with treatment was high in 99% (95% CI 98% to 100%; I=0.00%) of women (3 studies; n=679).
TA results in a number of common side effects, though acceptability remains high among women treated in LMICs. Standardised side effect and acceptability reporting are needed as TA becomes more readily available.
CRD42020197605.
在低收入和中等收入国家（LMICs）大规模应用筛查和治疗方案之前，有必要了解热消融（TA）的副作用和可接受性。
两名独立评审员选择纳入的文章。使用唐斯和布莱克的标准评估偏倚风险。提取汇总数据，并在必要时联系作者获取数据。使用随机效应模型估计感兴趣的比例和 95%置信区间。根据治疗地点和治疗后随访时间进行亚组分析。使用 I 估计异质性。
报告在接受 LMIC 地区接受 TA 治疗的女性中使用 TA 治疗宫颈后出现一种或多种副作用或患者可接受性指标的研究，这些女性接受了宫颈癌筛查试验。纳入的文章为临床试验或观察性研究，可用英文发表，发表时间在 2020 年 12 月 18 日之前。
对 Ovid MEDLINE、EMBASE、CINAHL、CAB Global Health 和 WHO Global Index Medicus 进行了系统评价和元合成搜索。
共筛选出 1590 篇摘要，84 篇全文论文进行了审查，15 篇论文纳入定性综述，10 篇论文进行元合成（N=2039）。用于确定符合 TA 治疗条件的女性的筛查试验和确定副作用的方法存在显著的异质性。治疗过程中最常报告的副作用是疼痛（70%，95%CI 52%至 85%；I=98.01%）（8 项研究；n=1454）。没有女性因疼痛而停止治疗。在治疗随访时，常见的副作用包括阴道分泌物（72%，95%CI 18%至 100%；I=99.55%）（5 项研究；n=771）和出血（38%，95%CI 15%至 64%；I=98.14%）（4 项研究；n=856）。3 项研究（n=679）中 99%（95%CI 98%至 100%；I=0.00%）的女性对治疗非常满意。
TA 会导致一些常见的副作用，但在 LMIC 接受治疗的女性中，接受度仍然很高。随着 TA 更容易获得，需要标准化的副作用和可接受性报告。
PROSPERO 注册号：CRD42020197605。
