Chan Vincy, Estrella Maria Jennifer, Babineau Jessica, Colantonio Angela
KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Front Med (Lausanne). 2022 Jul 22;9:815660. doi: 10.3389/fmed.2022.815660. eCollection 2022.
When used optimally, clinical practice guidelines (CPGs) can reduce inappropriate variations in practice, improve application of research to practice, and enhance the quality of healthcare. However, a common criticism, despite its potential, is the lack of consideration for equity and disadvantaged populations.
This protocol is for a systematic review of CPGs for traumatic brain injury (TBI) and homelessness that aims to assess (1) the extent to which evidence regarding TBI and homelessness is integrated in CPGs for homelessness and TBI, respectively, and (2) equity considerations in CPGs for TBI and homelessness.
The methodology for this review is guided by the PRISMA-P, validated search filters for CPGs, and methodological guides to searching systematic reviews and gray literature. CPGs will be identified from (a) databases for peer-reviewed literature (MEDLINE, Embase, CINAHL, and PsycInfo), (b) targeted websites and Google Search for gray literature, and (c) reference lists of peer-reviewed and gray literature that meet the eligibility criteria. Searching for gray literature, including from guideline-specific resources, is a critical component of this review and is considered an efficient approach to identifying CPGs, given the low precision of searching peer-reviewed databases. Two independent reviewers will screen all articles based on pre-determined eligibility criteria. A narrative synthesis will be conducted to identify the proportion of CPGs that integrate evidence about TBI and homelessness and how TBI and homelessness is or is not integrated in CPGs. Quality appraisal will take the form of an equity assessment of CPGs and will be completed independently by two reviewers.
This protocol outlines the methodology for a systematic review of CPGs for TBI and homelessness. The resulting systematic review from this protocol will form an evidence-based foundation to advance CPGs for individuals with lived experience of TBI and homelessness.
identifier: CRD42021287696.
临床实践指南（CPG）若得到最佳应用，可减少实践中的不当差异，促进研究成果在实践中的应用，并提高医疗保健质量。然而，尽管其具有潜力，但常见的批评是缺乏对公平性和弱势群体的考虑。
本方案旨在对创伤性脑损伤（TBI）和无家可归者的临床实践指南进行系统评价，以评估（1）关于TBI和无家可归者的证据分别在无家可归者和TBI的CPG中整合的程度，以及（2）TBI和无家可归者的CPG中的公平性考量。
本评价的方法遵循PRISMA-P、经过验证的CPG搜索过滤器以及搜索系统评价和灰色文献的方法指南。CPG将从以下来源识别：（a）同行评审文献数据库（MEDLINE、Embase、CINAHL和PsycInfo），（b）目标网站和谷歌搜索灰色文献，以及（c）符合纳入标准的同行评审和灰色文献的参考文献列表。搜索灰色文献，包括来自特定指南资源的文献，是本评价的关键组成部分，鉴于搜索同行评审数据库的精度较低，这被认为是识别CPG的有效方法。两名独立评审员将根据预先确定的纳入标准筛选所有文章。将进行叙述性综合分析，以确定整合了TBI和无家可归者证据的CPG的比例，以及TBI和无家可归者在CPG中是如何或未被整合的。质量评估将采取对CPG进行公平性评估的形式，并将由两名评审员独立完成。
本方案概述了对TBI和无家可归者的CPG进行系统评价的方法。本方案产生的系统评价将为推进针对有TBI和无家可归经历者的CPG奠定循证基础。
标识符：CRD42021287696。
