Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Independent Consultant, Annapolis, Maryland, USA.
J Glob Health. 2022 Dec 30;12:08005. doi: 10.7189/jogh.12.08005.
The Lives Saved Tool (LiST) is a mathematical modelling tool for estimating the survival, health, and nutritional impacts of scaling intervention coverage in low- and middle-income countries (LMICs). Various nutrition interventions are included in LiST and are regularly (and independently) reviewed and updated as new data emerge. This manuscript describes our latest in-depth review of nutrition evidence, focusing on intervention efficacy, appropriate population-affected fractions, and new interventions for potential inclusion in the LiST model.
An external advisory group (EAG) was assembled to review evidence from systematic reviews on intervention-outcome (I-O) pairs for women and children under five years of age. GRADE quality was assigned to each pair based on a LiST-specific checklist to facilitate consistent decisions during the consideration. For existing interventions with new information, the EAG was asked to recommend whether to update the default efficacy values and population-affected fractions. For the new interventions, the EAG decided whether there was sufficient evidence of benefit, and in affirmative cases, information on the efficacy and affected fraction values that could be used. Decisions were based on expert group consensus.
Overall, the group reviewed 53 nutrition-related I-O pairs, including 25 existing and 28 new ones. Efficacy and population-affected fractions were updated for seven I-O pairs; three pairs were updated for efficacy estimates only, three were updated for population-affected fractions only; and nine new I-O pairs were added to the model, bringing the total of nutrition-related I-O pairs to 34. Included in the new I-O pairs were two new nutrition interventions added to LIST: zinc fortification and neonatal vitamin A supplementation.
For modelling tools like LiST to be useful, it is crucial to update interventions, efficacy and population-affected fractions as new evidence becomes available. The present updates will enable LiST users to better estimate the potential health, nutrition, and survival benefits of investing in nutrition.
生命保存工具（LiST）是一种数学建模工具，用于估计在中低收入国家（LMICs）扩大干预措施覆盖范围对生存、健康和营养的影响。LiST 中包含各种营养干预措施，并根据新出现的数据定期（独立）进行审查和更新。本文描述了我们对营养证据的最新深入审查，重点关注干预效果、适当的受影响人群比例以及可能包含在 LiST 模型中的新干预措施。
成立了一个外部顾问小组（EAG），审查了针对五岁以下妇女和儿童的干预措施-结果（I-O）对的系统评价证据。根据 LiST 特定的检查表，为每个 I-O 对分配 GRADE 质量，以促进在考虑过程中的一致决策。对于具有新信息的现有干预措施，要求 EAG 建议是否更新默认疗效值和受影响人群比例。对于新的干预措施，EAG 决定是否有足够的受益证据，在肯定的情况下，提供可用于疗效和受影响人群比例的信息。决策基于专家组的共识。
总体而言，该小组审查了 53 个与营养相关的 I-O 对，其中包括 25 个现有和 28 个新的 I-O 对。对七个 I-O 对更新了疗效和受影响人群比例；三个 I-O 对仅更新了疗效估计，三个仅更新了受影响人群比例；有九个新的 I-O 对被添加到模型中，使与营养相关的 I-O 对总数达到 34 对。包括在新的 I-O 对中的是两个被添加到 LIST 的新营养干预措施：锌强化和新生儿维生素 A 补充。
对于像 LiST 这样的建模工具，为了使其有用，必须根据新证据更新干预措施、疗效和受影响人群比例。本更新将使 LiST 用户能够更好地估计投资营养的潜在健康、营养和生存收益。
