Obstetrics and Gynaecology, Amsterdam UMC Location AMC, Amsterdam, Netherlands
Pregnancy Sickness Support, 19G Normandy Way, Bodmin, UK.
BMJ Open. 2022 Sep 6;12(9):e052687. doi: 10.1136/bmjopen-2021-052687.
Knowledge gaps regarding hyperemesis gravidarum (HG) are substantial. We aimed to systematically identify and map recent evidence addressing the top 10 priority questions for HG, as published in 2021 in a James Lind Alliance Priority Setting Partnership.
Systematic evidence map.
We searched MEDLINE and EMBASE on 12 January 2021 and CINAHL on 22 February 2021 with search terms hyperemesis gravidarum, pernicious vomiting in pregnancy and their synonyms. Results were limited to 2009 onwards. Two reviewers independently screened titles and abstracts to assess whether the studies addressed a top 10 priority questions for HG. Differences were discussed until consensus was reached. Publications were allocated to one or more top 10 research questions. Study design was noted, as was patient or public involvement. Two reviewers extracted data synchronously and both cross-checked 10%. Extracted data were imported into EPPI-Reviewer software to create an evidence map.
The number and design of studies in the search yield, displayed per the published 10 priority questions.
Searches returned 4338 results for screening; 406 publications were included in the evidence map. 136 publications addressed multiple questions. Numerous studies address the immediate and long-term outcomes or possible markers for HG (question 8 and 9, respectively 164 and 82 studies). Very few studies seek a possible cure for HG (question 1, 8 studies), preventative treatment (question 4, 2 studies) or how to achieve nutritional requirements of pregnancy (question 10, 17 studies). Case reports/series were most numerous with 125 (30.7%) included. Few qualitative studies (9, 2.2%) were identified. 25 (6.1%) systematic reviews addressed eight questions, or aspects of them. 31 (7.6%) studies included patient involvement.
There are significant gaps and overlap in the current HG literature addressing priority questions. Researchers and funders should direct their efforts at addressing the gaps in the top 10 questions.
关于妊娠剧吐（HG）的知识差距很大。我们旨在系统地识别和绘制最近的证据，这些证据涉及 2021 年詹姆斯林德联盟优先设置伙伴关系中公布的 HG 的前 10 个优先问题。
系统的证据图。
我们于 2021 年 1 月 12 日在 MEDLINE 和 EMBASE 上搜索，于 2021 年 2 月 22 日在 CINAHL 上搜索，使用的搜索词为妊娠剧吐、妊娠恶阻及其同义词。结果仅限于 2009 年以后。两名审查员独立筛选标题和摘要，以评估研究是否解决了 HG 的前 10 个优先问题之一。有分歧的地方进行了讨论，直到达成共识。出版物被分配到一个或多个前 10 个研究问题。注意研究设计，以及患者或公众的参与情况。两名审查员同步提取数据，并交叉检查 10%。提取的数据被输入 EPPI-Reviewer 软件，以创建证据图。
按公布的 10 个优先问题显示，搜索结果中的研究数量和设计。
搜索结果返回了 4338 个筛选结果；406 篇出版物被纳入证据图。136 篇出版物涉及多个问题。许多研究都关注 HG 的近期和长期结果或可能的标志物（问题 8 和 9，分别有 164 项和 82 项研究）。很少有研究试图寻找 HG 的可能治疗方法（问题 1，8 项研究）、预防治疗（问题 4，2 项研究）或如何满足妊娠的营养需求（问题 10，17 项研究）。病例报告/系列最多，有 125 项（30.7%）被纳入。很少有定性研究（9 项，2.2%）被确定。25 项（6.1%）系统评价涉及 8 个问题或其中的部分问题。31 项（7.6%）研究包括患者参与。
目前关于 HG 的文献在解决优先问题方面存在重大差距和重叠。研究人员和资助者应集中精力解决前 10 个问题中的差距。
