Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
Centre for Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
BMJ Open. 2023 Feb 17;13(2):e067182. doi: 10.1136/bmjopen-2022-067182.
Homelessness is a major contributor to health inequalities. People who experience homelessness are at markedly increased risk of multiple and complex health morbidities which likely increase their susceptibility to early, preventable death. Despite this, the mortality burden in this group remains poorly understood, limited in part by insufficient synthesis of data at a global level. This systematic review will synthesise international literature examining rates of risk and protective factors for mortality among people who have experienced homelessness.
We will search MEDLINE, PsycINFO, Embase and PubMed for peer-reviewed cohort studies examining mortality among people who have experienced homelessness. No study eligibility restrictions will be placed on the date, country of origin, or language of publications, or age of the sample. We will assess the quality of included studies using the Methodological Standards for Epidemiological Research scale. Our measures of mortality will include: (A) incidence-all cause and cause specific, expressed as a crude mortality rate (CMR) per 1000 person-years, with 95% CI and (B) all cause and cause specific, indirectly standardised mortality ratios (SMRs) with 95%CI. Associations between risk and protective factors and all-cause and cause-specific mortality will be reported using pooled relative risk ratios with 95% CI. Where there are sufficient data, the influence of subgroup and methodological factors on CMRs, SMRs and predictive factors will be examined using meta-regression.
This study does not require institutional ethics review or approval as it will synthesise findings from published studies that have previously been granted relevant ethics approvals. Study findings will be disseminated through a peer-reviewed journal article, conference and seminar presentations. A plain language summary will be distributed through the authors' academic and professional networks.
CRD42021272937.
无家可归是造成健康不平等的一个主要因素。无家可归者罹患多种复杂健康疾病的风险明显增加，这可能使他们更容易过早死于可预防的疾病。尽管如此，由于缺乏全球范围内的数据综合，该人群的死亡率负担仍不为人知。本系统评价将综合国际文献，研究经历过无家可归的人群的死亡率的风险和保护因素。
我们将在 MEDLINE、PsycINFO、Embase 和 PubMed 中搜索同行评审的队列研究，以研究经历过无家可归的人群的死亡率。我们不会对研究的日期、来源国、出版物的语言或样本的年龄进行任何限制。我们将使用流行病学研究方法学标准量表评估纳入研究的质量。我们的死亡率衡量标准包括：（A）发生率——所有原因和特定原因，以每 1000 人年的粗死亡率（CMR）表示，并有 95%置信区间（CI）和（B）所有原因和特定原因，间接标准化死亡率比（SMR），并有 95%CI。将使用合并的相对风险比和 95%CI 报告风险和保护因素与全因和特定原因死亡率之间的关系。在有足够数据的情况下，将使用元回归检查亚组和方法因素对 CMR、SMR 和预测因素的影响。
由于本研究将综合先前已获得相关伦理批准的已发表研究的结果，因此不需要机构伦理审查或批准。研究结果将通过同行评议的期刊文章、会议和研讨会报告进行传播。将通过作者的学术和专业网络分发通俗易懂的摘要。
PROSPERO 注册号：CRD42021272937。
