Basirat Reyhane, Soleimani Sevim, Shakiba Behnam, Maghsoudi Robab
School of Medicine Iran University of Medical Sciences Tehran Iran.
Student Research Committee, Faculty of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran.
Health Sci Rep. 2023 Feb 24;6(2):e1133. doi: 10.1002/hsr2.1133. eCollection 2023 Feb.
Health injustice is defined as "unnecessary, preventable, unjustified and unfair health differences." One of the most important scientific sources on the prevention and management of urolithiasis are Cochrane reviews in this field. Given that the first step in eliminating health injustice is to identify the causes, the aim of the present study was to evaluate equity considerations in Cochrane reviews and the included primary studies on urinary stones.
Cochrane reviews on kidney stones and ureteral stones were searched through the Cochrane Library. The included clinical trials in each of the reviews published after 2000 were also collected. Two different researchers reviewed all the included Cochrane reviews and primary studies. The researchers reviewed each PROGRESS criteria independently (P: place of residence, R: race/ethnicity/culture, O: occupation, G: gender, R: religion, E: education, S: socioeconomic status, S: social capital and networks). The geographical location of the included studies was categorized as low-income, middle-income and high-income countries, based on the World Bank income criteria. Each PROGRESS dimension was reported for both the Cochrane reviews and the primary studies.
In total, 12 Cochrane reviews and 140 primary studies were included in this study. None of the included Cochrane reviews had specifically mentioned the PROGRESS framework in the Method section whereas gender distribution and place of residence were reported in two and one reviews, respectively. In 134 primary studies at least one item of PROGRESS was reported. The most frequent item was gender distribution, followed by place of residence.
According to the results of this study, the authors of Cochrane systematic reviews on urolithiasis, and researchers who have conducted such trials, have rarely considered health equity dimensions when designing and performing their studies. Therefore, researchers worldwide should be motivated to study populations from low-income countries with low socioeconomic status in addition to different cultures, ethnicities, and so forth. Furthermore, RCT reporting guidelines such as CONSORT should include health equity dimensions and the editors and reviewers of scientific journals should encourage researchers to further emphasize on health equity in their studies.
健康不公正被定义为“不必要、可预防、不合理且不公平的健康差异”。关于尿石症预防与管理的最重要科学来源之一是该领域的Cochrane系统评价。鉴于消除健康不公正的第一步是找出原因，本研究的目的是评估Cochrane系统评价及其中纳入的关于尿路结石的原始研究中的公平性考量。
通过Cochrane图书馆检索关于肾结石和输尿管结石的Cochrane系统评价。还收集了2000年后发表的各系统评价中纳入的临床试验。两名不同的研究人员对所有纳入的Cochrane系统评价和原始研究进行了审查。研究人员独立审查每个PROGRESS标准（P：居住地，R：种族/民族/文化，O：职业，G：性别，R：宗教，E：教育程度，S：社会经济地位，S：社会资本和网络）。根据世界银行的收入标准，将纳入研究的地理位置分为低收入、中等收入和高收入国家。报告了Cochrane系统评价和原始研究的每个PROGRESS维度。
本研究共纳入12篇Cochrane系统评价和140项原始研究。纳入的Cochrane系统评价中没有一篇在方法部分特别提及PROGRESS框架，而分别有两篇和一篇系统评价报告了性别分布和居住地。在134项原始研究中，至少报告了一项PROGRESS项目。最常报告的项目是性别分布，其次是居住地。
根据本研究结果，关于尿石症的Cochrane系统评价的作者以及进行此类试验的研究人员在设计和开展研究时很少考虑健康公平维度。因此，除了不同文化、种族等群体外，全球研究人员应积极研究社会经济地位较低的低收入国家的人群。此外，诸如CONSORT等随机对照试验报告指南应纳入健康公平维度，科学期刊的编辑和审稿人应鼓励研究人员在其研究中进一步强调健康公平。
