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全球多发性骨髓瘤患者的差异:快速证据评估。

Global disparities in patients with multiple myeloma: a rapid evidence assessment.

机构信息

University Hospital of Salamanca/IBSAL, Salamanca, Spain.

Division of Hematology/Oncology, Department of Medicine, Mayo Clinic, Jackson, FL, USA.

出版信息

Blood Cancer J. 2023 Jul 18;13(1):109. doi: 10.1038/s41408-023-00877-9.

Abstract

There are disparities in outcomes for patients with multiple myeloma (MM). We evaluated the influence of sociodemographic factors on global disparities in outcomes for patients with MM. This rapid evidence assessment (PROSPERO, CRD42021248461) followed PRISMA-P guidelines and used the PICOS framework. PubMed and Embase® were searched for articles in English from 2011 to 2021. The title, abstract, and full text of articles were screened according to inclusion/exclusion criteria. The sociodemographic factors assessed were age, sex, race/ethnicity, socioeconomic status, and geographic location. Outcomes were diagnosis, access to treatment, and patient outcomes. Of 84 articles included, 48 were US-based. Worldwide, increasing age and low socioeconomic status were associated with worse patient outcomes. In the US, men typically had worse outcomes than women, although women had poorer access to treatment, as did Black, Asian, and Hispanic patients. No consistent disparities due to sex were seen outside the US, and for most factors and outcomes, no consistent disparities could be identified globally. Too few studies examined disparities in diagnosis to draw firm conclusions. This first systematic analysis of health disparities in patients with MM identified specific populations affected, highlighting a need for additional research focused on assessing patterns, trends, and underlying drivers of disparities in MM.

摘要

多发性骨髓瘤(MM)患者的治疗结果存在差异。我们评估了社会人口因素对 MM 患者全球治疗结果差异的影响。本快速证据评估(PROSPERO,CRD42021248461)遵循 PRISMA-P 指南,并使用 PICOS 框架。从 2011 年至 2021 年,我们在 PubMed 和 Embase® 上检索了英文文章。根据纳入/排除标准筛选文章的标题、摘要和全文。评估的社会人口因素包括年龄、性别、种族/民族、社会经济地位和地理位置。结果是诊断、治疗机会和患者结局。在 84 篇文章中,有 48 篇是基于美国的。在全球范围内,年龄增长和社会经济地位较低与患者结局较差相关。在美国,男性的治疗结果通常比女性差,尽管女性获得治疗的机会较差,黑人、亚裔和西班牙裔患者也是如此。在美国以外的地区,没有观察到因性别导致的一致差异,对于大多数因素和结果,也无法在全球范围内确定一致的差异。评估诊断差异的研究太少,无法得出明确结论。这是首次对 MM 患者健康差异进行的系统分析,确定了受影响的特定人群,突出了需要更多研究来评估 MM 中差异的模式、趋势和根本驱动因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d94/10352266/e17fc42955d7/41408_2023_877_Fig1_HTML.jpg

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