Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
Upper Limb Unit, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan, UK.
BMJ Open. 2023 Aug 30;13(8):e071705. doi: 10.1136/bmjopen-2023-071705.
Total elbow replacement (TER) has higher failure rates requiring revision surgery compared with the replacement of other joints. Understanding the factors associated with failure is essential for informed decision-making between patients and clinicians, and for reducing the failure rate. This review aims to identify, describe and appraise the literature examining prognostic factors for failure of TER.
This systematic review will be conducted and reported in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Electronic literature searches will be conducted using Medline, EMBASE, PubMed and Cochrane. The search strategy will be broad, including a combination of subject headings (MESH) and free text search. This search will be supplemented with a screening of reference lists of the included studies and relevant reviews. Two independent reviewers will screen all search results in two stages (title and abstract, and full text) based on the Population, Index prognostic factor, Comparator prognostic factor, Outcome, Time and Setting criteria. The types of evidence included will be randomised trials, non-randomised trials, prospective and retrospective cohort studies, registry studies and case-control studies. If the literature lacks enough studies, then case series with 50 or more TERs will be considered for inclusion. Data extraction and risk of bias assessment for included studies will be performed by two independent reviewers using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies for Prognostic Factors and Quality In Prognostic Studies tools.Meta-analyses of prognostic estimates for each factor will be undertaken for studies that are deemed to be sufficiently robust and comparable. Several challenges are likely to arise due to heterogeneity between studies, therefore, subgroup and sensitivity analyses will be performed to account for the differences between studies. Heterogeneity will be assessed using Q and I statistics. If I>40% then pooled estimates will not be reported. When quantitative synthesis is not possible, a narrative synthesis will be undertaken. The quality of the evidence for each prognostic factor will be assessed using the Grades of Recommendation Assessment, Development and Evaluation tool.
CRD42023384756.
与其他关节置换相比，全肘置换（TER）的失败率更高，需要进行翻修手术。了解与失败相关的因素对于患者和临床医生做出明智的决策以及降低失败率至关重要。本综述旨在确定、描述和评估检查 TER 失败的预后因素的文献。
本系统评价将按照系统评价和荟萃分析方案的首选报告项目进行，并进行报告。将使用 Medline、EMBASE、PubMed 和 Cochrane 进行电子文献检索。搜索策略将广泛，包括主题词（MESH）和自由文本搜索的组合。该搜索将辅以纳入研究和相关综述的参考文献列表的筛选。两名独立审查员将根据人群、指标预后因素、比较预后因素、结局、时间和设置标准，分两个阶段（标题和摘要以及全文）筛选所有搜索结果。纳入的证据类型将包括随机试验、非随机试验、前瞻性和回顾性队列研究、登记研究和病例对照研究。如果文献中缺乏足够的研究，则将考虑纳入 50 例或更多 TER 的病例系列。两名独立审查员将使用预测模型研究的预后因素和预后研究的质量的关键评估和数据提取清单工具，对纳入研究进行数据提取和偏倚风险评估。对于被认为足够稳健和可比的研究，将对每个因素的预后估计进行荟萃分析。由于研究之间存在异质性，因此可能会出现几个挑战，因此，将进行亚组和敏感性分析以考虑研究之间的差异。使用 Q 和 I 统计量评估异质性。如果 I>40%，则不会报告汇总估计值。当无法进行定量综合时，将进行叙述性综合。使用推荐评估、制定和评估工具（Grades of Recommendation Assessment, Development and Evaluation tool）评估每个预后因素的证据质量。
CRD42023384756。
