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报告加拿大青少年特发性关节炎随机对照试验中健康不公平决定因素和参与者特征:范围综述。

Reporting of determinants of health inequities and participant characteristics in randomized controlled trials of juvenile idiopathic arthritis in Canada: a scoping review.

机构信息

Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, V6T 1Z3, Vancouver, BC, Canada.

Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada.

出版信息

Pediatr Rheumatol Online J. 2023 Nov 6;21(1):134. doi: 10.1186/s12969-023-00917-5.

Abstract

BACKGROUND

Juvenile Idiopathic Arthritis (JIA) is the most common form of childhood inflammatory arthritis. The disease burden of JIA is substantial as patients require specialized medical practitioners for diagnosis and chronic treatments that are both costly and time intensive. Discrepancies in access to care due to health inequities such as socioeconomic status or geographic location may lead to vastly different health outcomes. As research informs advances in care, is important to consider inclusion and diversity in JIA research.

METHODS

We reviewed and synthesized randomized controlled trials for juvenile idiopathic arthritis, the most common type of arthritis among children and adolescents, in Canada with the aim of characterizing participants and identifying how determinants of health inequities are reported. To do so, we searched Medline (1990 to July 2022), Embase (1990 to July 2022), and CENTRAL (inception to July 2022) for articles meeting all of the following criteria: Canadian randomized controlled trials evaluating pharmacological or non-pharmacological interventions on juvenile idiopathic arthritis populations. Data extraction was guided by the Campbell and Cochrane Equity Methods Group's PROGRESS-Plus framework on determinants that lead to health inequities (e.g., Place of residence; Race; Occupation; Gender/Sex; Religion; Education; Socioeconomic status; and Social capital).

RESULTS

Of 4,074 unique records, 5 were deemed eligible for inclusion. From these determinants of health inequities, Gender/Sex and Age were the only that were reported in all studies with most participants being female and 12.6 years old on average. In addition, Race, Socioeconomic status, Education and Features of relationships were each reported once in three different studies. Lastly, Place of residence, Occupation, Religion, Social Capital and Time-dependent relationships were not reported at all.

CONCLUSIONS

This scoping review suggests limited reporting on determinants of health inequities in randomized controlled trials for JIA in Canada and a need for a reporting framework that reflects typical characteristics of juvenile patient populations.

摘要

背景

幼年特发性关节炎(JIA)是儿童中最常见的炎症性关节炎形式。由于患者需要专门的医疗从业者进行诊断和慢性治疗,这些治疗既昂贵又耗时,因此 JIA 的疾病负担很大。由于健康不平等(如社会经济地位或地理位置)导致的获得护理的差异可能导致截然不同的健康结果。随着研究为护理提供信息,考虑 JIA 研究中的纳入和多样性非常重要。

方法

我们对加拿大儿童和青少年中最常见的关节炎类型——幼年特发性关节炎的随机对照试验进行了综述和综合分析,目的是描述参与者并确定健康不平等的决定因素是如何报告的。为此,我们在 Medline(1990 年至 2022 年 7 月)、Embase(1990 年至 2022 年 7 月)和 CENTRAL(成立至 2022 年 7 月)中搜索符合以下所有标准的文章:评估药物或非药物干预对幼年特发性关节炎人群的加拿大随机对照试验。数据提取由 Campbell 和 Cochrane 公平方法组的 PROGRESS-Plus 框架指导,该框架针对导致健康不平等的决定因素(例如,居住地;种族;职业;性别/性别;宗教;教育;社会经济地位;和社会资本)。

结果

在 4074 条独特记录中,有 5 条被认为符合纳入标准。在这些健康不平等的决定因素中,性别/性别和年龄是所有研究中唯一报告的因素,大多数参与者为女性,平均年龄为 12.6 岁。此外,种族、社会经济地位、教育和关系特征在三项不同的研究中各报告了一次。最后,居住地、职业、宗教、社会资本和时变关系根本没有报告。

结论

这项范围综述表明,加拿大 JIA 随机对照试验中对健康不平等决定因素的报告有限,需要一个反映青少年患者群体典型特征的报告框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65cc/10629131/df91658958c3/12969_2023_917_Fig1_HTML.jpg

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