Foot & Ankle Research and Innovation Laboratory (FARIL), Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
JBJS Rev. 2024 Sep 3;12(9). doi: e24.00071. eCollection 2024 Sep 1.
Although the prevalence of primary bone tumors (PBTs) was reported to be relatively low, they represent a difficult category of tumors for appropriate prediction, prevention, diagnosis, and treatment. Among different factors contributing to the prognosis and treatment outcomes of patients with these tumors, it is assumed that social determinants of health (SDOH) have not been well investigated nor applied in the process of decision making for these patients.
In this systematic review, databases including PubMed, Web of Science, Scopus, Embase, Science Direct, and CINAHL were used. To ensure the quality of the studies and assess them for bias, we used the Methodological Index for Nonrandomized Studies scaling tool. The relevant data were extracted from the included studies and reported.
Twenty-five studies were included in our review based on the inclusion criteria. Age, socioeconomic status, education, and employment status; place of living and neighborhood; race and ethnicity; and insurance coverage were found to impact the outcomes and prognosis of PBTs.
Literature has shown correlations of various SDOH with the outcomes of PBTs. SDOH are not independent of each other; including and interpreting them in the process of decision making should be in a multifactorial and intercalated manner. We suggest prospective studies on finding the effect of inventing with SDOH through changes in health care policies, educating patients and care providers, improving socioeconomic conditions, and providing better insurance support, on the outcomes of PBTs.
Level III. See Instructions for Authors for a complete description of levels of evidence.
尽管原发性骨肿瘤 (PBT) 的患病率相对较低，但它们代表了一类难以准确预测、预防、诊断和治疗的肿瘤。在影响这些肿瘤患者预后和治疗结果的诸多因素中，人们认为健康的社会决定因素 (SDOH) 尚未得到充分研究，也未应用于这些患者的决策过程中。
在这项系统评价中，我们使用了 PubMed、Web of Science、Scopus、Embase、Science Direct 和 CINAHL 等数据库。为了确保研究质量并评估其偏倚，我们使用了非随机研究方法学指数评估工具。从纳入的研究中提取相关数据并进行报告。
根据纳入标准，本综述共纳入了 25 项研究。研究发现，年龄、社会经济地位、教育和就业状况；居住和邻里环境；种族和民族；以及保险覆盖范围，都会影响 PBT 的结局和预后。
文献表明，各种 SDOH 与 PBT 的结局存在相关性。SDOH 不是相互独立的；在决策过程中应综合考虑并解释这些因素。我们建议进行前瞻性研究，通过改变医疗保健政策、教育患者和护理提供者、改善社会经济条件以及提供更好的保险支持，来发现 SDOH 对 PBT 结局的影响。
III 级。有关证据水平的完整描述，请参见作者指南。
