Foremnik Karolina, Sroczynski Gaby, Stratil Jan, Neumann Anja, Buchberger Barbara
Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
UMIT TIROL - University for Health Sciences and Technology, Institute of Public Health, Medical Decision Making und HTA, Hall in Tirol, Austria.
PLoS One. 2025 Mar 10;20(3):e0318792. doi: 10.1371/journal.pone.0318792. eCollection 2025.
PURPOSE: Children and adolescents experiencing psychiatric crises often undergo inpatient treatment, which may limit family involvement, stigmatize young individuals, and impede the application of therapeutic outcomes in their daily lives. This situation can result in increased rates of rehospitalization, the development of chronic conditions, and prolonged hospital stays. Home-based treatment represents a potential alternative to traditional inpatient care. The objective of the planned systematic review is to provide a comprehensive comparison of the effectiveness and cost-effectiveness of inpatient and home-based treatment modalities, with a particular focus on primary outcome parameters such as psychopathology, family functioning, and social functioning. Furthermore, secondary outcomes, including rates of relapses and rehospitalizations, will be evaluated. METHODS: The systematic search will be conducted using Medline, Embase, PsycInfo and Cochrane databases, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The included studies will undergo a rigorous quality assessment using the Cochrane Risk of Bias (RoB2) tool for randomized trials and the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool for non-randomized studies. Where appropriate, data will be synthesized by meta-analysis using R-Studio and supplemented by sensitivity analyses to assess the robustness of the results. The overall quality of the evidence is assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. DISCUSSION: The planned systematic literature review will provide a synthesis of the current state of research on the comparative effectiveness of both treatment modalities. The objective is to furnish information for the delivery of effective patient care that also represents a cost-efficient solution for the healthcare system. SYSTEMATIC REVIEW REGISTRATION: This review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42023458888.
目的：经历精神危机的儿童和青少年常常接受住院治疗，这可能会限制家庭参与，给年轻人带来污名化，并阻碍治疗成果在他们日常生活中的应用。这种情况可能导致再住院率上升、慢性病的发展以及住院时间延长。居家治疗是传统住院护理的一种潜在替代方案。这项计划中的系统评价的目的是全面比较住院治疗和居家治疗方式的有效性和成本效益，特别关注精神病理学、家庭功能和社会功能等主要结局参数。此外，还将评估包括复发率和再住院率在内的次要结局。 方法：将按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，使用Medline、Embase、PsycInfo和Cochrane数据库进行系统检索。纳入的研究将使用Cochrane偏倚风险（RoB2）工具对随机试验进行严格的质量评估，并使用非随机干预研究中的偏倚风险（ROBINS-I）工具对非随机研究进行评估。在适当的情况下，将使用R-Studio通过荟萃分析合成数据，并辅以敏感性分析以评估结果的稳健性。使用推荐分级、评估、制定和评价（GRADE）框架评估证据的总体质量。 讨论：计划中的系统文献综述将综合目前关于两种治疗方式比较有效性的研究现状。目的是为提供有效的患者护理提供信息，这对医疗保健系统来说也是一种具有成本效益的解决方案。 系统评价注册：本综述方案已在国际前瞻性系统评价注册库（PROSPERO）注册，注册号为CRD42023458888。
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