实施科学（IS）在学习型卫生系统（LHS）中的应用：一项范围综述方案。

Applications of implementation science (IS) in learning health systems (LHS): a scoping review protocol.

作者信息

Huang Aimee K, Vanderkruik Rachel, Mita Carol, Argueta Salma, Bartels Stephen J

机构信息

Massachusetts General Hospital, Boston, Massachusetts, USA

Harvard Medical School, Boston, Massachusetts, USA.

出版信息

BMJ Open. 2025 Aug 12;15(8):e101596. doi: 10.1136/bmjopen-2025-101596.

DOI:10.1136/bmjopen-2025-101596

PMID:40803732

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12352175/

Abstract

INTRODUCTION

Despite advancements in biomedical and healthcare research, the translation of evidence into routine practice within healthcare systems often lags, perpetuating inefficiencies and disparities in care delivery. Learning health systems (LHS), which integrate internal data and external evidence for continuous improvement, hold promise for addressing these gaps. Implementation science (IS), focused on promoting the systematic uptake of evidence-based practices, offers a robust framework to drive sustainable improvements within LHS. However, the practical application of IS principles in LHS remains underexplored. This scoping review aims to systematically map the literature on the application of IS in LHS, highlighting themes, gaps and opportunities for advancing future practices.

METHODS AND ANALYSIS

This review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews, supported by the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. The review employs a population-concept-context framework, focusing on studies engaged in LHS activities and the application of IS principles in various healthcare settings. Relevant literature will be searched across multiple databases, including OVID/Medline, Embase, Web of Science Core Collection and Health Policy Reference Center. Eligible studies will be screened, and data will be extracted and synthesised using both quantitative and qualitative methods. Key outcomes include characterising IS applications in LHS, evaluating barriers and facilitators, exploring equity integration, and identifying knowledge gaps.

ETHICS AND DISSEMINATION

As this study does not involve primary data collection, ethical approval is not required. Findings will be disseminated through peer-reviewed publications and conference presentations to inform future research and practice.

REGISTRATION

This protocol has been registered on the Open Science Framework (DOI: 10.17605/OSF.IO/BMQ6J).

摘要

引言

尽管生物医学和医疗保健研究取得了进展，但将证据转化为医疗保健系统中的常规实践往往滞后，导致护理提供效率低下和不平等现象长期存在。学习型卫生系统（LHS）将内部数据和外部证据整合起来以持续改进，有望解决这些差距。实施科学（IS）专注于促进循证实践的系统采用，为推动LHS内的可持续改进提供了一个强大的框架。然而，IS原则在LHS中的实际应用仍未得到充分探索。本范围综述旨在系统梳理关于IS在LHS中应用的文献，突出主题、差距以及推进未来实践的机会。

方法与分析

本综述将遵循乔安娜·布里格斯研究所（JBI）的范围综述方法，并以系统评价和元分析扩展的范围综述（PRISMA-ScR）清单为支持。该综述采用人群-概念-背景框架，重点关注参与LHS活动的研究以及IS原则在各种医疗保健环境中的应用。将在多个数据库中搜索相关文献，包括OVID/Medline、Embase、科学引文索引核心合集和卫生政策参考中心。将对符合条件的研究进行筛选，并使用定量和定性方法提取和综合数据。主要结果包括描述IS在LHS中的应用、评估障碍和促进因素、探索公平整合以及识别知识差距。