Sabongi Rodrigo Guerra, Moraes Vinicius Ynoe de, Santos João Baptista Gomes Dos, Civile Vinicius Tassoni, Carvas Junior Nelson, Faloppa Flávio
Disciplina de Cirurgia da Mão e Membro Superior, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Programa de Pós-graduação em Saúde Baseada em Evidência, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ortop (Sao Paulo). 2025 Sep 8;60(3):s00451811595. doi: 10.1055/s-0045-1811595. eCollection 2025 Jun.
To compare the effectiveness and safety of surgical and injection-based interventions for Dupuytren's disease (DD) using systematic review and network meta-analysis methodology.
The current protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and is registered in The International Prospective Register of Systematic Reviews (PROSPERO). Randomized controlled trials involving adult patients with DD treated by surgical (e.g., fasciectomy, fasciotomy) or injection-based interventions (e.g., collagenase, corticosteroids) must be included. A comprehensive search must be conducted across MEDLINE, CENTRAL, EMBASE, LILACS, IBECS, and trial registries, without language or date restrictions. Two reviewers must perform independent screening, data extraction, and risk of bias assessment (RoB2). Primary outcomes must include functional improvement and adverse effects. Secondary outcomes must include recurrence, range of motion, and pain. Data synthesis should involve random-effects pairwise and network meta-analyses, with GRADE used to assess certainty of evidence. Subgroup analyses should explore heterogeneity based on clinical and methodological variables.
This proposal of review aims to generate comparative estimates of effectiveness and safety across all eligible interventions, incorporating both direct and indirect evidence. Functional outcomes must be synthesized using a predefined hierarchy of patient-reported outcome measures (PROMs), and treatments must be ranked based on efficacy and safety profiles.
The present systematic review aims to fill current evidence gaps by comparing all relevant interventions for DD, supporting clinical decision-making through robust synthesis of functional and safety outcomes.
采用系统评价和网络荟萃分析方法，比较手术和注射干预治疗掌腱膜挛缩症（DD）的有效性和安全性。
本方案遵循系统评价和荟萃分析方案的首选报告项目（PRISMA-P）指南，并已在国际前瞻性系统评价注册库（PROSPERO）中注册。必须纳入涉及接受手术（如筋膜切除术、筋膜切开术）或注射干预（如胶原酶、皮质类固醇）治疗的成年DD患者的随机对照试验。必须在MEDLINE、CENTRAL、EMBASE、LILACS、IBECS和试验注册库中进行全面检索，无语言或日期限制。两名评审员必须独立进行筛选、数据提取和偏倚风险评估（RoB2）。主要结局必须包括功能改善和不良反应。次要结局必须包括复发、活动范围和疼痛。数据合成应包括随机效应成对和网络荟萃分析，使用GRADE评估证据的确定性。亚组分析应根据临床和方法学变量探索异质性。
本综述方案旨在通过纳入直接和间接证据，对所有符合条件的干预措施的有效性和安全性进行比较估计。必须使用预先定义的患者报告结局测量（PROMs）层次结构来综合功能结局，并根据疗效和安全性概况对治疗进行排名。
本系统评价旨在通过比较DD的所有相关干预措施，填补当前的证据空白，通过对功能和安全性结局的有力综合来支持临床决策。
