常见手术干预中实践风格变化的临床和经济后果,Medicine

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常见手术干预中实践风格变化的临床和经济后果
Medicine ( IF 1.3 ) Pub Date : 2018-10-01 , DOI: 10.1097/md.0000000000012439
Mojtaba Nouhi ₁ , Mohamad Hadian ₁ , Alireza Olyaeemanesh _{2,

3}

Affiliation

背景：外科干预是应用于众多疾病的常见治疗干预之一。不同地点的实践风格的无根据的变化被认为是实践风格的变化（PSV），这会对患者的健康状况和经济后果造成不良影响。近年来，人们对手术干预的变化幅度及其对患者临床结果和资源利用的影响进行了调查。但研究结果显示，规模和后果存在相当大的异质性。我们制定了一个方案来系统地回顾当前的 PSV 文献，以解释 PSV 的严重程度及其临床和经济后果。方法：该系统评价将包括观察性和实验性研究，以调查 PSV 在常见外科干预、心血管疾病、泌尿系统和眼科疾病中的影响和后果。信息来源是科学数据库、论文、临床试验注册网站和灰色文献。将通过 PubMed、Web of Science、EBSCO、EMBASE 和 Scopus 数据库进行全面的电子搜索。研究由 2 名研究者进行系统评估。纳入研究的方法学质量通过 STROBE 和 CONSORT 检查表进行评估。在数据可用的情况下，我们将通过 CMA 软件中的荟萃分析技术汇总纳入研究的结果。亚组分析基于干预措施的类型和选定的疾病。结果：本研究获得伊朗医科大学伦理委员会的伦理批准，伦理代码：IR.IUMS.REC1395.9221504203。结果将发表在同行评审期刊上。结论：系统评价被认为是就 PSV 的规模和后果达成共识的适当科学方法。这项研究的结果将帮助临床专家获得更多关于 PSV 的知识，并鼓励他们使用一些工具，如临床指南和共同决策来减轻其后果。系统评价被认为是就 PSV 的规模和后果达成共识的适当科学方法。这项研究的结果将帮助临床专家获得更多关于 PSV 的知识，并鼓励他们使用一些工具，如临床指南和共同决策来减轻其后果。系统评价被认为是就 PSV 的规模和后果达成共识的适当科学方法。这项研究的结果将帮助临床专家获得更多关于 PSV 的知识，并鼓励他们使用一些工具，如临床指南和共同决策来减轻其后果。

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The clinical and economic consequences of practice style variations in common surgical interventions

Background: Surgical intervention is one of the common therapeutic interventions applied to a vast class of diseases. Unwarranted variation in practice style in different locations is considered as practice style variations (PSVs), which cause undesirable effects on patient health status and economic consequences. The magnitude of the variations in surgical interventions and its effects on clinical outcomes of patients and also utilization of resources have been investigated in recent years. But the findings show considerable heterogeneities in magnitude and consequences. We develop a protocol to systematically review the current literature of PSV to explain the magnitude of PSV and its clinical and economic consequences. Method: This systematic review will include observational and experimental studies to investigate magnitude and consequences of PSV in common surgical interventions, cardiovascular disease, urological, and ophthalmological diseases. Source of information is scientific databases, theses, clinical trials registrations website, and grey literature. A comprehensive electronic search will be conducted through PubMed, Web of Science, EBSCO, EMBASE, and Scopus databases. Studies are assessed systematically by 2 investigators. Methodological quality of the included studies is evaluated by the STROBE and CONSORT checklists. In case of data availability, we will pool findings of included studies by meta-analysis techniques in the CMA software. Subgroup analyses are based on the type of the interventions and selected diseases. Results: This study has ethical approval from ethical committee of Iran University of Medical Sciences, ethic code: IR.IUMS.REC1395.9221504203. The results will be published in a peer-reviewed journal. Conclusion: A systematic review is considered as an appropriate scientific method for reaching a consensus on magnitude as well as consequences of PSV. Results of this study will help clinical experts to attain more knowledge about PSV and encourage them to use some tools such as clinical guidelines and shared decision making to alleviate its consequences.

更新日期：2018-10-01

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