揭示知识生成和指导方针开发中的代表性差异
Carlos P B Almeida1,2, Afom T Andom3,4, Alain Casseus4,5
1Universidade Federal Do Sul E Sudeste Do Pará, Marabá, Brazil.
BMC health services research
|November 30, 2024
概括
来自低收入和中低收入国家 (LLMICs) 的全球卫生专家在制定多药耐药结核病 (MDR/RR-TB) 指南和研究方面代表性不足. 这种知识差距影响了指导方针的相关性,并可能加剧健康不平等.
科学领域:
- 全球健康 全球健康
- 传染病流行病学 传染病流行病学
- 卫生政策和健康研究
背景情况:
- 多药耐药结核病 (MDR/RR-TB) 构成了全球重大健康威胁,主要影响低收入和中低收入国家 (LLMICs).
- 世界卫生组织 (WHO) 为解决MDR/RR-TB提供了关键的指导,但这些指导和相关知识的来源需要审查.
- 这项研究调查了来自高负担国家的专家在全球卫生脱殖的背景下在知识生成中的代表性.
研究的目的:
- 评估全球卫生指导和有关MDR/RR-TB的相关知识是由受影响最严重的国家的专家生成的程度.
- 分析参与世卫组织MDR/RR-TB准则开发小组 (GDGs) 和相关同行评审出版物的专家的地理分布.
- 将研究结果置于全球卫生脱殖的更广泛运动中的背景,并解决认识不公正问题.
主要方法:
- 审查了世卫组织在2016年至2022年期间的MDR/RR-TB治疗指南开发小组 (GDGs) 的组成.
- 根据其附属国家的MDR/RR-TB负担和世界银行收入水平,分类GDG成员和指南相关出版物的作者 (2016-2023年).
- 搜索了PubMed的同行评审出版物,这些出版物来自与世卫组织指南审查相关的个人患者数据元分析.
主要成果:
- 在2016-2022年期间,33个高负担的MDR/RR-TB国家中有72.1%是LLMIC,没有一个是高收入国家.
- 只有30.3%的世卫组织GDG成员和10.4%的相关出版物的作者来自LLMIC.
- 来自高负担的MDR/RR-TB国家的代表占世卫组织GDG成员的34.3%,出版作者的14.7%.
结论:
- 在MDR/RR-TB负担的地理分布和专家参与知识和指导生成之间存在显著的不平衡.
- 这种差异可能导致指导方针的拒绝,资金问题,以及由于与当地的疾病流行病学不匹配而加剧的健康不平等.
- 建议采取强制性LLMIC参与研究资助和更广泛地纳入指导方针委员会等改革措施,以解决认识不公正并提高相关性.
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