剖析不平等:创伤临床指导的全球系统审查
Gabriela Zavala Wong1,2,3, Maclean S Panshin4, Tina Samsamshariat5
1Sociedad de Cirujanos Generales del Peru, Lima, Peru.
Trauma surgery & acute care open
|September 9, 2025
概括
这次审查发现,全球创伤临床指导主要由高收入国家制造,低收入和中等收入国家的代表性有限. 方法学专家的参与显著提高了指导质量,但仍然未得到充分利用.
科学领域:
- 创伤护理 创伤护理
- 临床实践指南 临床实践指南
- 全球卫生平等全球卫生平等
背景情况:
- 临床实践指导有助于基于证据,经验和患者价值观的决策.
- 加强医疗保健系统需要高质量,可访问的临床指导.
研究的目的:
- 评估全球创伤临床指导的可访问性,相关性和质量.
- 确定影响创伤临床实践指南质量的因素.
主要方法:
- 从八个数据库和28个社会网站上对创伤相关的临床指导 (2016-2023) 的系统审查.
- 评估108份指导文件,使用国家指导清算中心 (NEATS) 的"信誉标准的遵守程度"得分卡.
- 分析作者来源,访问成本和质量指标.
主要成果:
- 大多数指导来自高收入国家 (HIC),低收入和中等收入国家 (LMIC) 的投入有限.
- 82%的指导是开放式的;付费资源平均为45.7美元,可能会阻碍LMIC访问.
- 平均NEATS质量得分为3.81/5;方法专家参与是高质量的唯一预测因素 (≥4).
结论:
- 创伤指南主要包括HIC作者,尽管LMIC的伤害负担更高.
- 加强指导需要促进LMIC作者权,多区域合作,并解决访问障碍 (成本,语言).
- 涉及方法专家对于提高临床实践指南的质量至关重要.
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