危重新生儿和儿童保健指南的循证证据： Cochrane 能提供帮助吗？
Evidence for perinatal and child health care guidelines in crisis settings: can Cochrane help?
机构信息
Monash Institute of Health Services Research, Monash University, Locked Bag 29, Clayton 3168 Australia.
出版信息
BMC Public Health. 2010 Mar 29;10:170. doi: 10.1186/1471-2458-10-170.
BACKGROUND
It is important that healthcare provided in crisis settings is based on the best available research evidence. We reviewed guidelines for child and perinatal health care in crisis situations to determine whether they were based on research evidence, whether Cochrane systematic reviews were available in the clinical areas addressed by these guidelines and whether summaries of these reviews were provided in Evidence Aid.
METHODS
Broad internet searches were undertaken to identify relevant guidelines. Guidelines were appraised using AGREE and the clinical areas that were relevant to perinatal or child health were extracted. We searched The Cochrane Database of Systematic Reviews to identify potentially relevant reviews. For each review we determined how many trials were included, and how many were conducted in resource-limited settings.
RESULTS
Six guidelines met selection criteria. None of the included guidelines were clearly based on research evidence. 198 Cochrane reviews were potentially relevant to the guidelines. These reviews predominantly addressed nutrient supplementation, breastfeeding, malaria, maternal hypertension, premature labour and prevention of HIV transmission. Most reviews included studies from developing settings. However for large portions of the guidelines, particularly health services delivery, there were no relevant reviews. Only 18 (9.1%) reviews have summaries in Evidence Aid.
CONCLUSIONS
We did not identify any evidence-based guidelines for perinatal and child health care in disaster settings. We found many Cochrane reviews that could contribute to the evidence-base supporting future guidelines. However there are important issues to be addressed in terms of the relevance of the available reviews and increasing the number of reviews addressing health care delivery.
背景
在危机环境中提供的医疗保健服务应基于最佳现有研究证据，这一点非常重要。我们对儿童和围产期保健危机情况的指南进行了审查，以确定它们是否基于研究证据，这些指南所涉及的临床领域是否有 Cochrane 系统评价，以及 Evidence Aid 是否提供了这些评价的摘要。
方法
广泛进行了互联网搜索以确定相关指南。使用 AGREE 对指南进行评估，并提取与围产期或儿童健康相关的临床领域。我们搜索了 Cochrane 系统评价数据库，以确定可能相关的评价。对于每一项评价，我们确定了纳入的试验数量，以及有多少试验是在资源有限的环境中进行的。
结果
符合选择标准的指南有 6 条。纳入的指南均未明确基于研究证据。有 198 项 Cochrane 评价可能与指南相关。这些评价主要涉及营养补充、母乳喂养、疟疾、孕产妇高血压、早产和预防 HIV 传播。大多数评价纳入了来自发展中环境的研究。然而，对于指南的大部分内容，特别是卫生服务提供，没有相关的评价。仅有 18 项（9.1%）评价在 Evidence Aid 中有摘要。
结论
我们没有发现任何针对灾害环境中围产期和儿童保健的循证指南。我们发现了许多 Cochrane 评价，可以为支持未来指南的证据基础做出贡献。然而，在现有评价的相关性和增加解决医疗保健提供问题的评价数量方面，仍存在重要问题需要解决。
Zotero 插件