低收入和中等收入国家先天性异常新生儿手术的成本效益：一项系统评价方案
Cost-effectiveness of neonatal surgery for congenital anomalies in low-income and middle-income countries: a systematic review protocol.
作者信息
Kim Na Eun, Vervoot Dominique, Hammouri Ahmad, Riboni Cristiana, Salem Hosni, Grimes Caris, Wright Naomi Jane
机构信息
Department of General Surgery, Boston Medical Center, Boston, Massachusetts, USA.
King's College London, London, UK.
出版信息
BMJ Paediatr Open. 2020 Aug 30;4(1):e000755. doi: 10.1136/bmjpo-2020-000755. eCollection 2020.
INTRODUCTION
Congenital anomalies are the fifth leading cause of death in children under 5 years old globally (591 000 deaths reported in 2016). Over 95% of deaths occur in low-income and middle-income countries (LMICs). It is estimated that two-thirds of the congenital anomaly health burden could be averted through surgical intervention and that such interventions can be cost-effective. This systematic review aims to evaluate current evidence regarding the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.
METHODS AND ANALYSIS
A systematic literature review will be conducted in PubMed, MEDLINE, Embase, Cochrane Library, Scielo, Google Scholar, African Journals OnLine and Regional WHO's African Index Medicus databases for articles on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs. The following search strings will be used: (1) congenital anomalies; (2) LMICs; and (3) cost-effectiveness of surgical interventions. Articles will be uploaded to Covidence software, duplicates removed and the remaining articles screened by two independent reviewers. Cost information for interventions or procedures will be extracted by country and condition. Outcome measurements by reported unit and cost-effectiveness ratios will be extracted. Methodological quality of each article will be assessed using the Drummond checklist for economic evaluations. The Agency for Healthcare Research and Quality's Effective Health Care Program guidance will be followed to assess the grade of the studies.
ETHICS AND DISSEMINATION
No ethical approval is required for conducting the systematic review. There will be no direct collection of data from individuals. The finalised article will be published in a scientific journal for dissemination. The protocol has been registered with PROSPERO (International Prospective Register of Systematic Reviews).
CONCLUSION
Congenital anomalies form a large component of the global health burden that is amenable to surgical intervention. This study will systematically review the current literature on the cost-effectiveness of neonatal surgery for congenital anomalies in LMICs.
PROSPERO REGISTRATION NUMBER
CRD42020172971.
引言
先天性异常是全球5岁以下儿童的第五大死因（2016年报告有59.1万例死亡）。超过95%的死亡发生在低收入和中等收入国家（LMICs）。据估计，通过手术干预可避免三分之二的先天性异常健康负担，且此类干预具有成本效益。本系统评价旨在评估目前关于低收入和中等收入国家先天性异常新生儿手术成本效益的证据。
方法与分析
将在PubMed、MEDLINE、Embase、Cochrane图书馆、Scielo、谷歌学术、非洲在线期刊和世界卫生组织非洲地区医学索引数据库中进行系统的文献综述，以查找关于低收入和中等收入国家先天性异常新生儿手术成本效益的文章。将使用以下检索词：（1）先天性异常；（2）低收入和中等收入国家；（3）手术干预的成本效益。文章将上传至Covidence软件，去除重复项，其余文章由两名独立评审员进行筛选。将按国家和病情提取干预措施或手术的成本信息。将提取按报告单位和成本效益比进行的结果测量。将使用经济评价的德拉蒙德清单评估每篇文章的方法学质量。将遵循美国医疗保健研究与质量局的有效医疗保健计划指南评估研究的等级。
伦理与传播
进行系统评价无需伦理批准。不会直接从个人收集数据。最终定稿的文章将发表在科学期刊上以供传播。该方案已在PROSPERO（国际系统评价前瞻性注册库）注册。
结论
先天性异常是全球健康负担的重要组成部分，适合进行手术干预。本研究将系统综述目前关于低收入和中等收入国家先天性异常新生儿手术成本效益的文献。
PROSPERO注册号：CRD42020172971。
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