PDF(Pubmed)
Abstract：
Despite its prohibition by the United Nations Convention against Torture and other international treaties, torture has been perpetrated against countless individuals worldwide, and health care practitioners globally are increasingly encountering refugee torture survivors in their clinical practices. The methods, geographic distribution, and frequency of torture globally are not well described, which limits health care practitioners\' ability to adequately diagnose and treat the sequelae of torture.
To rank the commonness of torture methods and identify the regions of the world with which they are associated.
For this systematic review and meta-analysis, Ovid MEDLINE, Ovid Embase, Web of Science, and The Cochrane Library were searched from inception to July 2021.
Included studies were peer-reviewed articles in English, contained an independent sample population of individuals who experienced torture, and outlined the type(s) of torture experienced. Excluded studies were not peer reviewed, lacked an independent sample population, or did not specify torture methods. Articles were chosen for inclusion by 2 independent and blinded reviewers, and a third, independent reviewer resolved discrepancies. Overall, 266 articles-15.3% of the 1739 studies initially identified for full review-met the inclusion criteria.
Data abstraction and quality assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 2 independent and blinded reviewers into predefined templates, and a third, independent reviewer resolved discrepancies. The risk of bias was evaluated using the Downs and Black Checklist.
Torture methods were ranked by their average frequencies, numbers of reporting studies, and numbers of countries wherein the methods occurred.
A total of 9937 titles and abstracts were screened, and 266 studies encompassing 103 604 individuals (13 350 men, 5610 women, and 84 644 unspecified) were analyzed. Torture was reported for 105 countries; 21 methods accounted for 84% of all reported methods and 10 methods accounted for 78% of all physical tortures. The top 3 methods were beating or blunt-force trauma (reported in 208 studies and 59 countries; average frequency, 62.4%; 95% CI, 57.7%-67.1%), electrical torture (reported in 114 studies and 28 countries; average frequency, 17.2%; 95% CI, 15.0%-19.4%), and starvation or dehydration (reported in 65 studies in 26 countries; average frequency, 12.7%; 95% CI, 10.2%-15.2%). According to the Downs and Black appraisal tool, 50 studies were rated as good or excellent and 216 as fair or poor.
The findings of this study suggest that torture remains widespread. Although innumerable torture methods exist, a limited number account for the vast majority of reported tortures. So that targeted therapies may be developed, additional investigation is needed to better elucidate the sequelae associated with the most common torture methods, described here.
To rank the commonness of torture methods and identify the regions of the world with which they are associated.
For this systematic review and meta-analysis, Ovid MEDLINE, Ovid Embase, Web of Science, and The Cochrane Library were searched from inception to July 2021.
Included studies were peer-reviewed articles in English, contained an independent sample population of individuals who experienced torture, and outlined the type(s) of torture experienced. Excluded studies were not peer reviewed, lacked an independent sample population, or did not specify torture methods. Articles were chosen for inclusion by 2 independent and blinded reviewers, and a third, independent reviewer resolved discrepancies. Overall, 266 articles-15.3% of the 1739 studies initially identified for full review-met the inclusion criteria.
Data abstraction and quality assessment followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data were extracted by 2 independent and blinded reviewers into predefined templates, and a third, independent reviewer resolved discrepancies. The risk of bias was evaluated using the Downs and Black Checklist.
Torture methods were ranked by their average frequencies, numbers of reporting studies, and numbers of countries wherein the methods occurred.
A total of 9937 titles and abstracts were screened, and 266 studies encompassing 103 604 individuals (13 350 men, 5610 women, and 84 644 unspecified) were analyzed. Torture was reported for 105 countries; 21 methods accounted for 84% of all reported methods and 10 methods accounted for 78% of all physical tortures. The top 3 methods were beating or blunt-force trauma (reported in 208 studies and 59 countries; average frequency, 62.4%; 95% CI, 57.7%-67.1%), electrical torture (reported in 114 studies and 28 countries; average frequency, 17.2%; 95% CI, 15.0%-19.4%), and starvation or dehydration (reported in 65 studies in 26 countries; average frequency, 12.7%; 95% CI, 10.2%-15.2%). According to the Downs and Black appraisal tool, 50 studies were rated as good or excellent and 216 as fair or poor.
The findings of this study suggest that torture remains widespread. Although innumerable torture methods exist, a limited number account for the vast majority of reported tortures. So that targeted therapies may be developed, additional investigation is needed to better elucidate the sequelae associated with the most common torture methods, described here.
摘要：
■尽管《联合国禁止酷刑公约》和其他国际条约禁止，全世界有无数人遭受酷刑，和卫生保健从业者在全球越来越多地遇到难民酷刑幸存者在他们的临床实践。方法,地理分布,全球酷刑的频率没有得到很好的描述，这限制了医疗保健从业人员充分诊断和治疗酷刑后遗症的能力。
■对酷刑方法的共性进行排名，并确定与之相关的世界区域。
■对于本系统综述和荟萃分析，OvidMEDLINE,OvidEmbase,WebofScience,从成立到2021年7月，搜索了Cochrane图书馆。
■纳入的研究是同行评审的英文文章，包含了经历过酷刑的个体的独立样本，并概述了所经历的酷刑类型。排除的研究未进行同行评审，缺乏独立的样本人口，或者没有指定酷刑方法。文章由两名独立和盲目的审稿人选择纳入，还有第三个,独立审查员解决了差异。总的来说,266篇文章-最初确定为全面审查的1739项研究中的15.3%-符合纳入标准。
■数据抽象和质量评估遵循系统评价和荟萃分析指南的首选报告项目。数据由2个独立和盲审稿人提取到预定义的模板中，还有第三个,独立审查员解决了差异。使用Downs和Black检查表评估偏倚风险。
■酷刑方法按其平均频率排名，报告研究的数量，以及这些方法发生的国家数量。
■总共筛选了9937个标题和摘要，和266项研究，涵盖103604名个体(13350名男性，5610名女性,和84644未指定)进行了分析。报告了105个国家的酷刑；21种方法占所有报告方法的84%，10种方法占所有身体酷刑的78%。前3种方法是殴打或钝器创伤（在208项研究和59个国家/地区中报告；平均频率，62.4%；95%CI，57.7%-67.1%），电酷刑(在114项研究和28个国家报告；平均频率，17.2%；95%CI，15.0%-19.4%），和饥饿或脱水(在26个国家的65项研究中报告；平均频率，12.7%；95%CI，10.2%-15.2%）。根据唐斯和布莱克评估工具，50项研究被评为好或优，216项被评为一般或差。
■这项研究的结果表明，酷刑仍然普遍存在。尽管存在无数的酷刑方法，有限的数量占了报告的酷刑的绝大多数。所以可以开发靶向治疗，需要进一步调查以更好地阐明与最常见的酷刑方法相关的后遗症，这里描述。
■对酷刑方法的共性进行排名，并确定与之相关的世界区域。
■对于本系统综述和荟萃分析，OvidMEDLINE,OvidEmbase,WebofScience,从成立到2021年7月，搜索了Cochrane图书馆。
■纳入的研究是同行评审的英文文章，包含了经历过酷刑的个体的独立样本，并概述了所经历的酷刑类型。排除的研究未进行同行评审，缺乏独立的样本人口，或者没有指定酷刑方法。文章由两名独立和盲目的审稿人选择纳入，还有第三个,独立审查员解决了差异。总的来说,266篇文章-最初确定为全面审查的1739项研究中的15.3%-符合纳入标准。
■数据抽象和质量评估遵循系统评价和荟萃分析指南的首选报告项目。数据由2个独立和盲审稿人提取到预定义的模板中，还有第三个,独立审查员解决了差异。使用Downs和Black检查表评估偏倚风险。
■酷刑方法按其平均频率排名，报告研究的数量，以及这些方法发生的国家数量。
■总共筛选了9937个标题和摘要，和266项研究，涵盖103604名个体(13350名男性，5610名女性,和84644未指定)进行了分析。报告了105个国家的酷刑；21种方法占所有报告方法的84%，10种方法占所有身体酷刑的78%。前3种方法是殴打或钝器创伤（在208项研究和59个国家/地区中报告；平均频率，62.4%；95%CI，57.7%-67.1%），电酷刑(在114项研究和28个国家报告；平均频率，17.2%；95%CI，15.0%-19.4%），和饥饿或脱水(在26个国家的65项研究中报告；平均频率，12.7%；95%CI，10.2%-15.2%）。根据唐斯和布莱克评估工具，50项研究被评为好或优，216项被评为一般或差。
■这项研究的结果表明，酷刑仍然普遍存在。尽管存在无数的酷刑方法，有限的数量占了报告的酷刑的绝大多数。所以可以开发靶向治疗，需要进一步调查以更好地阐明与最常见的酷刑方法相关的后遗症，这里描述。
