目的:为加拿大预防保健工作组提供关于18岁及以上成人高血压初级保健筛查的最新建议。本协议概述了一系列系统审查的范围和方法,以及一份审查概述。
方法:为了评估高血压筛查的益处和危害,该工作队将依靠2021年美国预防服务工作队系统审查的相关关键问题。此外,将进行一系列审查,以确定,评价,并综合以下方面的证据:(1)血压测量方法与未来心血管(CVD)相关结局的关联,(2)讨论开始治疗的门槛,(3)患者对高血压筛查方法的可接受性。关于血压测量方法和未来CVD相关结果的回顾,我们将进行从头审查并搜索MEDLINE,Embase,中部,和APAPsycInfo用于随机对照试验,前瞻性或回顾性队列研究,嵌套病例对照研究,和干预研究的手臂内分析。对于治疗开始审查的讨论阈值,我们将对相关的2019年英国NICE审查进行审查和更新结果的概述。我们将搜索MEDLINE,Embase,APAPsycInfo,和Epistemonikos进行系统评价。对于可接受性审查,我们将进行系统的回顾和搜索MEDLINE,Embase,和APAPsycInfo用于随机对照试验,对照临床试验,以及对照组的观察性研究。相关组织的网站,灰色文献来源,所包括的研究和评论的参考列表将进行手工搜索。标题和摘要筛选将由两名独立审稿人完成。全文筛选,数据提取,偏见风险评估,和等级(建议评估的等级,开发和评估)将由两名审阅者独立完成。纳入研究的结果将以叙事方式进行综合,并在适当时通过荟萃分析进行汇总。等级方法将用于评估结果证据的确定性。
结论:证据综述的结果将被用来为加拿大18岁及以上成人高血压筛查建议提供参考。
背景:该协议已在PROSPERO上注册,并在OpenScienceFramework(osf.io/8w4tz)上可用。
To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening in a primary care setting for hypertension in adults aged 18 years and older. This protocol outlines the scope and methods for a series of systematic reviews and one overview of reviews.
To evaluate the benefits and harms of screening for hypertension, the Task Force will rely on the relevant key questions from the 2021 United States Preventive Services Task Force systematic review. In addition, a series of reviews will be conducted to identify, appraise, and synthesize the evidence on (1) the association of blood pressure measurement methods and future cardiovascular (CVD)-related outcomes, (2) thresholds for discussions of treatment initiation, and (3) patient
acceptability of hypertension screening methods. For the review of blood pressure measurement methods and future CVD-related outcomes, we will perform a de novo review and search MEDLINE, Embase, CENTRAL, and APA PsycInfo for randomized controlled trials, prospective or retrospective cohort studies, nested case-control studies, and within-arm analyses of intervention studies. For the thresholds for discussions of treatment initiation review, we will perform an overview of reviews and update results from a relevant 2019 UK NICE review. We will search MEDLINE, Embase, APA PsycInfo, and Epistemonikos for systematic reviews. For the
acceptability review, we will perform a de novo systematic review and search MEDLINE, Embase, and APA PsycInfo for randomized controlled trials, controlled clinical trials, and observational studies with comparison groups. Websites of relevant organizations, gray literature sources, and the reference lists of included studies and reviews will be hand-searched. Title and abstract screening will be completed by two independent reviewers. Full-text screening, data extraction, risk-of-bias assessment, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers. Results from included studies will be synthesized narratively and pooled via meta-analysis when appropriate. The GRADE approach will be used to assess the certainty of evidence for outcomes.
The results of the evidence reviews will be used to inform Canadian recommendations on screening for hypertension in adults aged 18 years and older.
This protocol is registered on PROSPERO and is available on the Open Science Framework (osf.io/8w4tz).