目的:回顾肾结石疾病比较有效性研究的现状,重点是研究结果,type,人口,时间趋势,和以病人为中心的方法。
方法:对2005年1月1日至2021年3月30日发表的文章进行了系统范围审查,使用与肾结石疾病相关的关键词。以英文发表的研究比较了两种或两种以上的预防方法,诊断,治疗,监测,或护理交付包括在内。两名审阅者独立审阅摘要,一名仲裁员解决了差异。九位审稿人从全长研究中提取了信息。总结了描述性统计数据,并进行线性回归以评估研究特征的时间趋势。
结果:我们回顾了1773篇摘要和707篇全长手稿,重点是手术干预(440);药物治疗(MET)(152);镇痛控制(80);和顺势疗法,诊断,和/或预防(84)。随机对照试验在所有结局类别中都很常见,包括手术(41.6%),MET(60.2%),镇痛控制(81.3%),顺势疗法(41.2%),诊断(47.6%),和预防(49.1%)。71.7%和95%的MET和镇痛对照研究利用了患者报告的结果(PRO)。分别,但在所有其他研究主题中占少数。随着时间的推移,荟萃分析和多中心研究增加[P<0.001]。
结论:手术和MET主题在已发表的肾结石疾病比较文献中占主导地位。不同手术主题的PRO使用存在很大差异。多中心研究和产生更高层次证据的研究随着时间的推移而增加,但存在改善协作的机会,高品质,以及以患者为中心的肾结石疾病研究。
To
review the status of comparative effectiveness studies for kidney stone disease with focus on study outcome, type, population, time trends, and patient-centered approaches.
A systematic scoping
review was performed for articles published between January 1, 2005, and March 30, 2021, using keywords relevant to kidney stone disease. Studies published in English that compared two or more alternative methods for prevention, diagnosis, treatment, monitoring, or care delivery were included. Two reviewers independently reviewed abstracts and an arbitrator resolved discrepancies. Nine reviewers abstracted information from full-length studies. Descriptive statistics were summarized, and linear regression was performed to evaluate temporal trends of study characteristics.
We reviewed 1773 abstracts and 707 full-length manuscripts focused on surgical intervention (440); medical expulsive therapy (MET) (152); analgesic control (80); and homeopathic, diagnostics, and/or prophylaxis (84). Randomized controlled trials were common across all outcome categories, including surgery (41.6%), MET (60.2%), analgesic control (81.3%), homeopathic (41.2%), diagnostic (47.6%), and prophylaxis (49.1%). Patient-reported outcomes were utilized in 71.7% and 95% of MET and analgesic control studies, respectively, but in the minority of all other study themes. Over time, meta-analyses and multicenter studies increased [P < .001].
Surgical and MET themes dominate published comparative literature in kidney stone disease. There is substantial variation in use of patient-reported outcomes across surgical themes. Multicentered studies and those generating higher level evidence have increased over time but opportunities exist to improve collaborative, high-quality, and patient-centered research in kidney stone disease.