目标:使用健康不平等/不平等指导来支持其审查的证据综合文章进行批判性审查和分析。
方法:全面,对6个社会科学数据库(1990年至2022年5月)和灰色文献来源进行了系统搜索。采用了叙事综合方法,对收录文章的特征进行描述和分类。还对现有的方法指南进行了比较,讨论它们之间的异同。
结果:从2008年至2022年之间发布的205项确定的评论中,有62项(30%)关注健康不平等/不平等,符合标准。审查在方法上是多种多样的,人口,干预水平,和临床领域。只有19个(31%)的评论讨论了不平等/不平等的定义。确定了两个方法学指南:(I)PROGRESS/Plus框架,和(Ii)PRISMA-Equity检查表。
结论:对方法指南的批评重申,在如何考虑健康不平等/不平等方面缺乏明确或指导。PROGRESS/Plus框架狭隘地关注健康不平等/不平等的层面,但很少考虑这些维度的途径和相互作用及其对结果的影响。另一方面,PRISMA-Equity检查表,提供报告指导。需要一个概念框架,显示健康不平等/不平等维度的路径和相互作用。
To critically review and analyze evidence synthesis articles using health inequality/inequity guidance to support their review.
A comprehensive, systematic search of six social science databases (1990 to May 2022) and grey literature sources was undertaken. A narrative approach to synthesis was adopted, describing and categorizing the characteristics of included articles. A comparison of the existing methodological guides was also conducted, discussing the similarities and differences between them.
From 205 identified reviews published between 2008 and 2022, 62 (30%) focusing on health inequality/inequity, met the criteria. The reviews were diverse in terms of methodology, populations, intervention level, and clinical areas. Only 19 (31%) reviews discussed the definition of inequality/inequity. Two methodological guides were identified: (i) the PROGRESS/Plus framework and (ii) the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity checklist.
A critique on the methodological guides reaffirms a lack of clarity or guidance on how health inequality/inequity should be considered. The PROGRESS/Plus framework narrowly focuses on dimensions of health inequality/inequity but rarely considers the pathways and interactions of these dimensions and their effect on outcomes. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity checklist on the other hand provides guidance on report. A conceptual framework is needed to show the pathways and interactions of dimensions of health inequality/inequity.