RESUMEN
OBJECTIVE: To identify preventive practices for psychosocial risks in Ibero-American health centers, including gaps in evidence, and to synthesize effectiveness according to dimensions and level of intervention. METHODS: Design: a global evidence mapping type systematic review. Data sources: Cochrane Central Register of Controlled Trials, Health Systems Evidence, The Campbell Collaboration, PubMed, BioMed Central, CINAHL, EMBASE, Lilacs, and Health Evidence Portal. Review methods: Ad hoc descriptors were used to identify randomized controlled trials and other types of studies. The search was done between January 2003 and March 2020, limited to the English, Portuguese, and Spanish. The PRISMA-P protocol was applied to register the synthesis of the included studies. The quality of the evidence was evaluated according to the GRADE protocol and by three external evaluators. RESULTS: A total of 8959 studies were identified, and, after screening and eligibility assessment, 18 studies were included in the systematic review, involving 1777 workers from 176 health centers in Spain, Portugal, Mexico, Nicaragua, Colombia, Brazil, Peru, and Argentina. Half of the included studies are randomized controlled trials; 37.2% of the included studies were deemed of moderate quality, while 18.7% were of high quality. CONCLUSIONS: Preventive practices with strong evidence correspond to policies that improve the working conditions of night hospital work. We found low-quality evidence in six preventive dimensions for the practices based on multi-component interventions. We found evidence gaps in five domains of preventive interventions for psychosocial risks.
OBJETIVO: Identificar las prácticas preventivas para riesgos psicosociales en centros sanitarios iberoamericanos, incluyendo los vacíos de la evidencia, y sintetizar la efectividad según dimensión y nivel de intervención. MÉTODOS: Diseño: revisión sistemática de tipo global evidence mapping. Fuentes de datos: Cochrane Central Register of Controlled Trials, Health Systems Evidence, The Campbell Collaboration, PubMed, BioMed Central, CINAHL, EMBASE, Lilacs y Health Evidence Portal. Métodos de la revisión: se emplearon descriptores ad hoc para identificar ensayos controlados aleatorios y otros tipos de estudio. El período de búsqueda comprendió entre enero de 2003 y marzo de 2020, limitado a los idiomas inglés, portugués y español. Para el registro de síntesis de estudios incluidos se aplicó el protocolo PRISMA-P. La calidad de la evidencia fue evaluada según protocolo GRADE por tres evaluadores externos. RESULTADOS: Se identificaron 8959 estudios y, tras el tamizaje y análisis de elegibilidad, se admitieron 18 estudios para revisión sistemática que involucran a 1777 trabajadores de 176 centros sanitarios de España, Portugal, México, Nicaragua, Colombia, Brasil, Perú y Argentina. La mitad de los estudios incluidos son ensayos controlados aleatorios. Las frecuencias de desenlaces predominantes son de calidad moderada (37,2%), y las de alta calidad son 18,7%. CONCLUSIONES: Las prácticas preventivas con alta calidad de evidencias corresponden a las políticas para mejorar condiciones laborales del trabajo hospitalario nocturno. Prácticas basadas en intervenciones multicomponentes presentan evidencias de baja calidad en cinco dimensiones preventivas. Los vacíos de la evidencia están en seis dominios de la intervención preventiva para los riesgos psicosociales.
Asunto(s)
Personal de Salud/psicología , Enfermedades Profesionales/prevención & control , Salud Laboral , Humanos , Servicios de Salud del Trabajador/organización & administración , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
BACKGROUND: Although cannabis and cannabinoids are widely used with therapeutic purposes, their claimed efficacy is highly controversial. For this reason, medical cannabis use is a broad field of research that is rapidly expanding. Our objectives are to identify, characterize, appraise, and organize the current available evidence surrounding therapeutic use of cannabis and cannabinoids, using evidence maps. METHODS: We searched PubMed, EMBASE, The Cochrane Library and CINAHL, to identify systematic reviews (SRs) published from their inception up to December 2017. Two authors assessed eligibility and extracted data independently. We assessed methodological quality of the included SRs using the AMSTAR tool. To illustrate the extent of use of medical cannabis, we organized the results according to identified PICO questions using bubble plots corresponding to different clinical scenarios. RESULTS: A total of 44 SRs published between 2001 and 2017 were included in this evidence mapping with data from 158 individual studies. We extracted 96 PICO questions in the following medical conditions: multiple sclerosis, movement disorders (e.g. Tourette Syndrome, Parkinson Disease), psychiatry conditions, Alzheimer disease, epilepsy, acute and chronic pain, cancer, neuropathic pain, symptoms related to cancer (e.g. emesis and anorexia related with chemotherapy), rheumatic disorders, HIV-related symptoms, glaucoma, and COPD. The evidence about these conditions is heterogeneous regarding the conclusions and the quality of the individual primary studies. The quality of the SRs was moderate to high according to AMSTAR scores. CONCLUSIONS: Evidence on medical uses of cannabis is broad. However, due to methodological limitations, conclusions were weak in most of the assessed comparisons. Evidence mapping methodology is useful to perform an overview of available research, since it is possible to systematically describe the extent and distribution of evidence, and to organize scattered data.
Asunto(s)
Cannabinoides/uso terapéutico , Cannabis , Marihuana Medicinal/uso terapéutico , Humanos , Revisiones Sistemáticas como AsuntoRESUMEN
OBJETIVO: Identificar las prácticas preventivas para riesgos psicosociales en centros sanitarios iberoamericanos, incluyendo los vacíos de la evidencia, y sintetizar la efectividad según dimensión y nivel de intervención. Métodos: Diseño: revisión sistemática de tipo global evidence mapping. FUENTES DE DATOS: Cochrane Central Register of Controlled Trials, Health Systems Evidence, The Campbell Collaboration, PubMed, BioMed Central, CINAHL, EMBASE, Lilacs y Health Evidence Portal. MÉTODOS DE LA REVISIÓN: se emplearon descriptores ad hoc para identificar ensayos controlados aleatorios y otros tipos de estudio. El período de búsqueda comprendió entre enero de 2003 y marzo de 2020, limitado a los idiomas inglés, portugués y español. Para el registro de síntesis de estudios incluidos se aplicó el protocolo PRISMA-P. La calidad de la evidencia fue evaluada según protocolo GRADE por tres evaluadores externos. RESULTADOS: Se identificaron 8959 estudios y, tras el tamizaje y análisis de elegibilidad, se admitieron 18 estudios para revisión sistemática que involucran a 1777 trabajadores de 176 centros sanitarios de España, Portugal, México, Nicaragua, Colombia, Brasil, Perú y Argentina. La mitad de los estudios incluidos son ensayos controlados aleatorios. Las frecuencias de desenlaces predominantes son de calidad moderada (37,2%), y las de alta calidad son 18,7%. CONCLUSIONES: Las prácticas preventivas con alta calidad de evidencias corresponden a las políticas para mejorar condiciones laborales del trabajo hospitalario nocturno. Prácticas basadas en intervenciones multicomponentes presentan evidencias de baja calidad en cinco dimensiones preventivas. Los vacíos de la evidencia están en seis dominios de la intervención preventiva para los riesgos psicosociales.
OBJECTIVE: To identify preventive practices for psychosocial risks in Ibero-American health centers, including gaps in evidence, and to synthesize effectiveness according to dimensions and level of intervention. METHODS: Design: a global evidence mapping type systematic review. DATA SOURCES: Cochrane Central Register of Controlled Trials, Health Systems Evidence, The Campbell Collaboration, PubMed, BioMed Central, CINAHL, EMBASE, Lilacs, and Health Evidence Portal. REVIEW METHODS: Ad hoc descriptors were used to identify randomized controlled trials and other types of studies. The search was done between January 2003 and March 2020, limited to the English, Portuguese, and Spanish. The PRISMA-P protocol was applied to register the synthesis of the included studies. The quality of the evidence was evaluated according to the GRADE protocol and by three external evaluators. RESULTS: A total of 8959 studies were identified, and, after screening and eligibility assessment, 18 studies were included in the systematic review, involving 1777 workers from 176 health centers in Spain, Portugal, Mexico, Nicaragua, Colombia, Brazil, Peru, and Argentina. Half of the included studies are randomized controlled trials; 37.2% of the included studies were deemed of moderate quality, while 18.7% were of high quality. CONCLUSIONS: Preventive practices with strong evidence correspond to policies that improve the working conditions of night hospital work. We found low-quality evidence in six preventive dimensions for the practices based on multi-component interventions. We found evidence gaps in five domains of preventive interventions for psychosocial risks.
Asunto(s)
Humanos , Salud Laboral , Personal de Salud/psicología , Enfermedades Profesionales/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Servicios de Salud del Trabajador/organización & administraciónRESUMEN
PURPOSE: Soft tissue sarcomas are a heterogeneous group of rare tumours of mesenchymal origin. Evidence mapping is one of the most didactic and friendly approaches to organise and summarise the range of research activity in broad topic fields. The objective of this evidence mapping is to identify, describe and organise the current available evidence about therapeutic interventions on soft tissues sarcomas. METHODS: We followed the methodology of global evidence mapping. We performed a search of the PubMed, EMBASE, The Cochrane Library and Epistemonikos to identify systematic reviews (SRs) with or without meta-analyses published between 1990 and March 2016. Two independent literature reviewers assessed eligibility and extracted data. Methodological quality of the included systematic reviews was assessed using AMSTAR. We organised the results according to identified PICO questions and used tables and a bubble plot to display the results. RESULTS: The map is based on 24 SRs that met eligibility criteria and included 66 individual studies. Three-quarters were either observational or uncontrolled clinical trials. The quality of the included SRs was in general moderate or high. We identified 64 PICO questions from them. The corresponding results mostly favoured the intervention arm. CONCLUSIONS: This evidence mapping was built on the basis of SRs, which mostly included non-experimental studies and were qualified by the AMSTAR tool as of moderate quality. The evidence mapping created from PICO questions is a useful approach to describe complex and huge clinical topics through graphical media and orientate further research to fulfil the existing gaps. However, it is important to delimitate the steps of the evidence mapping in a pre-established protocol.
Asunto(s)
Medicina Basada en la Evidencia , Sarcoma/terapia , Neoplasias de los Tejidos Blandos/terapia , Revisiones Sistemáticas como Asunto , Ensayos Clínicos como Asunto/estadística & datos numéricos , Humanos , Metaanálisis como Asunto , Estudios Observacionales como Asunto/estadística & datos numéricosRESUMEN
Few Orthopaedics and Traumatology journals from Latin America and Spain are indexed in major databases; controlled clinical trials published in these journals cannot be exhaustively retrieved using electronic literature searches. We aimed to identify, describe and assess the quality of controlled clinical trials published in Orthopaedics and Traumatology journals from Latin America and Spain through handsearching and evidence mapping methods. We identified controlled clinical trials published in eligible Orthopaedics/Traumatology journals in Spanish until July 2017 by handsearching. Data were extracted for controlled clinical trials main characteristics and the Cochrane risk of bias tool was used to assess the controlled clinical trials methodological quality. In addition, we mapped the main findings of these trials. As a result, we assessed 5631 references in 29 eligible journals of which 57 were controlled clinical trials (1.0%). Controlled clinical trials were published between 1995 and 2017 at a rate of 2.5 per year. Journals from Spain and Mexico published around 63% of the controlled clinical trials identified. The median sample size of patients enrolled was 60 (range = 30-300 participants). About conditions assessed, 38.5% of controlled clinical trials assessed issues related to knee conditions, 15.7% about hip and 10.5% about trauma or spine. The risk of bias domains most affected was selective reporting bias and random sequence generation. In addition, only two and seven trials had low risk of bias in all items related to participant/personnel and outcome assessment blindings, respectively. More than 40% of studies did not report differences on benefits/harms between the interventions assessed. As a conclusion, the number of controlled clinical trials published in Orthopaedics/Traumatology journals from Latin America and Spain is low. These controlled clinical trials had important methodological shortcomings and were judged as unclear or high risk of bias. These trials are now available in CENTRAL for their potential inclusion in systematic reviews and other documents of synthesis.