Pathways to diagnosis of a second primary cancer: protocol for a mixed-methods systematic review.
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ABSTRACT:
SUBMITTER: Kanguru L
PROVIDER: S-EPMC5988126 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
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Project description:BackgroundWith the accumulation of evidence regarding potential harms of cancer screening in recent years, researchers, policy-makers, and the public are becoming more critical of population-based cancer screening. Consequently, a high-quality cancer screening program should consider individuals’ values and preferences when determining recommendations. In cervical cancer screening, offering women autonomy is considered a “person-centered” approach to health care services; however, it may impact the effectiveness of the program should women choose to not participate. As part of a larger project to investigate women’s cervical screening preferences and correlates of these preferences, this systematic review will capture quantitative and qualitative investigations of women’s cervical screening preferences and the methods used to elicit them.Design and methodsThis mixed methods synthesis will use a thematic analysis approach to synthesize qualitative, quantitative, and mixed methods evidence. This protocol describes the methods that will be used in this investigation. A search strategy has been developed with a health librarian and peer reviewed using PRESS. Based on this strategy, five databases and the gray literature will be searched for studies that meet the inclusion criteria. The quality of the included individual studies will be examined using the Mixed Methods Appraisal Tool. Three reviewers will extract data from the primary studies on the tools or instruments used to elicit women’s preferences regarding cervical cancer screening, theoretical frameworks used, outcomes measured, the outstanding themes from quantitative and qualitative evidence, and the identified preferences for cervical cancer screening. We will describe the relationships between study results and the study population, “intervention” (e.g., tool or instrument), and context. We will follow the PRISMA reporting guideline. We will compare findings across studies and between study methods (e.g., qualitative versus quantitative study designs). The strength of the synthesized findings will be assessed using the validated GRADE and CERQual tool.DiscussionThis review will inform the development of a tool to elicit women’s cervical screening preferences. Understanding the methods used to elicit women’s preferences and what is known about women’s cervical screening preferences will be useful for guideline developers who wish to incorporate a woman-centered approach specifically for cervical screening guidelines.Systematic review registrationPROSPERO CRD42016035737Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0310-9) contains supplementary material, which is available to authorized users.
| S-EPMC4982264 | biostudies-other
Project description:BACKGROUND:Prostate cancer accounts for about 10% of cancers affecting and claiming the lives of men. Studies have reported that women are better than men in recognition of the early manifestations of various cancers. Besides, women have been recognized to show a profound interest in their partners' health and hence, make observations that men do not know. Several studies have reported on the knowledge gaps of prostate cancer among patients and the general population. It is vital to comprehensively review the available evidence and identify research gaps in our current understanding of knowledge of women on prostate cancer. METHODS:A search of bibliographic databases, MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Web of Science, and EMBASE (Ovid) will be undertaken from January 1999 to December 2019. The search will be limited to studies published in the English language. Duplication of studies will be removed using the EndNote citation manager. After deduplication, citations will be screened independently by two authors according to prespecified criteria. Data extraction and quality assessment of the selected studies will be done independently by two authors. Meta-analytic methods will be used where appropriate. The convergent segregated method of synthesis will be adopted in this review. ETHICS AND DISSEMINATION:Primary data collection will not be involved in this study, hence formal ethical clearance will not be needed. The results of the study will be presented through a peer-reviewed journal and conference presentation. PATIENT AND PUBLIC INVOLVEMENT:Patients or the public will not be engaged in the conduct of this study. TRIAL REGISTRATION:Open Science Framework (OSF) registration DOI: https://doi.org/10.17605/OSF.IO/EYHF2.
| S-EPMC7641856 | biostudies-literature
Project description:IntroductionExposure to different types of psychological trauma may lead to a range of adverse effects on trauma survivors, including poor mental and physical health, economic, social and cognitive functioning outcomes. Trauma-informed (TI) approaches to care are defined as a service system grounded in and directed by an understanding of how trauma affects the survivors' neurological, biological, physiological and social development. TI service system involves training of all staff, service improvements and sometimes screening for trauma experiences. The UK started incorporating TI approaches into the National Health Service. While policies recommend it, the evidence base for TI approaches to healthcare is not well established. We aim to conduct a systematic review to synthesise evidence on TI approaches in primary and community mental healthcare globally.Methods and analysisWe will undertake a systematic search for primary studies in Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane library, websites of organisations involved in the development and implementation of TI approaches in healthcare, and databases of thesis and dissertation. Included studies will be in English published between 1990 and February 2020. Two reviewers will independently perform study selection with data extraction and quality appraisal undertaken by one reviewer and checked for accuracy by a second reviewer. A results-based convergent synthesis will be conducted where quantitative (narratively) and qualitative (thematically) evidence will be analysed separately and then integrated using another method of synthesis. We set up a trauma survivor group and a professional group to consult throughout this review.Ethics and disseminationThere is no requirement for ethical approval for this systematic review as no empirical data will be collected. The findings will be disseminated through a peer-reviewed publication, scientific and practitioner conferences, and policy briefings targeted at local and national policy makers.Prospero registration numberCRD42020164752.
| S-EPMC7896604 | biostudies-literature
Project description:IntroductionAustralia has the highest incidence of skin cancer in the world, with two out of three Australians expected to be diagnosed with skin cancer in their lifetime. Such incidence necessitates large-scale, effective skin cancer management practices. General practitioners (in mainstream practice and in skin cancer clinics) play an important role in skin cancer care provision, making decisions based on relevant evidence-based guidelines, protocols, experience and training. Diversity in these decision-making practices can result in unwarranted variation. Quality indicators are frequently implemented in healthcare contexts to measure performance quality at the level of the clinician and healthcare practice and mitigate unwarranted variation. Such measurements can facilitate performance comparisons between peers and a standard benchmark, often resulting in improved processes and outcomes. A standardised set of quality indicators is yet to be developed in the context of primary care skin cancer management.AimsThis research aims to identify, develop and generate expert consensus on a core set of quality indicators for skin cancer management in primary care.MethodsThis mixed-methods study involves (1) a scoping review of the available evidence on quality indicators in skin cancer management in primary care, (2) identification and development of a core set of quality indicators through interviews/qualitative proforma surveys with participants, and (3) a focus group involving discussion of quality indicators according to Nominal Group Technique. Qualitative and quantitative data will be collected and analysed using thematic and descriptive statistical analytical methods.Ethics and disseminationApproval was granted by the university's Research Ethics Committee (HREC no. 520211051532420). Results from this study will be widely disseminated in publications, study presentations, educational events and reports.
| S-EPMC9214379 | biostudies-literature
Project description:IntroductionThe recent global expansion of routine adolescent vaccination programmes has the potential to protect young people against the acquisition of infectious disease and improve their health. Although in many countries the legal framework supports young people to provide consent for medical interventions if they are considered competent, written parental consent can act as a barrier to uptake as it is frequently a condition of adolescent vaccination programmes. The aim of this systematic review protocol is to document the methods which will be used to identify, appraise and synthesise the available qualitative and quantitative evidence to address: (1) whether implementation of adolescent self-consent procedures can increase vaccination uptake and (2) the barriers and facilitators to implementation of adolescent self-consent procedures.Methods and analysisComprehensive search strategy of all relevant electronic databases for both qualitative and quantitative studies using predefined inclusion and exclusion criteria. At least two authors will independently review titles and abstracts, extract data and assess the methodological quality of eligible primary studies, resolving disagreements by consensus. Quantitative studies will be reported narratively and where possible pooled in a meta-analysis using a random-effects model. The findings of qualitative primary studies will be extracted, interpreted and synthesised to identify overarching themes as well as similarities and differences within those themes.Ethics and disseminationAs this systematic review involves analysis of secondary data, the study does not require ethical approvals. We will use our findings to assess whether the evidence supports the hypothesis that self-consent procedures can increase coverage of adolescent vaccination programmes. We will identify barriers and facilitators to the implementation of adolescent self-consent for vaccination and make recommendations for policy makers and practitioners in relation to consent procedures within vaccination programmes for young people.Prospero registration numberCRD42017084509.
| S-EPMC5961593 | biostudies-literature
Project description:IntroductionSecond opinion programmes aim to support the patients' decision-making process and to avoid treatments that are unnecessary from a medical perspective. The German second opinion directive, introduced in December 2018, constitutes a new legal framework in statutory health insurance for seeking second opinions for elective procedures and so far includes tonsillectomy, tonsillotomy, hysterectomy and shoulder arthroscopy. The directive mandates physicians who recommend one of the above-mentioned surgeries to inform their patients of their legal right to visit a certified second opinion provider. Since second opinion programmes are a fairly recent phenomenon in Germany, no comprehensive data are yet available on the degree of implementation, users, potential barriers and their effectiveness. We aim to examine the characteristics and the use of second opinion programmes as well as the needs and wishes from the perspective of (potential) users in Germany, with focus on the decision-making process, the patient-physician relationship and the motivation to seek a second opinion, as well as the role of health literacy.Methods and analysisSix substudies will include the following stakeholders: (1 and 2) patients with one of the four surgery-indications covered by the directive, (3) patients who electively sought an online-based second opinion, (4) patients with oncological diseases, (5) the general population and (6) medical specialists. A mixed-methods approach will be used, including questionnaires, interviews and focus groups. The data will be evaluated using quantitative descriptive analysis and qualitative content analysis. The integration of the results will take place in the form of a triangulation protocol.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Brandenburg Medical School. The findings will be published in peer-reviewed journals and presented at scientific conferences.
| S-EPMC7878127 | biostudies-literature
Project description:BackgroundIt is well recognised that access and receipt of appropriate guideline recommended treatment with systemic anti-cancer therapies for secondary breast cancer is a key determinant in overall survival. Where there is disparity in access this may result in unwarranted variation and disparity in outcomes. Individual, clinical and wider contextual factors have been associated with these disparities, however this remains poorly understood for women with secondary breast cancer. The purpose of the review is to examine individual, clinical and contextual factors which influence access to evidence-based systemic anti-cancer therapies for women with secondary breast cancer. This will include barriers and facilitators for access and receipt of treatment and an exploration of women and clinicians experience and perspectives on access.MethodsA mixed methods approach with a segregated design will be used to examine and explore factors which influence access to systemic anti-cancer therapies for women with secondary breast cancer. Electronic databases to be searched from January 2000 onwards will be EBSCO CINAHL Plus, Ovid MEDLINE, Ovid EMBASE, PsychINFO and the Cochrane Library and JBI database. This will include NHS Evidence which will be searched for unpublished studies and gray literature. Title and abstract citations and full-text articles will be screened by the author and second reviewer. Data will be extracted by the author and validated by the second reviewer. An overarching synthesis will be produced which brings together quantitative and qualitative findings. Methodological quality and risk of bias will be assessed using the Mixed Methods Appraisal Tool.DiscussionUnderstanding individual, clinical and wider contextual factors associated with access and receipt of systemic anti-cancer therapies for secondary breast cancer is a complex phenomenon. These will be examined to determine any association with access. Review findings will be used to guide future research in this area and the development of an evidence-based service level intervention designed to address unwarranted variation in access based upon the Medical Research Council (MRC) approach to the development, implementation and evaluation of complex interventions.Systematic review registrationThe review protocol has been registered in PROSPERO CRD42020196490 .
| S-EPMC8299679 | biostudies-literature
Project description:IntroductionMental disorders such as depression are common, and an estimated 264 million people are affected by them throughout the world. In recent years, studies on digital health interventions to treat mental disorders have shown evidence of their efficacy, and interest in using them has increased as a result. In the primary care setting, depression and anxiety are the two most frequently diagnosed and treated mental disorders. When they do not refer them to specialists, primary care professionals such as general practitioners treat patients with mental disorders themselves but have insufficient time to treat them adequately. Furthermore, there is a shortage of psychotherapists and those that exist have long waiting lists for an appointment. The purpose of this mixed methods systematic review is to explore the attitudes of primary care professionals towards the use of digital health interventions in the treatment of patients with mental disorders. Their attitudes will provide an indication whether digital mental health interventions can effectively complement standard care in the primary care setting.Methods and analysisWe searched for qualitative, quantitative and mixed methods studies published in English, German, Spanish, Russian, French and Dutch after January 2010 for inclusion in the review. The included studies must involve digital mental health interventions conducted via computer and/or mobile devices in the primary care setting. The search was conducted in July 2020 in the following electronic bibliographic databases: MEDLINE, Embase, CINAHL, PsycINFO and Web of Science Core Collection. Two reviewers will independently screen titles, abstracts and full texts and extract data. We will use the 'Integrated methodology' framework to combine both quantitative and qualitative data.Ethics and disseminationEthical approval is not required. We will disseminate the results of the mixed methods systematic review in a peer-reviewed journal and scientific conferences.Prospero registration numberCRD42020188879.
| S-EPMC8204153 | biostudies-literature
Project description:IntroductionCerebral palsy (CP) is a neurodisability that primarily results in motor impairments and activity limitations, but is often associated with epilepsy and disturbances of sensation, perception, cognition, behaviour and speech. Most children with CP survive well into adulthood. Adults with CP experience increased risk of age-related chronic conditions such as arthritis, stroke, cardiorespiratory and mental health conditions in addition to the ongoing disabilities experienced from childhood. Therefore, adults with CP often require extensive health services. However, health service use among adults with CP has not been well documented. This mixed method review aims to identify, appraise and synthesise quantitative and qualitative literature examining health service use among adults with CP.Methods and analysisThe mixed method systematic review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. A systematic search of MEDLINE (Ovid), CINAHL, Embase, PsycINFO and Cochrane Library from inception to March 2020 will be conducted. Quantitative observational studies, qualitative studies and mixed method studies examining health service use among adults with CP (≥18 years) will be included. Outcomes of interest are the proportion of adults using health services frequency of use and experiences of health services from the perspectives of adults with CP, caregivers and health service providers. Two reviewers will independently screen titles, abstracts and full-texts, extract data and assess the quality of included studies using JBI instruments. Where possible a pooled analysis and aggregation of findings will be performed for quantitative and qualitative data, respectively, and Grading of Recommendations Assessment, Development and Evaluation (GRADE)/GRADE-CERQual (Confidence in Evidence from Reviews of Qualitative research) employed. Quantitative and qualitative findings will be integrated using a triangulation approach at the synthesis stage. A narrative synthesis will be carried out where this is not possible.Ethics and disseminationEthical approval is not required for this review. The findings will be disseminated through a peer-reviewed journal and conferences.Prospero registration numberCRD42020155 380.
| S-EPMC7462157 | biostudies-literature
Project description:BACKGROUND:South Asia has one of the largest proportions of undernourished children in the world, especially stunting, wasting, and underweight as well as micronutrient deficiencies such as the deficiency of iron, vitamin A, and zinc. Undernutrition continues to pose a major threat to this region's economic and social growth. This systematic review aims to assess the drivers and identify priorities for child undernutrition in South Asia. It aims to appraise, synthesise, and summarise literature to create an evidence base that looks at multiple faces of macro and micro child undernutrition in South Asia. METHODS:A systematic review of published and grey literature on child undernutrition, including macro and micronutrient deficiencies, in South Asia covering the period January 2000 to September 2019 will be undertaken. Studies with all relevant study designs and those published in English will be considered for inclusion. Five academic databases will be searched: CINAHL, EMBASE, PubMed, PsycINFO, and Scopus, in addition to various grey literature sources. The analysis will incorporate a narrative synthesis, meta-ethnography or a meta-analysis as appropriate, depending on the nature of the retrieved data. Quality of the included studies will be assessed by validated tools. The UNICEF conceptual framework on child undernutrition will be used to frame findings. DISCUSSION:This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. The protocol gives an insight into the scope and parameters for the systematic review to be carried out. SYSTEMATIC REVIEW REGISTRATION:The protocol was registered by the PROSPERO international prospective register of systematic reviews, reference CRD42018112696 .
| S-EPMC6668084 | biostudies-other