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Screening strategies for adults with type 2 diabetes mellitus: a systematic review protocol

机译：2型糖尿病成人的筛选策略：系统审查议定书

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There is limited evidence on whether screening for type 2 diabetes mellitus affects health outcomes. A recent systematic review of randomised clinical trials found only one trial that met their inclusion criteria; therefore, current guidelines for screening interventions for type 2 diabetes mellitus are based on expert opinions and best practice rather than synthesised evidence. This systematic review seeks to collate evidence from non-randomised studies to investigate the effect of screening for adults with type 2 diabetes on outcomes including diabetes-related morbidity, mortality (all-cause and diabetes-related) and harms. This systematic review will follow Effective Practice and Organisation of Care (EPOC) guidelines for the synthesis of non-randomised studies. We will search PubMed/MEDLINE, Scopus, Web of Science, CINAHL, Academic Search Premier and Health Source Nursing Academic (from inception onwards). We will include non-randomised trials, controlled before-after studies, interrupted time-series studies, repeated measures studies and concurrently controlled prospective cohort studies. The primary outcome will be diabetes-related morbidity (microvascular complications of diabetic retinopathy, nephropathy or neuropathy or macrovascular complications of non-fatal myocardial infarction, peripheral arterial disease or non-fatal stroke). The secondary outcomes will be mortality (all-cause and diabetes-related) and harms of screening strategies to patients (including psychological harms or adverse events following treatments) or to health care system (including resource allocation for false-positives or overdiagnosis). Two reviewers will independently screen all citations and full-text articles. Data will be abstracted by one reviewer and checked by a second. The risk of bias of individual studies will be appraised using the ROBINS-I tool. GRADE will be used to determine the quality of the scientific evidence. If feasible, we will conduct random effects meta-analysis where appropriate. If necessary, analyses will be conducted to explore the potential sources of heterogeneity (e.g. age, sex, socio-economic status, rural versus urban or low-middle income versus high-income country). We will disseminate the findings via publications and through relevant networks. The protocol outlines the methods for systematically reviewing and synthesising evidence of screening strategies for type 2 diabetes mellitus and their effect on health outcomes associated with the disease. The potential impact of this systematic review is improved evidence-informed decision-making for policies and practice for screening of type-2 diabetes.
机译：有关2型糖尿病的筛选是否影响了健康结果存在有限的证据。最近对随机临床试验的系统审查仅发现了一项试验，符合其纳入标准;因此，目前用于筛选2型糖尿病的干预措施的准则基于专家意见和最佳实践而不是合成证据。这种系统审查旨在巩固来自非随机性研究的证据，探讨筛选成人患有2型糖尿病的疗效，包括糖尿病相关的发病率，死亡率（患有糖尿病相关的）和危害。该系统审查将遵循有效的实践和保育协调（EPOC）综合非随机性研究的合成。我们将搜索PubMed / Medline，Scopus，科学，CINAHL，学术搜索总理和健康源护理学术（从成立开始）。我们将包括非随机试验，在研究前进行控制，中断时间序列研究，重复措施研究和同伴控制的前瞻性队列研究。主要结果将是糖尿病相关的发病率（非致命心肌梗死，外周血动脉疾病或非致命中风的糖尿病视网膜病变，肾病或神经病变或大血管并发症）。二次结果将是死亡率（全因和糖尿病相关的）和筛查对患者的策略（包括治疗后的心理危害或不良事件）或卫生保健系统（包括伪阳性或过度诊断的资源分配）危害。两位审稿人将独立筛选所有引文和全文文章。数据将由一个审阅者抽象，并通过一秒钟检查。将使用Robins-I工具评估个体研究偏见的风险。等级将用于确定科学证据的质量。如果可行，我们将在适当的情况下进行随机效应META分析。如有必要，将进行分析以探索潜在的异质性来源（例如，年龄，性，社会经济地位，农村与城市或低中收入与高收入国家）。我们将通过出版物和相关网络传播调查结果。该方案概述了系统地审查和综合筛选2型糖尿病策略的证据的方法及其对与该疾病相关的健康结果的影响。这种系统审查的潜在影响是提高证据知识的决策，用于筛查2型糖尿病的政策和实践。

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