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Relationship between volume and outcome for gastroschisis: a systematic review protocol

机译：胃科血清体积与结果的关系：系统审查议定书

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Gastroschisis is a congenital anomaly that needs surgical management for repositioning intestines into the abdominal cavity and for abdominal closure. Higher hospital or surgeon volume has previously been found to be associated with better clinical outcomes for different especially high-risk, low volume procedures. Therefore, we aim to examine the relationship between hospital or surgeon volume and outcomes for gastroschisis. We will perform a systematic literature search from inception onwards in Medline, Embase, CENTRAL, CINAHL, and Biosis Previews without applying any limitations. In addition, we will search trial registries and relevant conference proceedings. We will include (cluster-) randomized controlled trials (RCTs) and prospective or retrospective cohort studies analyzing the relationship between hospital or surgeon volume and clinical outcomes. The primary outcomes will be survival and mortality. Secondary outcomes will be different measures of morbidity (e.g., severe gastrointestinal complications, gastrointestinal dysfunctions, and sepsis), quality of life, and length of stay. We will systematically assess risk of bias of included studies using RoB 2 for individually or cluster-randomized trials and ROBINS-I for cohort studies, and extract data on the study design, patient characteristics, case-mix adjustments, statistical methods, hospital and surgeon volume, and outcomes into standardized tables. Title and abstract screening, full text screening, critical appraisal, and data extraction of results will be conducted by two reviewers independently. Other data will be extracted by one reviewer and checked for accuracy by a second one. Any disagreements will be resolved by discussion. We will not pool results statistically as we expect included studies to be clinically and methodologically very diverse. We will conduct a systematic synthesis without meta-analysis and use GRADE for assessing the certainty of the evidence. Given the lack of a comprehensive summary of findings on the relationship between hospital or surgeon volume and outcomes for gastroschisis, this systematic review will put things right. Results can be used to inform decision makers or clinicians and to adapt medical care.
机译：GastroChisis是一种先天性异常，需要手术管理，用于将肠道重新定位到腹腔中并腹部闭合。先前已发现高等医院或外科医生体积与不同尤其是高风险，低批量手术的更好的临床结果相关。因此，我们的目标是检查医院或外科医生体积与胃科的结果的关系。我们将在Medline，Embase，Central，Cinahl和Biosis预览中从Incepion开始执行系统的文献搜索，而无需应用任何限制。此外，我们将搜索试用登记委和相关会议诉讼。我们将包括（Cluster-）随机对照试验（RCT）和预期或回顾性队列研究分析医院或外科医生体积和临床结果之间的关系。主要结果将是生存和死亡率。二次结果将是不同的发病措施（例如，严重的胃肠道并发症，胃肠功能困扰和败血症），生活质量和逗留时间。我们将系统地评估使用Rob 2用于单独或群集随机试验和Robins-I的群组的偏倚风险，用于队列研究，并提取关于研究设计，患者特征，案例混合调整，统计方法，医院和外科医生的数据体积和结果转化为标准表。标题和抽象筛选，全文筛选，批判性评估和数据提取的结果将由两位审稿人独立进行。其他数据将由一个审阅者提取，并通过第二个审阅检查精度。任何分歧都将通过讨论解决。我们不会在统计上统计汇集结果，因为我们预期包括临床和方法论非常多样化。我们将进行系统合成，无需荟萃分析，并使用成绩来评估证据的确定性。鉴于缺乏关于医院或外科医生的关系的全面摘要和胃科的成果，这一系统审查将正确地提出。结果可用于通知决策者或临床医生并适应医疗保健。

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