The impact of limited English proficiency on oncological outcomes in the United States: A systematic review.

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Kierstyn M Smith, Camille R Rogers, Olawale O Akinola, Renata W Yen, Natalie A Holbert, Heather B Blunt
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引用次数: 0

Abstract

Background: The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient-provider language discordance, which may impact oncologic health outcomes.

Objectives: To assess the effects of LEP compared to English proficiency (EP) for oncological outcomes in adult cancer patients in the United States.

Search methods: We searched MEDLINE (Ovid), the Cochrane Library (Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials), PsycINFO, CINAHL and Scopus from data inception to 26 January 2023. We also searched the reference lists and cited lists of included studies. Studies were limited to the United States and the English language.

Selection criteria: We included retrospective and cross-sectional studies that analyzed one or more clinical outcomes (survival, readmission, length of stay, complications and discharge disposition) in LEP and EP cancer patients. Studies were eligible if they assessed cancer patients in the United States who were 18 years and older.

Data collection and analysis: Using a piloted, standardized data collection form, two non-blinded, independent reviewers extracted data in duplicate from studies meeting our inclusion criteria. Reviewers resolved discrepancies through discussion. We then performed a qualitative assessment of the findings.

Main results: We retrieved 2425 records from the database searches. We screened 1496 records by title and abstract and reviewed the full text of eight records. We retrieved 347 records from additional search methods and reviewed the full text of six records. We included 14 papers in total for analysis. The studies included 55,141 total patients and assessed outcomes in brain, oesophageal, head and neck, pancreatic and skin cancer. Our qualitative assessment demonstrated limited information on whether LEP impacted survival, complications and discharge disposition. We found no significant association between LEP and readmission or length of stay.

Conclusions: Studies assessing the impact of LEP and EP on the health outcomes of cancer patients are sparse and inconsistent in the measurements of outcomes and data reporting. The inconclusiveness of our study indicates that further standardized research is needed to assess the impact of LEP on the outcomes of cancer patients in the United States.

在美国,英语水平有限对肿瘤治疗效果的影响:系统综述。
背景:美国移民人数不断增加,导致更多患者的英语水平有限(LEP)。LEP 造成了患者与医护人员之间的语言差异,这可能会影响肿瘤的治疗效果:评估 LEP 与英语熟练程度(EP)相比对美国成年癌症患者肿瘤治疗效果的影响:我们检索了 MEDLINE (Ovid)、Cochrane 图书馆(Cochrane 系统性综述数据库和 Cochrane 对照试验中央登记册)、PsycINFO、CINAHL 和 Scopus(从数据开始到 2023 年 1 月 26 日)。我们还检索了纳入研究的参考文献列表和引用列表。研究仅限于美国和英语:我们纳入了对 LEP 和 EP 癌症患者的一种或多种临床结果(生存率、再入院率、住院时间、并发症和出院处置)进行分析的回顾性和横断面研究。对美国 18 岁及以上癌症患者进行评估的研究均符合条件:两名非盲的独立审稿人使用试行的标准化数据收集表,从符合纳入标准的研究中提取一式两份的数据。审稿人通过讨论解决差异问题。然后,我们对研究结果进行了定性评估:我们从数据库中检索到 2425 条记录。我们通过标题和摘要筛选了 1496 条记录,并审阅了 8 条记录的全文。我们通过其他搜索方法检索到 347 条记录,并审阅了 6 条记录的全文。我们共纳入了 14 篇论文进行分析。这些研究共纳入了 55141 名患者,评估了脑癌、食道癌、头颈癌、胰腺癌和皮肤癌的治疗效果。我们的定性评估显示,关于 LEP 是否影响生存、并发症和出院处置的信息非常有限。我们发现,LEP与再入院或住院时间之间没有明显关联:评估 LEP 和 EP 对癌症患者健康结果影响的研究很少,而且在结果测量和数据报告方面也不一致。我们研究的不确定性表明,需要进一步开展标准化研究,以评估 LEP 对美国癌症患者预后的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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