在 COVID-19 大流行期间实施的公共卫生和社会措施 (PHSM) 的效果:系统回顾综述

Racha Fadlallah, Fadi El-Jardali, Lama Bou Karroum, Nour Kalach, Reem Hoteit, Andrew Aoun, Lara Al-Hakim, Francisca Verdugo-Paiva, Gabriel Rada, Atle Fretheim, Simon Lewin, Ramona Ludolph, Elie A. Akl
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引用次数: 0

摘要

引言 系统综述旨在降低2019年冠状病毒疾病(COVID-19)传播规模和风险的公共卫生和社会措施(PHSM)的有效性及其对健康和社会经济造成的意外后果。 方法 本综述遵循《科克伦干预措施系统综述手册》中关于综述的指导,并将 Epistemonikos 数据库的 COVID-19 活体证据综述库作为主要检索来源。方法学质量采用系统性综述评估工具(AMSTAR 2)清单进行评估。 结果 共纳入了 94 篇综述,其中 8 篇(9%)在 AMSTAR 2 中获得了 "中 "至 "高 "的置信度评级。在 16 篇(17%)采用 GRADE 框架进行报告的综述中,没有一篇综述为我们所关注的任何结果找到确定性较高的证据。在 94 篇综述中,最常研究的 PHSM 是个人防护(n = 18,19%)。在多成分干预中,所谓的 "封锁 "是最常被研究的成分(n = 39,41%)。报告最多的结果类别是与 COVID-19 无关的健康结果(n = 58,62%)。只有五篇(5%)综述报告了社会经济成果。现对 AMSTAR 2 中置信度为中或高的八篇综述的研究结果进行叙述性总结。有低确定性证据表明,多成分干预措施可在不同环境中减少 COVID-19 的传播。在主动监测和应对措施方面,低确定性证据表明,对长期护理机构中的居民和员工进行常规检测可减少居民的感染、住院和死亡人数。我们发现关于个人防护措施、旅行相关控制措施和环境措施有效性的证据确定性很低。这八篇综述很少对意外后果进行研究。 结论 我们发现有关 PHSM 在控制 COVID-19 传播风险和规模方面的有效性和意外后果的证据主要为低确定性到极低确定性。有必要改进系统综述的进行和报告。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The effects of public health and social measures (PHSM) implemented during the COVID-19 pandemic: An overview of systematic reviews

The effects of public health and social measures (PHSM) implemented during the COVID-19 pandemic: An overview of systematic reviews

Introduction

To systematically review the effectiveness and unintended health and socioeconomic consequences of public health and social measures (PHSM) aimed at reducing the scale and risk of transmission of coronavirus disease 2019 (COVID-19).

Methods

This review followed guidance about overviews of reviews in the Cochrane handbook for systematic reviews of interventions and used the Epistemonikos database's COVID-19 Living Overview of Evidence repository as a primary search source. Methodological quality was evaluated using the Measurement Tool to Assess Systematic Reviews (AMSTAR 2) checklist.

Results

A total of 94 reviews were included, of which eight (9%) had “moderate” to “high” confidence ratings on the AMSTAR 2. Of 16 reviews (17%) reporting applying the GRADE framework, none found high certainty evidence for any of our outcomes of interest. Across the 94 reviews, the most frequently examined PHSM were personal protection (n = 18, 19%). Within multicomponent interventions, so-called “lockdown” was the most frequently examined component (n = 39, 41%). The most frequently reported outcome category was non-COVID-19-related health outcomes (n = 58, 62%). Only five (5%) reviews reported on socioeconomic outcomes. Findings from the eight reviews with moderate or high confidence ratings on AMSTAR 2 are narratively summarized. There is low-certainty evidence that multicomponent interventions may reduce the transmission of COVID-19 in different settings. For active surveillance and response measures, low-certainty evidence suggests that routine testing of residents and staff in long-term care facilities may reduce the number of infections, hospitalizations, and deaths among residents. We found very low-certainty evidence about the effectiveness of personal protection measures, travel-related control measures, and environmental measures. Unintended consequences were rarely examined by those eight reviews.

Conclusion

We found predominantly low- to very low-certainty evidence regarding the effectiveness and unintended consequences of PHSM in controlling the risk and scale of COVID-19 transmission. There is a need to improve the conduct and reporting of systematic reviews.

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