Una nuova ricerca condotta dall’Oregon Health & Science University ha […]
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Measures of diabetic retinopathy treatment coverage: protocol for a methodological review
Introduction
Diabetic retinopathy is one of the leading causes of vision impairment globally. Alongside the systemic control of diabetes and timely detection of diabetic retinopathy, the prompt initiation and completion of treatment is essential to prevent vision loss. Routine monitoring of access to retinal screening services for the detection of diabetic retinopathy is common, while monitoring of coverage of subsequent treatment services is far less common. When diabetic retinopathy treatment coverage is assessed, there is great variability in how it is defined and reported. If a definition of treatment coverage could be standardised, the monitoring of the quality of diabetes eye care could more readily be compared between settings and over time. The aim of this review is to summarise how diabetic retinopathy treatment coverage has been measured in published studies and the extent to which these have been disaggregated by population groups.
Methods and analysis
A search will be conducted on Medline and Embase without any language restrictions, for cohort and cross-sectional studies published from 1 January 2015 that report diabetic retinopathy treatment coverage for adults with diabetic retinopathy and/or macular oedema. We will include studies from any world region reporting diabetic retinopathy treatment coverage for one or more of: (1) laser photocoagulation; (2) intravitreal injections of antivascular endothelial growth factor agents; (3) intravitreal injections of corticosteroids; (4) vitrectomy. The PROGRESS framework (place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status and social capital) will be used to assess disaggregation by population groups. Two investigators will independently screen studies and extract relevant data. Data will be synthesised descriptively to outline the full range of definitions of diabetic retinopathy treatment coverage in the literature and identify the common sources of data used.
Ethics and dissemination
This review will only include published data; thus, no ethical approval will be sought. The findings of this review will be published in a peer-reviewed journal and presented at relevant conferences. The findings will also be considered in conjunction with an ongoing review on retinal screening for diabetic retinopathy to develop indicators for monitoring of services along the diabetes eye care pathway, which may include an indicator of effective service coverage.
Registration
Open Science Framework registration 6/08/2024: https://osf.io/5b93m
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As a component of the human dietary, old-fashioned molasses has largely gone out of use. Under a variety of names it has had a long and varied history in connection with human nutrition. There was a time, not many generations ago, when treacle was regarded as a panacea for a diversity of bodily ailments. It was mixed with various medicaments to provide supposed tonics or otherwise effective remedies. Its ancient glory, however, has given way before the advent of the therapeutic novelties and the dietary innovations of the present day. Formerly molasses was the mother liquor remaining after the removal of one crop of sugar crystals from the boiled-down juice of the sugar cane. As the separation of cane sugar by one crystallization is far from complete, the molasses thus secured was rich in sucrose and contained also much the greater part of the other components of the cane juice.
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A recent Commonwealth Fund report confirmed that the US overdose death rate remains far higher than in any other country. In 2022, the US overdose rate was 324 deaths per 1 million people, 1.5 times greater than in Scotland, the second-ranked nation with 219 deaths per million people. Although Scotland saw fewer deaths in 2022 than in previous years, rates in the US continued to climb, up about 53% from 2019. For the third consecutive year, drug overdoses claimed more than 100 000 lives in the US, according to provisional 2023 data from the US Centers for Disease Control and Prevention.