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癫痫监测单元(Epilepsy monitoring unit,EMU)在优化癫痫人群管理方面是一项很有价值的资源,但也许会因为在其停止治疗和诱导发作的过程而将患者置于一定的风险之中。研究目的是总结已有的关于EMU质量和安全性的数据,从而得出能够指导未来EMU发展相关的一些指标。根据系统评价和Meta分析推荐的分析和汇报标准进行系统评价。文献的搜索方法为在6个医学数据库以及会议进展中广泛搜索与EMU相关的名词及其同义词。针对纳入文献,提取病人和EMU的特征信息以及与质量、安全性相关的变量。根据一个共计15项的修正版流行病学观察性研究汇报重点(Strengthening the Reporting of Observational Studies in Epidemiology,STROBE)的对照表进行文献质量的评估分析。研究得出的证据建立在描述性统计和Meta分析的基础上。共计搜索出7 601篇相关文献,其中604篇回顾了全文,最终纳入135项研究。由此而得出的分析结果建立在181 823例患者和34项不同的与质量和安全性相关的变量纳入的研究。患者数(108项研究,中位患者数为171.5例),患者年龄(49项研究,中位患者年龄为35.7岁)以及患者收治入EMU的原因(34项研究)。其中与质量和安全性相关最普遍的相关汇报为收治入EMU的有效性(38项研究)。有33项研究(24.4%)汇报了不良事件,由此而得出的不良事件发生概率为7%[95%CI(5%-9%)]。这些关于EMU的文献平均质量评估得分为73.3%(方差为17.2)。研究说明了不同研究在汇报EMU的质量及安全性方面有很大的差异。不同研究之间的研究质量也有较大的差异。目前这些发现都突出了在评估EMU急需发展出一套建立在证据和共识基础上的质量评估标准。
Epilepsy monitoring unit (EMU) is a valuable resource in optimizing the management of people with epilepsy, but may put patients at risk because of the cessation of treatment and the induction of the episode. The purpose of the study was to summarize the available data on the quality and safety of the EMU to arrive at some of the indicators that could guide future EMU development. A systematic review was conducted based on the analysis and reporting criteria recommended by the systematic review and meta-analysis. The literature search method is to extensively search EMU-related nouns and their synonyms in six medical databases and conference proceedings. For inclusion in the literature, extract patient and EMU signature information and quality and safety-related variables. A literature review of the quality of the literature was conducted based on a cross-sectional comparison of a total of 15 revised STROBE. The evidence obtained from the study is based on descriptive statistics and meta-analysis. A total of 7 601 related articles were searched, of which 604 reviewed the full article and eventually included 135 studies. The resulting analysis was based on a study of 181,823 patients and 34 different quality- and safety-related variables included. The number of patients (108 studies, 171.5 for the median patient population), patient age (49 studies, median age 35.7 years), and the reasons for admission to the EMU (34 studies). Among them, the most common relevant reports related to quality and safety were the effectiveness of admission to the EMU (38 studies). A total of 33 studies (24.4%) reported adverse events and the resulting probability of adverse events was 7% [95% CI (5% -9%)]. The average quality evaluation score for these EMUs was 73.3% (variance 17.2). The research shows that there is a big difference between the different studies in reporting the quality and safety of the EMU. The quality of research between different studies is also quite different. These findings so far highlight the need to develop an EMU-based quality assessment standard based on evidence and consensus.