OBJECTIVE:This review will map the use of the Fundamentals of Care (FoC) Framework in health care. INTRODUCTION:Health care systems are increasingly complex, but person-centered care remains central to nursing, and the FoC Framework provides a structured approach to embedding this principle in practice. It emphasizes therapeutic relationships and the integration of physical and psychosocial needs through relational actions, supported by an enabling context. Despite growing evidence on person-centered care, no review has mapped the use of this framework to guide health care professionals and organizations. ELIGIBILITY CRITERIA:This scoping review will consider sources reporting the use of the FoC Framework to guide or structure activities in any health care setting (eg, hospital, primary care, community, disability, social care), with no geographic restrictions. Eligible sources will include quantitative, qualitative, or mixed methods studies, systematic reviews, and selected gray literature, such as dissertations, theses, discussion pieces, or opinion papers. Sources will be excluded if they do not reference the framework, lack empirical or descriptive data, or report solely on educational contexts (eg, student training, curricula). METHODS:This review will follow the JBI methodology for scoping reviews. Searches will be conducted in key bibliographic and gray literature sources, including CINAHL Ultimate (EBSCOhost), Embase (Embase.com), MedNar, ProQuest Central (ProQuest), OpenAlex, PubMed, and PsycINFO (APA PsycNet), with no language restrictions. Titles and abstracts, then full texts, will be screened against the eligibility criteria. Data will be extracted using a structured tool and analyzed descriptively, and results will be presented using tables and figures, with a narrative summary. REVIEW REGISTRATION:https://osf.io/srbe9/.
OBJECTIVE:This mixed methods systematic review will aim to identify, synthesize, and integrate quantitative and qualitative evidence on the barriers and facilitators affecting the implementation of exercise therapy for patients with diabetic neuropathy. INTRODUCTION:Diabetic neuropathy is one of the most prevalent and debilitating complications of diabetes, often leading to impaired mobility, pain, reduced physical function, and diminished quality of life. Exercise therapy is widely recommended as a core component of management; however, its implementation in clinical and community settings remains inconsistent. ELIGIBILITY CRITERIA:This review will include qualitative, quantitative, and mixed methods studies involving adults (≥18 years) with type 1 or type 2 diabetes mellitus and diabetic peripheral neuropathy. The review will consider evidence relating to barriers and facilitators influencing the implementation, uptake, adherence, or delivery of exercise therapy from multiple perspectives, including patient (eg, beliefs, motivation, health literacy), provider (eg, knowledge, attitudes, training), and health system (eg, accessibility, policies, financing, service delivery). METHODS:The review will follow the JBI methodology for mixed methods systematic reviews using a convergent integrated approach. The data will be extracted from databases and gray literature, including MEDLINE (Ovid), CINAHL (EBSCOhost), Embase (Ovid) Scopus, Cochrane CENTRAL, ProQuest Dissertations and Theses Global, the WHO International Clinical Trials Registry Platform (ICTRP), and Google Scholar. Two reviewers will independently extract data using a customized form, screen titles, abstracts, and full texts, and assess methodological quality. Qualitative data will be transformed into "qualitized" statements and integrated with quantitative findings. A single set of integrated findings will be developed using meta-aggregation and narrative integration techniques, resulting in synthesized statements and practical recommendations. The review will follow PRISMA reporting guidelines. REVIEW REGISTRATION:PROSPERO CRD420261284500.
OBJECTIVE:This scoping review will describe the nature and extent of evidence on intergenerational trauma (IGT) and chronic diseases impacting Indigenous peoples of Australia, Canada, Aotearoa New Zealand (NZ), and the US. INTRODUCTION:Indigenous peoples of Australia, Canada, NZ, and the US have been impacted by historical and ongoing effects of colonization. Growing evidence links past and successive trauma among these groups, that is, IGT, to a greater risk of poor mental health. This review will contribute to the growing literature on IGT as a framework for comprehensively analyzing health inequities, particularly disproportionate rates of chronic diseases, experienced by Indigenous peoples. ELIGIBILITY CRITERIA:This review will consider evidence sources that include Indigenous peoples of Australia, Canada, NZ, and the US, of all ages and genders, who are diagnosed with chronic disease(s). The sources must address IGT and its physiological impact. The review will include studies published in English and French between 1999 and 2025. METHODS:This review will follow the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Four electronic databases will be systematically searched: Scopus, PubMed, CINAHL Ultimate (EBSCOhost), and PsycINFO (Ovid). A supplementary Google Scholar search and consultation with First Nations experts in IGT will be undertaken to identify published and unpublished literature, including gray literature, such as government documents and community-led resources. Studies on any chronic disease with IGT will be eligible. Data will be extracted and analyzed, and studies' findings and characteristics will be presented in diagrams and tables. REVIEW REGISTRATION:OSF https://osf.io/8e5kg.
OBJECTIVE:This scoping review will map and describe the literature on interventions or strategies to improve access to mental health services among Black African immigrants residing in high-income countries. INTRODUCTION:Black African immigrants residing in high-income countries experience a disproportionately high prevalence of mental health issues driven by pre-migration trauma, migration stressors, and post-migration social determinants. Despite this burden, access to mental health services remains limited due to barriers such as stigma, cultural incongruence, and systemic inequities. While existing systematic reviews have explored barriers to care, little is known about interventions or strategies that have been implemented to address these challenges. ELIGIBILITY CRITERIA:This review will consider studies involving adult Black African immigrants residing in high-income countries. Eligible sources will include qualitative, quantitative, and mixed methods studies and relevant gray literature that describe, evaluate, or report on interventions or strategies aimed at improving access to mental health care (including approachability, acceptability, availability and accommodation, affordability, and appropriateness). METHODS:This review will be conducted in accordance with the JBI methodology for scoping reviews. A comprehensive search will be conducted across PubMed, Embase (Embase.com), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), and ProQuest Central (ProQuest) along with relevant gray literature sources. Two reviewers will independently screen all identified sources and extract data using an extraction tool developed by the review team. Data will be presented in tabular and graphical formats and summarized descriptively. Findings will be mapped to the 5 dimensions of accessibility to identify existing strategies and gaps in the evidence. REVIEW REGISTRATION:https://osf.io/8sqyx.
OBJECTIVE:The objective of this review is to map the characteristics of family interventions for caregivers of people with schizophrenia and assess the completeness of their reporting using the Template for Intervention Description and Replication (TIDieR) checklist. INTRODUCTION:Family caregivers play a central role in supporting people with schizophrenia. Although family interventions demonstrate benefits, inconsistent and incomplete reporting limits their reproducibility and implementation. The TIDieR checklist provides a standardized framework to improve reporting transparency; however, its application in this field has not been systematically examined. A scoping review is required to identify these interventions, their characteristics, and to assess reporting completeness based on the TIDieR framework. ELIGIBILITY CRITERIA:This review will consider primary studies employing quantitative, qualitative, or mixed methods designs that evaluate structured family interventions involving caregivers of people with schizophrenia across all settings and geographical locations. METHODS:This scoping review will be conducted in accordance with JBI methodology and follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). A comprehensive search will be conducted in PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, CINAHL, CNKI, and Wanfang, with no date limits. Two reviewers will independently screen, select, and extract data. Findings will be presented in tabular and narrative formats, including mapping of intervention characteristics and assessing the reporting completeness using the TIDieR checklist. REVIEW REGISTRATION:OSF https://osf.io/93fk8.
OBJECTIVE:The objective of this review is to explore the factors influencing pharmacovigilance practices among health care professionals in lower-middle-income countries (LMICs). INTRODUCTION:Pharmacovigilance minimizes potential harm to patients and consumers by ensuring that high-quality, safe, and efficacious medicines are used rationally. Pharmacovigilance supports public health initiatives by providing balanced information for assessing risk-benefit profiles, enhancing patient care and safety. Despite global initiatives to standardize pharmacovigilance systems, many LMICs have yet to develop fully functional frameworks capable of generating reliable, high-quality safety data. ELIGIBILITY CRITERIA:Studies published from 2017 to 2025 including health care professionals (eg, medical doctors, dentists, optometrists, pharmacists, nurses, and midwives) will be considered for inclusion. We will focus on factors reported to influence pharmacovigilance practices in LMICs. METHODS:This scoping review will follow JBI methodology. A 3-step search will include an initial search in PubMed and EBSCOhost to identify key terms; tailored strategies for PubMed, Cochrane Library, Ovid, MEDLINE Complete (EBSCOhost), CINAHL (EBSCOhost), Web of Science, and Scopus; and supplementary searches through citation tracking, expert consultation, and gray literature sources, such as the World Health Organization, relevant national websites, and the first 200 results of ProQuest Dissertations and Theses and Google Scholar. Screening and analysis will be conducted by 2 independent reviewers, with complete search strategies reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Review parameters will undergo descriptive analysis. Extracted data will be charted and mapped utilizing the Theoretical Domains Framework (TDF) to systematically categorize both the qualitative and quantitative factors influencing pharmacovigilance practices. REVIEW REGISTRATION:OSF https://osf.io/r7zs6/overview.
OBJECTIVE:This review will synthesize studies on costs, the impact of these costs, and the cost-effectiveness of kangaroo mother care (KMC) compared with conventional neonatal care for preterm and low-birthweight infants in low- and middle-income countries. INTRODUCTION:Preterm birth and low birthweight are leading causes of neonatal mortality and long-term disability worldwide, and KMC has been promoted as a potentially low-cost, resource-efficient intervention, yet the economic evidence remains fragmented and methodologically heterogeneous. ELIGIBILITY CRITERIA:Studies that include preterm (gestational age <37 weeks) and/or low-birthweight (<2500g) infants receiving KMC, compared with conventional neonatal care, will be considered eligible for inclusion. Full and partial economic evaluations alongside comparative effectiveness data will be included, with no restrictions on date, language, setting, or geographical location. METHODS:A preliminary search in MEDLINE (PubMed) has informed a comprehensive strategy using MeSH terms and keywords for KMC, preterm/low-birthweight infants, and economic evaluation, which will be adapted for multiple databases and gray-literature sources. Two independent reviewers will screen titles/abstracts and full texts, extract data using piloted forms, and assess methodological quality using JBI and Cochrane tools, resolving disagreements by consensus or a third reviewer. Where appropriate, studies will be pooled using meta-analysis; otherwise, narrative synthesis will be undertaken. The JBI dominance ranking matrix will be used to summarize and compare results across different types of economic evaluations. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess the certainty of economic evidence. REVIEW REGISTRATION:PROSPERO CRD42017055742.
Objective: This scoping review will systematically map and describe evidence on cardiometabolic disease management in and for South Asian tribal (Indigenous) populations and identify key knowledge gaps to inform future studies and interventions. Introduction: South Asia is home to diverse tribal populations facing persistent health inequities due to geographic isolation, socioeconomic disadvantage, and limited access to formal health systems. Cardiometabolic diseases are increasingly reported in these communities, where care involves biomedical services and traditional healing practices. The literature on the management of these diseases in and for tribal populations is fragmented across diverse study designs, health systems, and population groups, with no prior scoping review. Eligibility criteria: Studies on the management of 1 or more cardiometabolic disease—including hypertension, diabetes, dyslipidemia, obesity, and cardiovascular diseases—in or for South Asian tribal populations will be considered. Any community or health care setting will be eligible, and all empirical study designs. Methods: This review will follow the JBI methodology for scoping reviews and will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Fifteen databases will be comprehensively searched for published and gray literature, supplemented by Google Scholar searches, reference lists, and forward citation tracking. No date or language restrictions will be applied. Identified studies will be screened by 2 reviewers independently, and data extracted from included studies using a standardized tool. Extracted data will be analyzed using simple descriptive statistics and descriptive content analysis and presented using tables and figures.
OBJECTIVE:This systematic review will evaluate the effectiveness of medication-related services for people residing in residential aged care homes when nurse practitioners are involved in their care compared to services provided in the absence of nurse practitioners. INTRODUCTION:Nurse practitioners are involved in providing medication-related services such as prescribing, education on medication optimization, and deprescribing to people living in residential aged care homes. The effectiveness of these services is unclear. ELIGIBILITY CRITERIA:The review will include quantitative, qualitative, and mixed methods studies describing older adults (median and/or mean age ≥65 years), living in residential aged care homes, receiving medication-related services from nurse practitioners. Medication-related services will include prescribing, education on medication optimization, or deprescribing. Outcomes of interest will be suboptimal prescribing, infection management, pain management, hospitalizations, falls management, behavior management, and bowel management. METHODS:This review will follow the JBI methodology for systematic reviews of effectiveness. Searches will be conducted of PubMed, CINAHL Ultimate (EBSCOhost), Embase (Ovid), Cochrane Library, Web of Science Core Collection, and PsycINFO (Ovid). Studies will need to be published from 2000 onward in English. Gray literature will be identified through Google searches. Two reviewers will independently screen studies, extract data, and conduct critical appraisal. Quantitative data will be summarized descriptively, while qualitative data will be examined using thematic analysis. Risk of bias will be assessed using the Cochrane Risk of Bias (RoB 2) tool and the Risk Of Bias In Non-randomized Studies - of Interventions, Version 2 (ROBINS-I V2). Methodological quality will be assessed using JBI critical appraisal tools. Certainty of evidence will be evaluated using the GRADE approach. REVIEW REGISTRATION:PROSPERO CRD420251059820.
OBJECTIVE:This scoping review will map the available evidence on extracorporeal membrane oxygenation (ECMO) education for nursing professionals. INTRODUCTION:Patients receiving ECMO are a high-acuity population, and the demand for a highly skilled nursing workforce to manage the associated complexity and risks continues to grow. Despite a growing emphasis on ECMO education in both academic and clinical settings, evidence-based educational approaches tailored to nursing professionals are limited. ELIGIBILITY CRITERIA:This scoping review will include studies on ECMO education for nursing professionals, such as registered nurses, advanced practice nurses, and nursing students, across academic and clinical settings. Eligible studies will be those that employ qualitative, quantitative, or mixed methods designs and report data relevant to the nursing workforce. METHODS:A comprehensive search will be conducted across 6 databases-PubMed, Embase (Embase.com), CINAHL (EBSCOhost), Cochrane Library, RISS, and ScienceON-along with relevant gray literature sources. Two reviewers will independently screen the titles and abstracts of all retrieved citations, followed by full-text assessments of studies meeting the eligibility criteria. The search will not be restricted by publication year or language; however, screening and full-text review will be limited to studies published in English and Korean due to the review team's language capacity. Data will be extracted using a reviewer-developed tool and presented descriptively by study characteristics, educational program features, and outcomes. REVIEW REGISTRATION:OSF https://osf.io/mp2j6/.
OBJECTIVE:This review aimed to analyze the causes of neonatal mortality in India, explore the temporal distribution of death, and assess variations across causes and time intervals. INTRODUCTION:India accounts for approximately 25% of global neonatal deaths. Understanding when and why neonatal deaths occur is essential for designing and delivering context-specific interventions more effectively. ELIGIBILITY CRITERIA:Studies focusing on newborn deaths (within 28 days of birth) in India were eligible for inclusion. Observational studies, including cross-sectional, prevalence, and cohort studies published from database inception to April 1, 2025, in any language were considered for inclusion. METHODS:The review followed the approaches by PERSyst group and the JBI Manual for Evidence Synthesis . Studies were identified through searches in PubMed, ProQuest, and Scopus. Screening of the studies was done manually. Data were independently extracted using a predefined master sheet, and methodological quality was assessed using JBI critical appraisal tools. Findings were synthesized narratively, and pooled estimates were generated using random effects meta-analysis for overall timing of neonatal death and overall causes of neonatal death. RESULTS:A total of 32 studies comprising 14,681 neonatal deaths were included. Pooled estimates reported that 75% (95% CI: 68-81%) of deaths occurred in the early neonatal period (1 to 7 days) and 25% (95% CI: 20-30%) in the late neonatal period (8 to 28 days). Of all deaths, 36% occurred on the first day of life and 18% on days 2 and 3. Over 90% of deaths due to birth asphyxia and prematurity/low birth weight occurred within the first week, whereas sepsis was more evenly distributed across the early (45%) and late (52%) neonatal periods. Prematurity/low birth weight was the leading cause of death (31%). Over time, early neonatal mortality showed marginal decline, while late neonatal mortality slightly increased; deaths due to asphyxia and prematurity increased, whereas those from congenital anomalies, sepsis, and other causes showed modest reductions. CONCLUSION:The first 3 days of a newborn's life are the most critical, contributing to the majority of mortalities due to asphyxia, prematurity, or low birth weight. The study also reported cases of sepsis during early life. This study highlights the need to scale up evidence-based practices and interventions for the overall improvement of newborn survival. REVIEW REGISTRATION:PROSPERO CRD420251072864.
OBJECTIVE:This systematic review will aim to evaluate the effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) on implantation rate, clinical pregnancy rate, live birth rate, and clinical miscarriage rate compared to standard in vitro fertilization/intracytoplasmic sperm insemination (IVF/ICSI) in women with recurrent implantation failure. INTRODUCTION:Recurrent implantation failure is a complex condition in assisted reproductive technology, attributed to multifactorial causes, with chromosomal aneuploidy being a leading contributor. PGT-A has been proposed as a strategy for selecting euploid embryos, but its effectiveness on reproductive outcomes remains unclear due to conflicting evidence. ELIGIBILITY CRITERIA:This review will include clinical trials and observational studies comparing PGT-A to standard IVF/ICSI in women with recurrent implantation failure. The review will assess the implantation rate, clinical pregnancy rate, live birth rate, and clinical miscarriage rate as outcomes. METHODS:This review will follow the JBI methodology for systematic reviews of effectiveness. A systematic search will be conducted in PubMed, Scopus, and Embase (Embase.com). Two reviewers will independently screen titles, abstracts, and full texts. Data will be extracted using Excel software, and methodological quality will be assessed. Meta-analysis will be performed using a random effects model, with heterogeneity assessed by I2, and publication bias will be evaluated. Evidence certainty will be rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. English-language studies will be included from the earliest searchable date of each database until January 19, 2026. SYSTEMATIC REVIEW REGISTRATION NUMBER:PROSPERO CRD420251029623.
OBJECTIVE:This scoping review will identify and synthesize evidence regarding implemented and evaluated innovations aimed at improving communication between patients, caregivers, health care providers, and trainees in inpatient pediatric setting. INTRODUCTION:Communication has an important role in promoting safe, effective, and equitable patient care. Medical interactions in the inpatient pediatric setting require unique communication strategies. While family-centered rounds are beneficial, additional adaptations and innovations are needed to meet patient and family communication needs and reduce disparities in communication. There is currently no synthesis of innovations to improve communication between patients, caregivers, health care providers, and trainees in inpatient pediatric settings. ELIGIBILITY CRITERIA:Participants in this review will include hospitalized pediatric patients or their caregivers, and health care providers or medical trainees. The review will explore implemented and evaluated innovations aimed at improving communication of patients and/or caregivers with health care providers and/or medical trainees. Inpatient pediatric medical units will be investigated in any geographic location, but only English studies with an evaluative component in their design will be included. METHODS:This review will follow JBI methodology for scoping reviews. Databases to be searched include MEDLINE, Embase, and CINAHL. Study selection and data extraction will be conducted in duplicate, with data extracted using a tool created by the authors. The Implementation Outcomes Framework, Consolidated Framework for Implementation Research, and Health Equity Implementation Framework will be used to develop a conceptual map and support analysis. The results will be narratively described and presented visually using tables and figures. REVIEW REGISTRATION:OSF https://osf.io/3zs59/overview.
Objective: This review will synthesize existing evidence on oral health interventions developed for Bengali children in the UK and identify the application of behavior change frameworks to their culture. Introduction: Despite improvements in children’s oral health over the past half-century, a higher percentage of Bengali children experience dental caries than other ethnicities in the UK. The experience of dental caries is strongly shaped by oral health behaviors, including parental attitudes, traditional dietary practices, and cultural beliefs about teeth. Certain oral health interventions incorporate behavior change frameworks and techniques, but little is known about their application to different cultures, in particular, the Bengali culture. This scoping review will address these research gaps by synthesizing evidence on oral health interventions developed for UK-based Bengali children and their families. Eligibility criteria: This review will consider all study types presenting an oral health behavior intervention, including diet, toothbrushing, and dental service utilization, for Bengali children and their families in the UK. Interventions will be assessed for the use of behavior change frameworks, intervention target and deliverer, and cultural consideration. This review will include full-text studies from the UK only, published in English. Methods: This review will follow the JBI methodology for scoping reviews. MEDLINE, Embase, CINAHL, and the Cochrane Database of Systematic Reviews will be searched. Two reviewers will independently screen sources for eligibility. Methodological quality will be assessed using the Mixed Methods Appraisal Tool. Review registration: OSF https://osf.io/mrn27
OBJECTIVE:This review aims to assess the intrarater and interrater reliability of lung ultrasound (LUS) in adult patients in emergency and intensive care settings, and to understand the associated influencing factors. INTRODUCTION:LUS is an increasingly important tool for diagnosis and monitoring of diseases of the respiratory system, especially in emergency and intensive care settings. LUS findings, however, are largely dependent on operator technique and expertise to identify and interpret images, thus concerns remain about its reliability across different examiners and clinical settings. A comprehensive review of reliability, specifically intrarater and interrater, is needed to ensure the accuracy and reproducibility of LUS findings in clinical practice. ELIGIBILITY CRITERIA:The review will include eligible studies of LUS examinations on adult patients (>18 years) receiving care in emergency or intensive care settings for the investigation of any signs, symptoms, or conditions suggestive of alteration of the respiratory system. Studies published from the 1990s to the present will be considered for inclusion, without restriction on language or methodological quality. METHODS:The review will follow Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) for systematic reviews. The search will be conducted in MEDLINE (Ovid), Embase (Ovid), Web of Science, CINAHL (EBSCOhost), Scopus, and gray literature sources. Two independent reviewers will assess studies against predefined criteria and the COSMIN Risk of Bias tool. Intrarater and interrater reliability of relevant LUS findings will be extracted and synthesized, with meta-analyses and subgroup analysis, where relevant. REVIEW REGISTRATION:PROSPERO CRD420251081274.
OBJECTIVE:This review will map and synthesize evidence on integrated service strategies across health care and community-based settings for addressing co-occurring intimate partner violence and substance use problems among women, including reported outcomes and contextual barriers and facilitators of implementation. INTRODUCTION:Intimate partner violence disproportionately affects women and is highly associated with substance use problems, either their own or their partners'. Although services for intimate partner violence and substance use have demonstrated effectiveness individually, they frequently operate in silos, creating barriers for women experiencing both. While earlier reviews explored related collaborations, no recent synthesis has systematically assessed integrated service strategies specifically tailored to women facing co-occurring intimate partner violence and substance use problems. ELIGIBILITY CRITERIA:This review will consider evidence sources examining integrated service strategies for women experiencing co-occurring challenges, such as co-treatment, joint screening, coordinated service delivery, or referral linkages. Eligible sources will include peer-reviewed primary studies, reviews, and opinion papers published in English since 2010. Exclusions will apply to research addressing only intimate partner violence or substance use, general collaboration without clear integration models, or populations and outcomes not focused on women. METHODS:A comprehensive search will be conducted in multiple databases. Titles and abstracts will be screened, and data will be extracted using a structured form, then synthesized with coding and descriptive analysis. Results will be presented in tabular and narrative formats to classify integrated service strategies, reported outcomes, and contextual factors related to implementation barriers and facilitators. REVIEW REGISTRATION:OSF https://osf.io/ry3tf/overview.
OBJECTIVES:This scoping review will map the global evidence on post-elimination trachoma surveillance, with a particular focus on integration models within primary health care, aiming to draw lessons for Nigeria. INTRODUCTION:Trachoma, the leading infectious cause of preventable blindness, has been eliminated as a public health issue in 27 countries. Maintaining these achievements requires strong post-elimination surveillance, yet evidence on incorporating trachoma monitoring into primary health care and health information systems remains scattered and incompletely synthesized. ELIGIBILITY CRITERIA:The eligibility criteria will be determined using the JBI Participants-Concept-Context framework. METHODS:The review will follow the JBI scoping review methodology. Searches will be conducted for peer-reviewed in PubMed, Embase (Embase.com), Web of Science Core Collection, Scopus, Global Health, and CINAHL (via EBSCOhost), as well as gray literature from WHO IRIS, national elimination dossiers, and partner repositories. Search strategies will incorporate trachoma, surveillance, primary health care, and facility-level service delivery concepts. The review will cover all available literature from database inception to December 2025. No language restrictions will be applied. For studies published in languages other than English, DeepL Translator will be used.Two reviewers will independently screen and extract data using a piloted framework. Findings will be synthesized through descriptive mapping and qualitative content analysis, and presented in tables and maps. An operational integration framework will be developed as a primary synthesis output of this study. No critical appraisal will be performed. REVIEW REGISTRATION:OSF https://doi.org/10.17605/OSF.IO/EH98C.
OBJECTIVE:The aim of this systematic review was to determine whether suture button fixation is superior to traditional screw fixation for injuries to the distal tibiofibular syndesmosis. INTRODUCTION:Injuries to the distal tibiofibular syndesmosis that require surgical intervention are common. Effectiveness of surgical management of these injuries has been firmly established; however, there remains ongoing debate surrounding which implant should be used. Suture button fixation offers theoretical benefits allowing dynamic fixation of a mobile structure compared to the static alternative offered with screw fixation. ELIGIBILITY CRITERIA:This review evaluated studies that met the following criteria: (i) randomized controlled trials; (ii) comparison of outcomes of suture button vs screw fixation for the management of acute syndesmotic injury (<6 weeks since injury); and (iii) skeletally mature patient (age >18 years). The primary outcome of interest was composite functional ankle scores, with secondary outcomes including range of motion, pain, joint malreduction, complication rates, re-operation rates, and return to work/sport. METHODS:A systematic search of PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Web of Science was conducted from inception to May 2024. Gray literature was searched via MedNar, ProQuest Dissertations and Theses, OpenGrey, and Libraries Australia. Two reviewers independently screened titles, abstracts, and full texts against prespecified eligibility criteria, critically appraised included studies using the JBI Critical Appraisal Checklist for Randomized Controlled Trials, and extracted data using the JBI data extraction tool. Outcomes were pooled using random-effects meta-analysis. Certainty of the evidence was assessed using GRADE and presented in a Summary of Findings. RESULTS:The literature search identified 16 reports of randomized controlled trials, involving 783 unique participants comparing outcomes for suture button compared to screw fixation of acute syndesmotic injuries. Patients treated with suture button fixation had a significantly better complication profile with fewer overall complications (odds ratio [OR] 0.22, 95% CI 0.10 to 0.50, P ≤ 0.01), overall reoperations (OR 0.34, 95% CI 0.19 to 0.62, P ≤ 0.01), implant breakage (OR 0.09, 95% CI 0.03 to 0.21, P ≤ 0.01), and unplanned implant removal (OR 0.37, 95% CI 0.18 to 0.76, P =0.01) without significant differences in rates of infection (OR 1.58, 95% CI 0.61 to 4.14, P =0.35), syndesmotic malreduction (OR 0.48, 95% CI 0.22 to 1.03, P =0.06), or range of ankle plantarflexion (standardized mean difference [SMD] 0.22, 95% CI -0.07 to 0.51, P =0.13) or dorsiflexion (SMD 0.07, 95% CI -0.22 to 0.36, P =0.62). Across a range of clinical outcome measures, suture button fixation had comparable outcomes to screw fixation, with the only statistically significant difference being an improvement in the composite functional ankle score at 1 year measured using the American Orthopaedic Foot and Ankle Society (AOFAS) score (SMD 0.32, 95% CI 0.07 to 0.57). CONCLUSIONS:Suture button fixation has a significantly improved complication profile when compared to screw fixation for the management of acute syndesmotic injuries. Suture button fixation also had slightly improved early functional outcomes, with similar short-, medium-, and long-term clinical outcomes. Suture button fixation should be recommended for the surgical management of syndesmotic injuries. REVIEW REGISTRATION:PROSPERO CRD42022331211.
