172 lines
5.6 KiB
YAML
172 lines
5.6 KiB
YAML
abstract: 'This systematic review analyzes published studies to identify social and
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clinical factors in head and neck cancer treatment in low-income and
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lower-middle-income countries predominantly in South Asia.
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Importance The identification of the barriers to care for patients with
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head and neck cancer in low-income and lower-middle-income countries is
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a crucial first step toward the identification of targets for developing
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and implementing cost-effective programs to increase awareness,
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prevention, and treatment of head and neck cancer in this setting.
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Objective To identify the barriers to care for patients presenting with
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head and neck cancer in low-income and lower-middle-income countries.
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Evidence Review Nine databases were searched from their inception to
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December 21, 2017: Africa-Wide Information, the Cochrane Library,
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Embase, Global Health, LILACS, MEDLINE, BIOSIS Previews, and Web of
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Science. Search terms referred to head and neck cancer, barriers to
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care, and low- and lower-middle-income countries, and no temporal and
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linguistic restrictions were imposed. Articles were reviewed by 2
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independent investigators, and differences in inclusion were resolved by
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discussion. Bibliographies of all included articles were screened, and
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all relevant articles were reviewed using the same procedure.
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Quantitative articles were assessed using the Methodological Index for
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Non-Randomized Studies tool, and articles with qualitative data used the
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Critical Appraisal Skills Programme qualitative checklist. This
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systematic review was registered in PROSPERO (registration No.
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CRD42018092448) and followed the Preferred Reporting Items for
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Systematic Review and Meta-Analysis Protocols. Findings Of the 44
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articles selected for review, 18 (41\%) met the selection criteria. All
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articles reported quantitative results, and 3 (17\%) added some
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qualitative material to the study design. Most (11 {[}61\%]) of the
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studies originated from India. A total of 41 different barriers to care
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were identified, with low level of education (cited in 8 articles
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{[}44\%]), low socioeconomic status (in 4 articles {[}22\%]), and lack
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of knowledge about head and neck cancer (in 3 articles {[}17\%]) being
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statistically associated with a delayed presentation. Misunderstanding
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of signs and symptoms, use of alternative medicine, and inability to
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access health care were other barriers discussed in the qualitative
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articles. Conclusions and Relevance This systematic review highlighted
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the lack of both qualitative and quantitative information for patients
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with head and neck cancer in low-income and lower-middle-income
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countries. The findings suggest that integrating the barriers to care
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with information from patient lives may identify the clinical and social
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relevance of these barriers and guide future research.
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Question What are the barriers to care for patients presenting with head
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and neck cancer in low-income and lower-middle-income countries?
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Findings In this mixed-methods systematic review of 18 studies that
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originated from Asia and Africa, a low level of literacy was
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statistically associated with a delayed presentation in 8 articles
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(44\%), and lower socioeconomic status was statistically associated in 4
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articles (22\%). Qualitative articles identified misunderstanding of
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symptoms, use of alternative medicine, and inability to access health
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care as factors associated with a delayed presentation. Meaning Findings
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of this study may help identify the clinical and social validity of a
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given barrier to care in low-income and lower-middle-income countries
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and may guide future work in this understudied area.'
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affiliation: 'Beaudoin, PL (Corresponding Author), Univ Montreal, OTL HNS, Otolaryngol
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Head \& Neck Surg, 1051 Rue Sanguinet, Montreal, PQ H2X 3E4, Canada.
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Beaudoin, Pier-Luc, McGill Univ, Dept Surg, Montreal, PQ, Canada.
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Beaudoin, Pier-Luc, Univ Montreal, PGY Otolaryngol Head \& Neck Surg 4, Montreal,
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PQ, Canada.
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Anchouche, Sonia; Gaffar, Rouan, McGill Univ, Dept Med, Montreal, PQ, Canada.
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Guadagno, Elena, McGill Univ, Ctr Hlth, Pediat Gen \& Thorac Surg, Montreal, PQ,
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Canada.
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Ayad, Tareck, Ctr Hosp Univ Montreal, Otolaryngol \& Head \& Neck Surg Dept, Montreal,
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PQ, Canada.
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Ayad, Tareck, Univ Montreal, Otolaryngol \& Head \& Neck Surg, Montreal, PQ, Canada.
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Poenaru, Dan, McGill Univ, Ctr Hlth, Dept Pediat Surg, Montreal, PQ, Canada.'
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author: Beaudoin, Pier-Luc and Anchouche, Sonia and Gaffar, Rouan and Guadagno, Elena
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and Ayad, Tareck and Poenaru, Dan
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author-email: pier-luc.beaudoin@mail.mcgill.ca
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author_list:
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- family: Beaudoin
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given: Pier-Luc
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- family: Anchouche
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given: Sonia
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- family: Gaffar
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given: Rouan
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- family: Guadagno
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given: Elena
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- family: Ayad
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given: Tareck
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- family: Poenaru
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given: Dan
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da: '2023-09-28'
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doi: 10.1001/jamaoto.2019.4311
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eissn: 2168-619X
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files: []
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issn: 2168-6181
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journal: JAMA OTOLARYNGOLOGY-HEAD \& NECK SURGERY
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keywords-plus: ORAL-CANCER; DELAY; CAVITY; HEALTH
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language: English
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month: MAR
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number: '3'
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number-of-cited-references: '35'
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orcid-numbers: 'Poenaru, Dan/0000-0002-6267-6140
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Guadagno, Elena/0000-0002-4616-9990'
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pages: 291-297
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papis_id: ce7ac0b16d068209b4ba730e426f4079
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ref: Beaudoin2020barriersaccess
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researcherid-numbers: 'Poenaru, Dan/S-2562-2017
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'
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tags:
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- review
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times-cited: '10'
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title: Barriers in Access to Care for Patients With Head and Neck Cancer in Resource-Limited
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Settings A Systematic Review
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type: article
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unique-id: WOS:000522034800014
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usage-count-last-180-days: '0'
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usage-count-since-2013: '5'
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volume: '146'
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web-of-science-categories: Otorhinolaryngology; Surgery
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year: '2020'
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