Assessment of health equity consideration in Cochrane systematic reviews and primary studies on urolithiasis

Abstract Background and Aims Health injustice is defined as “unnecessary, preventable, unjustified and unfair health differences.” One of the most important scientific sources on the prevention and management of urolithiasis are Cochrane reviews in this field. Given that the first step in eliminating health injustice is to identify the causes, the aim of the present study was to evaluate equity considerations in Cochrane reviews and the included primary studies on urinary stones. Methods Cochrane reviews on kidney stones and ureteral stones were searched through the Cochrane Library. The included clinical trials in each of the reviews published after 2000 were also collected. Two different researchers reviewed all the included Cochrane reviews and primary studies. The researchers reviewed each PROGRESS criteria independently (P: place of residence, R: race/ethnicity/culture, O: occupation, G: gender, R: religion, E: education, S: socioeconomic status, S: social capital and networks). The geographical location of the included studies was categorized as low‐income, middle‐income and high‐income countries, based on the World Bank income criteria. Each PROGRESS dimension was reported for both the Cochrane reviews and the primary studies. Results In total, 12 Cochrane reviews and 140 primary studies were included in this study. None of the included Cochrane reviews had specifically mentioned the PROGRESS framework in the Method section whereas gender distribution and place of residence were reported in two and one reviews, respectively. In 134 primary studies at least one item of PROGRESS was reported. The most frequent item was gender distribution, followed by place of residence. Conclusion According to the results of this study, the authors of Cochrane systematic reviews on urolithiasis, and researchers who have conducted such trials, have rarely considered health equity dimensions when designing and performing their studies. Therefore, researchers worldwide should be motivated to study populations from low‐income countries with low socioeconomic status in addition to different cultures, ethnicities, and so forth. Furthermore, RCT reporting guidelines such as CONSORT should include health equity dimensions and the editors and reviewers of scientific journals should encourage researchers to further emphasize on health equity in their studies

Socioeconomic status in relation to childhood general and central obesity in primary school children in the city of Farokh Shahr in 2009

Introdution: Since limited data are available in regard of the association between socioeconomic status (SES) and obesity among children, our aim was to examine the association between SES and obesity among children. Methods: This cross-sectional study was done in Farokh Shahr among children aged 6-12y in 2009. 380 students were recruited through multi-stage cluster random sampling method from different districts. SES was defined through the questionnaire and participants were classified in to tertiles. Overweight/obesity and abdominal obesity were defined based on age- and sex-specific national cut-off points. Comparison of continuous and categorical variables was conducted by using independent samples’ t-test and Chi-square test, respectively. Binary logistic regression analysis was used to assess SES in relation to general and abdominal obesity in uni- and several multi-variable adjusted models. All statistical analyses were done using the Statistical Package for Social Sciences (SPSS, version 15.0). P values less than 0.05 were considered as statistically significant. Results: Comparing individuals in the highest versus lowest tertile of SES, there was no significant difference in waist circumference mean, but those in the middle tertile of SES had greater means of BMI after controlling for potential confounders (16.19±0.27 vs. 15.27±0.27 kg/m2, P= 0.002). We observed a greater chance of being overweight/obese for those in the highest tertile of SES compared with the lowest tertile (OR: 4.00, 95% CI: 1.53-10.59, Ptrend=0.004). No significant association was seen between SES and abdominal adiposity, either before or after controlling for potential confounders. Conclusion: We found that children in the highest SES class had a greater chance of being overweight/obese than those in the lowest SES class