专业利益相关方对儿童1型糖尿病早期筛查的看法：一项系统综述。
完整摘要 · 中文译文
随着症状前筛查项目和疾病修饰疗法的不断扩展，1型糖尿病（T1D）的早期筛查正受到越来越多的关注。然而，在实施、患者参与和卫生系统准备方面发挥关键作用的专业利益相关者的观点尚未得到系统整合。我们开展了一项系统综述，以考察专业人士对儿童T1D早期筛查的看法。按照PRISMA指南，检索了六个数据库（Medline、Embase、Scopus、CINAHL、PsycINFO、ASSIA）和灰色文献，检索时间截至2026年1月。12项研究符合纳入标准，主要涉及儿科医生和糖尿病专科医生；护士、遗传咨询师、政策制定者及其他医疗保健专业人员在少数研究中有所体现。使用混合方法评价工具（MMAT）进行方法学评估，发现样本代表性和潜在无应答偏倚方面存在反复出现的局限性。鉴于研究设计和结局的异质性及主要描述性特征，对结果进行了叙述性综合。专业观点因目标人群、所研究的专业群体、筛查情景和实施背景而异。在直接比较的情况下，对高危人群筛查的支持度高于全人群筛查。报告的优势包括预防糖尿病酮症酸中毒（DKA）、更早的临床参与以及提高家庭准备度。然而，人们仍对心理社会负担、人力能力和尚不明确的转诊路径存有顾虑。 错误与随访路径。在一些结构化的项目中报告了更为良好的评价，尽管这些发现可能反映了对现有基础设施的依赖以及有针对性的受试者选择。通过整合此前零散的证据，本综述明确了与儿科1型糖尿病（T1D）筛查相关的反复出现的临床、社会心理和组织层面的考量因素。这些发现主要反映了临床观点，提示支持是有条件的，而非一致的。进一步的研究应评估标准化路径、专业培训和整合的社会心理支持如何在不同医疗背景下影响筛查的可行性和可接受性。
完整摘要 · 英文原文
Early screening for type 1 diabetes (T1D) is receiving increasing attention as presymptomatic screening initiatives and disease-modifying therapies continue to expand. However, the perspectives of professional stakeholders, who play a pivotal role in implementation, patient engagement, and health system preparedness, have not been systematically synthesised. We conducted a systematic review to examine professional views on paediatric early T1D screening. Following PRISMA guidelines, six databases (Medline, Embase, Scopus, CINAHL, PsycINFO, ASSIA) and grey literature were searched through January 2026. Twelve studies met the inclusion criteria, predominantly involving paediatricians and diabetes specialists; nurses, genetic counsellors, policymakers, and other healthcare professionals were represented in few studies. Methodological appraisal using the Mixed Methods Appraisal Tool (MMAT) identified recurring limitations in sample representativeness and potential nonresponse bias. Given the heterogeneity and primarily descriptive nature of the study design and outcomes, findings were synthesised narratively. Professional perspectives varied according to the population targeted, professional group studied, screening scenario, and the implementation context. Where directly compared, support was greater for at-risk than for general-population screening. Reported benefits included diabetic ketoacidosis (DKA) prevention, earlier clinical engagement, and improved preparedness for families. However, concerns persisted regarding psychosocial burden, workforce capacity, and unclear referral and follow-up pathways. More favourable evaluations were reported in some structured programmes, although these findings may reflect reliance on existing infrastructures and targeted participant selection. By consolidating previously fragmented evidence, this review identifies recurring clinical, psychosocial, and organisational considerations relevant to paediatric T1D screening. These findings primarily reflect clinical perspectives and indicate conditional rather than uniform support. Further studies should evaluate how standardised pathways, professional training, and integrated psychosocial support affect the feasibility and acceptability of screening across different healthcare contexts.