摘要：目的 探讨与敌草快(diquat,DQ)急性中毒患者预后有关的影响因素,为辨别预测效能高、可靠性稳定的预后指标,合理诊疗急性DQ中毒患者提供循证依据.方法 以"敌草快""中毒""危险因素""预后""影响因素"等中文及相应的英文检索词为主题词或自由词,检索中国知网、万方医学网、维普数据库、中国优秀硕士学术论文全文数据库、中国生物医学数据库、PubMed、Embase、Web of science、The Cochrane Library等数据库截至2024年1月1日收录的相关文献,依据纳入排除标准提取数据资料,并评价文献的质量;应用R软件,对急性敌草快中毒患者预后影响因素进行meta分析.结果 初步检索到759篇文献,最终纳入11篇文献,其中英文文献2篇,中文文献9篇,均来自中国,且均为高质量文献.纳入759例急性DQ中毒患者,其中死亡组296例,存活组463例.依据加尔布雷斯图结果、敏感性分析结果,剔...

Background: White light (conventional) colonoscopy (WLC) is widely used for colorectal cancer screening, diagnosis and surveillance but endoscopists may fail to detect adenomas. Our goal was to assess and synthesize overall and subgroup-specific adenoma miss rates (AMR) of WLC in daily practice. Methods: We conducted a systematic review in MEDLINE, EMBASE, Cochrane Library, and grey literature on studies evaluating diagnostic WLC accuracy in tandem studies with novel-colonoscopic technologies (NCT) in subjects undergoing screening, diagnostic or surveillance colonoscopy. Information on study design, AMR overall and specific for adenoma size, histology, location, morphology and further outcomes were extracted and reported in standardized evidence tables. Study quality was assessed using the QUADAS-2 tool. Random-effects meta-analyses and meta-regression were performed to estimate pooled estimates for AMR with 95% confidence intervals (95% CI) and to explain heterogeneity. Results: Out of 5,963 identified studies, we included sixteen studies with 4,101 individuals in our meta-analysis. One in three adenomas (34%; 95% CI: 30-38%) was missed by WLC in daily practice individuals. Subgroup analyses showed significant AMR differences by size (36%, adenomas 1-5 mm; 27%, adenomas 6-9 mm; 12%, adenomas ≥ 10 mm), histology (non-advanced: 42%, advanced: 21%), morphology (flat: 50%, polypoid: 27%), but not by location (distal: 36%, proximal: 36%). Conclusions: Based on our meta-analysis, one in three adenomas could be missed by WLC. This may significantly contribute to interval cancers. Our results should be considered in health technology assessment when interpreting sensitivity of fecal occult blood or other screening tests derived from studies using WLC as "gold standard".

Background: Population-wide newborn blood spot screening programmes are a successful public health intervention used to detect whether the baby is at risk of certain rare conditions, with the aim of earlier diagnosis and provision of optimal care and treatment. Evaluating candidate conditions to include in newborn blood spot and genetic sequencing raises questions regarding acceptability to parents/carers. Methods: In the context of the possible expansion of the newborn blood spot screening programme in the United Kingdom, this review aimed to systematically review research on the acceptability to parents of newborn blood spot screening and genetic sequencing. A protocol was developed prior to commencing the review and was registered on the PROSPERO database. A team of researchers carried out the review, with checking at all stages carried out by at least two individuals. We included research published after 2013 with participants who were pregnant or a recent parent of a newborn and were resident in a high-income country. We included quantitative and qualitative studies that investigated the acceptability to parents/carers of newborn blood spot screening or genetic sequencing. Quantitative studies were narratively synthesised, and theories/frameworks identified and evaluated. Qualitative studies were analysed for recurring themes, and a meta-synthesis was carried out to compare and contrast these two types of data. We quality appraised included articles using tools appropriate for their study design. Results: Searches were carried out in September to November 2023 and screening identified 25 relevant research articles. Just over half were from North America, with four existing reviews and nine qualitative studies. Domains of acceptability described in the literature were: support for screening; level of anxiety, information and knowledge; consent; views of the procedure; and support after screening. The research indicated consensus support for blood spot screening, and for expanding to some other conditions, although some parental anxiety was reported. Parents/carers mostly perceived that they had received sufficient information, but the timing of this could be improved. While parents indicated interest in genomic screening, studies highlighted the need for clearer consent procedures and greater support for parents following genomic screening than for blood spot screening. Only three included studies reported using any kind of theoretical framework. Discussion: Most parents/carers found newborn blood spot screening programmes to be acceptable and favoured their large-scale implementation. A minority of parents/carers expressed concerns regarding the acceptability of processes underpinning newborn blood spot screening, such as consent, the timing of receiving information and support available after testing. More research is needed regarding the acceptability of newborn genomic sequencing screening programmes, which are less established compared with newborn blood spot screening programmes. Limitations: The over-representation of studies conducted in the United States has implications for the applicability of findings to other countries where testing is not typically mandatory and health systems differ considerably. Most studies were of cross-sectional design and there was limited representation of people from lower incomes and non-white ethnicity. While the inclusion of studies only in populations of future or very recent parents provided coherence to the findings, unclear reporting of participants may have resulted in under- or overinclusion of some studies. Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR159927.

Background: Mobile health interventions that utilize artificial intelligence may provide way for underserved populations to engage with healthcare. Purpose: Examine the policy considerations that must be deliberated when developing, regulating, implementing, and sustaining mHealth apps among historically underserved individuals. Methods: Reproductive Justice was used to investigate policy considerations for those with criminal legal system supervision who engage with mHealth apps. Three policy considerations resulted: 1) improving the legislative and regulatory landscape of digital technology, 2) enhancing comprehensive data protection legislation, 3) heightening privacy protections. Discussion: The need to bring awareness to policy protections on the local, institutional, state, federal, and global levels specific to mHealth apps among underserved groups with criminal legal supervision is required. Conclusion: These emerging advances in technology serve as an avenue for direct healthcare services to collaborate with other professions and organizations to implement ethical interventions that respect human rights and improve reproductive health equity.

Objectives: This study aimed to evaluate the effectiveness of interventions in reducing loneliness among community-dwelling older adults. Design: A network meta-analysis (NMA) and systematic review. Setting and participants: Interventional studies were included if they contained original quantitative data on interventions to reduce loneliness among community-dwelling older adults. Qualitative studies were included if they contained views on loneliness coping strategies or intervention evaluation. Methods: Six English databases and 3 Chinese databases were searched for studies published before August 2023. We extracted mean and standard deviation for the NMA to examine the overall effectiveness and efficacy of different interventions on loneliness. Thematic analysis was used to derive perspectives on coping strategies to mitigate loneliness. Results: Forty-six quantitative studies with 6049 participants and 40 qualitative studies with 1095 participants were included in the analysis. The pooled effect size was large and significant [standardized mean difference (SMD), -0.95; 95% CI, -1.32 to -0.58; P < .001], indicating a strong effect of interventions in reducing loneliness. Subgroup analyses revealed significant differences in effect sizes by study region and health risk. Results of the NMA suggested interventions seem to be most effective when having psychosocial interventions as the content, a combination of individual and group as the delivery mode, and a mixture of face-to-face and online methods as the contact mode. Findings of the qualitative synthesis revealed 2 main dimensions of activities for reducing loneliness, including delivery modes (individual or group or combination) and settings (indoor or outdoor or combination). Strategies for coping with loneliness at the social, cognitive, and behavioral levels were also identified. Conclusions and implications: The present study identified the most effective components of loneliness interventions in reducing loneliness among older adults. Findings offer important insights for practice and policy-making on potential strategies that can be used to reduce loneliness among community-dwelling older adults.

Study design: Descriptive study. Objectives: The National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) is a registry system to survey Traumatic Spinal Column/Spinal Cord Injuries (TSC/SCIs) patients and obtain the required data for quality-of-care assessment. Setting: Iran. Methods: In 2022, the pre-hospital, in-hospital, and post-hospital Quality of Care (QoC) of registered patients with TSC/SCIs in 8 referral hospitals in Iran were studied. Results: Based on the study reports, TSCI/SCIs and their complication management were highly influenced by the health system's performance. In particular, the health system structure and medical process were identified to affect patient outcomes. According to the QoC study reports, several recommendations, including goal setting by emergency medical service providers to transport patients with possible spinal injury to first care facilities in <1 h and to an equipped care facility in <8 h, the dedication of operating room available 24/7 for patients with TSC/SCIs in referral centers, the distinction between early vs late surgery in patients with TSC/SCIs by healthcare insurance to increase the propensity for early surgery, operating a specialized SCI care unit with trained physicians and personnel in the management of acute complications following SCI and early rehabilitation in referral hospitals were specified. Conclusion: This article provides a policy brief of this report. The role of the health system and medical process, as well as addressing TSC/SCIs health concerns by policymakers and stakeholders in the Ministry of Health and the parliament, to improve the QoC for patients with TSC/SCIs are discussed.

目的:系统评价正念疗法对慢性心力衰竭患者健康状况的干预效果。方法:检索PubMed、CochraneLibrary、Clinic Trials、PsycInfo、EMbase、Web of Science、CNKI、VIP、WanFang、SinoMed数据库建库及中外临床试验注册中心，检索正念疗法对慢性心力衰竭患者健康状况影响的随机对照试验，检索时限均为从建库至2024年2月1日。由2名研究者进行质量评价，采用RevMan 5.4软件进行Meta分析。结果:最终纳入8项研究，评估调查对象714人；Meta分析结果显示，与对照组比较，正念疗法能有效地提高心力衰竭患者的运动耐量[SMD=2.50,95%CI(5.68,46.91),P0.05;SMD=1.98,95%CI(-5.22,-0.02),P=0.05]。结论:正念疗法可以有效地提高心力衰竭患者运动...

目的 系统评价临床护理路径健康教育对慢性肾小球肾炎患者康复的影响。方法 计算机检索中国知网、万方数据知识服务平台、中国科技期刊数据库、PubMed、Embase及The Cochrane Library等数据库，收集有关以临床护理路径健康教育为主要干预手段进行慢性肾小球肾炎患者康复管理的文献。在筛选文献、提取资料及质量评价后，采用RevMan 5.3软件进行Meta分析。结果 共纳入12篇文献。Meta分析结果显示，观察组疾病知晓率及心理功能、社会功能、生理功能、躯体功能的评分高于对照组，住院时间短于对照组（P<0.05）。结论 与常规健康教育或常规护理干预相比，实施临床护理路径健康教育有利于提高慢性肾小球肾炎患者的疾病知晓度，缩短住院时间，改善患者生活质量，具有较好的临床应用价值。

Background: Adolescent sexual and reproductive health (ASRH) is fundamental to the overall wellbeing and development of young people. In Southern Ethiopia, adolescents face significant barriers to accessing and utilizing ASRH services: they include limited information, pervasive cultural stigma, and inadequate healthcare infrastructure. Addressing these barriers is critical to reducing unintended pregnancies, preventing sexually transmitted infections, and achieving national and international health objectives. Despite the existence of policies aimed at improving ASRH, these challenges persist, highlighting the urgent need for targeted policy reforms and effective implementation strategies to ensure a healthier future for adolescents in the region. Main findings: Recent research has identified substantial barriers to ASRH services in Southern Ethiopia. Key challenges include widespread gaps in knowledge, socio-cultural stigma, and strong influences from family and peers, compounded by limited service availability. The absence of adolescent-friendly care, coupled with insufficient outreach efforts, further restricts access. Healthcare providers also encounter significant obstacles, such as stigma, inadequate training, and a lack of institutional support, which undermine their ability to deliver effective services. Service utilization varies markedly based on geographic location, economic status, and educational attainment, with approximately half of adolescents lacking a comprehensive understanding of sexual and reproductive health and rights (SRHR). Moreover, persistent stigma, low levels of social support, and limited self-efficacy continue to hinder the uptake of these essential services. Policy implications: To improve ASRH services in Southern Ethiopia, a multi-faceted approach is imperative. Increasing public education through school programs and awareness campaigns can mitigate stigma and misinformation, fostering a more supportive environment. Initiatives such as providing transportation support and establishing mobile health clinics will significantly improve access for adolescents in underserved areas. Strengthening healthcare services by offering specialized training for providers and establishing adolescent-friendly clinics will elevate the quality of care. Engaging families, communities, and peer networks is essential for building a supportive framework that encourages adolescents to utilize SRH services. Finally, implementing skill-building and counseling programs will empower adolescents to make informed decisions regarding their sexual and reproductive health, ultimately contributing to improved health outcomes across the region.

目的 系统分析基于护理程序的护理缺失内容的相关研究，总结护理缺失的具体内容、类型和原因，以期为医护人员今后开展相关干预提供参考。方法 根据范围综述的研究方法，检索The Cochrane Library、CINAHL、PubMed、Embase、Medline、生物医学文献数据库、中国知网、万方数据知识服务平台、维普中文科技期刊数据库等国内外数据库，检索时限为建库至2023年11月20日。对纳入文献进行筛选、提炼和汇总分析。结果 最终纳入14篇符合标准的文献，缺失最多的护理内容为基础护理，护理程序中缺失最多的为护理评估，主要原因分为人力资源、物质资源、沟通交流、组织管理4个维度。结论 现存护理缺失仅调查护理程序中的3个步骤，涵盖不全且存在多方面护理内容缺失，今后编制新的工具可考虑护理程序的5个步骤，充分发挥护理程序在护理中统一性、规范性以及指导性的作用，并在组织管理方面做出改善，减少护理缺失，提高护理质量。

目的 为进一步规范消化道肿瘤患者家庭肠内营养支持治疗流程和居家管理，检索并总结相关证据。方法 系统检索PubMed、Web of Science、Cochrane Library、国际指南协作网、美国国家综合癌症网、医脉通、中国知网、万方数据库、中国生物医学文献数据库等数据库和网站中，关于不同肠内营养管理方法在居家消化道肿瘤患者中应用的相关证据。由两名研究者分别进行文献质量评价和证据提取，总结居家消化道肿瘤患者肠内营养管理的最佳证据。结果 共纳入13篇文献，其中4篇指南、1篇专家共识、5篇系统评价、3篇随机对照研究，从筛查与评估、适应证与禁忌证、家庭肠内营养方式、监测与终止、健康教育和效果评价6个方面进行汇总，共总结出24条最佳证据。结论 本研究总结了居家消化道肿瘤患者肠内营养管理的最佳证据，提示临床应组建多学科团队，从营养评估、营养支持方式选择、健康教育等多方面入手，为消化道肿瘤患者提供规范和全面的居家肠内营养管理措施，以改善肿瘤患者的居家营养状况，提高其生活质量。

目的:检索和总结慢性心力衰竭病人药物管理的最佳证据。方法:按照“6S”证据模型从上到下依次检索指南网、相关专业协会网站以及中文、英文数据库中关于慢性心力衰竭病人药物管理的相关文献，检索时限从建库至2023年10月。由2名经过循证护理学课程培训的硕士研究生独立进行文献筛选、质量评价、资料提取和证据整合。结果:共纳入26篇文献，包括2篇临床决策、8篇指南、6篇专家共识、7篇系统评价和3篇证据总结。最终形成了包括多学科合作、健康评估、用药监测及处理、依从性管理、健康教育及随访管理6个方面共39条证据。结论:本研究总结了慢性心力衰竭病人药物管理的最佳证据，为规范药物管理临床实践、改善慢性心力衰竭病人服药行为提供借鉴及参考；医护人员可根据临床实际工作情景结合病人意愿进行应用。

目的：采用贝叶斯网状Meta分析技术对非药物干预方式减轻ICU转出病人家属迁移应激水平的效果进行评价。方法：计算机系统检索中国知网（CNKI）、Web of Science(SCIE)、Cochrane Library、Embase等中英文数据库，搜集不同非药物干预方式对减轻ICU转出病人家属迁移应激的随机对照试验（RCT），检索时限均为建库至2023年6月。使用Stata 15软件进行网状Meta分析。结果：共纳入15项RCT，累计研究患者1 186例，涉及5种非药物干预方式。结果显示：英文FRSS评分方面，减轻照顾者迁移应激水平的干预措施效果排序为行为改变轮模式>ICU联络护士>迁移手册>综合护理>认知行为干预。汉化版FRSS评分方面，减轻照顾者迁移应激水平的干预措施效果排序为迁移手册>认知行为干预>结构化健康教育>综合护理。FCTI评分方面，减轻照顾者迁移应激水平的干预措施效果排序为行为改变轮模式>ICU联络护士>迁移手册>综合护理。STAI评分方面，减轻照顾者迁移应激水平的干预措施效果排序为ICU联络护士>迁移手...

目的 总结肝癌术后患者疲乏症状非药物管理策略的最佳证据，供临床护理实践参考。方法 系统检索Up ToDate、BMJ Best Practice、Cochrane Library﹑JBI循证卫生保健中心数据库、CINAHL﹑Web of Science﹑PubMed﹑中国知网﹑万方数据库、维普数据库、中华医学期刊全文数据库、中国生物医学文献数据库、指南网站、专业协会网站及数据库中关于肝癌术后患者疲乏症状非药物管理的相关文献，检索时限为建库至2023年8月30日。由2名研究者对纳入的文献进行质量评价、证据提取和整合。结果共纳入14篇文献，包括临床决策2篇、指南7篇、Meta分析1篇、系统评价2篇、专家共识2篇，从筛查与评估、多学科管理、运动干预、营养管理、心理干预、健康教育、睡眠干预、补充疗法8个维度总结出29条证据。结论 在肝癌术后患者疲乏症状非药物管理中，医护人员需对患者进行及时、准确的筛查与评估，并采用多学科协作管理实施全面的治疗方案。同时，结合运动干预、营养管理、心理干预、健康教育、睡眠干预及补充疗法等多种方法，提高患者的生活质量。

目的:系统评价自我管理教育护理模式对肝硬化病人的影响。方法:系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、the Cochrane Library、EMbase、Web of Science、PubMed中关于自我管理教育对肝硬化病人影响的随机对照试验，检索时限为建库至2022年1月11日。由2名研究者独立筛选文献、提取资料，并根据Cochrane评价手册5.1.0的评价标准对纳入文献进行质量评价。采用Review Manager 5.4软件进行Meta分析。结果:共纳入12篇文献，Meta分析结果显示，干预组病人自我效能高于对照组[SMD=2.33,95%CI(1.27,3.40),P<0.000 1]，生活质量高于对照组[SMD=0.38,95%CI(0.05,0.72),P=0.02]，日常生活管理能力高于对照组[MD=3.66,95%CI(2.44,4.89),P<0.000 01]、饮食管理能力高于对照组[MD=3.33,95%CI(2.63,4.04),P<0.000 01]、病情监测管理能力高于对照组[SMD=0.98,95%CI(0...

Background: Expanding chronic hepatitis B (CHB) testing through effective implementation strategies in primary- and community-care setting is crucial for elimination. Our study aimed to determine the effectiveness of all available strategies in the literature and evaluate their specifications and implementation outcomes, thereby informing future programming and policymaking. Methods: We conducted a systematic review and meta-analysis (PROSPERO CRD42023455781), searching Scopus, Embase, PubMed, and CINAHL databases up to June 05, 2024, for randomized controlled trials investigating primary- and community-care-based implementation strategies to promote CHB testing. Studies were screened against a priori eligibility criteria, and their data were extracted using a standardized protocol if included. ROB-2 was used to assess the risk of bias. Implementation strategies' components were characterized using the Behavior Change Wheel (BCW) framework. Random-effect models were applied to pool the effectiveness estimate by strategy. Mixed-effect meta-regression was employed to investigate if effectiveness varied by the number of strategy's BCW components. Findings: 7146 unique records were identified. 25 studies were eligible for the review, contributing 130,598 participants. 19 studies were included in the meta-analysis. No studies were conducted in low-and-middle-income countries. Implementation outcomes were reported in only ten studies (40%). Community-based strategies included lay health workers-led education (Pooled Risk Difference = 27.9% [95% Confidence Interval = 3.4-52.4], I2 = 99.3%) or crowdsourced education on social media (3.1% [-2.2 to 8.4], 0.0%). Primary care-based strategies consisted of electronic alert system (8.4% [3.7-13.1], 95.0%) and healthcare providers-led education (HCPs, 62.5% [53.1-71.9], 27.5%). The number of BCW-framework-driven strategy components showed a significant dose-response relationship with effectiveness. Interpretation: HCPs-led education stands out, and more enriched multicomponent strategies had better effectiveness. Future implementation strategies should consider critical contextual factors and policies to achieve a sustainable impact towards hepatitis B elimination targets. Funding: Tran Dolch Post-Doctoral Fellowship in Hepatology, Johns Hopkins University School of Medicine, Baltimore MD, USA.

Background: Antimicrobial resistance (AMR) is a global public health concern that is fueled by the overuse of antimicrobial agents. Low- and middle-income countries, including those in Africa,. Point prevalence surveys (PPS) have been recognized as valuable tools for assessing antimicrobial utilization and guiding quality improvement initiatives. This systematic review and meta-analysis aimed to evaluate the prescription rates, indications, and quality of antimicrobial use in African health facilities. Methods: A comprehensive search was conducted in multiple databases, including PubMed, Scopus, Embase, Hinari (Research4Life) and Google Scholar. Studies reporting the point prevalence of antimicrobial prescription or use in healthcare settings using validated PPS tools were included. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A random-effects meta-analysis was conducted to combine the estimates. Heterogeneity was evaluated using Q statistics, I² statistics, meta-regression, and sensitivity analysis. Publication bias was assessed using a funnel plot and Egger's regression test, with a p-value of < 0.05 indicating the presence of bias. Results: Out of 1790 potential studies identified, 32 articles were included in the meta-analysis. The pooled prescription rate in acute care hospitals was 60%, with significant heterogeneity (I2 = 99%, p < 0.001). Therapeutic prescriptions constituted 62% of all the prescribed antimicrobials. Prescription quality varied: documentation of reasons in notes was 64%, targeted therapy was 10%, and parenteral prescriptions were 65%, with guideline compliance at 48%. Hospital-acquired infections comprised 20% of all prescriptions. Subgroup analyses revealed regional disparities in antimicrobial prescription prevalence, with Western Africa showing a prevalence of 65% and 44% in Southern Africa. Publication bias adjustment estimated the prescription rate at 54.8%, with sensitivity analysis confirming minor variances among studies. Conclusion: This systematic review and meta-analysis provide valuable insights into antimicrobial utilization in African health facilities. The findings highlight the need for improved antimicrobial stewardship and infection control programs to address the high prevalence of irrational antimicrobial prescribing. The study emphasizes the importance of conducting regular surveillance through PPS to gather reliable data on antimicrobial usage, inform policy development, and monitor the effectiveness of interventions aimed at mitigating AMR.

目的 筛选国内外蠕形螨相关干眼症护理的相关证据，并对最佳证据进行总结。方法 系统检索UpToDate、BMJ Best Practice、美国指南网、亚洲干眼协会、国际泪表与眼表协会、中国知网和万方数据等数据库，查找和研究相关的原始研究、指南、专家共识和系统评价。检索期限为建库至2024年3月31日。由2名研究员对文献质量进行评价，并结合专业判断，选取符合标准的文献。结果 最终共纳入9篇文献，其中指南2篇、专家共识3篇、系统评价2篇、原始研究2篇。最佳证据包括居家护理、健康教育、干预措施3个类别，共总结出27条证据。结论 证据应用人员需结合临床环境及医院特点，针对性地选取应用蠕形螨相关干眼症护理的最佳证据，以提升护理质量，促进患者健康。

目的 研究基于微信平台的健康教育对心脏瓣膜置换术患者术后康复及生活质量的影响，以期为心脏外科手术患者的术后康复提供相关参考。方法 采用复合逻辑检索方式，以“心脏瓣膜置换术”、“心脏瓣膜病变”、“微信平台健康教育”“Transcatheter aortic valve replacement”、“Heart valve replacement”、“Health education”等为检索词对Pubmed、Medline、知网等从建库至2023年10月的文献进行检索，并筛选心脏瓣膜置换术后对患者实施健康教育相关的参考文献。Review Manager 5.3软件进行Meta分析，若合并结果无明显的异质性（P≥0.1,I2≤50%），选用固定效应模型。若存在明显的异质性（P50%），选用随机效应模型。以P<0.05表示合并统计量有统计学意义。结果 研究共纳入9篇参考文献，结果显示，两组患者术后生活质量评分差异有统计学意义（Z=16.33,P<0.001）。抗凝知识知晓率分析结果显示，合并的文献无明显的异质性...

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) is key for policy making. Low back pain is the leading cause of disability in terms of years lived with disability (YLDs). Due to sparse data, a current limitation of GDB is that a uniform severity distribution is presumed based on 12-Item Short Form Health Survey scores derived from US Medical Expenditure Panel Surveys (MEPS). We present a novel approach to estimate the effect of exposure to health interventions on the severity of low back pain by country and over time. Methods We extracted treatment effects for ten low back pain interventions from the Cochrane Database, combining these with coverage data from the MEPS to estimate the hypothetical severity in the absence of treatment in the USA. Severity across countries was then graded using the Health Access and Quality Index, allowing estimates of averted and avoidable burden under various treatment scenarios. Findings We included 210 trials from 36 Cochrane systematic reviews in the network analysis. The pooled effect sizes (measured as a standardised mean difference) for the most effective intervention classes were -0460 (95% uncertainty interval -0606 to -0309) for a combination of psychological and physical interventions and -0366 (-0525 to -0207) for surgery. Globally, access to treatment averted an estimated 176% (148 to 238) of the low back pain burden in 2020. If all countries had provided access to treatment at a level estimated for Iceland with the highest Health Access and Quality Index score, an extra 91% (64 to 112) of the burden of low back pain could be avoided. Even with full coverage of optimal treatment, a large proportion (659% [569 to 704]) of the low back pain burden is unavoidable. Interpretation This methodology fills an important shortcoming in the GBD by accounting for low back pain severity variations over time and between countries. Assumptions of unequal treatment access increased YLD estimates in resource-poor settings, with a modest decrease in countries with higher Health Access and Quality Index scores. Nonetheless, the large proportion of unavoidable burden indicates poor intervention efficacy. This method, applicable to other GBD conditions, provides policy makers with insights into health gains from improved treatment and underscores the importance of investing in research for new interventions.