Despite growing evidence and specific guidelines, people with knee and hip osteoarthritis often do not receive appropriate care. This review aims to identify healthcare utilisation and its predictors to optimise existing services and identify unmet needs across different healthcare systems using Andersen’s Healthcare Utilisation Model as a reference.

We conducted a scoping review and included studies published between 2010 and 2023 that assessed the healthcare utilisation in people with osteoarthritis. We examined general practitioner and orthopaedist consultations, physiotherapy, medication, hospitalisation and emergency department visits.

PubMed, Livivo, Cochrane Library, CINAHL Complete and Web of Science were searched from January 2010 until November 2023. An updated literature search was conducted in December 2025.

We analysed the included studies by means of thematic analysis and descriptive representation of quantitative data.

The literature search identified 4228 articles, of which 2380 articles were included in the title/abstract screening after excluding duplicates. After the full-text screening of 97 articles, we included 39 (n=4 233 566) publications for data extraction and data synthesis. Most studies were conducted in the USA, Australia, Germany and the UK—few from Asia, Middle and South America and other European countries. Utilised healthcare services are general practitioner consultations (mean use: 43% of participants, n=6), opioid (36%, n=8) and non-steroidal anti-inflammatory drug use (42%, n=7), emergency department visits (27%, n=3), orthopaedic surgeon consultations (26%, n=4), total joint replacement surgery (26%, n=3), physiotherapy (14%, n=8), hospitalisation (11%, n=7) and psychotherapy (6%, n=2). Among predisposing characteristics, older age, female gender, ethnicity, high socioeconomic status, social support and fear of certain treatment options were related to higher healthcare utilisation. In those, gender (n=8 studies) and age (n=6 studies) were primarily discussed. Regarding enabling and need factors, increased healthcare utilisation is associated with urban residence and being insured as well as having pain and comorbidities.

Results vary between countries. Against the background of existing guidelines, there is a need for promoting the utilisation of non-surgical and non-pharmacological treatments, such as physiotherapy, which have proven to be effective. Special attention should be given to predictors when promoting appropriate healthcare utilisation. Addressing the identified predictors associated with healthcare utilisation may lead to more appropriate osteoarthritis care. Further research is needed to address healthcare stakeholders’ (physiotherapists, insurers, patients and practitioners) needs and roles in the process.

Protocol registration on PROSPERO (CRD42023475803).

With a prevalence of around 7.6%, developmental language disorders (DLDs) without comorbidities are among the most common and most frequently treated childhood disorders. Standard DLD therapy in Germany consists of individual therapy sessions once per week within speech–language therapy practices. In reality, these sessions only take place every 10–14 days on average. Online therapy may be beneficial but is not yet standard practice in Germany. Although DLD group therapy has been proven to be effective, it is rarely undertaken in Germany. The aim of this study is to compare the effectiveness of online DLD therapy for small groups of children with standard one-to-one therapy.

The effectiveness of two treatment settings is evaluated in 212 children with moderate-to-severe DLD (ages 3 years to 6 years 11 months) in the multicentre, block randomised controlled trial (RCT) THErapy ONline. Five centres in Germany participate. Children are randomly assigned to the intervention group (online interval-intensive therapy, IG1, n=106) or the control group (extensive standard in-person therapy, IG2, n=106). A speech and language assessment is conducted at baseline (study entry, T0), 12 months (T1) and 18 months (T2) after therapy start. The co-primary outcome parameters are the speech and language test scores of phonological speech sound production, expressive vocabulary, grammar production and language comprehension at T1. The secondary outcome parameters comprise two composite speech and language test scores at T1 and T2, including phonological working memory scores and the individual scores of the aforementioned tests at T2, as well as process evaluation parameters (time expenditure, resource utilisation, such as salary costs of speech–language therapists, additional costs of the online therapy, adherence to appointments and therapy acceptance).

This study has been approved by the Institutional Ethics Review Board of Westphalia-Lippe (2022-282 f-S). Parents provide written informed consent. Findings will be disseminated through presentations, peer-reviewed journals and conferences.

DRKS00030068

One of the challenges in managing patients with hantavirus infection is accurately identifying individuals who are at risk of developing severe disease. Prompt identification of these patients can facilitate critical decisions, such as early referral to an intensive care unit. The identified prognostic factors could be of utility in guiding medical care to enhance the management of hantavirus infection.

To identify and evaluate prognostic factors associated with mortality in hantavirus infection.

We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-reported systematic review following Cochrane guidance adapted for prognosis. We searched PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Biblioteca Virtual de Saúde or Lilac and EMBASE, from 1 January 1993 to 2 October 2025. We included studies evaluating individual prognostic factors or risk assessment models of New World hantavirus infections, with no restrictions on study design, publication status or language. When feasible, we conducted meta-analyses for prognostic factors using the inverse variance-based method with random effect model. We assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach.

We included 25 studies with a total of 7284 participants. We identified the following prognostic factors for which we found moderate to high certainty that are associated with increased mortality: age over 18 years, female sex, rural residence, elevated creatinine levels, increased haematocrit, signs of bleeding and the presence of infiltrates on chest radiographs.

Our systematic review identified prognostic factors for mortality in patients with New World hantavirus infection. These factors can inform clinicians in making more informed management decisions. Furthermore, our findings lay the groundwork for the future development of a clinical prognostic model, potentially enhancing patient care and outcomes.

CRD42021225823.

Adolescents and young adults (AYAs) in low- and middle-income countries (LMICs) are at high risk of harmful sexual and reproductive health (SRH) practices due to limited knowledge, low availability or acceptability of modern contraceptives, gender inequality and cultural practices like child marriage. Preventive and educational interventions by lay health workers or through technological means are a cost-effective and scalable solution. Unfortunately, too little is currently known about the scope, content and conditions of the effectiveness and sustainability of these approaches and synthetic evidence on this topic is scarce. To help fill this knowledge gap and to identify where further research is needed, we will conduct a scoping review of technology-based or lay health-worker delivered preventive and educational SRH interventions targeting AYAs in LMICs. This information is valuable to both policymakers and researchers as it provides a synthesis of existing interventions, highlights best practices for their implementation and identifies potential avenues for future research.

This review will include studies on SRH preventive and educational interventions targeting AYAs aged 10–24 years in LMICs. It encompasses interventions delivered by lay health workers or via technological means, assessing various outcomes including but not limited to SRH literacy, sexual risk behaviours, pregnancies, sexually transmitted infections and gender-based violence. Key databases, including PubMed via MEDLINE and Embase, will be searched from 1 January 2000 up to 23 January 2024, using a comprehensive search strategy. Screening will be conducted using Covidence software. Data extraction will cover study details, methods, intervention strategies, outcomes and findings. A narrative synthesis will be conducted following synthesis without meta-analysis guidelines.

The scope of this scoping review is limited to publicly accessible databases that do not require prior ethical approval for access. The findings will be disseminated through peer-reviewed journal publications, as well as presentations at national and international conferences and stakeholder meetings in LMICs.

The final protocol is prospectively registered with the Open Science Framework on 7 May 2024 (osf.io/vna2z).