TITLE: Efeito do uso de antidepressivos na redução de escores de depressão em mulheres com câncer de mama em tratamento com quimioterápicos antineoplásicos: Revisão Sistemática e metanálise
AUTHORS: brunosilva

[DESCRIPTION]
PRotocol for a sytematic review

[STEPS]
SECTION: Title
1. Effect of the use of antidepressants on the reduction of depression scores in women with breast cancer undergoing treatment with antineoplastic chemotherapy: Systematic Review and meta-analysis

SECTION: Original title
2. Efeito do uso de antidepressivos na redução de escores de depressão em mulheres com câncer de mama em tratamento com quimioterápicos antineoplásicos: Revisão Sistemática e metanálise
SECTION: Start date
3. 08/01/2
SECTION: Anticipated completion date
4. 10/15/23
SECTION: Stage of review at time of this submission.
5. Preliminary searches: 
Started: No
Completed: No
SECTION: Stage of review at time of this submission.
6. Piloting of the study process:
Started: No
Completed: No
SECTION: Stage of review at time of this submission.
7. Formal screening of search results against eligibility criteria:
Started: No
Completed: No
SECTION: Stage of review at time of this submission.
8. Data extraction:
Started: No
Completed: No
SECTION: Stage of review at time of this submission.
9. Risk of bias (quality) assessment:
Started: No
Completed: No
SECTION: Stage of review at time of this submission.
10. Data analysis: 
Started: No
Completed: No
SECTION: Named contact
11. Bruno Spalenza da Silva
SECTION: Named contact email
12. brunosilva821@hotmail.com
SECTION: Named contact phone number
13. 55 27 999395729
SECTION: Organisational affiliation of the review
14. Centro Universitario do Espirito Santo (UNESC)
SECTION: Organisation web address
15. https://www.unesc.br
SECTION: Review team members and their organisational affiliations
16. Mrs Bruno Spalenza da Silva. Centro Universitario do Espirito Santo (UNESC).
Mrs Kaique Avancini Soerio. Centro Universitario do Espirito Santo (UNESC).
Miss Mirele Morais Mayrink. Centro Universitario do Espirito Santo (UNESC).
Miss Paloma de Araujo Figueira. Centro Universitario do Espirito Santo (UNESC).
SECTION: Funding sources/sponsors
17. Centro Universitario do Espirito Santo (Scientific initiation scholarship).
SECTION: Conflicts of interest
18. None.
SECTION: Collaborators
19. None.
SECTION: Review question
20. Are antidepressants effective for depressive symptoms caused by treatment with antineoplastic chemotherapy?
SECTION: Searches
21. PubMED, CENTRAL, Embase and CINAHL databases will be used to search for articles. All terms related to depression, antidepressants, randomized clinical trials and breast cancer will be used in the search.
SECTION: Condition or domain being studied
22. According to Inca (National Cancer Institute), breast cancer is a disease caused by the uncontrolled proliferation of abnormal breast cells, which form a tumor capable of invading and multiplying in other organs. This type of cancer is the most recurrent malignant disease among the female population. Among women with breast cancer, about 40% have a depressive condition and about 10 to 25% are diagnosed with major depression (CALLARI, 2013). 
Depression is a chronic psychiatric illness, marked by mood swings, such as anguish, sadness and lack of interest. Depression is the psychiatric disorder that most prevails in cancer patients, being a limiting factor in the therapeutic process of cancer, due to the difficulty of accurate diagnosis and the high hospitalization of patients, thus reducing adherence to chemotherapy treatment.
SECTION: Participants/population
23. Inclusion: women with breast cancer diagnosed with depression undergoing chemotherapy treatment; Exclusion: women with breast cancer, without diagnosis of depression; children; men.
SECTION: Intervention(s), exposure(s)
24. Patients with breast cancer and diagnosed with depression, who start the administration of antidepressants during the chemotherapy process with antineoplastic agents, are subject to drug reactions that can be harmful to said organisms. Considering that there are restrictions on the use of some antidepressants in line with breast cancer therapy, as they compromise the action of chemotherapy drugs, this work aims to verify the effectiveness of this joint treatment in women with such a pathology, evaluating the possible drug reactions and the its adverse effects when associated with chemotherapy.
SECTION: Comparator(s)/control
25. Not applicable.
SECTION: Types of study to be included
26. We will include all randomized clinical trials that used depression scores in the evaluation of treatment of depressive symptoms in women with breast cancer.
SECTION: Context
27. Articles/studies that discuss depression and its treatment with antidepressants, breast cancer and its psychological effects, chemotherapy and its effects. Surveys done in other countries will also be used.
SECTION: Main outcome(s)
28. The main objective of this research is to show the effects of antidepressants in reducing depression scores in women with breast cancer undergoing chemotherapy.
SECTION: Additional outcome(s)
29. List the most effective antidepressants for these cases and discuss the effect of breast cancer and its treatment on the patients' psychology.
SECTION: Data extraction (selection and coding)
30.  After selecting the articles, the titles and abstracts will be analyzed by 2 evaluators for selection, and in case of disagreement, a third evaluator will judge the inclusion or exclusion. After selecting the articles, the data will be manually extracted and analyzed by a meta-analysis using the Revision Manager 5.4 ® software. The heterogeneity between the results will also be evaluated, and the final result will be expressed in Confidence Intervals (CI95%) and graphically through the forest plot. The risk of bias analysis will be performed using the RoB 2.0 tool, and the writing will follow the PRISMA criteria. If possible, subgroup analyzes will be performed for each class of antidepressants. 
All data from all steps will be stored.

SECTION: Risk of bias (quality) assessment
31. RoB2

SECTION: Strategy for data synthesis
32. The formal method of combining individual study data including, as applicable, information about statistical models that will be fitted (e.g. risk ratios for individual studies will be combined using a random effects meta-analysis) or methods of synthesising qualitative data.

SECTION: Analysis of subgroups or subsets
33. If there is a need for subgroup analysis, a meta-regression will be performed.
SECTION: Type and method of review
34. Intervention.
SECTION: Language
35. Portuguese - BR and English.
SECTION: Country
36. Brazil.
SECTION: Keywords
37. Antidepressant; Depression; Breast cancer; Depression scores; Chemotherapy; Medicines; Treatment; Women;
SECTION: Current review status
38. initial: the review is being started with a search strategy for the analysis of articles and data relevant to the construction of the work.