Low- and Middle-Income Countries

The review may guide development of context-specific tools that reflect family decision-making, expenditure, caregiver reliance, community health workers, and local cultural expectations. LMICs bear nearly 70% of global cancer deaths while having fewer diagnostic, treatment, and supportive care resources than high-income countries. Mixed Alzheimer-vascular pathology and small-vessel disease burden appeared especially prominent in LMIC cohorts compared with high-income settings. The evidence base for CDSS in low- and middle-income countries is sparse and fragmented. Patient and public involvement in LMIC settings and in the area of quality routine health data and health service delivery is scarce, making the protocol's engagement approach distinctive. Evidence on the scalability and sustainability of CDSS in LMIC settings is limited. The 2000 start date for included studies is justified by LMIC health system reforms and investments in routine health database platforms following the launch of the Millennium Development Goals. Governments in LMICs have increasingly invested in strengthening health information systems, but fragmented systems and inadequate data-use culture continue to…