Objective To explore the research progress of the multimodal clinical support system (CSS). Methods With recognized development and operation of the multi-model CSS, and compared to the traditional CSS, to explore the research progress of the multimodal CSS. Results Based on the realization of the concept, purpose and characteristics of the multimodal CSS, it has been known that the international research progress of the multimodal CSS. Conclusion The developing and evolving of the CSS model have offered a new assist to the multi-disciplinary treatment model, and have enhanced the improving system associated with the practice of evidence-based medicine. However, the application of clinical support system program (CSSP) in our country still needs more research.
Evidence-based medicine emphasizes that treatment must be based on the following elements ： the latest and best evidence, clinicians＇ expertise and patients＇ preference. Evidence-based medicine embodies the ethos both to explore medical science and to respect patients＇ values. Evidence-based medicine is an integration of the scientific and the humanistic spirit.
Gordon Henry Guyatt(1953-)is a professor of Department of Clinical Epidemiology amp; Biostatistics and Department of Medicine in McMaster University. He has engaged in evidence-based clinical research and practice for about 20 years. In 1992, he first proposed the term “evidence-based medicine” in one of his articles published in JAMA. He is dedicated to bringing the wonderful idea of evidence-based medicine to bedside and systematically training clinicians from all over the world to acquire the basic skills for evidence-based clinical practice. His great contribution to evidence-based medicine is introduced in this article through demonstrating the development of evidence-based clinical practice.
Gout is caused by abnormal metabolism of purine. Its most common symptom attack of intense pain and swelling in the joints. Attacks of gout can according to the alteration if it is in acute interval periods. How can we get the optimal effect? The development of methodology has provided much convincing evidence for us to choose the most appropriate treatment.
To analyze the current doctor-patient relationship and explore its underlying reasons. Evidence-based medicine may provide scientific evidence for the deepening of healthcare reforms as well as the improvement of social security system; provide abundant information for both sides of the doctor-patient relationship; improve medical quality and reduce medical costs, so as to establish a harmonious patient-oriented doctor-patient relationship .
1992年,循证医学(evidence-based medicine,EBM)倡导者提出新"范式",即卫生研究证据是对个体病人及卫生系统决策的最好基础.该方法原意是拟除去传统医学知识体系仅关注疾病本身的病理生理过程及临床经验的积累,因此在2001年被lt;纽约时代杂志gt;评为最具影响力的理论之一.本文回顾了循证医学的产生、发展、哲学局限性和临床实践的挑战.指出EBM的演变、发展早已超出它原来(误解的)概念,即EBM有可能替代传统医学.EBM现正力求去增强而不是替代个人的临床经验及了解疾病的机制.并且EBM一定要继续发展、并探讨一系列的问题包括加强科学基础,伦理道德的重要性及其有关传播及应用的实际事务.例如,为了促进科学研究成果用于临床,证据往往都是从经选择过的人群的不完整证据而来,这些人群仅能从那些贵重技术中得到一些边缘性的好处.而证据的应用就会把这些有限的好处普遍化,由此引发出一系列问题即有多少人和谁能用得起这些新的疗法.因此循证医学的倡导者希望医生及用户关注那些来自临床研究、有效且适于临床应用的好证据.而要达到此目标还需做很多的工作.
Objective To summarize the available clinical research evidence on gliquidone for treating diabetes mellitus. Methods The clinical research on gliquidone for diabetes mellitus was systematically searched and appraised. Result Six randomized controlled trials and eleven controlled clinical trials were identified. The methodological quality of most papers about gliquidone for diabetes mellitus was poor. Currently, clinically patient-related endpoints as outcome measures and health economic analyses are lacking in this field. Conclusions Based on the available evidence, gliquidone appears specifically applicable to elderly diabetic patients with kidney diseases. More methodologically sound and patient-related endpoints and economic analyses based on clinical research are required.