With the rapid development of evidence-based medicine during the past two decades, evidence andevidence-based methods were not only used in the field of health care, but also applied to other non-medical fields. Asystematic literature search and a comparative study were conducted to investigate the definition of evidence. We also putforward our own definition of evidence: Evidence is the information from the systematic review process. We also discussedthe development of evidence-based paradigm and hope this will act as a reference for other subjects and industries.
Objective To systematically review the value of ultrasound in the diagnosis of fracture of the distal radius and ulna for providing evidence for clinical diagnosis. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 7, 2016), CNKI, CBM and WanFang Data databases for studies about ultrasound in the diagnosis of fracture of the distal radius and ulna from inception to August 1st, 2016. Two reviewers independently screened literatures according to inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool, and then meta-analysis was performed by using Meta-Disc 1.4 software. ResultsA total of 16 articles involving 1 182 patients and 631 fractures were included. The results of heterogeneity test revealed that there was statistical heterogeneity among the results of studies, thus, random effects model was used for meta-analysis. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio for ultrasound diagnosis fracture of the distal radius and ulna were 0.95 (95%CI 0.94 to 0.97), 0.92 (95%CI 0.89 to 0.94), 9.98 (95%CI 5.20 to 19.15), 0.07 (95%CI 0.04 to 0.13), 187.94 (95%CI 65.67 to 537.84), respectively. The area under the SROC curve was 0.976 4. ConclusionUltrasound is a useful non-invasive method as a routine examination for fracture of the distal radius and ulna. Due to the limited quality and quantity of included studies, the above conclusion is needed to be validated by more high-quality studies.
Objective To investigate the reading habits of authors of articles published in the Chinese Journal of Evidence-Based Medicine (CJEBM) and to compare the findings with those from other surveys. Methods A total of 512 questionnaires were sent to authors who had contributed to CJEBM over the past 7 years. Results A total of 129 questionnaires were returned (response rate 31.6%). The replies showed that the main purpose of reading literature was to keep up with the latest developments in medicine (94% of replies). The main reading material was medical journals (86%). Most respondents (57%) spent more than 3 hours a week reading journals. The biggest problem identified by authors was the lack of full text papers, but the first choice was the electronic versions of the literature. More than half of the authors (57%) said that they spent less time reading than in the past. Conclusion Effective reading of the medical literature is a basic requirement in the practice of evidence-based medicine. It is necessary and important for clinicians and healthcare providers to improve their reading skills and methods.
This article discussed the development and current situation about both national and international diagnostic practice guidelines, as well as the role of evidence based medicine and systematic reviews in the development of such guidelines. Authors also analyzed the opportunities and challenges developers faced, and the methods and processes of development. Finally, authors proposed several strategic suggestions about how to improve the quality of diagnostic practice guideline in China.
The interpretation of the guideline is an important method to learn, understand and apply authoritative guidelines. This is the fourth article of the research group about evidence-based diagnosis clinical practice guidelines. We would analyze the ACR Appropriateness Criteria® Right Lower Quadrant Pain—Suspected Appendicitis from the methodological perspective which was made by American College of Radiology, referring to the standard of AGREE.
This study was an interpretation study based on the standard of AGREEⅡ. It analyzed methodological perspective of the International Evidence-Based Recommendations for Focused Cardiac Ultrasound determined by the International Conference on Focused Cardiac UltraSound (IC-FoCUS).
This is the second paper in the evidence-based medicine glossary series. It provides information on the principles for evidence-based medicine through definitions, criteria for inclusion and screening, regular flow-sheet, reporting format and the establishment of databases.
This is the fifth paper in the evidence-based medicine glossary series. In this paper, we mainly introduce the systematic error（bias）and random error in medical research, review the definition and classification of bias made by different institutions and individuals. We also identify and categorize more than 10 types of bias in systematic review, which are considered the best evidence in evidence-based medicine. Additionally, we introduce some methods to reduce and eliminate bias, explaine six subject headings related to bias in MeSH, and introduce a new glossary — uncertainty in metrology.
ObjectiveTo investigate the citation status of systematic reviews on imaging diagnosis in clinical practice guidelines (CPGs) and provide reference for the development of Chinese imaging diagnosis guidelines. MethodsWe electronically searched PubMed databases to collect systematic reviews on imaging diagnosis. The date was limited from January 1st 2010 to December 31th 2012. Two reviewers independently screened literature and extracted data. The citation data of included systematic reviews were obtained on the Web of Science. Citation analysis method was used to analyze the citation frequency of systematic reviews on imaging diagnosis in CPGs. Results292 systematic reviews on imaging diagnosis were included, of which 94% (275/292) were indexed by Science Citation Index. The total citation frequency of these systematic reviews was 5413 (medium:20, range:0 to 131). 28% (78/275) were cited by CPGs. Of which, 7% (19/275) were used as the source of the evidence of recommendations in CPGs. ConclusionThe ratio of systematic reviews cited by CPGs is low, the ratio of being the source of evidence of recommendations of systematic reviews in CPGs is lower, and furthermore, the citation is time-delayed.