Objective To assess the quality of diagnostic studies on detecting the tuberculosis antibody to diagnose tuberculosis.Methods CBM (1978 to 2006) and VIP (1994 to 2006) were searched; any author-claimed diagnostic studies which used the dot immunogold filtration assay (DIGFA) to detect the tuberculosis antibody and to diagnose tuberculosis were included. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was used to assess the quality of included diagnostic studies by two reviewers independently.Results Thirty-eight papers were included and assessed. We found that most of the quality items were not met with QUADAS. Most papers adopted the retrospective diagnostic case-control design. Thirty-one papers did not describe the selection criteria clearly, 18 did not describe whether all the included patients were verified by using a reference standard of diagnosis, 36 did not describe whether the index test results were interpreted without knowledge of the results of the reference standard, 37 did not report the uninterpretable/intermediate test results, and 34 did not report the withdrawals from the study.Conclusion There are few high quality studies on using DIGFA to detect tuberculosis antibody to diagnose tuberculosis.
Advancing patient safety is one of the most important strategies developed by WHO. The following paper outlined the main content, aims and goals of WHO the second global patient safety challenges “ Safe surgery saves lives” as well as discussed the importance of communication between surgeons and patients.
Advancing patient safety is one of the most important strategies developed by WHO and patients must be in the center of advancing patient safety activities. This paper outlined the importance of partnership between health professionals and patients in patient safety activities in the WHO global patient safety challenges “Safe surgery saves lives”.
Objective To compare and review worldwide journals titled “evidence-based” in order to provide an overview of these healthcare journals and suggestions for improving the quality of this type of journal in China and to introduce a quick way for healthcare professionals and patients to obtain high quality clinical evidence. Methods We searched PubMed, EMBASE, Ulrich’s Periodicals Directory, Wanfang and some relevant websites to identify journals titled “evidence-based”. The last issues in 2006 of these kind of journals were analyzed by bibliometric method. Results Twenty-four journals were included. Covering 12 disciplines such as clinical, nursing, health care, etc. They were divided into the primary journals and the secondary journals, published in two languages in six countries. These journals had differences and similarities in their aims, columns and contents, etc. Conclusions Evidence-based medical journals provide the latest developments and the best evidence for healthcare professionals in their own fields, save their time in searching for and reading information, and provide ideas for improving the quality of similar journals in our country.
Objective To compare articles published in global primary journals titled “evidence-based” via bibliometric analysis in order to provide suggestion for evidence-based research and development of related journals. Methods We searched electronic databases to retrieve global primary journals titled “evidence-based”, and collected their impact factors, article click, download and citation frequency through the journal’s website and related citation databases. Results Three English and 4 Chinese primary journals titled “evidence-based” met the inclusion criteria. (1) Citation frequency: Evidence-Based Complementary amp; Alternative Medicine and Worldviews on Evidence-Based Nursing were indexed by SCI with impact factor over 1 (5th and 13th in relevant subject category), and their immediacy index was about 7 times as much as that of Chinese journals (0.2 vs 0.03). Chinese Journal of Evidence-Based Pediatrics (CJEBP) had the highest impact factor among 4 Chinese journals (0.946, 23rd in the relevant subject category), while Chinese Journal of Evidence-Based Medicine had the highest immediacy index with 0.07; (2) Download frequency: Journal of Evidencebased Medicine (JEBM) had the highest download frequency per article in database (72 vs 23), but the website download frequencies per article of CJEBM and CJEBP were about 5 to 6 times as much as that of database; (3) Number of articles published: Two English journals published the fewest articles but with the highest impact factors. Chinese Journal of Evidence-Based Medicine had the 2nd highest impact factor although published the most articles, as well as the highest download frequency and immediacy index among the 4 Chinese journals. It suggested that there was no direct relationship between the number of the published articles and the impact factor of a journal. Conclusion The impact of English journals is better than that of Chinese journals. CJEBM and CJEBP are the top 2 ones among the Chinese journals with open access websites. The selection of articles should be driven by readers’ demand, and the impact of journals could be improved by online publication with open access.
Objective To investigate the effect of training courses of evidence-based medicine (EBM) on the knowledge, skill, attitude and behavior of medical postgraduates and to explore the barriers to evidence-based practice (EBP), so as to provide knowledge to improve further EBM teaching and EBP. Methods A total of 110 medical postgraduates of Sichuan University who selected EBM courses in the autumn semester of 2004 were given questionnaires that combined both open and closed questions. The KAB (knowledge, attitude and behavior) of EBM and barriers to EBP were compared before and after the training courses. Results Differences were observed in KAB of EBM and barriers to EBP after the training courses, compared to the assessments done before the courses. In “Knowledge”: there was a significant increase in the understanding of specific terms in EBM after the training courses (75% of the items showed a statistically significant improvement). This was especially marked for “absolute risk”, “systematic review”, “meta-analysis” and “publication bias” (Plt;0.01). We also found an improvement in familiarity with medical search engines (Plt;0.05). In “Attitude”: the mean scores for most items (55%) were relatively high both before and after the training courses (gt;4), and a significant improvement was observed in 2 items. These were “Strong evidence is lacking to support most of the interventions I use with my patients” and “EBP needs to take into account patient preferences” (Plt;0.01). The mean scores of 2 items were relatively low both before and after the training courses (lt;3). These were “the adoption of EBP places an reasonable demand on physical therapists” and “EBP does not take into account the limitations of my clinical setting”. Another 2 items had mean scores close to 5: “I need to increase the use of evidence in my daily practice” and “I am interested in learning or improving the skills necessary to incorporate EBP into my practice”. In terms of “Behavior”: the medical postgraduates continued not to think highly of the use of literature after the training courses. About 60% of the postgraduates did not read any literature related to their specialties at all. Although searching of MEDLINE and other electronic databases was relatively frequent (gt;6 times/month: 60.3% before training and 65.7% after training), using professional literature and research findings in the process of clinical decision-making was not equal (gt;6 times/month: 29% before training and 35.1% after training). No significant difference was observed in applying clinical practice guidelines before and after the training courses. As for “Barriers”: the postgraduates considered “poor ability to critically appraise literature” as the most important barrier both before and after the training courses. The second and third most important barriers were different compared to after the training courses. The barrier of “lack of research skills” was larger than that of “lack of information resources” before the training courses, but after that the course, the order of these was reversed. Conclusion The knowledge of medical postgraduates increased significantly after the current training courses of EBM. Some improvement was also found in attitude and behavior. The top three barriers to EBP were “Poor ability to critically appraise literature”, “Lack of information resources”, and “Lack of research skills”
Objective To provide references for production and dissemination of evidence in the fields of medical emergency management, treatment, and prevention of epidemics after May 2008 Wenchuan earthquake by systematically reviewing, analyzing, and comparing quake related papers in medical journals. Methods We systematically searched MEDLINE and CBM (Chinese Biomedical Literature) databases (range: from inception to Sept. 2009). Quake related papers were imported into EndNote software, checked for duplication, and categorized by predefined standards. Descriptive statistical analysis was performed by SPSS 13.0. Results There were relatively fewer quake related articles globally before the occurrence of the Wenchuan earthquake, and the quantity of papers in MEDLINE was four times than that in CBM. In contrast, the quantity of Chinese quake articles increased rapidly after Wenchuan earthquake, peaking in Aug. 2008 at 6.9 times the average during the 50 years before the quake. The quake related papers in CBM appeared in 378 journals covering a diverse range of subject matter. Meanwhile, there was little change in the quantity of quake related articles in MEDLINE database. Conclusions The effort of producing and disseminating Wenchuan earthquake related medical research has been effectively organized and conducted in a scientific and timely manner, producing the largest in number of quake related medical papers in human history. It has provided first-hand guidance for disaster medical relief around the globe. We should strengthen the systematic construction of disaster medicine, and make an effort to summarize and disseminate evidence in the fields of rehabilitation, system reestablishment, and prevention of epidemics.
Objective To assess whether the results of clinical trials on systematic reviews presented in different ways would influence postgraduates’ perception of risk and clinical decision after attending a research design course. Methods We distributed a questionnaire to all postgraduates who attended the final examination. The questionnaire presented the results of a systematic review. Data were presented in four different ways in the following order: as a relative risk reduction (RRR), as an absolute risk reduction (ARR), as the proportion of difference in event-free patients (EFP), and as the number of patients who needed to be treated to prevent one death (NNT). We asked all postgraduates to mark their decisions along a linear scale. Results We distributed and retrieved 342 questionnaires. Three were incomplete and excluded from our analyses. The results showed that the mean score and recommended level were significantly higher when data were expressed as NNT compared with RRR, ARR and EFP (Plt;0.01). There was no difference among RRR, ARR and EFP. However, 279 postgraduates’ score ranges were greater than 4 among the four different presentations. Conclusion The way of presenting data has significant influence on postgraduates’ perception of risk and their clinical decisions, even after a course teaching them about research design. Further improvements are needed for teachers on how to interprete different ways of presenting risk and their clinical importance.