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 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.
David Eddy, one of the founders of evidence-based medicine, is a famous American expert in evidence-based medicine. He was first author on a key article in JAMA in 1990 and coined the term "evidence-based". He made great contributions in medical decision making, applied mathematics, health economics and devoted himself to the establishment and dissemination of evidence-based guidelines. In this article, the process of his striving and academic research is introduced and his unique insight into and new interpretion of evidence-based medicine are elaborated.
China Association of Chinese Medicine officially issued the Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine-Headache (T/CACM 1271-2019) on January 30th, 2019. The guideline provided 27 recommendations, including clinical diagnosis, treatment, prevention and care of headache. This paper introduces the background of this guideline and interprets its contents of clinical diagnosis, treatment and prevention.
Decision-making is often a complex and hard-to-routinize process. Based on the decision-making experience of fighting COVID-19, policymakers have gradually realized that climate action, quality education, and other societal challenges, as well as the sustainable development goals (SDGs) need to be addressed with the best available evidence using an evidence-informed decision-making (EIDM) approach. The Global Commission on Evidence was established in 2021. In addition, the Evidence Commission issued reports in 2022 and 2023. A systematic methodology to address societal challenges with EIDM has been constructed in the report. Five types of domestic evidence (data analytics, evaluation, modeling, qualitative insights, and behavioural/implementation research) and four steps in decision-making process (understanding a problem and its causes, selecting an option for addressing the problem, identifying implementation considerations, and monitoring implementation and evaluating impacts) were used to support four types of decision-makers (government policymakers, organizational leaders, professionals and citizens) in EIDM, as demonstrated by the reports. To further disseminate the concept and methodology of EIDM globally, the secretariat works with 25 Evidence Commissioners to write the report, and continues to cooperate with Country Leads Group from 12 countries to conduct rapid evidence-support system assessments (RESSAs), and collaborates with Evidence Commission Implementation Council to accelerate the implementation of 24 recommendations. The main history, core methodology, and latest developments of the Global Committee on Evidence were systematically reviewed in this paper. We aimed to show decision-makers a new version of how to scientifically address the societal challenges of EIDM.
Objective To survey and analyze the quality assessment of the included studies in the Overviews of reviews (Overviews), so as to provide methodology references for Overviews authors. Methods A computerized search was performed for collecting Overviews in The Cochrane Library (Issue 1, 2010), PubMed, EMBASE, and CBM, and the search time ended by December, 2009. Then the relevant data, such as assessment standard etc, were extracted, and the staple standards were analyzed. Results A total of 43 typical Overviews were included. Thirty-two (74.4%) of them assessed the methodology quality of the included systematic reviews with different standards, including OQAQ (34.9%/15), AMSTAR (9.1%/3), Checklist from DARE (4.6%/2), Assendelft scale (4.6%/2), Effective Public Health Practice Project standards (2.3%/1), self-formulated standards (14.0%/ 6), syntaxic standards (2.3%/1), and other standards (4.6%/2). Ten Overviews (23.6%) assessed the quality of evidence, including eight (18.6%) applied the GRADE system. Only 7 studies (16.3%) assessed the quality of evidence and applied the GRADE system as well. Conclusion The quality assessment in Overviews includes the assessment of both methodological quality and evidence quality. But most Overviews do not assess comprehensively. The methodological quality standards applied in current Overviews are numerous and no standard is acknowledged. Yet, the OQAQ and AMSTAR are applied widely and recommended because they are comprehensive and easy to be conducted. It suggests that Overviews authors should choose appropriate methodological quality assessment standards according to concrete conditions. The GRADE system is much more comprehensive and systematic than other systems, so it is recommended that Overviews authors should apply GRADE to assess the quality of evidence in their studies in order to make the study results more comprehensive and easier for clinical application.
Objective To evaluate quality of orthopedic clinical practice guidelines in China by AGREE Ⅱ Instrument. Methods A systematic search of relevant literature databases (CBM, WanFang Data, VIP and CNKI) was conducted to identify the orthopedic clinical practice guidelines of China published up to October 2016. Guidelines selection and data extraction were independently performed by two authors. AGREEⅡ instrument was used to evaluate the quality of the included guidelines. Intra-class correlation coefficient tests were performed to appraise the uniformity of the overall assessment scores. Results A total of 54 guidelines for orthopedics were finally included. The mean scores of six domains by AGREE Ⅱ instrument were 60.44%, 21.40%, 5.17%, 22.17%, 6.02% and 0.56%. The overall intra-class correlation coefficient was 0.84. Conclusion The quality of orthopedic clinical practice guidelines in China was low or moderate in general. The methodology of making guidelines, especially in terms of rigor of development, applicability and editorial independence, should be improved.
In order to develop the clinical practice guideline (CPG) of intra-articular injection for knee osteoarthritis, based on the definition of Institution of Medicine (IOM) about CPG, the WHO handbook, the GRADE instrument, the AGREE Ⅱinstrument, and the Right for Reporting CPG, Chinese Orthopaedic Association,Chinese Journal of Orthopaedics, Arthritis Clinic and Research Center of Peking University People’s Hospital, Chinese GRADE Center established the guideline working groups and develop protocol of the guideline.
National Center for Medical Service Administration of National Health and Family Planning Commission of China was established at the beginning of 2015. It is mainly in charge of developing and managing standards of medical technology and organizing their implementation, and giving technical guidance and consulting for evaluation of medical institutions. The foundation of the center fills in the blank of lacking central administrative department of the guideline development and evaluation. This paper introduces the definition and the function of clinical practice guideline, and analyzes the current situation, problems and challenges of domestic guidelines, and proposes some potential suggestions on improving the quality of Chinese guidelines from national level for promoting the standardization, scientification and transparency of clinical practice guidelines in China.
若在已发表的报告中干预措施描述不完整，临床工作者和患者就无法可靠地实施有效的干预措施，其他研究人员也无法在此研究基础上重复或进一步开展研究。然而，已发表文章中干预措施的报告质量非常差。为提高报告的完整性并最终提高干预措施的可重复性，一个国际专家组和利益相关方共同制订了描述干预措施的清单和报告规范（Template for Intervention Description and Replication，TIDieR）。制订过程包括：相关清单和研究的文献综述，针对国际专家小组的德尔菲调查以指导选择清单条目及召开面对面的小组会议。最终确定的 12 条 TIDieR 清单条目（包括：干预措施简称、实施理由、实施资料、实施过程、干预措施实施者、实施方法、实施地点、实施时间及强度、个性化方案、方案更改、预期效果和实际效果）是对 CONSORT（The Consolidated Standards of Reporting Trials）2010 声明中条目 5 和 SPIRIT（Standard Protocol Items: Recommendations for Interventional Trials）2013 声明中条目 11 的扩展。虽然该清单强调的是试验中干预措施描述，但该指导仍适用于所有评价性研究设计。本文对 TIDieR 清单的每个条目进行了解释和说明并呈现了高质量报告的实例。TIDieR 清单和报告规范可提高干预措施的报告质量，并且使得作者对干预措施的描述、审稿人和编辑对有关干预措施描述的评估、读者对干预措施的使用更加容易。