Objective To evaluate the quality of Chinese clinical practice guidelines published in domestic medical journals in 2011. Methods The following 4 Chinese databases including WanFang Data, VIP, CNKI and CBM were searched from January 2011 to December 2011. The quality of included guidelines was assessed by using AGREE II. Results A total of 75 guidelines published in 2011 were included. Among them, 10 guidelines (13%) stated the conflict of interest, 10 guidelines (13%) mentioned evidence-based developing, 5 guidelines (7%) performed evidence grading system, 8 guidelines (11%) performed recommendation strength grading system, and 4 guidelines (5%) performed both evidence and recommendation strength grading systems. The ratio of the 6 domains’ scores of AGREEⅡ were as follows: scope and purpose (18%), stakeholder involvement (11%), rigour of development (8%), clarity of presentation (34%), applicability (5%), and editorial independence (14%). Conclusion Compared with the guidelines published before, the guidelines of 2011 have a higher quality and some of them are progressively standardized in developing methodology.
Evidence-based medicine (EBM) practice requires high-quality evidence. With the rigorous and systematic processes including legislation, literature search, literature screening, literature quality assessment, data collection, data analysis, results interpretation and original evaluation updating, the systematic review/meta-analysis is recognized as the clinical evidence with highest intensive argument for reasons of ensuring the authenticity and reliability of the findings and conclusions. Before it is applied to the specific clinical practice, a clinical doctor has to evaluate whether its results are applicable to patients or not, whether it contains all possible important results or not, whether the diagnosis and treatment benefiting from its interventions are clinically significant to patients or not, and additionally, has to take the treatment expense and patient’s value orientation into consideration. EBM clinical practice occurs for demands, and updates consciously for its authenticity, patient’s individuation and disease complexity. It has a broad development space for no other reason than its defect and imperfection.
Objective To study the effect of PBL teaching method which was applied in the clinical practice of diabetes nursing, and to analyze its advantages and shortages. Methods Seventy-seven undergraduates in major of nursing were randomly grouped into two: one as an experimental group was taught with PBL teaching method, while the other as a control group was taught with traditional teaching method. The questionnaire and final examination were adopted to analyze the teaching effect. Results The effect of PBL teaching method was better in the experimental group for stimulating learning motivation, helping students to closely combine the theory and practice, and promoting communication ability. However, there was no statistical difference in final examination between the two groups (Pgt;0.05). Conclusion PBL teaching method is much better than traditional teaching method in clinical nursing practice of internal medicine, for it can guide students to get the approaches for solving problems and cultivate their integrated diathesis and other abilities.
Objective To investigate the status of clinical practices and side effects related to Shenfu injection.Method We searched the China National Knowledge Infrastructure (CNKI) database using the key word “Shenfuinjection”. Original clinical studies of Shenfu injection which were published from January 1993 to December 2008 inChinese magazines were included. Results A total of 576 relevant clinical studies were identified. There were 21 496 cases in the study group and excluding the control group patients. We investigated and analyzed the side effects of Shenfu injection. For cases with side effects, the medication dosage, the diseases for treatment, the method of medication, the menstruum, and course of treatment for the side effects were evaluated. All the side effects were mild except one case of anaphylactic shock. Conclusion Shenfu injection has been widely used in clinical patients since it came into the market in 1993. However, systematic evaluation of its clinical application is lacking, and there are some unsolved problems and deficiency in selecting and expanding diseases for treatment, evaluating the dosage and treatment method, and investigating the side effects of the drug. Therefore, it is imperative to enhance the evaluation drugs and good clinical application after the drugs come into the market with evidence-based medicine.
Objective To review and evaluate the basic contents and development of the current global clinical guidelines for lung cancer practice so as to provide useful information for domestic study. Methods Six databases including PubMed (to June 2008) and relevant websites (both in Chinese and English) were searched. Articles were screened according to the predefined inclusion and exclusion criteria. The number of clinical guidelines was counted and the quality of guidelines was also assessed. Results A total of 208 articles were found to be clinical guideline-related and 133 were finally included. Of those, 78 were original versions and 55 were updated versions. And 86 articles mentioned guideline development methodology. The guidelines were issued by 14 countries/regions, mainly by USA (39.85%), Canada (24.81%) and France (8.27%). The earliest one was published by USA in 1984. 125 guidelines were issued by oncological or thoracic institutions, and the other 8 were not issued by specialized institutions or not specified. The 133 articles were classified into 3 major clinical categories: synthesis (24), multi-subject (21) and single-subject (88). As for quality evaluation, the average score of all guidelines was 72.09 (full score 100). The highest average score was found in 1996 which was 83.50, and the lowest in 1997 (66.80). The guidelines issued by France had the highest average score (79.80), and Japan, with the lowest average score (48.00). The average score of 4 categories of lung cancer were 73.54 (non-smallcell lung cancer), 65.74 (lung cancer), 74.72 (small-cell lung cancer), and 76.00 (bronchogenic lung cancer), respectively. Conclusion The number of clinical guidelines showed an increasing trend. Most guidelines were issued by developed countries. The subjects included in the synthetic guidelines showed an expanding trend covering about 20 subjects from prevention to palliative care. A trend of multi-country contribution to the guidelines development and revision was noted. Researches became more focused on different types and stages. Evidence-based methodology was accepted globally in the clinical guideline development, but unfortunately very few applied the method of health technology assessment. China issued only 2 original guidelines, which were based on literature review and expert opinions, respectively. Due to the limitation of language restriction, inaccessibility of full-text articles and unavailability of authorized and specific quality evaluation protocols, the conclusions of this study should be interpreted with caution.
This article illustrates the development, current status and future prospects of knowledge translation. Its importance and necessity are introduced and some measurements or approaches to promote knowledge translation are discussed.
Objective To undertake a preliminary study of the concept and approach of patient value and preference and to learn how to understand and elicit patient preference in the light of evidence-based medicine so as to promote evidence-based practice and improve the relationship between clinicians and patients. Methods The searching key words were developed and pertinent data were retrospectively retrieved for the years of 1992-2002. MEDLINE and CBMdisc were searched along with handsearching 9 Chinese medical journals and 4 evidence-based medicine books. Data were scanned and analyzed. Results A total of 2 646 related articles were identified, most of which were found in MEDLINE (2 403), followed by CBMdisc (185) and the journals (58). Currently there is no original article to study in this field from a point of view of evidence-based medicine in China. Conclusion Patient value and preference have been emphasized in the approach of evidence-based medicine and it is a worthwhile topic for us to explore.