Some statistical measures in evidence-based medicine, such as RRR, ARR and NNTwere introduced.
Objective To use visualization methods to illustrate and compare major subjects, domains, and developments in evidence-based medicine (EBM) in recent years. Methods We analyzed MeSH terms and keywords in EBM articles in the MEDLINE and CNKI databases, and developed subject charts, research field relationship charts, and strategy coordination charts using word co-occurrence, PFNET algorithms, and visualization methods. Results Rapid developments and growth are taking place in EBM in China and around the world. Studies on humans comprised 94.4% of the EBM studies that we identified, while animal studies accounted for 2.6% (three quarters of these animal studies were on primates). The six countries with the largest number of EBM articles and the eight host nations for the 108 journals with the most EBM publications were from high-income countries. In China, 31 provinces, municipalities, and autonomous regions have published EBM articles, although most of these publications come from the more highly-developed areas of the country. The investigation of word co-occurrence showed that EBM articles outside of China involve seven main fields: “Therapy”, “Methods”, “Standards”, “Research”, “Education”, ”Nursing” and “Organization and Administration”. Five of these fields (“Therapy”, “Nursing”, “Research”, “Education” and “Management”) were common to China but the top seven fields for this country included “Traditional Chinese Medicine (TCM)” and “Information resources”; and did not include “Methods” and “Standards”. Furthermore, studies on “Nursing” and “Research” were not as advanced in China as in other countries. Conclusion There are similarities between China and the rest of the world in several areas in the EBM literature but also some important differences. Throughout the world, the most resource-rich regions or organizations tend to have the most well-developed EBM. These regions and organizations are producing more evidence and conducting more methodology research than the less resourced regions and organizations. There is an urgent need for these regions and organizations to strengthen their use of evidence, to learn more about the philosophy that underpins EBM, and to improve accessibility to, and use of, evidence in choices about health care.
Objective To evaluate the published case-reports of evidence-based practice(EBP) over three years,and to improve the quality of the papers and provide a recommended writing model. Methods Collecting the published 20 case-report of EBP and assessing their writing quality in 5 aspects according to the steps of EBP. Results Many Abstracts did not reflect entire context, and convey the overall information to readers, a formative structured Abstract should be taken. Most case-reports only involved with therapy,few diagnostic,harm and prognostic case-reports were republished,few EBP of surgery and other specialties, such as ENT,ophthalmology were mentioned.Searching strategies were not sufficiently described.Most authors only search The Cochrane Library and PubMed,while predigested sources were seldom used.Critical appraisal of evidence was difficult to each author,most papers were lack of appraisal or simply evaluated the validity of used evidence,and applicability of evidence was not clearly explained.All the papers did not conduct post evaluation.Conclusions Much needs to be done in improving the quality of published case-reporters of EBP,a standardized writing model should be recommended.
Objective To find the best teaching method of summer EBM course to help students understand and apply EBM principles in research. Methods Training medical students to participate in an international team of clinical research for best evidence. We used a step-by-step method to teach how to write Cochrane systematic review and apply its method to other researches. Results Since our training program was launched three years ago, 38 medical students have taken part in the training. Five Cochrane systematic reviews and 19 protocols were published in The Cochrane L ibrary. Three medical students were the principal investigators and played an important role in another 2 studies. Seven articles were published in Chinese medical key journals, and 1 was indexed by SCI. Eleven students were funded to participate in the international academic conferences.Conclusions Medical students will benefit from taking part in the EBM research. This activity will help them not only understand method of clinical research and EBM , improve the quality of research and their cooperative skills but also master related clinical knowledge.
ObjectiveTo investigate the updating period, methods and procedures of Clinical Practice Guidelines (CPGs) in China. MethodsWe searched WanFang Data, VIP, CNKI using the term "guideline" in the title, and Chinese Biomedical Literature Database (CBM) using "guideline" as the topic word up to December 2012. Then we screened and analyzed all included papers. ResultsA total of 380 Chinese CPGs were included. Thirty-eight (10%) guidelines have been updated, among which the longest update period was 10 years and the shortest was 1 year, and the average update period was 5.1 years. Eight (2%) of the updated guidelines had been updated more than once, and the average update time of them was 3, average update period was 4.9 years. There were 42 (12%) of the rest 342 guidelines which have never been updated mentioned that they would be updated. The detailed information of the updated guidelines according to their clinical objectives were as follow:1 (0.3%) was prevention guideline, of which the update period was 4 years; 8 (2%) were treatment guidelines and the average update period was 4.3 years; 5 (1%) were prevention and treatment guidelines, and the average update period was 6.8 years; 18 (5%) were diagnosis and treatment guidelines, and the average update period was 5.3 years; 4 (1%) were technology guidelines and the average update period was 5.5 years; and the average update period of the 2 (0.5%) integrative guidelines was 2.5 years. Forty (10%) of the total 380 guidelines had described their updating methods. ConclusionAccording the analysis of international studies and domestic guidelines, the update rate of Chinese CPGs is low, the update period is comparatively long, with differences found among them. The reporting of the updated CPGs' methods and procedures is insufficient, with less normalization. Big differences have been found in their updating condition among CPGs of different types and institutional developers.
The PICO model is a general model in building problems of evidence-based medicine (EBM). However, with the deepening and refinement of the medical research and the rising of qualitative research, the PICO model could not satisfy all problems. This article introduces the expansions of the PICO model and puts forward the SPIDER model according to the qualitative problem and its relationship with the PICO model, which can build the best search strategy of clinical problems in a short time.
Objectives To analyze evidence-based medicine (EBM) related projects funded by National Natural Science Foundation of China (NSFC) from 2000 to 2019. Methods The online NSFC database, Internet-based Science Information System, Biomart.cn, and MedSci.com were searched to obtain all EBM grants funded by NSFC. The achievements, Chinese papers and SCI-indexed papers, were obtained by searching the database of CNKI, VIP, SinoMed, WanFang Data and Web of Science. All data screened and extracted manually, and then managed and analyzed with Microsoft Excel 2016 software. Results The NSFC has funded 94 projects regarding EBM, with a total amount of 44.763 million Yuan (RMB) since 2000. Beijing, Shanghai, Guangdong and Sichuan ranked highly in the number of projects and their undertaking institutions and total amount of fundings. General programs and youth scientist programs constituted the main parts of fundings. The funded projects mainly originated from three subjects of new technologies and methods of TCM, health management and policy, clinical basis of integrated Chinese and western medicine. General programs contributed the most articles, while the distinguished young scientist programs had the highest average outputs. Three papers from Chinese EBM Center were published on BMJ and were highly cited. Conclusions Support of NSFC on EBM has increased continuously for the last twenty years, but it is still below the average. The fundings are unbalanced in areas and institutions. The supported research fields change every year, and show a trend of subjects aggregation.
Objective To identify patterns in information sharing between a series of Chinese evidence based medicine (EBM) journals and the Cochrane Database of Systematic Reviews, to determine key evidence dissemination areas for EBM and to provide a scientific basis for improving the dissemination of EBM research. Method Data were collected on citing and cited from the Chinese Journal of Evidence-Based Medicine (CJEBM), Journal of Evidence-Based Medicine (JEBMc), Chinese Journal of Evidence Based Pediatrics (CJEBP), and the Cochrane Database of Systematic Reviews (CDSR). Relationships between citations were visualized. High-frequency key words from these sources were identified, to build a word co-occurrence matrix and to map research subjects. Result CDSR contains a large collection of information of relevance to EBM and its contents are widely cited across many journals, suggesting a well-developed citation environment. The content and citation of the Chinese journals have been increasing in recent years. However, their citation environments are much less developed, and there is a wide variation in the breadth and strength of their knowledge communication, with the ranking from highest to lowest being CJEBM, JEBMc and CJEBP. The content of CDSR is almost exclusively Cochrane intervention reviews examining the effects of healthcare interventions, so it’s contribution to EBM is mostly in disease control and treatment. On the other hand, the Chinese journals on evidence-based medicine and practice focused more on areas such as education and research, design and quality of clinical trials, evidence based policymaking, evidence based clinical practice, tumor treatment, and pediatrics. Conclusion Knowledge and findings of EBM are widely communicated and disseminated. However, citation environments and range of knowledge communication differ greatly between the journals examined in this study. This finds that Chinese EBM has focused mainly on clinical medicine, Traditional Chinese Medicine, pediatrics, tumor treatment, nursing, health economic and management, and medical education. Internationally, EBM research topics have begun to shift, from drug treatment to surgery or other non-pharmacological treatments; from therapy to diagnosis, rehabilitation, and prevention; from evidence based clinical practice to evidence based management and policymaking. The philosophy and method of EBM, evidence production and translation are also shifting from well resourced settings to low- and middle-income countries, especially those in which English is not a major language.