Evidence-based medicine emphasizes that treatment must be based on the following elements ： the latest and best evidence, clinicians＇ expertise and patients＇ preference. Evidence-based medicine embodies the ethos both to explore medical science and to respect patients＇ values. Evidence-based medicine is an integration of the scientific and the humanistic spirit.
Gout is caused by abnormal metabolism of purine. Its most common symptom attack of intense pain and swelling in the joints. Attacks of gout can according to the alteration if it is in acute interval periods. How can we get the optimal effect? The development of methodology has provided much convincing evidence for us to choose the most appropriate treatment.
Based on the site visit on the current application and practice of evidence-based medicine in USA, we find the difference between China and USA so as to further promote and plan the development of evidence-based medicine in China.
Objective To assess the effectiveness of evidence-based medicine for improving core competencies of undergraduate medical students. Methods MEDLINE, ERIC, Academic Source Premier, Campbell Library databases and three Chinese Databases (CBM, CNKI, VIP) were searched from January 1992 to May 2009.We also used Google to searching related literature. The design is a systematic review of randomized, non-randomized, and before-after studies. Two reviewers did study selection, quality assessment, and data abstraction independently. Different opinions were resolved by consensus. We used an adaptation of the quality measure from Gemma Flores-Mateo et al to assess the quality of selected studies. And descriptive analysis was conducted. Results A total of 17 studies met the selection criteria, 2 of them were of high quality, the others were of moderate quality. Studies involved Competencies of Scientific Foundation of Medicine, Clinical Skills, and Management of Information. Conclusion Competencies of Scientific Foundation of Medicine, Clinical Skills, and Management of Information are improved by evidence-based medicine teaching. No study on professional values, attitudes, behavior and ethics, population health and health systems, management of information, critical thinking and research is available. It is impossible to assess the four domains above.
MOOCs is a new education mode which by using the Internet to transmit the curriculums to the world to gratified the desire and the pursuit of people. In addition, it's not only an important way to accomplish convenience and mobility of study, but also a study way put emphasis on scenario and sharing. This paper will use the MOOCs and Flipped Classroom to design the teaching resources of evidence-based medicine. By combining the teaching content and characteristics of evidence-based medicine with the successful experience of the existing MOOCs, we make a teaching mode of the evidence-based medicine which is based on the students' autonomous learning and flipped classroom. And the practice of the MOOCs of evidence-based medicine will according to this mode in the future.
Archibald Leman Cochrane（1909 to 1988）was a physician and clinical epidemiologist from the UK. The basic theroy of evidence-based medicine was established because of his influential book, Effectiveness and Efficiency: Random Reflections on Health Services published in 1972. The randomized controlled trial and systematic review promoted by Archie has become the key stone of evidence-based medicine. He was known as one of the forefathers of evidence-based medicine because of his outstanding contribution. In commemoration of Arichie Cochrane, The Cochrane Collaboration was named after him. His legendary life story and the early stages of the development of evidence-based medicine are introduced in this article.
Objective To evaluate the effectiveness of teaching evidence-based medicine (EBM). Methods 1. Introducing EBM teaching material in Chinese. 2. Offering EBM course in medical college of Sichuan University. 3. Problem-based,self-directed teaching methods. 4. A variety of test method. Results 36 Cochrane systematic review titles were registered, 17 Cochrane systematic review protocols were published in Cochrane Library, 6 Cochrane systematic reviews were published in Cochrane Library. 62 EBM research papers were published on Chinese Journal of EBM. Feedback of teaching EBM from postgraduates: 77.6%, 22.4% postgraduates consider this EBM course is very helpful and helpful for them respectively; 14.3%, 80% postgraduates achieve completely the goal and achieve the goal in greater part by this EBM course respectively; the reason of not achieving the goal is a lack of time to read and attend the course. 61.2%-80% and 16.3%-32.7% postgraduates consider the teaching contents is very good and good respectively; 61.2%-75.5% and 12.3%-28.6% postgraduates consider this teaching model is very good and good respectively; 44.9% postgraduates hope to increase hours of EBM course, increase discusses, increase EBM practice in future; 10.2% postgraduates consider the questions of test are hard to solve. Conclusion This EBM course is effective.
Objective To study the methodology of Chinese literature retrieval. Methods The manual review of the literature was served as the “gold standard” against database search strategies (the diagnostic tests). We selected original articles about treatment, rehabilitation and randomized controlled trials from 31 journals. The articles were downloaded from the Chinese Biomedical Database (CBM). We selected potentially useful words through a word frequency analysis and determined the frequency of all the words in the titles, abstracts, and subject indexes. All the selected journals functioned as a closed database. The sensitivity, specificity and precision of all the high frequency words were calculated and the high frequency words of large sensitivity×precision were considered as final searching words. All the searching strategies were produced by computer programe which consisted of all searching words, title field and abstract field. Meanwhile, the sensitivity, specificity, precision and NNR (number needed to read) were calculated. Among the strategies, those comprised of all searching words would be used in CBM disc database, those of title and abstract words in Chinese Web Databases. The best strategies were those of high sensitivity and high specificity. Results 2 570 articles were selected and 45 articles met the gold standard. The strategies emphasized sensitivity were “therapeutic use OR random OR control(for CBM disc) and multicenter OR therapeutic outcome OR random (for Chinese online databases)”. The strategies emphasized specificity were “placebo OR prospective study(MH) OR double blind OR random controled trial (MH) (for CBM disc) and placebo OR prospective) OR double blind OR efficiency (for Chinese online databases).”Conclusions The method is optimal for Chinese literature databases