Objective To evaluate the effectivenss of Chinese herbal retention enema in viral hepatitis patients. Methods Such databases as The Cochrane library, PubMed, EMbase, VIP, CNKI, CBM and WanFang Data were searched from the inception to December, 2011 to collect the randomized controlled trials (RCTs) about Chinese herbal retention enema in treating viral hepatitis, and the references of the included literature were also retrieved. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated and cross-checked the methodological quality. Then meta-analysis was conducted using RevMan 5.0 software. Results A total of 20 RCTs involving 1 735 patients were included. The subgroup analyses based on the length of intervention time showed that: a) after 2-week intervention: the overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=3.19, 95%CI 1.87 to 5.44, Plt;0.000 1). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?82.50, 95%CI ?145.66 to ?19.34, P=0.01), ALT (MD= ?44.78, 95%CI 65.90 to ?23.66, Plt;0.000 1) and TBIL (MD= ?37.51, 95%CI ?74.07 to ?0.95, Plt;0.0001). b) After 1-month intervention: The overall effective rate of the Chinese herbal retention enema group was higher than that of the control group, with a significant difference (OR=4.17, 95%CI 2.37 to 7.32, Plt;0.000 01). Compared with the control group, the Chinese herbal retention enema group better promoted the recovery of liver function by more reduction of AST (MD= ?17.86, 95%CI ?29.97 to ?5.76, P=0.004), ALT (MD= ?27.84, 95%CI ?42.45 to ?13.24, P=0.000 2), and TBIL (MD= ?54.15, 95%CI ?116.52 to ?8.23, P=0.09). Conclusion Chinese herbal retention enema can improve the overall effective rate for viral hepatitis patients, alleviate virus damage to liver cell and promote liver function recovery. The commonly used Chinese medicinals for enema are Radix et Rhizoma Rhei, Herba Artemisiae Capillaris, Salvia miltiorrhiza, and Radix Paeoniae Rubra.
Objective To evaluate reporting and methodological quality of systematic reviews or meta-analyses in nursing field in China. Methods CNKI database was searched for systematic reviews or meta-analyses in nursing field from the establishment date to December 2011. Two reviewers independently identified the literature according to inclusion and exclusion criteria, and then extracted the data using Excel software. The PRISMA and AMSTAR checklists were used to assess reporting characteristics and methodological quality, respectively. Results A total of 63 systematic reviews or meta-analyses involving 21 systematic reviews and 42 meta-analyses were identified. These articles were published on 13 journals such as The Chinese Nursing Research, the Chinese Journal of Nursing, and the Chinese Journal of Evidence-Based Medicine. The deficiencies of methodological quality mainly contained literature search, heterogeneity handling, recognition and assessment of publication bias. In addition, the deficiencies of reporting characteristics were reflected on incomplete reporting of literature search, quality assessment, risk of bias and results (some studies lacked forest plot, estimated value of pooled results, 95%CI or heterogeneity). Conclusion As a whole, the included reviews and meta-analyses have more or less flaws with regard to the quality of reporting and methodology based on the PRISMA and AMSTAR checklists. Focusing on the improvement of reporting and methodological quality of systematic review or meta-analysis in nursing field in China is urgently needed in order to increase the value of these studies.
Objective To evaluate the quality of evidence of systematic reviews or meta-analyses regarding outcomes in nursing field in China using the Grade system, so as to get known of the status of the quality of evidence and promote the application of the evaluation of the quality of evidence of systematic reviews. Methods The quality of evidence regarding the included outcomes was input, extracted and qualitatively graded, using GRADEpro 3.6 software. Then, we carefully analyzed and elaborated the factors of downgrading and upgrading that affects the quality of evidence in the process of evaluation. Results 53 systematic reviews or meta-analyses involving 188 outcomes were identified and evaluated. The results showed that high, moderate, low and very low levels of quality of evidence were 2.7%, 27.1%, 51.1%, and 19.1%, respectively; and low-level quality of evidence accounted for the most. Conclusion The quality of evidence produced by systematic reviews or meta-analyses in nursing field in China is poor and urgently needs improvement. The reviewers should abide by the methodological standards in the process of making systematic reviews or meta-analyses. The quality of evidence in terms of each outcome should be evaluated and fully reported.
ObjectiveTo systematically review the methods of clinical practice guidelines for integration traditional Chinese medicine (TCM) and western medicine (WM), in order to benefit the integration of TCM and WM in the future. MethodsThe PubMed, Web of Science, CNKI, WanFang Data,VIP databases, Yimaitong website, National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE) were electronically searched to collect clinical practice guidelines of integrated TCM and WM. The search time limit was from the inception of the database to July 2022. Two researchers independently screened the literature, extracted data, and then, descriptive analysis was performed using qualitative methods. ResultsA total of 54 guidelines were included. There were 25 guidelines that adopted the "combination of disease and syndrome" model of integrated TCM and WM, among which 20 adopted the "combination of disease period and syndrome" model, and the number of these guidelines increased with the time sequence. Among the 26 guidelines that provide ideas for the integration of TCM and WM, 22 guidelines clarify the relationship between the application of TCM and WM, among which 5 guidelines have A grade of quality evaluation, and a total of 61 articles were extracted to clarify the relationship between TCM and WM. ConclusionAt the present stage, the recommendations of TCM and WM in most guidelines of integrated TCM and WM are still independent of each other, and there is no special thinking and research on how to integrate TCM and WM evidence organically to generate recommendations with important guiding value for actual diagnosis and treatment, which is difficult to truly guide clinical practice.
ObjectiveTo systematically review the efficacy of Tai Chi on patients with heart failure.MethodsDatabases including CNKI, VIP, WanFang Data, Web of Science, PubMed, EMbase and The Cochrane Library (Issue 8, 2016) were searched from inception to August, 2016 to collect randomized controlled trials (RCTs) of Tai Chi for heart failure patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software.ResultsA total of 10 RCTs involving 689 patients were included. The results of meta-analysis showed that, compared with the control group, the heart failure patients in Tai Chi group had better score of minnesotaliving with heart failure questionnaire (MLHFQ) (MD=–9.37, 95%CI –13.09 to –5.65, P<0.000 01), longer six minute walk test (6MWT) (MD=40.37, 95%CI 9.48 to 71.27, P=0.01), higher left ventricular ejectionfractions (LVEF) (MD=7.89, 95%CI 3.01 to 12.77, P=0.002) and lower level of BNP (brain natriuretic peptide) (MD=–10.75, 95%CI –13.20 to –8.30, P<0.000 01); however, as to the maximal oxygen consumption (VO2max) (MD=0.29, 95%CI –1.223 to 1.81, P=0.71), systolic pressure (SBP) (MD=–2.81, 95%CI –8.52 to 2.90, P=0.33) and diastolic pressure (DBP) (MD=0.37, 95%CI –3.73 to 4.48, P=0.86), there were no significant differences between both groups.ConclusionThe current evidence shows that Tai Chi is feasible for patients with heart failure as it has positive effects on life quality, physiological functions. Due to the limited quality and quantity of included studies, the above conclusion should be validated by more high quality studies.
Objective To estimate the incidence of suicidal ideation of Chinese medical students in mainland China over the past ten years by meta-analysis, so as to provide references for suicide prevention and mental health education in Chinese medical students. Methods PubMed, CNKI, WanFang Data and CBM databases were searched for studies investigating the prevalence of suicidal ideation among Chinese medical students in mainland China from January 1st, 2007 to 31st May, 2017. After study selection according to inclusion and exclusion criterion, data extraction and quality assessment, meta-analysis was conducted using Stata 12.0 software. Heterogeneity was evaluated by performing subgroup analyses and meta-regression. We also used sensitivity analysis to determine the influence of individual studies on the overall prevalence estimates. Results A total of 30 studies with 58 757 participants were included, the individual-study incidence of suicidal ideation ranged from 0.84% to 41.35%, with significant between-study heterogeneity detected (I2=99.1%, P<0.001), and the pooled incidence by random-effects model was 12.51% with 95%CI 9.72% to 15.60%. Univariate and multivariate meta-regression revealed that instruments were related to heterogeneity (P<0.01), but other study-level covariates did not contribute to heterogeneity (P>0.1). Conclusion The incidence of suicidal ideation among medical students in mainland China is relatively high, calling more attention to this concern and actions in response for suicide prevention and mental health education in Chinese medical students.
To perform a meta-analysis of single nucleotide polymorphism needs to calculate gene frequency. This paper employs allele model as an example to introduce how to calculate gene frequency and display the process of a meta-analysis of single nucleotide polymorphism data using Review Manager 5.3 software.
ObjectiveTo provide the referencefor the guideline development and revision in China, we analyzed the composition of personnel who participated in developing Chinese clinical practice guidelines (CPGs)published in 2017. MethodsCNKI, WanFang Data, CBM and Google scholar were electronically searched to collect Chinese CPGs published from January 1st to December 31st, 2017. Two researchers independently screened literatures, extracted data of interest, such as composition and distribution of personnel, and analyzed the composition of personnel with Microsoft excel 2013. ResultsA total of 54 guidelines were included, and the majority of which are for treatment. Among which, 49 were developed by the associations accounting for 90.7%. Twenty-four (44.4%) guidelines reported the geographical distribution and unit ownership of the guideline developers, such as hospitals, schools, institutions (academies, institutes, laboratories, nursing homes, etc.). Almost all of the guidelines were developed by the cooperative work of experts from multidisciplinary clinical setting, 15 (27.8%) of which mentioned the participation of the methodologist. Among which, 13 (24.1%) of them involved literature retrieval experts, 2 (3.7%) of them involved epidemiologists, 2 (3.7%) of them involved evidence-based medicine experts, 1 (1.9%) of them involved statistical expert. Three of which mentioned external peer review. None of them has systematic review team. ConclusionIn China, the CPG formulation/revision organization is still not considering the importance of multidisciplinary collaboration, methodology researchers, and patients’ participation and external evaluation teams, which will affect the quality, practicability and maneuverability of CPG. We propose that multidisciplinary cooperation should be strengthened in the future while developing CPG, giving full consideration to the importance of medical personnel and the values of patients, and promoting the application of methodology.
With the development of evidence-based medicine, an increasing amount of clinical care experts are paying attention to recommendations in the guidelines and the application of guidelines in clinical nursing practice. The demand for clinical practice guidelines is becoming increasingly important. Based on characteristics of nursing, this paper focuses on primary steps in the formulation of nursing-clinical practice guideline, such as clinical problems, outcomes, nursing evidence retrieval and selection, evidence and recommendations classification, methods from evidence to recommendations, patients' preference and value, and provides suggestions for development of nursing-clinical practice guidelines.
Implementation science is a relatively emergent and growing research area. Implementation research can assist to transform what is possible in theory to reality in practice and address the challenge of implementing proven interventions in the real world. Implementation research has a wide range of usages and complex research problems, so appropriate research methods, designs, and outcomes variables are required to address different research objectives. To better conduct implementation research, this paper systematically introduces the research designs, outcome variables, and reporting guideline of the implementation research in health care, based on the purposes and research questions of implementation research.