ObjectiveTo systematically review the research issues related to evidence quality grading methods for public health decision making. MethodsPubMed, Web of Science, CNKI, WanFang Data, CBM and VIP databases were electronically searched to collect studies related to the application of evidence quality grading methods for public health decision making from inception to December 2022. The questions were constructed according to the SPIDER model. The quality of the included literature was evaluated by using the CASP checklist, and a three-level interpretation analysis of the questions on the application of quality rating methods for public health decision making was conducted using the thematic synthesis method to establish a pool of question entries. ResultsA total of 14 papers were included, covering seven countries. GRADE was the commonly used method for grading the quality of evidence. CASP evaluation results showed eight high quality studies, four medium quality studies and two low quality studies. The thematic synthesis method summarized 13 question entries in 7 categories. ConclusionThe existing methodology for grading the quality of evidence for public health decision making suffers from the diversity of evidence sources and the underestimation of the level of evidence from complex intervention studies.
Objective To evaluate the current status of human resources in healthcare-associated infection prevention and control (infection control) in Jiangxi Province, and explore the impact of emergency public health events on the human resources of infection control professionals in various levels and types of medical institutions. Methods From October 1st to 31st, 2023, questionnaire and on-site interviews were conducted to investigate the human resources situation of infection control professionals in various levels and types of medical institutions in Jiangxi Province. Three stages were selected for the investigation: before the outbreak of COVID-19 (before the event, December 2019), during the event (June 2022), and after the transition of COVID-19 (after the event, June 2023), focusing on the characteristics of human resources between before the event and after the event by the comparative analysis. Results Finally, 289 medical institutions were included. There was a statistically significant difference in the number of infection control professionals in medical institutions among 2019, 2022, and 2023 (χ2=189.677, P<0.001). The number of infection control professionals in 2019 was lower than that in 2022 (P<0.001) and 2023 (P<0.001), but there was no statistically significant difference between 2022 and 2023 (P=0.242). The number of infection control professionals per thousand beds in 2019, 2022, and 2023 was 4.40, 6.16, and 5.76, respectively. There was no statistically significant difference between 2019 and 2023 in terms of professional titles, gender, educational level, or professional background (P>0.05). Conclusion Emergency public health events have promoted the increase in the number of infection control professionals, but there is no statistical significance in the professional titles, educational level, or professional background of infection control professionals.
Objective To summarize and analyze the characteristics, advantages and disadvantages of the current governance framework for public health emergencies in China. Methods The CNKI, VIP, WanFang Data, CBM and PubMed databases were electronically searched to collect studies on the management of major infectious disease outbreaks in China from inception to April 15, 2023. The basic information and governance elements included in the study were extracted and analyzed. Results A total of 30 studies were included, and the time of issuance was from 2020 to 2022. Most of the studies were on COVID-19, focusing on the governance framework of big data governance, holistic governance, and multi-agent collaborative governance. The governance elements were mainly concentrated in three aspects: governance subject, governance cycle and institutional guarantee. The governance entities were concentrated on multi-agent collaborative governance, with the governance cycle mainly focused on in process governance, and the basic guarantee is a multiple guarantee with information technology big data as the main body. Conclusion The governance body of China's major infectious disease epidemic management framework has transitioned from a single entity to a multi entity collaborative governance. While increasing prewarning governance, attention should also be paid to governance during the post recovery period. In terms of system, comprehensive guarantees such as epidemic public opinion control system guarantees, privacy security guarantees, and psychological counseling guarantees should be added.
In response to the public health emergency and other urgent needs, World Health Organization (WHO) developed the concept and methodology of rapid advice guidelines (RAGs) in 2006. Compared with the standard guideline, striving to minimize the risk of bias, the RAG shortens the time to 1-3 months from more than 2 years. This study introduces the background, definition, application condition and performing methods of RAGs, and uses an example to clarify it, thus to provide a reference for the guideline development of public health emergency and other urgent need in China.
Objective To summarize and categorize the epidemiological evaluation indicators of disease burden, and to explore and analyze the research gaps in the existing evaluation indicators of disease burden. Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library databases were searched by computer to obtain qualitative studies on evaluation indicators of disease burden. The search time limit was from the establishment of the database to October 2023. CASP was used to evaluate the methodological quality of the included studies, and thematic analysis was used to summarize the evaluation indicators of disease burden by NVivo 12 software. Results A total of 19 studies were included, of which 10 studies were of high quality and 9 studies were of medium quality. The evaluation indicators of disease burden were summarized into two three-level core themes: positive indicators and negative indicators. Five second-level analytic themes were used: disease indicators, life loss indicators, life expectancy indicators, cause removal indicators and health status indicators. Twenty-nine level-1 descriptive themes. Conclusion The evaluation indicators of disease burden have their respective scopes of application and limitations. It is necessary to continue strengthening the construction of a comprehensive evaluation index system for disease burden, so that it is comparable and reliable, can adapt to local calculation weights, and covers both family burden and social burden.
During the coronavirus disease 2019 (COVID-19) epidemics, universities take responsibility for the health of their students and epidemic control. Our urgent recommendation focuses on four key questions of emergency management in universities following rigorous evidence-based approaches and provides timely suggestions to university managers, academic faculties and student affairs managers. We recommend universities during the COVID-19 epidemics should: 1) suspend offline lectures; 2) provide proper health education on the disease; 3) encourage face masks, however oppose using N95 masks on the campus; 4) encourage hand hygiene and provide sanitizing products on the campus.
Objective To evaluate the reporting quality of rapid guidelines on Chinese medicine responding to public health emergencies. Methods The databases of PubMed, Embase, CNKI, CBM, WanFang Data, and preprint platforms were electronically searched. A supplementary search was performed by navigating the websites and Wechat public platforms specific to guideline development and dissemination, health and medical governing bodies, and academic organizations of Chinese medicine. Only guidelines published within three months after the onset of acute respiratory infectious diseases were eligible. The database search settings were as follows: SARS guidelines up to May 2003, H1N1 guidelines up to August 2009, and COVID-19 guidelines up to April 2020. The report quality was assessed using the Reporting Items for practice Guidelines in HealThcare (RIGHT) and its extension for traditional Chinese medicine (TCM). Results A total of 50 rapid guidelines on Chinese medicine responding to public health emergencies were included, indicating a growing trend in the number of guidelines. The RIGHT items most frequently reported were item 1c (n=46, 92.00%), item 7a (n=47, 94.00%), item 13a (n=49, 98.00%). The items extended to TCM was generally frequently reported (≥50%). However, the ten key items related to evidence, recommendations, funding, and the declaration and management of interest were rarely reported. Conclusion Enhancing the reporting quality of rapid guidelines on Chinese medicine in response to public health emergencies requires methodological solutions. The development of such guideline reporting standards should consider the unique characteristics of public health emergencies and the special nature of Chinese medicine evidence.
Objective To investigate the accurateness and rapidity of information on SARS , and to provide evidence for decision-making in the construction of the public health information system of China, including information collection, identification and release. Method SARS related information was systematically collected, from ① databases including Medline, CBMdisc and Cochrane Library; ② official websites including WHO, MOH and CDC; ③ non-governmental websites including Sina, Sohu, Yahoo; ④ eleven Chinese Journals and ⑤ gray literatures, These evidence were graded based on their scientific sense, and were analyzed according to their rapidity of release. Results A total of 11 955 pieces of related information were collected. Non-governmental websites were the agents that released the largest number of information (46.7%). Regarding the scientific sense of evidence, hand searched journal was at the top of the evidence pyramid, and followed by Medline, gray literature, CBMdisc, official and non-governmental websites. Regarding the rapidity, official website achieved the most rapid information release, which was followed by nongovernmental website, journal, and database. 71.8 percent of information from official websites was in Chinese, while 65 percent was from database. Conclusions The SARS information from China has contributed enormously to the global information release. Although the amount and rapidity of the information were satisfied, management and deep processing of information should be improved.