Objective To analyze the causal relationship between educational attainment and the risk of systemic lupus erythematosus (SLE). Methods Based on the data from publicly available genome-wide association studies, we employed single nucleotide polymorphisms (SNPs) strongly associated with educational attainment as instrumental variables. Two-sample Mendelian randomization analysis was used to investigate the causal relationship between educational attainment and SLE. The primary analysis method used was the inverse variance weighted with multiplicative random effects. Validation methods included inverse variance weighted with fixed effects and MR-Egger methods. Additionally, sensitivity analysis was conducted using the leave-one-out approach. Results Finally, 433 SNPs were included. The inverse variance weighted with multiplicative random effects analysis indicated no causal effect of educational attainment on the risk of SLE [odds ratio =1.111, 95% confidence interval (0.813, 1.518), P=0.509]. Similarly, the other two methods did not find any evidence of a causal relationship (P>0.05); however, significant heterogeneity was observed. The MR-Egger regression analysis provided no evidence of horizontal pleiotropy among the included instrumental variables (P>0.05). The leave-one-out approach did not identify any individual SNP that had a significant impact on the overall effect estimate. ConclusionIn conclusion, this study does not support a causal effect of educational attainment on the risk of SLE.
ObjectiveTo investigate whether there is a causal relationship between the intake of milk or coffee and the risk of non-alcoholic fatty liver disease (NAFLD). MethodsUsing a two-sample Mendelian randomization approach, single nucleotide polymorphisms (SNPs) associated with milk or coffee intake were used as instrumental variables, and genome-wide association study data on NAFLD were used as the outcome event. Inverse-variance weighted (IVW) and MR-Egger methods were employed to investigate the causal effect of milk or coffee intake on the risk of NAFLD. ResultsBoth analyses indicated no causal association between milk or coffee intake and the risk of NAFLD (P>0.05). Sensitivity analysis indicated the robustness of the main findings, with no outliers, heterogeneity, horizontal pleiotropy, or significant influence of individual SNPs. ConclusionThis study does not support a causal relationship between the intake of milk or coffee and the risk of NAFLD.
ObjectiveTo biliometric analysis of the status quo of tracking rural health service quality, evaluation and supervision mechanism, in order to improve the quality of rural health service, optimize the allocation of resources and increase the quality and level of health service of rural medical staff. MethodsWe searched PubMed, The Cochrane Library (Issue 3, 2016), The Campbell Library, Web of Science, CBM, CNKI, and WanFang Data, as well as relevant websites up to March 2016. EndNote X7 software and Excel 2007 software were used for screening literature and analysis data. ResultsA total of 39 studies were included in the biliometric analysis. Eighteen studies were cross-sectional studies (46.2%), 18 were reviews (46.2%), 2 were cluster randomized trials (5.1%) and 1 was randomized controlled trial (2.6%). Thirteen studies were published in journals indexed by Science Citation Index, 3 were published in journals indexed by Chinese Science Citation Database, 18 were published on other peer-review journals, and 5 were thesis's. The involved theoretical models were as follows: 10 mechanisms (30.8%), 4 frameworks (18%), 11 systems (30.8%) and 12 methods (30.8%). The serviceable range included village clinics (n=3, 7.7%), town-level hospitals (n=3, 7.7%), and community (n=2, 5.1%). The research topics included public health (n=19, 48.7%), clinical care (n=16, 41%), medical insurance (n=4, 10.3%). ConclusionThe studies for rural health service quality tracking, research evaluation and supervision mechanism are still lack of systematic, pertinence and practicability, and the level of evidence is still low. We suggest pay attention and strengthen the rural health service quality tracking, research evaluation and supervision mechanism, and to provide effective evidence for effective evaluation and supervision to promote rural health service quality, and to promote the reasonable optimization the allocation of health resources in rural areas, and to greatly improve the quality and level of rural health service.
Evidence-based medicine (EBM) is a compulsory course for clinical medicine. How to use massive open online courses (MOOC) to improve teaching of EBM and teaching effect is what we should think and explore. Based on the practical applications and features of MOOC, this paper introduces conciseness of knowledge points for MOOC of EBM, design of the videos for MOOC of EBM, the preliminary exploration of MOOC in teaching practice. It is hopefully that using application of MOOC to promote the teaching effect for EBM, and promote the educational reform.
Objective To systematically review the effectiveness of short message intervention on smoking cessation. Methods Databases including PubMed, The Cochrane Library, EMbase, CBM were searched from inception to August 2016, to collect randomized controlled trials (RCTs) about short message service (SMS) for smoking cessation. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed using Stata 12.0 software. Results A total of 14 RCTs involving 15 543 participants were included. The results of meta-analysis showed that, compared with the control group, no significant difference was found in self-reported three months continuous abstinence (RR=0.830, 95%CI 0.679 to 1.014, P=0.069), 30 day point quit rate (RR=0.878, 95%CI 0.687 to 1.122, P=0.076). However, there were significant differences in the self-reported 7-day point abstinence (RR=1.149, 95%CI 1.014 to 1.303, P=0.03), the CO biochemical verification abstinence (RR=0.571, 95%CI 0.357 to 0.914, P=0.020), and the average number of cigarettes smoked per day (SMD=–0.25, 95%CI –0.37 to –0.12, P<0.001). Conclusion The available evidence indicates that short message intervention has a better effect on short-term smoking cessation. Therefore, more long-term studies are needed to determine the association between SMS and quit smoking behavior.
Statistical graph is an indispensable part of scientific papers. It is helpful to promote the communication, dissemination, and application of academic achievements by presenting research results intuitively and accurately through standardized and beautiful visual graphs. The safety of a medical intervention is the basic premise of its clinical application, and randomized controlled trial (RCT) as an important design to determine the efficacy and safety of medical interventions, it is extremely important to accurately present the information on the safety outcomes of interventions found therein. However, the research found that the reports of RCTs didn’t adequately use visual graphs to present harms data. In order to promote clinical researchers to better use visual graphs to present harms data, international scholars recently published a consensus study in BMJ, which identified and recommended 10 statistical graphs for presenting harms data in RCTs. In order to facilitate domestic scholars to understand and apply the consensus, this article interprets the consensus and recommendations, and it is expected to provide help for improving the quality of harms visualization in domestic papers of RCTs.
In response to the need for health economics modelers to apply more appropriate complex systems models to address complex challenges in public health, an international team of more than 40 experts in the field of complex systems models and economic evaluation has developed and recently published a guideline on the application of complex systems models to the economic evaluation of public health interventions. This paper introduces the development process and main content of the guidelines, which can provide references to facilitate the application of the guidelines by domestic researchers, aiming to ultimately improve the overall quality of public health research and services and improve the health of the population in China.
ObjectiveTo analyze the research status and hot spots of health technology assessment (HTA). MethodsDatabases including China National Knowledge Infrastructure (CNKI) and PubMed were searched to collect published studies on HTA. The software of BICOMS-2 and VOSviewer 1.6.10 was used to draw the network diagram and to conduct cluster analysis of keywords. ResultsA total of 1170 studies in Chinese and 8584 studies in English were included. The number of HTA-related publications increased annually, among which countries with the most publications were the United States, the United Kingdom, and Canada. Fudan University had the largest number of studies published in Chinese and York University had the largest number of studies published in English. The research topics mainly focused on hospital HTA, HTA decision transformation research, pharmacoeconomic evaluation, etc. The most frequent diseases were cancer and depression. Emerging keywords were real-word evidence, randomized controlled trials, cost-benefit analysis, etc. ConclusionHTA-related studies increase annually. Many HTA-related studies are performed in developed countries, such as the United States and the United Kingdom. The relevant research topics involve hospital HTA, HTA decision-making transformation research, and pharmacoeconomic evaluation. Current research focus is on the evaluation of health economics in the field of cancer based on the evidence of real-world research and randomized controlled trials.
Clinical prediction models typically utilize a combination of multiple variables to predict individual health outcomes. However, multiple prediction models for the same outcome often exist, making it challenging to determine the suitable model for guiding clinical practice. In recent years, an increasing number of studies have evaluated and summarized prediction models using the systematic review/meta-analysis method. However, they often report poorly on critical information. To enhance the reporting quality of systematic reviews/meta-analyses of prediction models, foreign scholars published the TRIPOD-SRMA reporting guideline in BMJ in March 2023. As the number of such systematic reviews/meta-analyses is increasing rapidly domestically, this paper interprets the reporting guideline with a published example. This study aims to assist domestic scholars in better understanding and applying this reporting guideline, ultimately improving the overall quality of relevant research.
Lumbar disc herniation (LDH) is one of the most important causes of back and leg pain, which seriously affects the quality of life of patients. As the first-line treatment for LDH, non-operative treatment can relieve 80% to 90% of symptoms among the patients with LDH. This guideline followed Guidelines for the Formulation/Revision of Clinical Treatment Guidelines in China (2022 edition) and WHO handbook for guideline development (2014 edition) to set up guideline working group. This guideline identified fourteen clinical questions through the literature review and clinical experts’ consensus. We drafted the recommendations after systematically searching and evaluating the evidence; delphi method was adopted for expert consensus on the preliminary recommendations, finally, 19 recommendations were made to guide non-operative treatments for LDH. This guideline can provide guidance for the clinical practice of Chinese and western orthopedics practitioners.