The Campbell collaboration (C2) is an international research network that produces and disseminates systematic reviews of the effects of interventions in education, criminal justice, and social welfare. It aims to generate the best research evidence to support policy and practice in order to bring about positive social change. This issue introduces the experiences of the author while taking part in the ninth annual Campbell colloquium, and tries to increase awareness about C2.
This paper reports publication status, authors distribution and the difficulties of producing Cochrane systematic reviews （CSRs） in China to offer new ideas for further development of CSR. in China. Up to Dec. 2005, Chinese authors have published 28 CSRs （1.1%）, 10 of which were indexed by SCI.
Objective To analyze the methodological quality of clinical practice guideline mentioned “evidence-based” in China. Methods We selected clinical guidelines developed based on evidence issued by the Chinese Medical Association in 2010-2012, and meanwhile, we conducted additional search for guidelines on clinical major diseases. Then, we selected literature according to the inclusion and exclusion criteria and evaluated the included guidelines according to 8 items relevant to methodological rigor which were selected from the Appraisal of Guidelines for Research and Evaluation (AGREE II). If the guidelines comply with the item, we recorded 1 point, otherwise 0 point. Results a) Among twenty-two included guidelines, 13 were originated and 9 were updated once every 3 to 5 years. b) Diseases covered stroke, diabetes, chronic hepatitis B, hypertension, pediatric nutrition, etc. c) The number of guideline references were 10 to 218, of which, nine guidelines cited 24 Cochrane systematic reviews (CDSRs), accounted for 2.62% (24/916). Among them, the acute ischemic stroke guideline cited the most (7 CDSRs). d) The number of experts involved in guidelines development was 2 to 95 and guidelines pages were 4 to 150. e) The guidelines’ quality generally scored 4 to 7, most of which described the process of guidelines development. The grades of recommendation were consistent with the levels of evidence. But most of the included guidelines did not clearly described literature research methods, peer reviewer, and update procedures. Conclusion There is a growing trend that clinical guidelines are developed based on evidence in China. However, the quality of reporting and the methodological rigor of guidelines need further improvement. The citation rates of Cochrane systematic reviews in these guidelines were relatively low. We suggest that guideline recommendations should be consistent with the levels of evidence and adapt to local conditions, and relevant support policies for guideline implementation in practice. In future, attention should be paid to the aspects of guideline development methods, reporting standard, guideline accessibility, and standard training for relevant personnel.
It is essential to improve the practice of community healthcare service for the resolution of the problem of inadequate and overly expensive medical services, to promote the harmonization of doctor-patient relationship. From the aspects of the introduction of community healthcare service and the necessity of its standard management, the civil legal relation of community healthcare and its major problems, as well as the rights and duties of community doctors, the authors discussed the importance and necessity of scientific management, right protection by law as well as sound and orderly development of community healthcare service.
Objective To explore the current problems of training on ethics reviews in clinical trials in China. Methods We designed a quantitative survey to collect participants’ feedbacks on the training workshop on ethics reviews, which included contents, arrangement and structure, relevant to the workshop and their difficulties on ethics review work. Results A total of 60 questionnaires were sent and the response rate was 56.7% (34/60). A total of 120 participants from 18 provinces of China. Most of them were members of the virtual research center of evidence-base medicine of the Ministry of education. A total of 78.1% (25/32) participants thought they achieved their purpose after training, and 12.5% (4/32) did not meet their needs due to the poor language. The feedbacks of contents and quality of the workshop on ethics were shown in Table 1. The top useful contents (cents in 8-10) were: clinical trial registration, policies of WHO and China (93.8%, 30/32), data management and quality control in clinical trials, the roles of clinical trial registries and ethics committees (93.3%, 28/30), transparency in clinical trials (93.3%, 28/30), informed consent and beyond (91.8%, 31/34), and how to approach ethical review case studies (90.9%, 30/33), etc. Nobody considered workshop of less help.The majority (85.1%, 23/27) thought difficulties on ethic reviews existed and the main difficulties include: short of operational administrative rules (82.6%, 19/23), poor training opportunity (52.1%, 12/23), less supports from administrative (30.4%, 7/23) and financial (21.7%, 5/23), etc. The relevance (8-10 cents) to ethics workshop was: methods of teaching 75.9% (22/29), PPT 75% (21/28) and materials 42.9% (12/28). Conclusions There is some limitations in the first workshop on ethic reviews due to the lower response rate. However, it still shows the importance of training on ethics reviews. Training strategies should focus on different participants’ needs and the relevance to methods of teaching, and materials, etc. Workshopadopted lectures, cases studies analysis, more discussions and necessary translation will be welcome.
Objective To explore the challenges of training workshops on Cochrane Systematic Review (CSR) in 2006–2008 and to identify strategies to meet better the needs of the participants. Methods We designed a quantitative survey for all participants and collected their feedback on the arrangements and challenges of the workshop, and on their needs. Results The overall response rate was 82.6% (138/167). The training on CSR evaluated more highly from 2006 to 2008. A total of 167 registered participants from 21 provinces in China took part, and 71.3% (119/167) of them were graduate students. Only 10.9 % (15/138) selected their topics before training. After training, most of the participants were satisfied with the arrangement of the workshop, and thought the most helpful contents were: meta-analysis and statistics 83.7% (113/135), trials selection, inclusion and extraction 79.4% (108/136), literature evaluation 78.1% (107/137), and results analysis and explanation 72.8% (99/136). Some participants desired more time for practical exercises and for advice on keeping track of the development of their reviews. Conclusion The training on CSR has been gradually improved in the past 3 years. Cochrane systematic reviews have become an important research topic for graduate students in this time in China. Most of the participants benefit from the CSR workshop. More time on exercises is needed and the trainees’ further development should be followed up.
Objective To know about the baseline and quality of clinical prophylaxis and treatment study on communicable diseases in China, by identifying and assessing the clinical studies published in Chinese Journal of Infectious Diseases for 18 years. Method Handsearching page by page to identify and register the clinical studies from the journal, the definition of randomized controlled trial (RCT) and controlled clinical trial (CCT) strictly according to the Cochrane Collaboration Handbook (1997). Results There were totally 214 clinical studies during the 18 years, including 67 RCTs, 67 CCTs and 80 Non-CCTs. The average sample size of the RCTs was 103.0±70.2 (range from 17 to 296). Counted by every 5 years period (3 years period from 1998 to 2000), the proportion of RCTs in clinical studies was increasing steadily. The proportion were 22.9% from 1983 to 1987 (11/48), 29.2% from 1988 to 1992 (14/48), 41.9% from 1993 to 1997 (26/62), 28.6% from 1998 to 2000 (16/56) respectively. The main diseases studied in 214 clinical studies include: virus hepatitis (65 studies), hemorrhagic fever with renal syndrome (19 studies), typhoid fever (11 studies), bacterial infection (13 studies), bacillary dysentery (5 studies), epidemic encephalitis B (3 studies) and parasitosis (9 studies). Conclusion RCT study design should be applied as much as possible. The quality of clinical studies on communicable diseases in China remains to be improved. Multi-center and large-scale collaborative study is worthy to advocate.
Background and Objective Nearly half of million have been reported dead after earthquakes in recent 20 years, and many people always concern seriously about whether those corpses pose a risk to epidemics after earthquakes. An evidence-based approach was conducted to assess the relationship between dead bodies and epidemic disease outbreak systematically. Methods We searched PubMed, The Cochrane Library (Issue 1, 2008), CNKI and WHO website and screened the references of eligible studies. Results A total of 10 papers published beween 1988 to 2007 were included for final analysis, including 2 editorials, 4 reviews and 4 technical reports (technical note or manual). The risk factors for epidemic outbreak after earthquakes were associated primarily with safe water, food and sanitation facilities, as well as the density of population, and no evidence was found that those corpses would pose a risk to the outbreak. But standard infection control precautions should be observed when human corpses were handled. Conclusion Management of dead bodies should be brought into the emergency preparedness system, disaster manuals and guidelines. A community-centered approach to informing communities about the management of the dead following earthquake is also needed. Meanwhile, the myth of about dead bodies and disease outbreak should be dispelled.
This article mainly introduced the purpose and scope relating to the 11 Cochrane methods groups for Cochrane systematic reviews and encourage more people to contribute to the research on methodology.
Objective To assess the effect of a new educational model for evidence-based medicine (EBM), which is called "2+N" model with the main characteristic of classroom teaching plus volunteer practice. Methods Questionnaire survey was conducted to collect data. Results There were averagely 39 volunteers participated in this activity per year, with an increasing trend. Most of them were sophomore and junior undergraduates from different specialties in medical filed. All participates acquired a better understanding of EBM knowledge; more than 60% of them could handle data searching, collecting and assessing by themselves in the end of the activity. Conclusion Our five years’ experience of EBM education practice for medical students suggested that the new educational model has a promising future.