Objective To investigate the hot topics of research on evidence-based medicine in 2002. Method To search MEDLINE for papers on evidence-based medicine published in 2002, identify high-frequency subject headings related to research on evidence-based medicine, and cluster the high-frequency subject headings according to rates they appeared in common papers. Results 545 papers, 1 554 subject headings, 30 high-frequency subject headings on evidence-based medicine, and nine clustering categories of high-frequency subject headings were identified through search. Conclusions Both high-frequency subject headings and their clustering categories suggested that “evidence-based practice guidelines and their innovation”, “evidence-based health research and health policy”, “methodology on systematic reviews and randomized clinical trials”, “method of evidence-based decision making and its application in various subjects”, were the hot topics of evidence-based medicine. They provided useful references for Chinese medical professionals to practice evidence-based medicine.
Objective To investigate evidence retrieval, appraisal, and reevaluation during evidence-based clinical decision making in China. Also, to analyze the related factors, so as to find the problems in the course of evidence-based clinical decision making and put forward corresponding solutions. Methods We searched Chinese Biomedical Literature Disc (CBM) and China Journal Full-text Database (Medical sciences) of the China National Knowledge Infrastructure (CNKI) to collect clinical evidence-based case reports. Relevant information was extracted from these reports by a selfdesigned investigation form.Then statistical analyses were performed. Results The search tools used in the course of evidence-based clinical decision making varied. The most frequently used were MEDLINE/PubMed (82.08%) and The Cochrane Library (60.38%). 30.63% of evidence-based case reports described the search strategy in detail, and 9.01% described how they modified their search strategy. All doctors evaluated the association between evidence and disease, but few of them integrated patient factors and relevant external factors when evaluating evidence. The scientific nature and validity of the evidence was evaluated in 74 evidence-based case reports (66.67%), and such evaluation was mainly based on the criteria of evidence grading (50.00%). Reevaluation was mentioned in 85.59% of evidence-based case reports. Conclusion In China, the application of evidence-based decision making varied in different clinical departments. Problems existed in the course of evidence retrieval, appraisal, and reevaluation. This revealed the low information diathesis level of doctors and their lack of evidence-based medicine knowledge. It is suggested that information education and evidence-based medicine education should be strengthened to improve doctors’ ability to use evidence-based clinical decision making. It is also recommended that the search tools, relevant search strategy, the modification of search strategy, and reevaluation on practice results of each case should be mentioned in evidence-based case reports.
Objective To investigate the prognostic value of B-type natriuretic peptide (BNP) for short-term all-cause mortality in patients with acute pulmonary embolism (APE). Methods Such databases as PubMed, EMbase, Central Register of Controlled Trials, CBM, and CNKI (from the date of their establishments to March 2010) were searched. The level of BNP and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was collected to conduct eligible cohort study for assessing their effects on APE prognosis. Quality assessment and data extraction were performed in those clinical trials in line with the inclusion criteria. Then, RevMan 5.0 software was applied to carry out meta-analyses. Results Sixteen relevant studies with 1 126 APE patients were included. Nine studies reported BNP level and seven studies reported NT-pro BNP level. There was less satistical and clinical Heterogeneity among the groups (P=0.94, I2=0; P=0.99, I2=0). The meta-analyses results showed: the BNP or NT-pro BNP level was closely related with the short-term all-cause mortality. SPE was 0.52, + LR was 1.87, –LR was 0.20, PPV was 0.16, NPV was 0.98, SROC area under the curve was 0.830 5, SE (AUC) = 0.033 5.Conclusion While elevated BNP levels can help to identify APE patients at a higher risk of death, the high negative predictive value of normal BNP levels is more useful for doctors to identify patients with less likelihood of adverse events so as to conduct a selective follow-up.