The first Global Evidence Summit (GES) was held in Cape Town in South Africa from September 13th to November 16th, 2017. This paper interprets the construction of digital and trustworthy evidence ecosystem which was proposed to be established by the GES.
ObjectiveTo systematically review the research status of risk prediction models for gestational diabetes mellitus (GDM). MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, JBI EBP, Ovid MEDLINE, Embase, Web of Science and Cochrane Library databases were electronically searched to collect relevant literature on risk prediction models for GDM from inception to October 2022. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies, and then qualitative description was performed. ResultsA total of 19 studies were included, involving 19 risk prediction models. The evaluation results showed that, in terms of the risk of bias, 18 studies were high risk, and 1 study was unclear. In terms of applicability, 14 studies were high risk, 2 studies were low risk, and 3 studies were unclear. The area under the receiver operating characteristic curve of the included models was 0.69 to 0.88. The most common predictors included age, weight, pre-pregnancy BMI, history of diabetes, family history of diabetes, and race. ConclusionThe overall performance of the risk prediction model for gestational diabetes mellitus is good, but the risk of bias of the model is high, and the clinical applicability of the model needs to be further verified.
Objective This study was to develop a framework of evidence-based continuous quality improvement and provide a framework for nursing professionals to promote evidence transfer and clinical nursing quality improvement. Methods Guided by the principles of PDCA, evidence-based nursing and work process, a framework of evidence-based quality continuous improvement was established through a citation analysis of evidence implementation related projects and literatures. Results The framework of evidence-based continuous quality improvement consisted of four stages and twelve steps, including evidence searching, practice audit, evidence implementation and outcome evaluation, and then it would turn to next cycle. Conclusion The framework of evidence-based continuous quality improvement provides nursing professionals a concept and method of promoting evidence into practice and promoting clinical nursing quality improvement.
To standardize and improve the reporting quality of implementation studies, BMJ published the standards for reporting implementation studies (StaRI). This paper introduces the background and process of StaRI development, and interprets the core content of StaRI. It is expected that StaRI will provide support for domestic researchers to carry out implementation studies and writing implementation research reports.
This paper introduces the background, significance, definition and types of clinical audit and describes five stages of clinical audit, including preparing for clinical audit, selecting criteria, measuring performance and sustaining improvement. This paper also introduces the international and national status quo of implementing clinical audit in nursing practice and describes the reporting guideline for articles of clinical audit. Finally, this article suggests that providing methodological training and creating a supportive environment are crucial strategies to promote the implementation of clinical audit and bridge the gaps between evidence and practice.
Objectives To establish the quality criteria for clinical nursing practice guidelines in China. Methods Two focus groups’ interviews for 26 clinical nursing experts and methodological experts from China were adopted to build the quality criteria for clinical nursing practice guidelines. Results The quality criteria for clinical nursing practice guidelines in China covered 5 domains and 15 items, which included scientificity/rigor, effectiveness/safety, economy, availability/feasibility, and conflict of interest. All items were from 0 to 5 scale and weighted 0.5 to 2 based on their contributions to the quality of guidelines. Conclusions The quality criteria for clinical nursing practice guidelines adopt the same framework with the quality criteria of guidelines in medical field and also integrate features of nursing. It provides the quality standard for Chinese clinical nursing practice guidelines.
ObjectivesTo evaluate the reliability and validity on quality criteria for clinical nursing practice guidelines.MethodsFive appraisers were included to assess two clinical nursing practice guidelines using the quality criteria for clinical nursing practice guidelines and AGREE Ⅱ. ICC and coefficient of consistency were adopted to assess the reliability and validity of the appraisal tools.ResultsICC for two guidelines of AIDS and infusion by the quality criteria for clinical nursing practice guidelines were 0.979 and 0.890. ICC for two guidelines of AIDS and infusion by AGREE Ⅱ were 0.957 and 0.887. The coefficient of consistency for guidelines of AIDS and infusion by the two appraisal tools were 0.880 and 0.886, both were highly consistent.ConclusionsThe quality criteria for clinical nursing practice guidelines has good reliability and validity and can be used as appraisal tool for quality evaluation of clinical nursing practice guidelines. It is strongly recommended that the users should understand the appraisal tool or should be trained to decrease the bias.
ObjectivesTo systematically review the efficacy of telemedicine on blood glucose level and pregnancy outcomes in patients with gestational diabetes mellitus.MethodsThe Cochrane Library, PubMed, Web of Science, CINAHL, Scopus, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on efficacy of telemedicine on blood glucose and pregnancy outcomes in patients with gestational diabetes from inception to January 1st, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then meta-analysis was performed by RevMan 5.3 software.ResultsA total of 10 RCTs involving 1 267 patients were included. The results of meta-analysis showed that there were no statistical significances in fasting blood glucose (MD=−0.34, 95%CI −1.62 to 0.93, P=0.60), HbA1c (MD=−0.22, 95%CI −0.61 to 0.17, P=0.27), gestational age at delivery (MD=0.03, 95%CI −0.13 to 0.19, P=0.72), premature rate (OR=0.52, 95%CI 0.26 to 1.01, P=0.05), caesarean delivery rate (OR=0.87, 95%CI 0.57 to 1.31, P=0.51), infant birth weight (MD=13.01, 95%CI −45.75 to 71.78, P=0.66), large for gestational age rate (OR=1.16, 95%CI 0.83 to 1.62, P=0.40), pre- eclampsia/pregnancy induced hypertension rate (OR=1.04, 95%CI 0.52 to 2.09, P=0.91), neonatal hypoglycaemia rate (OR=1.21, 95%CI 0.75 to 1.95, P=0.44) and neonatal jaundice rate (OR=1.09, 95%CI 0.59 to 2.00, P=0.78) between telemedicine management and outpatient follow-up of gestational diabetes mellitus. However, the telemedicine management group had lower 2h postprandial blood glucose (MD=−3.45, 95%CI −5.53 to −1.37, P=0.001).ConclusionsThe current evidence shows that telemedicine management of gestational diabetes mellitus achieves similar efficacy and safety in blood glucose level and pregnancy outcomes as outpatient follow-up. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
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.
Implementation science is a new field that aims to scale up and sustain the application of evidence-based practice. It primarily studies the dissemination, adoption, evaluation, and improvement, etc. of the implementation process of evidence-based practice. In recent years, tens of implementation theories, frameworks and models have been developed. We systematically collected 41 of them and classified them into several categories. The first is the classical theories which are extended from the traditional social science and used as the predecessors of the implementation science. The second category is the implementation science frameworks/models that are derived from the first category, and can be divided into four groups: 1) the implementation models that explain the law of a certain aspect in the implementation; 2) the implementation determinants frameworks that summarize and classify the implementation determinants; 3) the process models that discuss how research translates into practice; 4) the evaluation models that evaluate the implementation and outcome. The implementation science theories can provide implementation researchers with valuable guidance for development of implementation strategies and evaluation of implementation outcomes.