Colorectal cancer (CRC) screening is effective in reducing the burden of the disease. Participation rate is an important determinant of the magnitude of the effectiveness in population-based CRC screening. We summarize the current status of participation rate across the different organized CRC screening programs in China. The results indicate that the overall participation rates are low, and the acceptance of the screening protocols is poor in Chinese population. We conclude that the associated factors may include the poor health consciousness, low willingness-to-pay for screening, lack of personalized screening strategy and inadequate organization. Studies on the inventions to improve the willingness of screening and participation rate are of high demand and will provide important references in implementing large-scale CRC screening programs in China in the future.
目的 了解四川省人民医院2011年的医院感染情况及其高危因素、抗菌药物使用情况。 方法 2011年9月采用横断面调查、床旁调查和病历调查相结合的方法，调查该院在调查日的医院感染、高危因素和抗菌药物使用等信息。 结果 调查住院患者1 898例，医院感染现患率4.53%，医院感染例次率4.64%；动静脉插管、呼吸机使用、泌尿道插管、气管切开、激素使用、化学疗法和免疫抑制剂的使用、血液透析等为医院感染的高危因素；调查当日抗菌药物使用率为32.93%。 结论 通过医院感染横断面调查可方便、快捷地获得全院医院感染方面的信息，为医院感染防控工作的开展提供依据。
ObjectivesTo systematically review approaches to derive disability weights (DWs) based on EQ-5D instrument.MethodsPubMed, EMbase, Web of Science, CNKI and WanFang Data databases were electronically searched to collect studies on the approaches to derive disability weights based on EQ-5D from inception to June 1st, 2019. Two reviewers independently screened literature, extracted the basic information and evaluated risk of bias of included studies. Then, systematic review on approaches to derive DWs based on EQ-5D instrument was performed.ResultsA total of 18 studies were included, which were published between 2003 and 2018. The included studies involved a variety of diseases, mostly focusing on quality of life and the burden of disease. The approaches to derive DWs based on EQ-5D health instrument were as follows: DWs=health utility scoreNormal or Control−health utility scoreDisease (7 studies), DWs=1−VAS score/100 (6 studies), DWs=1−health utility scoreDisease (3 studies), linear regression model (1 study), and mapping (1 study).ConclusionsAmong all the included studies using EQ-5D-based disability weight measurement methods involves a variety of diseases, with relatively low comparability. More methodological studies are from abroad. Among all the applied approaches, DWs equally to health utility scoreNormal or Control minus health utility scoreDisease is the most commonly used.
It is potential for N-of-1 trials to evaluate economics of health care, however, it is still in the exploratory stage. With the advantage of accurate estimation of costs and effects, it is beneficial to promote the application of N-of-1 trials for economic evaluation in the era of precision medicine. In this study, we introduce the necessity, feasibility, selection, calculation of indicators and influence factors of N-of-1 trials for economic evaluation, and in order to provide references for researchers to perform related studies.
The study appeared the comparison between CONSORT and CENT, and promoted the combination with GRADE and N-of-1 trial. Our objective is to further develop the method of N-of-1 trial and to widely use it in clinical researches of some diseases.
An N-of-1 trial was conducted in a single patient. Statistical analysis is one of the most important parts of N-of-1 trials. The methods of statistical analysis for N-of-1 trials were reported in some reviews. However, there was still a lack of comparative analysis of these methods. In this study, we introduced the characteristics of statistical methods commonly used as well as some statistical problems which should be paid attention in N-of-1 trials. It is useful to provide some reference for statistical methods in order to high quality N-of-1 trials.
Bayesian N-of-1 trials is increasingly popular in recent years. This study introduced the principle, statistical requirements, application status, advantages and disadvantages of Bayesian N-of-1 trials. Although the application of Bayesian N-of-1 trials is still limited in small scale and some problems remain to be solved, but it can provide more posterior information, and it can be the most important type of N-of 1 trial in future.
Health technology assessment (HTA) is becoming more and more popular recently. For populations in China that share at least half of the global disease burden of liver cancer, it is extremely vital to give rise to an efficient secondary prevention strategy. The China central government launched liver cancer screening program in rural areas in 2005, and then extended to populations in urban in 2012. The studies of health technology assessment of liver cancer screening are based on available evidence, from an HTA perspective, aims to evaluate performance of liver screening, economic burden and cost-effectiveness and some other issues, in order to raise suggestions for possible directions in research and public health program related to liver cancer screening in China.
ObjectiveTo analyze targeted surveillance results of nosocomial infection in Neurosurgical Intensive Care Unit (ICU) and investigate the characteristics of nosocomial infection, in order to provide reference for constituting the intervention measures. MethodsWe monitored the incidence of nosocomial infection, the application and catheter-related infection of invasive operation, and the situation of multiple resistant bacteria screening and drug resistance characteristics of each patient who stayed more than two days in neurosurgical ICU during January to December 2013. ResultsThere were a total of 1 178 patients, and the total ICU stay was 4 144 days. The nosocomial infection rate was 4.92%, and the day incidence of nosocomial infection was 13.75‰. The nosocomial infection rate was significantly higher in January and between July and December compared with other months. Ventilator utilization rate was 9.75%; ventilator-associated pneumonia incidence density was 14.85 per 1 000 catheter-days; central line utilization rate was 28.40%; central line-associated bloodstream infection incidence density was 0.85 per 1 000 catheter-days; urinary catheter utilization rate was 97.90%; and the incidence density of catheter-associated urinary tract infection was 0.25 per 1 000 catheter-days. ConclusionThe nosocomial infection rate has an obvious seasonal characteristic in neurosurgical intensive care unit, so it is necessary to make sure that the hospital infection control full-time and part-time staff should be on alert, issue timely risk warning, and strengthen the risk management of hospital infection.
ObjectiveTo evaluate the risk of bias and reliability of conclusions of systematic reviews (SRs) of lung cancer screening. MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 2, 2016), Web of Knowledge, CBM, WanFang Data and CNKI to collect SRs of lung cancer screening from inception to February 29th, 2016. The ROBIS tool was applied to assess the risk of bias of included SRs, and then GRADE system was used for evidence quality assessment of outcomes of SRs. ResultsA total of 11 SRs involving 5 outcomes (mortality, detection rate, survival rate, over-diagnosis and potential benefits and harms) were included. The results of risk of bias assessment by ROBIS tool showed:Two studies completely matched the 4 questions of phase 1. In the phase 2, 6 studies were low risk of bias in the including criteria field; 8 studies were low risk of bias in the literature search and screening field; 3 studies were low risk of bias in the data abstraction and quality assessment field; and 5 studies were low risk of bias in the data synthesis field. In the phase 3 of comprehensive risk of bias results, 5 studies were low risk. The results of evidence quality assessment by GRADE system showed:three studies had A level evidence on the outcome of mortality; 1 study had A level evidence on detection; 1 study had A level evidence on survival rate; 3 studies on over-diagnosis had C level evidence; and 2 studies on potential benefits and harms had B level evidence. ConclusionThe risk of bias of SRs of lung cancer screening is totally modest; however, the evidence quality of outcomes of these SRs is totally low. Clinicians should cautiously use these evidence to make decision based on local situation.