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find Author "刘瀚旻" 5 results
  • 重症肌无力患儿呼吸道感染临床分析

    目的探讨重症肌无力(MG)患儿合并的呼吸道感染的临床特征及防治对策。 方法分析2005年4月-2015年11月合并呼吸道感染的22例住院MG患儿的临床资料,总结其呼吸道感染的类型、病原菌及治疗情况,分析影响呼吸道感染的因素。 结果MG患儿以下呼吸道感染为主,占68.2%(15/22);病原菌检出率为36.4%(4/11),86.4%(19/22)的患儿接受了抗生素治疗,其中14例为一联抗生素治疗;下呼吸道感染的MG患儿较上呼吸道感染者有咳嗽无力表现的比例更高,差异有统计学意义(P<0.05);有吞咽困难表现及使用激素对MG患儿上下呼吸道感染的发生无显著影响。 结论MG患儿合并呼吸道感染时多累及下呼吸道,尤其是有咳嗽无力表现者,大部分需要抗生素治疗;应早期识别该类患儿的临床特征,及时给予正确处理。

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  • Analysis on status of clinical guidelines and evaluation of evidence-based clinical guidelines for children in China

    ObjectiveTo analyze the current status of children's clinical practice guidelines from 2010 to 2021, and to evaluate the quality of evidence-based guidelines for children. MethodsPubMed, EMbase, CNKI, WanFang Data, and VIP databases and relevant domestic and foreign guideline websites were searched to collect Chinese pediatric clinical guidelines from January 1st 2010 to September 13th 2021. Two reviewers independently screened literature, extracted data; 4 reviewers used AGREE Ⅱ to evaluate the quality of the included evidence-based guidelines. ResultsA total of 164 guidelines were included, which involved 65 evidence-based guidelines and 99 non-evidence-based guidelines, 113 western medicine guidelines and 51 traditional Chinese medicine guidelines. The majority of the diseases with high hospitalization burden were covered by those guidelines, including 35 guidelines for respiratory diseases, ranking first among all diseases. However, there was no guideline for pediatric cardiovascular disease in China. The average scores for 65 evidence-based guidelines in 6 individual domains were 65.2%, 49.6%, 59.3%, 68.5%, 23.9% and 83.6%. ConclusionsThe scores for applicability, stakeholder involvement, and rigor of development are low for Chinese guideline for children. There is a lack of pediatric clinical guidelines for circulatory disorders.

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  • Global guideline clinical applicability evaluation tool: a systematic review

    ObjectivesTo investigate the current status of the clinical applicability evaluation tools, and to provide some foundation for establishment of the clinical applicability evaluation index system.Methods7 databases, 6 guideline databases and 16 academic institutions and the administrative department of health website were systematically searched from inception to April 2019. Two reviewers independently screened literature, extracted data and then included the literature related to the applicability of clinical guidelines. The CPG clinical applicability evaluation index was initially prepared through the subject comprehensive method.ResultsA total of 19 articles were finally included. Among them, there were 4 evaluation tools for the clinical applicability of the guidelines, and 15 evaluation tools for the guideline clinical applicability evaluation items. Through combing and comparison, we found that these tools had differences in evaluators, evaluation fields and items.ConclusionsThe global guidelines for clinical applicability assessment tools have different kinds of problems, such as that the tools are not targeted, the indicators are not well-formed, and the methodological knowledge requirement of the evaluators is high. There is still a lack of guidelines for clinical applicability assessment tools from target users’ view.

    Release date:2020-04-30 02:11 Export PDF Favorites Scan
  • Establishment of a tool for evaluating clinical applicability of guidelines

    ObjectivesTo establish a tool for evaluating clinical applicability of guidelines with the users of the guidelines as evaluators.MethodsThe research group formed a multidisciplinary team to establish an evidence- based tool for evaluating clinical applicability of guidelines through systematic evaluation and two rounds of Delphi expert consultation and external audit.ResultsThe established tool consisted: evaluator basic information (12 items); clinical applicability evaluation (12 items, including availability, readability, acceptability, feasibility and overall evaluation); and scoring scheme.ConclusionsThis study has established a tool for evaluating clinical applicability of guidelines with the users of the guidelines as evaluators and provides criteria and methods for evaluating clinical applicability of guidelines.

    Release date:2020-04-30 02:11 Export PDF Favorites Scan
  • Issues and demands for clinical applicability evaluation of clinical guidelines

    Clinical practice guidelines are decision-making tools for bridging the gap between current best evidence and clinical practice. Studies have shown poor clinical applicability of existing guidelines, which may not be solved by improving the quality of guidelines alone. National medical management service guidance center is developing clinical practice guidelines of clinical evaluation system of construction projects, based on evidence-based method formulated by the target users of clinical guidelines evaluators’ applicability evaluation system of clinical practice guidelines. It aims to identify guidelines with high clinical applicability and provide the evaluation results of clinical applicability to developers and revisers of clinical guidelines, and then optimize the development and update, eventually improving the clinical applicability of guides and promote Chinese clinical guidelines in clinical application.

    Release date:2020-04-18 07:22 Export PDF Favorites Scan
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