With vigorous development of the Evidence-Based Practice (EBP), systematic review as a reliable basis for decision making is becoming more and more important, especially in emergent and significant situation under the influence of various interferences. But there are many misunderstandings and fallacies in systematic review beyond medical field, which block the spread and application of systematic review in health system decisions. This paper takes the evidences of health intervention practice as examples, explores the functions of systematic review in health system decisions, tries to clarify these misunderstandings and fallacies, and so as to promote the development of systematic review.
Objective To evaluate the quality of Chinese clinical practice guidelines published in domestic medical journals in 2011. Methods The following 4 Chinese databases including WanFang Data, VIP, CNKI and CBM were searched from January 2011 to December 2011. The quality of included guidelines was assessed by using AGREE II. Results A total of 75 guidelines published in 2011 were included. Among them, 10 guidelines (13%) stated the conflict of interest, 10 guidelines (13%) mentioned evidence-based developing, 5 guidelines (7%) performed evidence grading system, 8 guidelines (11%) performed recommendation strength grading system, and 4 guidelines (5%) performed both evidence and recommendation strength grading systems. The ratio of the 6 domains’ scores of AGREEⅡ were as follows: scope and purpose (18%), stakeholder involvement (11%), rigour of development (8%), clarity of presentation (34%), applicability (5%), and editorial independence (14%). Conclusion Compared with the guidelines published before, the guidelines of 2011 have a higher quality and some of them are progressively standardized in developing methodology.
GRADE（Grades of Recommendation, Assessment, Development，and Evaluation）方法为卫生保健中的证据质量评价与推荐强度评级提供指导。对那些为系统评价、卫生技术评估及临床实践指南总结证据的人而言，GRADE具有重要意义。GRADE提供了一个系统而透明的框架用以明确问题，确定所关注的结局，总结针对某问题的证据，以及从证据到形成推荐或作出决策。GRADE方法的广泛传播与应用，获全球50余个组织认可，这些组织大多有很强的影响力（http://www.gradeworkinggroup.org/），足以证明该工作的重要性。本文介绍临床流行病学杂志将刊出的20篇系列文章，为如何使用GRADE方法提供指导。
Objective To investigate the effective, economic and viable long-term mechanism of Sichuan college students’ social practice. Methods A questionnaire was designed to investigate the students from North Sichuan Medical College and other 7 colleges in Sichuan province randomly. A secondary research of China students social practice status was combined and the results of Sichuan and other areas were compared. Results A total of 2 200 questionnaires were issued, of which 1 920 effective ones were taken back with the recovery rate of 87.27%. The most common forms of social practice were social investigation (47.5%), public welfare labor (42.3%), novitiate/internship (38.7%); the most interesting contents of social practice were social morality education (54.79%), credit morality education (53.07%), professional skill education (51.88%), and near 80% college students thought the contents had close relationships with their major. College students hoped that the contents could combine their job-hunting, characteristics of their major, local economy, and needs of social development. The social practice department they wanted to go most was public welfare or civil service departments (43.7%), corporations (27.8%), and government bodies (19.2%). The most difficult thing was to get connected with target department, shortage of fund, empty topics, hard-to-determine practice projects (44.1%), and lack of teachers’ guidance (43.6%). Degree of satisfaction from the students was moderate. Compared with other universities, social practice of Sichuan undergraduate students had broader coverage and was more closely related to students’ majors with more attention on the combination with moral education and employment. Conclusion Sichuan college students have higher expectations of social practice. However, the range and the time of actual participation are limited. The students are not very satisfied with status of social practice. The social practice of Sichuan college students should give prominence to the local features, be close to the students and serve the local place, strengthen the construction of practice bases, and establish effective systems of teacher training, funding, principle security mechanism and evaluation system.
This paper is to reveal how the traditional practice is being challenged by evidence-based medicine and it also indicates where does the best evidence come from, how to find and classify them. This paper will also show the clinicians how to practice evidence-based medicine, especially in the treatment of respiratory disease in a step by step fashion. Finally this paper will guide the Chinese physicians how to solve the commonly confronting problems in practicing evidence-based medicine.
The relationship between doctors and patients becomes a public hot topic recently, which becomes more prominent during the reforming and transition of the health care system. The emergence of evidence-based medicine corresponds to the requirement of the clinical practice brought by the transition of the health care system. It will play an important role in improving the relationship between doctors and patients. The promotion of evidence-based practice will be helpful to alleviate the conflict between doctors and patients and to increase the quality of health care.
To help better understanding on evidence-based medicine, five frequently asked questions relevant to evidence-based clinical practice were commented on. The questions included: 1. Dose evidence-based medicine only emphasize evidence and ignore clinical experiences? 2. Dose evidence only include randomized controlled trials and systematic reviews? 3. How to face the quality of evidence? 4. Is randomized evidence suitable for treating individual patient? 5. Is evidence-based medicine useless since there is no adequate evidence for many clinical questions?
Researches in evidence-based medicine have provided important evidence for family planning doctors to guide their clinical practice. With examples of clinical researches, the practical methods of evidence-based medicine in family planning service are discussed in this paper.
Evidence-based orthodontics has developed rapidly in recent years, but the lack of a good quality, clinical evidence base is a problem for orthodontic practice. All orthodontists should keep the concept of evidence-based medicine in mind during patient-oriented practice. This would help us to improve our practice and to make the best clinical decisions.